1. Sleep Hygiene Body Recommendations
Obtain regular exercise
cardiovascular exercise is essential to obtaining healthy, deep sleep.
However, exercise should be avoided at least 3 – 4 hours prior to bed
because it raises core body temperature, which can interfere with sleep.
Quell the body before bed
quelling the body before bed can help reduce somatic tension, which is
commonly looped with anxiety. Gentle yoga, stretching and massage can be
helpful in promoting somatic relaxation. A warm bath or shower can also
sooth tense muscles and trigger a reciprocal drop in body temperature
to promote sleep.
Stay well nourished
complex connection between good nutrition and healthy sleep is
beginning to receive attention. An anti-inflammatory diet likely
supports healthy sleep and dreams, while high glycemic foods can disrupt
normal energy rhythms.
Have a healthy bedtime snack
sugary and harder to digest foods as bedtime snacks. As an alternative,
consider complex carbohydrates that may help transport tryptophan, a
precursor to melatonin, across the blood-brain barrier.
Limit the consumption of stimulating substances.
cognizant of the impact of various stimulating substances that can
potentially interfere with sleep, especially caffeine. Given its
relatively long half-life, standard cautions about caffeine use may not
be sufficient for everyone.
Carefully manage alcohol consumption
alcohol promotes sleepiness, it can readily become a nightly crutch.
Alcohol can disrupt circadian rhythms, interfere with quality sleep,
suppress REM sleep and cause middle of the night awakenings. Drinking
less, earlier, and with food is best.
Know the sleep side effects of all medications
check for possible sleep or dream interfering side effects of all
medications used, both prescription and over the counter, including
“natural” alternatives. Check with your healthcare provider or
pharmacist regarding possible alternatives if necessary.
Consider natural alternatives for occasional sleeplessness
transient sleep difficulties associated with acute stress, consider
short-term supplementation with botanicals like lavender, jasmine,
valerian or hops. Chamomile may help but can also act as a diuretic.
Be mindful of melatonin
Maintain healthy endogenous levels of melatonin by avoiding substances and behaviors that suppress it. Consider melatonin replacement therapy if indicated by circadian rhythm irregularities or advancing age.
Address primary snoring
Aside from its literal noisiness, primary snoring (not associated with apnea) can be viewed as a kind of body noise. Once thought to be innocuous, it is now seen as a possible early sign of an inflammatory process and, unless it is clearly associated with an acute illness, pregnancy or an anatomical anomaly, should be addressed as such.
2. Sleep Hygiene Mind Recommendations
Establish a daily relaxation or rest practice
Engage in a pleasant relaxation practice on a daily basis. Possibilities include meditation, breathing exercises or self-hypnosis. Because rest is the bridge to sleep, it is essential to be familiar and comfortable with it.
Make bedtime a ritual
routines become meaningful rituals when engaged in mindfully. Create a
sweet and soothing bedtime ritual that incorporates all of your sleep
preparatory activities. Approaching sleep ritually helps maintain a
sense of its value and mystery.
Laugh before bed
is a potent and fast-acting relaxant. Whether it is watching a sitcom,
doing some lighthearted reading or getting playful with someone or a
pet, consider doing something that makes you laugh in the hour before
Journal your waking day to rest
a daily journal or diary can be most helpful in integrating that day’s
experiences and laying them to rest in preparation for sleep. Looking at
the day as a page in the great book of one’s life is an effective way
of emotionally deescalating and reframing even challenging experiences.
Keep the peace with bed partners
Even though we are not conscious in the ordinary sense of the word during sleep, sharing a bed is a very intimate experience. Maintaining a positive connection with one’s bed partner by sharing and being sensitive to one another’s needs promotes good sleep. Bed partners should support one another in managing loud snoring.
Go down gradually like the sun
Despite common language, we cannot literally “go to sleep.” The intention to do so simply tethers us to waking consciousness. Getting to sleep is more about letting go of waking–of learning to surrender. This process can be approached as a personal spiritual practice since it raises a fundamental question about where we place our faith.
Fall back in love with sleep
Understanding the numerous health benefits of sleep can encourage good sleep hygiene. But having a direct relationship with sleep can also be inspiring. Instead of slipping into bed with thoughts about tomorrow, focus on and indulge in the actual experience of sleep and dreams tonight. Good sleepers don’t just do it for the perks, they truly love sleep. (Listen to Dr. Naiman’s Falling in Love with Sleep Again)
Arise gradually like the sun
contrast to the common practice of getting jolted out of sleep by an
alarm clock, consider a slower, gradual awakening. Use a dawn simulator
or timed alarm apps to help with this. And bask for a few moments in
your grogginess–that exquisite hybrid state of waking, sleep and
Engage your dreams
A gradual awakening allows us to be more mindful of our dreams. Bridge your dreams to your waking life by journaling, thinking and talking about them. Dreaming supports emotional health, learning and memory. Dreaming is healing and can re-enchant lives entrenched in the mundane. Even occasional bad dreams are a part of good dreaming.
