30 Tips to Start Sleeping Better: Advice From the Top Sleep Researchers




Ryan Fiorenzi the authorResearch by Ryan Fiorenzi
Updated November 4, 2018

How to Start Sleeping Better

According to the National Sleep Foundation, 35% to 40% of adults in the U.S. have problems falling asleep or with daytime sleepiness. According to researchers at the University of Michigan, globally only a handful of nations get the recommended average of 8 hours per night.

Dr. Matthew Walker, director of the Center for Human Sleep Science at the University of California, says “The silent sleep loss epidemic is one of the greatest public health challenges we face in the 21st century." He claims that chronic sleep deprivation leads to higher rates of cancer (bowel, prostate, and breast), diabetes, obesity, depression, anxiety, Alzheimer's, and many other grave health consequences.

In the foreword to the book "Sleep Smarter" by Shawn Stevenson, Dr. Sara Gottfried explains that improving your sleep can result in the following benefits:

  • Better skin health and more healthful appearance
  • Emotional regeneration and better relationships
  • Decreased risk of stroke and cardiovascular disease
  • Fewer accidents
  • Lower levels of inflammation
  • Enhanced immune function
  • Hormonal balance
  • Faster rate of weight loss
  • Decreased pain
  • Stronger bones
  • Lower risk or Alzheimer's disease and cognitive decline; better memory
  • Longevity

If you're looking to improve the quality of your sleep, we've taken the advice from the top experts in the field of sleep medicine and organized their guidelines into 5 main categories for a good sleep foundation. We also included strategies for napping, traveling, as well as what you need to know about sleeping pills. The 5 major categories are:

  1. Circadian rhythms & light exposure
  2. Exercise
  3. Food & drink
  4. Stress and bedtime ritual
  5. Your bed and bedroom


Sleep Disorders

If you don’t sleep enough or the quality of your sleep needs to be improved, the first thing you need to figure out is if you have a sleep disorder. The most common sleep disorder is sleep apnea. Almost 7% of the US population has sleep apnea, a condition that causes the sleeper to not breathe for various lengths of time many times per night, which over a long period of time can have severe health consequences.

To find out if you have a sleep disorder such as restless legs syndrome, narcolepsy, or insomnia, talk to your doctor about getting a sleep study. A sleep study can be done at home where the sleep study clinic will give you an apparatus that you’ll wear overnight at home. If the data shows that you may have sleep apnea, you’ll make arrangements where you will stay overnight in a sleep clinic to verify whether you have sleep apnea or another issue. Click here for a full list of sleep disorders.



1. Circadian Rhythms


Quick Summary

  • Don't expose yourself to bright lights (specifically blue light) within 1-2 hours of going to bed.
  • Go to bed and wake up at the same time every night (including the weekends).
  •  Expose yourself to sunlight early in the morning and throughout the day, and exercise early in the morning outside if possible.
  • Respect your chronotype or tendency to go to bed earlier or later when figuring out the best time for you to go to bed every night.
  • Limit your naps to 20 minutes at the most, and don't nap late in the day. The best time is around 1-1:30 pm if you're an early riser, or 2:30-3 if you're a late riser.

Your circadian rhythms are physical, mental, and behavioral changes that follow a daily cycle, mainly influenced by light and darkness. Circadian rhythms are found in most living things, including animals, plants, and many tiny microbes.

The main thing you can do to get in sync with your circadian rhythm is to fall asleep and wake up at the same times each morning and night. The hardest part of following this guideline is to not sleep in on the weekends. If you’re sleep deprived and you want to catch up, the best way is with naps. You have to be careful with napping though, as they should be limited to 20 minutes in the afternoon. Taking naps longer than 20 minutes and or taking a nap too late in the day can negatively affect your sleep at night. Sleep experts tell us that if you're an early riser, your afternoon siesta will probably be around 1 pm, and if you wake up a little later, it may be around 1:30 or 2 pm. If you thought that you got tired in the afternoon because of lunch, the data shows us that people often naturally get tired in the afternoon, even if they haven't eaten (hence the Spanish or Latin American "siesta."

Your brain sets its circadian rhythm by it’s exposure to light. This is where a lot of people are making mistakes. Looking at TVs, tablets, and phones late at night expose your brain to blue light that tells your brain that it’s light out and it needs to be awake.

You should be exposed to sunlight in the morning and throughout the afternoon, and a great habit is to expose yourself to sunlight after you wake up, and exercise outside if possible. The other factor that influences your circadian rhythm is temperature, so regularly exercising in the morning will raise your temperature, signaling your brain to wake up, and reducing the temperature of your room at night will signal your brain to sleep (the optimum temperature is 60-68 degrees, you'll have to experiment to find your optimal sleep temperature).

You should have no exposure to blue light within 1-2 hours of going to sleep. As tvs don’t have blue light blockers, you can wear blue light blocking glasses, or watch programs on your computer, tablet or phone. Many phones have a blue light blocker that you can turn on at night, or you can install an app on your computer, tablet or phone that blocks blue light, such as f.lux.

Put a nightlight in your bathroom and don’t use your normal bathroom lights when getting ready to go to bed. When you get up during the night to go to the bathroom, you should only be exposed to the minimum amount of light. Make sure your bedroom is dark. You can use light-blocking or room-darkening shades, or you can use a sleep mask.

Make sure that you don’t have a bright clock next to your bed. If you do, use the dimmest setting. And if there are any other lights in your room (such as on the tv), cover them.

