“Sleep hygiene” is what sleep specialists call the pattern of good habits that promote healthy sleep. A solid sleep hygiene routine means a consistent sleep schedule. Be sure to keep regular hours, even on weekends and vacations. Go to bed at the same time every night and awaken at the same time every day.
A nighttime routine that allows you to decompress is important to keep the concerns and arousal level of your waking life separate from your sleeping life. Incorporate a regular routine for meals, exercise, and exposure to daylight, and give yourself proper time cues so that your body and brain can distinguish day from night and wakefulness from sleep.
Establishing good sleep hygiene helps your body know when it’s time to wind down and prepare for sleep. It’s an important part of treatment for sleep disorders. As you age and your sleep patterns shift, you need to sharpen the differences between day and night, activity and rest, so your body gets the proper signals for sleep.
In general, most people should limit naps, which can disrupt the normal sleep-wake cycle. Avoid stimulants, including caffeine, and don’t use alcohol or tobacco as a sleep aid. Try to avoid stressful activities right before bed, and remember that the adage about not going to bed angry is part of good sleep hygiene.
Invite Sleep Into Your Life
Create a suitable environment for sleeping. Install curtains to block out light and noise. Turn off all electronics that exude blue light or are backlit, such as cell phones, tablets, and televisions. Make sure you have a comfortable mattress and clean sheets. Your bedroom should be slightly cool—experts recommend 60 to 67 degrees for adults, and 65 to 70 degrees for babies and toddlers. (You can always add an extra blanket.)
We all awaken briefly four to five times a night after every episode of REM sleep, but most of the time, we’re not aware of it. However, if you do wake up, you want to be conditioned to keep your eyes closed, roll over, and go back to sleep. Don’t check your bedside clock, since opening your eyes will promote wakefulness and even cause anxiety (as in, “It’s 4:30 a.m., will I ever get back to sleep?”). If you tend to awaken at the same time on most nights, you will train yourself to continue to awaken at that time by looking at the glowing face of your clock. The best advice is to cover the clock or turn it from view.
When Sleep Won’t Come
Thanks to a strong mind-body connection, worrying and thinking negative thoughts cause the body to remain alert. If you can calm your body, your mind is likely to follow. Relaxation techniques can help, especially if you start them 30 to 60 minutes before bedtime.
Progressive muscle relaxation is one technique you can try. It involves consciously relaxing muscle groups in each section of your body, starting from your feet and working up to your head. Visualization also is a great way to relax. Picture that perfect beach, waterfall, or mountain view you found on your last vacation, or any place you’ve been happy and relaxed.
Deep, slow breathing can help you relax and fall asleep or fall back to sleep after waking. There are many effective strategies for relaxing breathing. Some involve breathing in deeply (so-called “abdominal breathing”), holding the deep breath for two or three seconds, and slowly exhaling to a count of six. This pattern is then repeated.
Nap Mindfully
Napping can interfere with a good night’s sleep if you have insomnia, but if you don’t have trouble getting to sleep, you may benefit from a well-timed nap. One study showed that a 90-minute daytime nap helps speed up the process of long-term memory consolidation. (Long-term memory is memory that lasts indefinitely, or that disappears only after many years or because of a head injury or brain disorder.) If you need to memorize something quickly, or if your schedule is filled with different activities that require learning how to do things, it is worth finding the time for an afternoon nap.
Simply anticipating taking an afternoon nap may lower your blood pressure and help protect your heart health. One study showed that participants who occasionally napped had a 12 percent lower risk of dying from heart disease than participants who didn’t nap, and participants who took a 30-minute nap at least three times a week had a 37 percent lower risk of heart-related death.
Setting aside time in the early afternoon for a brief nap may help compensate for some age-related sleep problems. A study of adults ages 55 to 85 found that taking a nap or engaging in quiet activities, such as reading between 2 p.m. and 4 p.m., helped mental performance and did not have significant effects on falling asleep at night.
If you’re going to nap, however, do it in the early afternoon. Choose a dark, comfortable room, and don’t sleep for too long: 20 to 30 minutes is best. If you nap past 5 p.m., you’re more likely to have trouble falling asleep later.
Change Sleep Positions
If you suffer from chronic back pain, changing your sleep position may help. Try sleeping on your side with a pillow between your legs to relieve pressure on your lower back. If you prefer to sleep on your back, slip a pillow under your knees to take pressure off your lower back. Avoid sleeping on your stomach, which puts stress on your neck and shoulders. You also can buy special body pillows and leg pillows designed for people with back pain.