3. Sleep Hygiene Bed Recommendations
Bed recommendations are about optimizing one’s sleep environment’s space and time, that is, creating a sense of sanctuary and living in tune with natural rhythms.
your circadian health by maintaining a regular bed and rising time,
even on weekends and holidays, if possible. Without becoming compulsive
about it, is also helpful to maintain fairly regular meal and exercise
See the light
as much safe outdoor light exposure as you are able on a daily basis.
When feasible, obtain 20-30 minutes of exposure to outdoor morning light
shortly after arising.
the hour or two before bedtime, dim household lights and/or use blue
blocker light bulbs or goggles to promote endogenous melatonin. Always
use blue blocker technology when watching television or using computers.
Sleep in the dark
in total darkness throughout the night or use a quality sleep mask to
block out light. If nightlights are necessary, use a motion detector
possible, awaken naturally without an alarm clock. As an alternative to
a standard alarm, consider a dawn simulator, which awakens one with
gradually increasing light or smartphone apps that can be programmed for
more gradual and gentle awakenings.
Green the bedroom
Gradually move toward a “green” bedroom by evaluating and diminishing exposure to bedroom toxins. Use a bed and bedding made with natural or organic fabrics and minimize outgassing from furnishings, floors, walls, or carpeting. Make sure the bedroom air is clean by using HEPA filtration or houseplants that refresh the air. Avoid exposure to electromagnetic fields during sleep.
Create a safe space
all you can to feel completely psychologically safe in your bedroom
during the night. This may involve installing a security system or
getting a watchdog. Some people find spiritual symbols or images
Keep the bedroom cool
bedroom temperatures at about 68° Fahrenheit or lower during sleep.
Ideally, use a programmable thermostat that allows programming
temperatures to gradually decrease by a few degrees through the night
and then climb back up in the morning.
Avoid clock watching at night
the time while in bed draws one back to the world of waking. Use a
non-illuminated battery operated clock to minimize light and EMF
Make your bedroom a personal sanctuary
your bedroom to be inviting, serene and free of negative associations.
Consider using the principles of Feng Shui as guidelines. Avoid reading
or watching overly stimulating material in bed. Try to keep relationship
conflict out of the bedroom.
Ten Insomnia Prevention Tips
- Recognize the value and joy of sleep.
- Pay attention to and journal your dreams.
- Engage in relaxation practices daily.
- Obtain adequate regular exercise.
- Obtain daily exposure to morning light.
- Limit the use of stimulants and sedatives.
- Maintain a regular sleep-wake schedule.
- Dim the lights or use blue blocker tools for 1 – 2 hours prior to sleep.
- Sleep in total darkness or use a sleep mask.
- Consider low-dose melatonin replacement therapy.
Melatonin plays a key role in initiating and maintaining sleep, higher night-time melatonin concentrations may also have an anti-inflammatory effect, immune-modulating effects, free-radical scavenging effects, and influences on bone growth and osteoporosis (Reiter, 2007).
The significance of suppressed nocturnal melatonin levels may be significant. Factors contributing to melatonin suppression include exposure to light at night (LAN) (Reiter, 2006; Evans, 2007; Blask, 2002), advancing age (Mahlberg, 2006), and common medications (e.g. beta blockers (Brismar, 1988), caffeine, alcohol, 8-methoxypsoralen).
Valerian (Valeriana officinalis) root
Valerian is a non-addictive and safe botanical with mild anxiolytic and hypnotic effects, that does not impair psychomotor or cognitive performance (Gutierrez, 2004; Hallam, 2003). Research on the effectiveness of valerian is mixed, though many clinicians find it useful for many patients when used in sufficient dosage, in combination with other botanicals and behavioral measures.
Valerian does not foster dependence and there are no withdrawal syndrome upon discontinuation. Valerian usually requires 2-3 weeks of nightly use before seeing a significant effect (Wheatley, 2005). Therefore, this botanical is more useful in treating chronic insomnia. The recommended adult dosage is 1-3 grams crude root or a 800-1200 mg of an extract standardized to 0.8-1.0% valerenic acid taken 30-60 minutes prior to bedtime.
Adapted from Arizona Center for Integrative Medicine – IMR – Family Medicine 2018