Calculating Your Optimum Bedtime

We go through a full cycle of sleep in 90 minutes:

  • Stage 1: light sleep where the eyes move slowly and muscle activity slows, and you can be awakened easily.
  • Stage 2: eye movement stops, the brain slows down, the heart rate slows, and the body temperature begins to drop; this is where the brain prepares for deep sleep.
  • Stage 3: the brain registers delta waves, which are extremely slow brain waves, with occasional small, faster waves.
  • Stage 4: the brain produces almost delta waves exclusively.
  • Stage 5: This is the rapid eye movement stage (REM) where the eyes move rapidly from side to side and when dreaming occurs. All other stages are non-REM sleep.

According to Dr. Michael Breus, Clinical Psychologist and both a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine, to be well-rested after a night of sleep, you need to go through 5 full sleep cycles. 90 minutes X 5 cycles=7.5 hours. To calculate your optimal bedtime, minus 7.5 hours off of your wake up time.

  • 6 am: 10:30 pm
  • 6:30 am: 11 pm
  • 7 am: 11:30 pm
  • 8 am:  12 am
  • 8:30 am: 12:30 am

You may want to add in a little time for falling asleep. So instead of going to bed at 10:30 pm for a 6 am wake time, go to bed at 10:20 pm.

Not all sleep experts agree that 7.5 hours is the optimum amount of sleep. The National Sleep Foundation recommends a range of 7-9 hours for adults ages 26-64, 7-8 hours for those 65 and older. If you find that 7.5 hours isn't enough for you, add 15 more minutes of sleep to your routine until you find the number that works for you.

The next step is to adjust your sleep and wake time to slightly earlier or later until you're waking up 5-10 minutes ahead of your alarm. This is because everyone can have slight variations in their sleep cycles. If you're waking up much earlier than your alarm, then go to bed a few minutes later. If you're sleeping through your alarm, then you'll want to go to bed earlier.

Your Chronotype

In addition to figuring out how much sleep you need, it's also helpful to know your chronotype, or when you prefer to sleep. Everyone pretty much knows what their preference for when to sleep is, with the two categories being a morning person, or phase advanced, or a night person, or phase delayed. Dr. Winter explains that our chronotype seems to be genetic, influenced by your clock genes, and can be manipulated to some degree by light exposure, light timing, exercise schedules, social interaction, and sleep schedules. Age is also a factor, with younger people tending towards going to bed late, and older people tending to go to bed earlier. Working with your chronotype will help you get quality sleep.

Circadian Rhythm Sleep Tips:

  • Don't expose yourself to bright lights (specifically blue light) within 1-2 hours of going to bed.
  • Go to bed and wake up at the same time every night (including the weekends).
  •  Expose yourself to sunlight early in the morning and throughout the day, and exercise early in the morning outside if possible.
  • Respect your chronotype or tendency to go to bed earlier or later when figuring out the best time for you to go to bed every night.
  • Limit your naps to 20 minutes at the most, and don't nap late in the day. The best time is around 1-1:30 pm if you're an early riser, or 2:30-3 if you're a late riser.


2. Exercise


Quick Summary

  • People who exercise regularly sleep better at night, and the more vigorously you exercise, the more you benefit.
  • Exercise regularly and if possible, early in the morning.
  • Journal your sleep quality every night and experiment to see how when you work out affects your sleep quality. Most people do better with morning or afternoon workouts, though you could be one of the more rare group that sleeps better after an evening workout.

People who exercise regularly sleep better at night, and the more vigorously you exercise, the more you benefit. Exercise can tire you out and relieves stress, both of which help many people fall asleep faster and increases sleep duration.

According to Sleep.org, people that work out early in the morning spend 75% more time in the most restorative stages of sleep compared to those who exercise later. It can reset your circadian rhythm by raising your core body temperature, and if you work out outside, being exposed to sunlight will also reset your circadian rhythm. The only issue is that your core body temperature is lower when you wake up, so make sure you warm up gradually as your risk of injury is higher.

Working out in the evening is not a good idea for most people as your core temperature will stay elevated for 4 to 5 hours, as one of the cues to your system to sleep is a drop in body temperature. It also elevates your cortisol levels, which can make it more difficult to get to sleep. Though it has been generally accepted that exercising vigorously within 3 hours of bedtime will prevent you from going to sleep, new research shows that it may not be true for everyone. Dr. Michael Breus says that everyone has a different chronotype, which is a classification of your genetic propensity towards when you'll sleep, based on the PER3 gene. 

The best way to find out what the best time to exercise is to try working out at different times and record the quality and quantity of your sleep in a journal. Make sure that you do the same length and intensity of workouts, and try to keep other factors the same so the only factor that's different is the time of exercise.



3. Food & Drink


Quick Summary

  • Avoid eating a lot at night; a small snack with protein and carbohydrates is best.
  • Avoid caffeine late in the day and nicotine entirely (both are stimulants).
  • Be careful with alcohol and marijuana consumption. You may fall asleep faster, but the overall quality of your sleep suffers.
  • Be careful with sugar, it can prevent quality especially if consumed in the evening.
  • Sleeping pills should only be used for a short period of time, if at all.

Caffeine and nicotine are common causes of people not sleeping well. Caffeine can cause issues with your sleep up to 12 hours after drinking it, so limit your intake to mornings. The nicotine in cigarettes is a stimulant that can interfere with sleep as well.