If you have degenerative disk disease in your neck, the right pillow can help you get a good night’s sleep. Solid foam rubber pillows don’t conform to the neck. Instead, use a pillow made of materials such as down or feathers, which will fill in the empty space between your head and shoulder. Thinner pillows are better if you sleep on your back, while thicker pillows will help support the space between the head and shoulder when you’re lying on your side.
Reading in the evening can relax you in preparation for sleep, but the way you sit can contribute to or prevent neck and shoulder pain. Sit up straight, use a chair with good back support, and maintain contact with as much of the back of the chair as possible. Your body position will follow your eyes. Try to keep your book or magazine at or just below the level of your eyes. You should be able to maintain a slight tuck of your chin. Don’t pile pillows behind your head and force your neck out of alignment.
Also, check the fit of your glasses. Loose-fitting eyeglass frames may cause you to make frequent readjustments of your neck position, resulting in undue muscle strain.
Move More, Sleep Better
Exercise can be useful for normalizing sleep patterns. Exercise not only burns calories and body fat, but it also helps to reduce stress and raises body temperature, potentially promoting deep sleep at night.
An analysis of more than 2,600 men and women ages 18 to 85 showed that people sleep significantly better and feel more alert during the day if they meet the current U.S. physical activity guidelines of 150 minutes of exercise a week (30 minutes a day for five days). After controlling for age, body mass index, health status, smoking status, and depression, researchers found the relative risk of often feeling overly sleepy during the day decreased by 65 percent for participants who met the guidelines. Exercise also helped reduce leg cramps while sleeping by 68 percent and difficulty concentrating when tired by 45 percent.
The best time to exercise for maximizing sleep is in the late afternoon or early evening. Try a brisk walk after dinner but avoid vigorous aerobic exercise within three hours of bedtime, since it can be stimulating and may lengthen the time it takes you to fall asleep.
A Little Night Music
Studies show that people with insomnia and other sleep disorders can benefit from listening to music. If you want to relieve insomnia in a simple, natural, and enjoyable way, you might want to turn to your favorite soothing songs.
Researchers conducted a study among 60 adults ages 60 to 83, who had trouble getting to sleep. Half listened to soft, slow music for 45 minutes a night. The soft music produced physical changes that aided restful sleep, such as lower heart and respiratory rates. The group that listened to the relaxing music reported a 26 percent overall improvement in the amount of time it took to fall asleep during the first week, and they continued to see improvement over time.
In another study, researchers found that 45 minutes of music at bedtime for three weeks resulted in longer sleep duration, shorter time to fall asleep, higher perceived sleep quality, and less daytime dysfunction.
A review of 10 studies with more than 500 participants found that music also eased acute or chronic sleep disorders like insomnia. Not only did people report feeling that their sleep was improved, but polysomnography testing also showed that people who listened to music had longer REM sleep duration.
Music is known to act on the central nervous system, producing anti-anxiety and relaxing effects. It also may impact the production of compounds like endorphins, which have pain-relieving and sedative qualities, and oxytocin, which is implicated in improving sleep as well.
These suggestions may help you use music therapy for better sleep:
- Choose music that you are familiar with.
- The music should have a slow and stable rhythm (a tempo of 60 to 80 beats per minute), with low-frequency tones and relaxing melodies.
- Try out different genres, like classical or acoustic, to find what works best for you.
- Put the music on before going to bed to help you relax and use a timer to turn off the music once you’re asleep so the music does not wake you up later in the night.
- Set the timer for a little longer than it takes you to fall asleep; this might be anywhere from 15 to 45 minutes depending on your sleep habits.
Aromatherapy
Some people believe that inhaling certain pleasant scents helps promote sleep. The practice of using fragrances to achieve a desired mental state is known as aromatherapy. Aromatherapy uses concentrated oils from flowers, leaves, and other parts of plants in oil preparations for diffusers, candles, sachets, and other products. Scents evoke emotions and memories and can stimulate areas of the brain that influence mood, heart rate, and breathing. The scent of lavender, for example, has been found to reduce stress and anxiety. Any sensation that you find soothing can help you sleep, so it can’t hurt to dab a small amount of lavender oil or lemon balm on your pillowcase to see if it helps relax you. If you have a cold or allergies, a little eucalyptus oil may help clear your sinuses and help you sleep.
