On Sleep Hygiene
And the importance of good sleep
Less than a year ago, I was given a unique opportunity as a therapist to treat a 16-year-old who was having trouble sleeping. This individual had gone through traumatic experiences, had many reasons to be stressed in their daily life, and consequently, could not fall asleep at night. When they would fall asleep, it would be close to dawn. It would have been very easy to say, “Let’s get you on some melatonin. Let’s get you to a psychiatrist and get you something to help you relax before bed.” But none of that would have solved the issue. I advocated for this individual and said, “You need to learn how to sleep because you will need to sleep well for the rest of your life.”
“You need to learn how to sleep because you will need to sleep well for the rest of your life.”
When someone tells me they are having trouble sleeping, some of the first things I ask are, “What time are you eating? How much sunlight are you getting during the day? Are you exercising? How are your relationships? Are you socializing? How is school/work?” Put simply, this is another area where my holistic approach comes in. If you know what balance in your life looks like (or what it does not look like), then you know what is affecting your sleep. Insomnia and general sleep disturbances are actually quite common, but in my perspective, they are a symptom of something greater happening in our lives. In fact, most adults only average 5.7 hours of sleep, according to WebMD. At times, restlessness can be a symptom of anxiety, depression, bipolar, post-traumatic stress disorder, etc.
In the case of the 16-year-old, we had several things going well already, but there were a few modifications that ended up helping them sleep like a baby (their words, not mine). They reported that the combination of white noise, reframing distortions, and practicing deep breathing helped the most as they were already practicing some of the strategies listed below.
Wind Down: For one, this individual had a sleep routine that began approximately around 7:00 or 8:00 p.m. It was important for me that this person’s body learned to “wind down” to reach that sleeping point faster. Having a set bedtime teaches your body that it is bed time. At the same time, it should align with your natural circadian rhythm (see below). We facilitated this by teaching progressive muscle relaxation and deep breathing techniques they could practice before trying to sleep. My favorite thing to practice before bed is actually meditation. Many people prefer to do it in the morning, but I have noticed I fall asleep within minutes after practicing meditation. Other times, I practice box breathing (inhaling for four seconds, holding for four seconds, exhaling for four seconds, holding for four seconds, repeating).
Dinner and Exercise: I have quit coffee altogether and replaced it with matcha because coffee aggravates anxiety, but if I were still drinking it, I would personally stay away from it after 3:00 p.m. I learned that coffee has several things in it besides caffeine that can stimulate you. With matcha, I get none of the jitters or crashes. The client I mentioned would not drink coffee, but in general, paying close attention to the time you drink coffee or consume caffeine is very important. Additionally, my client would eat dinner by six, which is very important because the later you eat your dinner, the longer your body takes to reach a restorative state at night. The same applies to exercise. If you are jogging at 8:00 p.m. and going to bed by 10:30 p.m., it is very likely that you are waking up to go to school/work feeling tired. However, if you exercise earlier, such as 5:00 or 6:00 p.m., you are more likely to feel ready for bed by 10:00 p.m. It is even better if you are exercising outdoors at that time and getting sunlight, as sunlight helps regulate your body’s circadian rhythm and stimulates the production of melatonin and Vitamin D, among many other benefits.
Screen Time: This individual did not have a cell phone, so this was not an issue, but there are all sorts of things to keep in mind related to screen time. Naturally, blue light causes your pupils constrict. Red light, on the other hand, can cause your pupils to dilate. This is the principle behind our phone’s “Night Shift” modes. Another factor with screen time is precisely what you are doing when you are on your phone. Scrolling through social media stimulates your brain in a way that you are getting certain “feel good” chemicals, but sometimes those chemicals keep us awake. If you are reading the news late at night, your mind can subconsciously worry about the state of the world among other things. It has a tendency to spiral that way.
White Noise: There is a lot of research supporting white noise. It is very much an accepted form of helping babies fall asleep and stay asleep, but as we get older, we steer away from it. If you are having trouble sleeping, you can try setting white noise 10-15 minutes before your intended sleep time. I like to use the Calm app to find meditations or white noise. They have had many collaborations with artists and brands such as Disney to develop themed experiences in meditation, soundscapes, and even bedtime stories for the little ones. All of those things will help your mind slow down before bed. Additionally, ambience music can help you relax. One example is “Weightless” by Marconi Union. It is a song that has actually been proven, through research, to calm people down. Have fun with it. Make a playlist.
Seek Balance in Life: Worth repeating. If you are having trouble sleeping, analyze the contributing factors. It is typically not one thing alone but a culmination of habits or experiences that have snowballed and are weighing you down. If you are not trying all of the above, then there is more work to do.
More often than not, our inability to sleep is amplified by our own reaction to it just like with anxiety. When you are having trouble falling asleep, accept it. Do not fight it. Get up, turn on a dim light, and read (avoid watching Netflix or scrolling through social media). Be kind and compassionate with yourself instead of beating yourself up for caring so deeply that you are worried to the point that you cannot sleep. Try to change your perspective on the struggle.
One last thing (a little afterthought)… I generally avoid supplementing things that our body should be able to produce on its own, like melatonin. While I am not a doctor, my general theory is that by supplementing it you are depriving your body of the need to produce it thus increasing the reliance on that supplement. Additionally, since it is one of many benefits of healthy exposure to sunlight, you are likely to lack in other areas that stem from that exposure (such as Vitamin D). This is not to say that you should never supplement but rather you should try everything possible to help your body naturally produce what it needs before supplementing.