The general rule with food and liquids is not too little, and not too much. Drinking too many liquids in the evening will make you get up too often during the night which interrupts our sleep cycles. Interrupted sleep is as bad or worse than not enough sleep.

At night limit the amount of sugar and refined carbohydrates as it can trigger wakefulness at night. Also, don’t eat too large of a meal at night within 3 hours of going to bed. Avoid spicy foods at night as they can be tougher to digest, and though there are a few exceptions below, avoid fatty foods close to bedtime as well.

Marijuana, Alcohol & Sleep

Though many use alcohol to relax before bed, there's evidence that it will prevent you from getting quality sleep because it significantly reduces stage 5 sleep or REM (rapid eye movement). A study out of the University of Melbourne found that students who drank before bed had interrupted sleep patterns. It may reduce the time it takes to get to sleep, but it won't help you get the benefits of restorative sleep. Stanford Health Care  states that alcohol speeds the onset of sleep, but causes wakefulness in the second half of the night, counteracting the benefit.

Marijuana looks to have a similar but more an even worse effect on REM sleep. REM is the stage of sleep where you dream, and when pot smokers stop smoking, they start having dreams again, and usually a lot more, as if the brain is making up for lost time. Though why humans sleep and dream is one of science's mysteries, when we dream our brain is reviewing images and experiences from the day and coming to terms with them. It also helps form memories. In REM sleep you also restore your brain chemistry to its normal balance.

A study out of the University of Pennsylvania found that people who started smoking pot early in life were more likely to have sleep problems later in life, and that marijuana seems to impair sleep quality.

The University of Pennsylvania study also found that 42% of pot smokers experienced sleep issues when they quit, just as many alcoholics experience insomnia when they quit.

Foods That Help you Sleep

Understand that eating foods that help you sleep can supplement a good sleep hygiene program, but don't treat it as the most important part and ignore the basics. You don't want to be making mistakes on the big things (such as going to bed at different times every night) and expect that your night time snack is going to make up the difference.

There's more scientific research needed, but there are a few foods that are promising to help you get quality sleep likely because they contain some of the following:

  • Melatonin: a hormone that plays an important role in regulating the sleep cycle. It's produced by the pineal gland in the brain, it's produced only released at night or in the dark. Studies have shown it to be effective in helping people get to sleep and in combating jet lag.
  • Magnesium:  people with insomnia often are magnesium deficient, and low magnesium levels often lead to sleep restlessly and waking up frequently during the night. Talk to your doctor about this, but people that often get muscle cramps, have muscle tightness, and/or have cold hands and feet often benefit from higher magnesium intake. Supplementing magnesium, or eating magnesium-rich foods can improve sleep quality by increasing muscular relaxation, helping regulate stress levels, and has been shown to help people with restless legs syndrome, which can cause insomnia. Supplementing magnesium has also shown to have a stabilizing effect on mood and effective in relieving symptoms of mild to moderate anxiety and mild to moderate depression.
  • Tryptophan: is an essential amino acid (meaning that your body doesn't produce it so you have to ingest it) that has similar effects to magnesium. It increases the production of serotonin, which gives you a sense of well-being. It's a natural mood regulator, has a calming effect, promotes sleep, and fights anxiety. It also has been found to reduce food cravings and fight sugar addiction.
  • Potassium: According to a study published in 1991 in the journal Sleep, potassium may help keep people asleep.  Another study out of the University of Wisconsin School of Medicine and Public Health found that without potassium channels, you don't get slow-wave sleep, which is important for restful sleep. Bananas are a good source, but not the best. Beans, leafy greens, baked potatoes, and avocados are the best sources.
  • Vitamin D: according to a 2012 study in the Journal of Sleep Medicine, lack of vitamin D may lead to daytime sleepiness. According to the National Health and Nutrition Examination Survey (NHANES), 90% of Asians, Blacks, and Hispanics living in the United States and 75% of the while population are vitamin D deficient. The best source is sun exposure, but vitamin D is also found in salmon, swordfish, and tuna.
  • Calcium: helps the brain to use tryptophan to manufacture the sleep hormone melatonin.
  • Selenium: according to data from the National Health and Nutrition Examination Survey, a selenium deficiency can keep you from falling asleep. High selenium foods include brazil nuts, oysters, tuna, shrimp, salmon, and cremini mushrooms.
  • Fiber: according to the Journal of Sleep Medicine, a low fiber high in saturated fat are associated with lighter, less restorative sleep.  "It was most surprising that a single day of greater fat intake and lower fiber could influence sleep parameters" said Dr. Marie-Pierre St-Onge,  principal investigator in the study.
  • Complex carbohydrates: unlike simple carbohydrates, complex carbohydrates break down slowly, preventing blood sugar spikes and keeping serotonin levels consistent. Some examples are beans, whole grains, and vegetables. Simple carbohydrates include candy, soda, and many processed foods that add sugar.