Be sure to use only diluted oils. Don’t use more than recommended, and don’t drink the oils or apply them directly to your skin. (Exceptions are oils that have been specially prepared to treat burns and insect bites.) If you have asthma or other breathing problems, be aware that aromatherapy may worsen your condition.
Food and Sleepiness
The type of food you eat affects your level of sleepiness or alertness during the day. Studies have found that increased fat consumption is associated with increased daytime sleepiness, while higher carbohydrate intake is associated with a higher level of alertness. No relationship has been seen between protein consumption and sleepiness or alertness.
A Warm Bath
Your core body temperature drops during slow-wave sleep, reaching its lowest point between 3 a.m. and 5 a.m., which is why sleeping in a cool bedroom improves sleep.
Taking a warm—but not hot—bath before you go to bed at night may help you fall asleep faster and stay asleep more easily. Soaking in a warm tub allows your body temperature to rise. When you lie down in a cool room, your body temperature will fall naturally, sending you off to sleep more quickly and enhancing deep sleep.
Yoga
Yoga is said to be a good nighttime exercise because it helps you relax and enhances your ability to fall asleep. More than 36 million Americans practice yoga. While it is widely touted as a stress-buster that boosts emotional well-being, it also offers wide-ranging physical health benefits. Yoga increases muscle strength and flexibility and can improve balance, help prevent falls, and ease muscular aches and pains. Several small studies suggest that the combination of gentle stretching, slow, deep breathing, and mindfulness may improve cardiovascular health by lowering blood pressure. Your brain also may benefit—yoga’s meditative exercises help to calm the mind and body, keeping distracting thoughts away. It is possible these processes may persist beyond yoga practice to assist you in performing mental tasks and day-to-day activities.
You also may sleep better if you regularly engage in yoga, particularly if lingering symptoms of menopause have been causing wakefulness. In one study, postmenopausal women who attended a weekly 90-minute yoga session reported improvements in their insomnia symptoms.
Go with the Flow
“Hatha yoga” is an umbrella term for forms of yoga, such as yin and vinyasa, which incorporate breath work, active postures, and, in many classes, meditation. Yin yoga is more gentle, with positions being held longer. Vinyasa is more flowing, meaning that you move slowly but seamlessly from one posture to the next, matching your movement to your breaths. As you focus on your breath and postures, you will clear your mind of clutter and become more relaxed. Over time, you develop a capacity to be less reactive to daily stresses by breathing through them.
Throughout a gentle yoga class, be sure to focus on your own body and not what other participants are doing. Each pose should feel comfortable and strong. Never push beyond the point of comfort, and don’t worry about how your pose looks compared to someone else’s.
What to Avoid
Be careful if you’re considering bikram, or “hot,” yoga. Because this type of yoga is done in a heated room, it can cause problems for people with high blood pressure or other cardiovascular issues. And if you’re dehydrated going in—which is the case for many older adults—you can become even more dehydrated as you exercise, raising the risk of heat exhaustion. Hot yoga classes often push participants in ways that are potentially harmful.
Avoid doing yoga poses on your own, whether by following a DVD, videos on the internet, or a book, unless you’ve already taken supervised classes and know how to do the poses. Working on your own without guidance increases your risk of injury. Remember, too, that your yoga instructor is a teacher and guide, not a health-care provider. If you hurt yourself in class or don’t feel right afterward, see your doctor, physical therapist, or other medical professional.
Tai Chi
Tai chi is a low-impact, slow-motion exercise with tremendous relaxation properties. There is growing evidence that tai chi has a positive impact on the prevention and treatment of many diseases associated with aging, and studies have found that tai chi improves the quality of sleep in older adults. The gentle breathing involved in tai chi relaxes the mind, reduces depression and anxiety, and promotes feelings of well-being.
Some of the elements of tai chi can be practiced while sitting down, lying down, or standing up, making the exercise suitable for just about anyone. Its movements are circular and gentle. Muscles are relaxed, joints are not fully extended or bent, and ligaments and connective tissues are not stretched. Tai chi has been shown to increase upper-body and lower-body strength, improve balance and reduce the risk of falls, boost cognitive function, increase energy, and improve quality of life.