Here are some of the top foods to help you sleep:

  1. Sweet potatoes: a great source of complex carbohydrates and potassium.
  2. Almonds: containing magnesium, just one ounce (a handful) has 19% of your daily recommended need.
  3. Bananas: also contains magnesium, potassium, and tryptophan.
  4. Turkey: contains tryptophan, but there's evidence that the protein in turkey may help promote sleepiness.
  5. Fatty fish:  the combination of vitamin D and omega-3 fatty acids have been shown to increase the production of serotonin, the sleep-enhancing brain chemical. One studied observed that men who ate 300 grams of Atlantic salmon three times per week for six months fell asleep 10 minutes faster than those who ate chicken, pork, or beef.
  6. Cherries: you might assume that the sugar in this fruit may keep you up, but there's evidence that eating cherries or drinking tart cherry juice before bed may improve your sleep quality, and has been studied for its role in relieving insomnia. It has high levels of melatonin. Research from Louisiana State University ran a study where participants (older adults with insomnia) who drank tart cherry juice twice per day for two weeks increased their sleep length by 90 minutes. “Even though the amount of tryptophan in Montmorency tart cherry juice is smaller than a normal dose given to aid sleep, the compounds in Montmorency tart cherries could prevent the tryptophan from breaking down so it’s able to work in the body more effectively. Even though the amount of tryptophan in Montmorency tart cherry juice is smaller than a normal dose given to aid sleep, the compounds in Montmorency tart cherries could prevent the tryptophan from breaking down so it’s able to work in the body more effectively,” Co-author of the study, Dr. Frank Greenway explains, “These compounds may help to improve tryptophan bioavailability for serotonin synthesis, which could have a positive effect on sleep.  Increasing serotonin also helps improve mood and decrease inflammation.”
  7. Kiwi: another fruit that contains serotonin, as well as antioxidants vitamin C and carotenoids, kiwis reduce inflammation, which may improve the quality of sleep. There have been several studies that link kiwis to better sleep. One conducted at Taiwan's Taipei Medical University tested a group of 22 women and 2 men between the ages of 20 and 55, all of whom had issues sleeping. For 4 weeks the volunteers ate 2 kiwis one hour before bed, and their results were surprising.  The amount of time it took to fall asleep dropped by 35%, the amount of waking up throughout the night dropped by 29%, sleep quality increased by 42%, and participants slept an average of 13% more.
  8. Honey: the glucose in honey reduces levels of orexin, a neurotransmitter in the brain that makes you more alert. It also allows tryptophan to enter the brain more easily.
  9. Oatmeal: high in carbs and a source of melatonin, oatmeal has been reported to induce drowsiness before bed.
  10. Passionflower tea: In a study published in the National Institutes of Health,  41 adults drank a cup of passionflower tea before bed and reported higher sleep quality.  This is probably due to its apigenin, an antioxidant that reduces anxiety as well as reduces insomnia and promotes sleepiness. The brain also produces more GABA (gamma-aminobutyric acid) when drinking passionflower tea, which is deficient in those with insomnia.
  11. Chamomile tea: contain apigenin, an antioxidant that binds to receptors in your brain to promote sleepiness and reduce insomnia.  A study from the University of Michigan published in the National Institutes of Health found that the 37 participants who drank chamomile extract twice per day for 28 days fell asleep 15 minutes faster and experienced less nighttime waking.
  12. Walnuts: a great source of many vitamins and minerals, including magnesium,  protein, melatonin,  as well as omega-3 fatty acids. Walnut's fatty acid profile has ALA, which is converted to DHA, which may increase the production of serotonin, the "happy hormone" that is also a sleep-enhancing brain chemical.

The Carbohydrate/Protein Snack

Carbohydrates make tryptophan more available to your brain, and with protein being a building block of tryptophan, it can be a good combination an hour or so before bed. It could be cereal with milk, but try to keep it low sugar, and a snack-sized portion, such as almond butter on toast.

Supplements

There are a lot of supplements that can help you sleep, but as with any other sleep tips, it's not a replacement to good sleep hygiene. For example, if you're going to bed at a different time every night (breaking a cardinal rule of sleep hygiene), you may have better sleep by supplementing magnesium, but you would do even better if you were getting at the root cause of poor sleep.

As with foods that can help you sleep, everyone responds to different supplements in different ways. Here are some of the top supplements to consider:

  1. Magnesium: There are several ways to supplement magnesium. The most common is in tablet form, but many people have found more success with creams and powders that you add to water. Many people are not fans of pills, especially larger ones. My doctor told me that I was magnesium deficient, and even when I took higher doses of magnesium tablets, for whatever reason my sleep didn't improve. It was only when I started using a powder that you add to warm water that I noticed my sleep improved.
  2. CBD: Cannabidiol is a chemical compound found in the cannabis plant. It doesn't make you high (THC does that). There's a growing body of research that demonstrate CBD's anti-inflammatory, pain-relieving, and calming effects (though more research is needed). Supplementing CBD for sleep has been found to relieve anxiety, reduce sleep latency (the amount of time it takes to fall asleep once you lay down), and increase the length of sleep as well as the depth.
  3. Melatonin: Produced naturally in your body, melatonin doesn't make you sleep. Melatonin levels rise in the evening that helps promote sleep. You can naturally inhibit this process by exposing yourself to bright lights within 2 hours of going to bed, and by not exposing yourself to natural light during the day. But it can be an option if you have a few nights where it takes a long time to get to sleep, or for jet lag, but you would only use it for a short time.
  4. Valerian: The National Institutes of Health published a study that showed that the use of valerian was found to almost double the chance of sleeping better. Valerian is relatively inexpensive and has no known side effects.
  5. GABA: Gamma-Aminobutyric acid is an amino acid naturally produced in the brain. Though it doesn't get as much press as other supplements, Dr. Michael Breus (also known as the "sleep doctor") refers to GABA as the breaks of the brain as it's the brain's most important inhibitory neurotransmitter. So for people that have a hard time shutting their brains down at night, GABA is a good option to supplement. GABA reduces stress, lowers anxiety, and creates a calm mental state. In a 2008 study, GABA was found to be 30% lower in insomnia patients. There are several supplements to affect GABA activity, including magnesium, valerian, hops, L-theanine, kava, passionflower, magnolia bark, skullcap, lemon balm, black seed oil, and ashwagandha. It's also found in several foods: halibut, shrimp, yogurt, soy, lentils, sunflower seeds, almonds, cocoa, tomatoes, berries, spinach, broccoli, potatoes, and fava beans. According to Dr. Breus, GABA can interact with other medications, such as high blood pressure, anti-depressant, and neurally-active medications; and can react with herbs and supplements that lower blood pressure. Speak with your doctor before you try GABA.
  6. 5-HTP: 5-hydroxytryptophan is converted by the brain to seratonin, which helps initiate sleep. It usually increases the amount of REM sleep by 25%, and increases deep sleep in stages 3 and 4.
  7. L-theanine: An amino acid found in tea plants, studies have shown that it improves the quality of sleep, reduces stress, diminishes PMS (premenstrual syndrome) symptoms, and reduces the negative side effects of caffeine. It works well with melatonin and 5-htp.

Sleeping Pills:

Most experts recommend using sleep pills for short-term situations, if at all, but not for long term use, such as:

  • You're traveling and crossed a few time zones and have a hard time falling asleep.
  • You have an important meeting in the morning and you're unable to sleep in a new environment, such as a hotel.
  • You start doing shift work and you're trying to acclimate to the new schedule.
  • Loss of a loved one, job, divorce, or chronic pain.

Dr. Winter recommends to have a plan for when you will and won't take a sleeping pill. You could plan on using it for a few days after your work shift changes, for example, but no longer. He's critical of doctors that don't discuss a plan with their patients.

There's a lot of research that tells us about the dangers of sleeping pills. According to the Dr. Daniel Kripke whose research is published by the National Institutes of Health, "Use of hypnotic drugs (sleeping pills) is associated prospectively with a greatly increased risk of all-cause mortality." He goes on to say, "In addition to respiratory depression, hypnotics appear to be causally related to serious illnesses and premature deaths from cancer, serious infections, mood disorders, accidental injuries, suicides and homicides."

Dr. Winter explains, "The problem is, the promise of these pills is a bit empty. I have never read a study that has shown these pills to reduce the time it takes to fall asleep by more than a few minutes, nor add more than a few minutes of total sleep to the user's night."

Users can become psychologically addicted to sleeping pills. According to recovery.org, the signs of sleeping pill abuse include:

  • memory loss
  • drowsiness during the day
  • dry mouth
  • dizziness
  • coordination issues
  • unusual dreams
  • slowed breathing
  • lightheadedness
  • itching and/or swelling

A better alternative is to take melatonin (also for temporary situation). The best option is to practice good sleep hygiene and to only use sleeping pills occasionally, if at all.



4. Stress & Your Night Routine


Quick Summary

  • Do your best to reduce your overall stress in your life. Your state during the day will affect your state at night.
  • Do relaxing things before bed, and avoid stimulating activities (such as work).
  • Have a relaxed attitude toward sleep. Tell yourself that if you don't sleep good one night, you'll make it up some other time.
  • Adopt a pre-sleep ritual that helps calm you down and tells your brain that it's time for sleep.
  • If you can't sleep, don't stay in bed. Get up, do any calming activity, and go to bed when you're sleepy.

Understand that whatever you do during the day can affect your sleep. If you’re experiencing stress and adrenaline at your job, at school, or in your relationships, it can hurt your sleep.

Many people work on their laptops in bed right before they go to bed, which isn’t helpful because it keeps your mind active, and most have stress associated with work. Your bedroom is for sleeping and sex, and having other associations with your bed may prevent you from quality sleep. The mind needs to be slowed down and calmed down.

Your Attitude Towards Sleep

Dr. Christopher Winter, dubbed "The Sleep Whisperer" by Ariana Huffington, and author of The Sleep Solution: Why Your Sleep is Broken and How to Fix It, explains that your attitude towards sleep is extremely important. He said, "When you talk with good sleepers, they have a flip-flops-and-Hacky-Sack mentality toward their sleep. "Whatever, dude." Within them is an inner belief that they are going to basically be okay no matter what happens that night in bed. This is the mentality that you must find, or you will be doomed to struggle forever."

He references several studies that have examined different sleepers. Dividing the sleepers into 4 categories (those who sleep well and believe they sleep well, those who  sleep well and believe they sleep poorly, those who don't sleep well and believe they well, and those who sleep poorly and believe they sleep poorly), it was discovered that your attitude towards sleep is as important as your belief about how well you sleep. If you sleep poorly, and you believe you sleep well, you'll function at a similar level to those who sleep well! Similarly, if you sleep well, but you believe that you sleep poorly, you'll function poorly (similar to those who sleep poorly).

If you're over-sensitive about your sleep, it could help you a lot to have a more relaxed attitude about your sleep. Dr. Winter likens it to performance anxiety for an athlete: "The more we concern ourselves with sleep, the harder it is to initiate it." If you worry about your sleep, you're approaching it with the wrong attitude. In order to fall asleep, you need to relax. Worry and anxiety prevent you from relaxing.