Transcendental Meditation
Transcendental meditation (TM) is a technique designed to clear and calm the mind. Its purported health benefits include relief from stress, anxiety, depression, and
insomnia. People who practice TM say they feel happier and calmer, yet more energized and creative.
TM is the only meditation technique that causes the brain to produce alpha waves. These are the waves that normally occur when you are asleep. This makes TM a valuable treatment for insomnia.
TM is different from other forms of meditation; it does not require intense concentration, and it does not involve controlling or “emptying” your mind. According to the TM website, by practicing TM, you can achieve a “restful state of mind beyond thinking.” The TM course consists of four sessions conducted by a certified TM instructor in your area. Once you learn how to do TM, you practice it every morning and evening for 20 minutes while sitting with your eyes closed. For more information on TM, including the cost of the training and finding a TM instructor in your area, visit www.tm.org.
Mindfulness Meditation
In older adults with moderate sleep disturbances, mindfulness meditation may improve sleep quality in as little as one session. In one study, the meditation group had fewer sleep disturbances and fewer symptoms of insomnia and depression and experienced less fatigue than the group that did not meditate. Although more research is needed to see if the findings can be duplicated, mindfulness meditation appears to be useful.
Mindfulness meditation helps you calm your mind and body to cope better with illness, pain, and stress. It means paying attention to the moment at hand, without judging or interpreting it. For example, if it is raining, you can sit quietly and be mindful of the sound the rain makes on the roof, or watch a single raindrop meandering down the windowpane. Alternatively, you could focus on each breath you take—the sensation of air flowing into and out of your body, and how it feels in your nostrils, shoulders, ribcage, and belly as they expand and relax.
Ideally, you should let everything else around you fall away and be attentive to that one thing. In theory, learning how to hone your concentration in this way means you can avoid dwelling on negative events in the past or worrying about the future. Thoughts like these can trigger anxiety that disturbs sleep. Conversely, letting go of these thoughts can help you accept things as they are instead of becoming stressed and anxious about your life circumstances.
Conclusion
The inability to regularly enjoy a good night’s sleep can impact not only your emotional well-being, but your physical health as well. Sleeping too few hours, too many hours, irregular hours, going to sleep too late or too early, or having your sleep frequently interrupted night after night opens the door to a host of medical problems, many of them serious. Both sleep disorders and medical problems negatively impact quality of life, so you shouldn’t delay seeking help if your sleep habits fall outside the norm.
Thanks to a growing body of knowledge in the field of sleep disorders, specialists in sleep medicine can diagnose most sleep issues quickly. Obtaining a diagnosis is the first step toward making lifestyle changes or pursuing other options that have been shown to restore proper sleep. These measures are effective in most people who make the effort to use them properly.
If you’ve had a sleep problem for more than a month, you may wish to invest in a digital sleep tracking device or phone app. A wearable sleep-tracking device can be helpful if you awaken often at night, feel sleepy during the day, or feel you need more sleep or better sleep to be at your best. That said, validation for sleep-tracking devices is still lacking, and the devices are not advised for people who do not have trouble sleeping, as they may create worry about a problem that does not exist.
Whether or not you choose to invest in a sleep tracker, sleep problems merit consultation with a sleep professional. Talk with your doctor or consult a specialist at a sleep center that is accredited by the American Academy of Sleep Medicine. Many of these are affiliated with teaching hospitals or academic medical centers.
Sleep centers conduct tests and provide treatment for all types of sleep disorders. A sleep center should have a medical director and a specialist in sleep disorders certified by the American Board of Sleep Medicine or the American Board of Medical Specialties. Sleep specialists may be MDs, DOs, or PhDs.
Take comfort in knowing that, for the most part, sleep problems are not self-made. This means there is not much you can do to prevent them. Except for short-term insomnia brought on by grief or anxiety, sleep problems tend to develop for reasons outside your control. In some cases, including delayed sleep phase disorder, your genes may be responsible. This underscores the need to discuss sleep problems with your doctor, and to seek help from a sleep professional if a sleep problem fails to resolve on its own within a matter of weeks. Nonetheless, changes in habits and learning about strategies to improve your routine, including reducing exposure to artificial lights and maintaining a regular sleep schedule, can certainly help improve your sleep.
We hope the information in this report has helped you understand more about sleep disorders and how they can be treated. And remember, even if you have a serious sleep disorder, if you enlist the help of a sleep expert, you can look forward to getting better sleep in the future.
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