Accept that even good sleepers are going to have a bad night of sleep occasionally, so don't put pressure on yourself that there's something wrong with you and you're doing things wrong (though you should continue to improve your sleep hygiene). And if you find yourself unable to sleep, Dr. Winter points out the work of Gilberte Hofer-Tinguely that showed that resting time is as beneficial for some cognitive tasks as sleeping.

Pre-Sleep Rituals

If you experience a lot of stress during the day, find ways to release the stress before you go to bed. You can try journaling to let go of some of the stress, reading something that’s not stimulating. There are also a number of things that you can try to reduce stress, such as:

  • Reading (especially fiction as non-fiction may stimulate thinking and be energy-inducing)
  • Meditation
  • Stretching
  • Foam rolling
  • Massage/foot massage
  • Drinking calming tea
  • Taking a bath (when you get out the drop in body temperature can help you sleep)

Some insomnia patients use specific visualizations to help them relax. One is to lay on your back and tense a muscle group for a second, then feel the relaxation in that area after, then move onto the next muscle group. You could start with your left foot, then calf, then thigh, and glute, and repeat the process on the right leg. Next is the left hand and forearm, upper arm, and chest, then right arm. Follow up with your abs and neck. After that, feel the sense of relaxation throughout your body.

One person we spoke to used to visualize energy in her hands and feet slowly withdrawing into her spine and brain. She said this ritual gave her something to focus on so her mind wouldn't run in a million directions like normal, and it helped her relax.

As mentioned earlier, make sure your room is dark and you’re not exposing yourself to bright lights before bed. Many people brush their teeth in front of really bright bathroom lights, then look at their phone, tablet, or tv, unknowingly telling their brain that it’s still light out. If you've ever felt really tired, did your nightly routine, then laid in bed unable to sleep though still tired, this could be your issue.

Make sure your room temperature is lower, around 65 degrees. Everyone is a little different, so your optimum sleep environment could be 60 degrees or 70 degrees, but your core temperature will drop when you sleep, so warm temperatures can prevent you from sleeping deeply. Part of your nightly ritual that signals your brain what to expect can be turning down the temperature.

What to do if you Can't Sleep

If it takes you longer than normal to sleep, and you don't feel like you're going to fall asleep any time soon, don't stay in bed. If you start getting angry or frustrated, your heart rate will go up and changes will occur in your brain that could keep you up for a lot longer. Go to a room with low light and do any of the activities recommended for a pre-sleep ritual. If it's been a while since you ate, having a snack of a small amount of protein with carbs may help put you to sleep also.



5. Your Bedroom


Quick Summary

  • Make sure your room is really dark. If you can't get it dark, wear a sleep mask.
  • Your room should be quiet. If it isn't, wear earplugs, use white noise, and/or add items to your walls and room to deflect and/or absorb sound.
  • Your mattress shouldn't be making you hot. If it is, get a cooling mattress topper or change your mattress to a cooling mattress.
  • Make sure that your mattress is the right firmness. Try sleeping on different mattresses (like if you travel and sleep in a hotel) to see what works best for you. Or you could take advantage of many mattress companies 100 night in-home trial.
  • Experiment with different pillows to find the one that works for you.
  • Consider the air quality of your room, especially if you have any breathing issues such as asthma or allergies.

Light & Sound

Your rooms needs to be really dark. If it's not dark enough, you can change your shades to room-darkening shades, or you can use a sleep mask. Remember that your circadian rhythm is triggered mainly by light and temperature, so if you're seeing light, your brain is being told it's time to stay up.

Your bedroom should be really quiet, as research has shown that we may have something in common with birds: birds will sleep with one eye open and half of their brain awake while sleeping. They do this to prevent from being attacked by predators while sleeping. So your brain could be reacting to sounds in your environment while you sleep, signaling to the left half of your brain to stay vigilant, which prevents the deeper stages of sleep.

If you live in a loud apartment or area, there are a few things that you can do. The best but the most amount of work is to make changes to your bedroom so sound isn't echoed throughout your room. When you have 2 flat surfaces and a noise occurs, the sound will bounce off of the walls 60 times per second, and there are 2 ways to interrupt that pinball effect: deflection or absorption. Absorption is the best, but most people's bedroom will have a combination of absorption and deflection. The most common material that will absorb sound would be your drapes or fabric hanging on the wall, and one of the best things you can have is padded headboard. If you want the best sound absorption, sound studio foam is the most effective. If you watch radio or singing being recorded, notice the sound studio will have foam strategically attached to various parts of the room to prevent any echo.

For deflection, any object in the room that is in between flat walls will deflect sound to other areas. Pictures attached to the wall or dresser, plants, dressers, etc. Pay attention when you go to a restaurant for absorbing and deflecting materials; they will often put what look like large pieces of art hanging from the ceiling, which are often absorbing and deflecting sound. Occasionally you will find a restaurant that doesn't have many and it will be really noisy.

You could also have a quiet background noise or white noise, such as a fan on low, or you can use a white noise app on your phone, such as white noise lite. You can use soft earplugs, but some people find that they hurt their ears after a few hours if they sleep on their side.

In addition to addressing light and sound, you might want to consider decluttering your room. Some people have found that by cleaning up their room they're slightly less stressed, and they sleep better.

Your Bed

The wrong mattress can prevent you from sleeping well. There are several criteria to evaluate a mattress that can make the difference between getting quality sleep at night or not.

Heat

Foam mattresses can compress and after a few hours your body heat can get trapped, which will make you warmer and prevent restful sleep. If you do a search for mattresses on Amazon, you'll find almost every retailer will make a claim about their mattress sleeping cool. There are a few ways that mattress manufacturers have found to keep you cool:

  • gel in injected/infused into their foam
  • multiple layers of foam to help promote air circulation
  • variations on foam that allow for heat to disperse

If you have a mattress that heats you up, but you don't want to invest in a new mattress, you could buy a cooling mattress topper, and/or a cooling blanket.

Firmness

Some people wake up with back pain and other joint pain because of their mattress. In general, back sleepers need a firmer mattress and side sleepers need a softer mattress. As many people switch throughout the night through different positions, most experts recommend a medium firm mattress.

I found that when I stayed in a hotel room with a very soft mattress, I woke up with no pain, which was not typical. I convinced my wife to get a 4" mattress topper, and her pain went away.

Other Mattress Tips

It's recommended that you change your mattress every 10 years or sooner. The good news is that the online mattress industry is extremely competitive, and many manufacturers will give you a 100-night in-home trial. You'll also pay significantly less than you would in a traditional brick and mortar store.

Pillow

Your pillow may also be reducing the quality of your sleep. If you wake up with a stiff neck, you may have too thick or too thin of a pillow. You can experiment with different sized pillows, or combinations of pillows, or you could buy a new pillow. Keep in mind that your spine will be in a better position if it is straight, so there should be support for your neck but space for your head to drop into.

Air Quality

This doesn't usually show up on recommendations for sleeping better, but researchers from the University of Washington found that people who live in high pollution areas were 60% more likely to sleep poorly compared to those who live in areas with cleaner air. The study found an association, not a cause and effect relationship, but air quality is especially relevant for people with breathing issues, such as asthma or allergies. And if you improve the air quality of your bedroom and it doesn't affect your sleep, it can still be beneficial for your health.

Some of the most common problems with air quality that can affect your sleep are:

  • You're allergic to cats or dogs and they sleep with you.
  • You have a dust mite allergy and your mattress and/or pillow has dust mites.
  • Exposure to VOCs (volatile organic compounds) that are emitted by many foams found in mattresses and pillows.

If you want to improve your air quality in your home, there are several things you can do:

1. Use a high-quality air purifier (remember if it has a bright light on it to cover it with a piece of tape).
2. Use dust mite covers on your mattress and all of your pillows.
3. Get rid of the carpeting in your bedroom and use tile or wood instead.
4. Have plants in your room that clean the air and give off oxygen at night, such as the snake plant.5. Clean your house regularly.
6. Put a high-quality filter with a MERV rating of 11 or 12 in your furnace and leave the fan running to help clean the air.
7. Don't vacuum or clean a few hours before bed as particulates can stay airborne for up to 2 hours (unless you have an ion air purifier that will make the particles drop tot he ground quickly). And if you have any allergies, wear a mask while you clean.
8. If you have a dust mite allergy, keep the humidity levels at 55% or lower.

How to Nap Properly

There's evidence that midday napping can boost focus, mood, energy, creativity and energy levels. The Japanese have a term for napping at work, called "inemuri," which translates as "sleeping while present."

Dr. Sara Mednick, associate professor of psychology at the University of California Riverside and co-author of "Take a Nap! Change Your Life," says “Naps had the same magnitude of benefits as full nights of sleep if they had a specific quality of nap.”

Napping too late can prevent you from sleeping at night, and napping for too long can cause grogginess (called sleep inertia). So what are the best nap lengths and times of day for napping?

The best time to nap for night owls (those who go to be around midnight or later) is around 2:30 or 3 pm. If you're an early bird (you go to sleep around 9 or 10 pm), the best time to nap is around 1 or 1:30 pm. Now it makes sense why many countries in Latin America take afternoon siestas.

The 15-20 Minute Nap

The most convenient nap for most people is the "power nap," which is 15-20 minutes. This nap is long enough for you to get the benefits of a nap without getting groggy because your brain doesn't enter the state of slow wave sleep. You can boost your energy, improve motor performance, alertness, and learning ability and is the best way to make up a sleep deficit from a poor night's sleep.

In a study published in the Journal of the American Medical Association, Dr. Androniki Naska found that napping for apparently healthy individuals is inversely associated with coronary mortality, especially among working men. Those who napped occasionally had a 12% lower coronary mortality, and those who napped systematically had a 37% lower coronary mortality.

The 20-60 Minute Nap

If you nap for 20-60 minutes your brain will enter deeper stages of sleep where your brain will slow down, which can help with memorization and learning. The problem with these naps is that when you wake up, it will take you a while to get out of this deeper state and you'll feel groggy for a while.

The 60-90 Minute Nap

If you nap over 60 minutes, you get into R.E.M. (rapid eye movement sleep), which is the state where you dream. It improves creativity, perceptual processing and associative thinking. A nap this long will also leave you with sleep inertia (grogginess).

The 90-Minute Nap

If you have the time, a 90 minute nap will give you one complete cycle where you went from the light stages of sleep, through the deep phase, and back to the light stage, so when you wake up, you'll feel refreshed. Naps of this length boost memory and creativity.

Two Ways to get the Right nap Length

Here are two ways to get the right length of a nap. The first is to set an alarm. If you want a 15 to 20-minute nap, and it may take you 5 minutes to get to sleep, set your alarm for 20 minutes.

The second is to drink caffeine right before you go to sleep. Caffeine takes around 20 minutes before it hits your system, so it will wake you up a the right time. Just be careful, if you drink a lot of caffeine it can hurt your sleep at night.

Napping Tips:

  • The best time for you "siesta" is 1 or 1:30 for early risers, and 2:30 or 3 for late risers.
  • Nap for no more than 20 minutes in order to wake up refreshed and not groggy. If you're sleep deprived, sleep for a full 90 minute cycle, just be careful that it doesn't harm your evening sleep.
  • After your nap, you can exposure yourself to sunlight and do some exercise to ensure your circadian rhythms are not disturbed.

Traveling & Jetlag

Traveling to different time zones can hurt your sleep because it impacts your circadian rhythm. The general rule is that it takes a day of recovery for each time zone you travel through, though jetlag doesn't seem to really disrupt you until you travel at least 2 time zones. And it's easier to travel west than east. If you flew from New York to Los Angeles, and you left at 3 pm Eastern Standard Time (EST), flew for almost 6 hours, you land at 6 pm Pacific Standard Time (PST).  Your day just got 3 hours longer. Because your day is longer, you'll be more tired, and you're likely to fall asleep when it's bedtime. But when you go back to New York, if you leave at 3 pm PST, you'll land at 12 am PST. When you land you'll feel like it's 9 pm, though it's 12 am.

There are several things you can do to acclimate your system to a new time zone:

  • Set your watch to the new time zone while you're on the plane. Let your brain know what to expect for the next day.
  • When you wake up in the morning the first day, exercise early, outside if possible, and expose yourself to sunlight. Remember light and temperature are the two main ways your circadian rhythm is set.
  • If you need to sleep earlier than you feel tired, take melatonin.
  • Follow sleep hygiene rules as best as possible. If you're staying in a hotel, which could be noisy and the rooms may have too much light, keep a sleep mask and earplugs in your travel bag. Take into account that your sleep may suffer, so try to get the highest quality and quantity of sleep as possible.
  • If you're tired at your destination, a 15-20 minute nap can help make up your sleep deficit.
  • Before you fly, you can gradually start altering your sleep and wake times to match your destination's times.

If you've ever found it difficult to get a good night's rest in a hotel or anywhere other than home, a study out of the School of Psychology, Georgia Institute of Technology explains why. It's a common event that participants in a sleep study don't sleep well on their first night, called the "first-night effect." It's so common that many scientists will not use the data from the first night of a sleep test. Their experiment involved studying reactions in the brains of sleepers when they played beeping noises during the night. Researchers found that beeps played in the left ear woke people up more often. The left side of the brain is more responsible for being vigilant, like a self-preservation instinct to stay half awake to prevent being attacked by predators while sleeping.

This is similar to birds, who can sleep with one eye open and one half of their brain awake when sleeping in danger-prone environments. If attacked by an animal, they will fly away while half of their brain is asleep.

As far as recommendations for how to sleep better in a strange environment, Masako Tamaki, a research associate at Brown University and co-author on the study explains, "You might be able to reduce the first-night effect, but we are not really sure if you can remove the effect completely."

It may be worth a try to walk around the building to get to know the area a little better, which could put your mind at ease. You can also deadbolt the door, if the door has one, and consider using a sleep mask to block light, and ear plugs and or some kind of white noise to reduce noise.

Health Risks of Sleep-Deprivation

Dr. Matthew Walker, a professor of neuroscience and psychology at UC Berkley, explains “The silent sleep loss epidemic is one of the greatest public health challenges we face in the 21st century.” He's the author of Why We Sleep: Unlocking the Power of Sleep and Dreams, has dedicated his professional life to the study of sleep. He claims that sleep deprivation leads to a host of health issues, including higher rates of cancer, Alzheimer's, depression, anxiety, diabetes, stroke, anxiety, heart attacks, and anxiety.

Auto & Plane Crashes

In 2009 a Continental flight killed 49 passengers, and the pilot hadn't slept the night before the flight. Also in 2009, an Air France plane crashed killing 228 people, and a judicial report found that the pilot had slept just one hour prior to the flight. A 2012 National Sleep Foundation survey had one in five pilots admitting that they had made a serious error due to sleep deprivation. So by 2011 the Federal Aviation Association (FAA) created a new regulation that prohibits pilots from getting less than 10 hours off between shifts.

The National Highway Traffic Safety Administration estimates that drowsy driving was responsible for 72,000 crashes, 44,000 injuries, and 800 deaths in 2013. The CDC, however, says that the number of deaths is actually closer to 6,000 fatal car crashes per year due to drowsy drivers.

Medical Errors

According to Johns Hopkins University, medical errors are now the third leading cause of death in the US. We don't know what percentage of this is due to sleep-deprived medical staff, but there's extensive research demonstrating the relationship between sleep deprivation and lowered coordination, attention, cognitive ability, working memory, and reaction time. Yet there are no sleep or work-hour guidelines in most specialties of medicine. According to Dr. Brian Goldman, physicians are "Part martyr and part hero, [sleep deprivation is] welded into the culture of medicine."

One study found that after 24 hours of sustained wakefulness, hand-eye coordination decreased to a level equal to the performance observed at a blood alcohol concentration of roughly 0.10% (.08% is considered drunk in most states). In a meta-analysis of 60 studies involving 959 physicians, staying awake for a continuous 24 to 30 hours decreased physicians' overall performance by nearly 1 standard deviation and clinical performance by more than 1.5 standard deviations. A study published in 2004 in the New England Journal of Medicine compared two groups of interns for a year, one group that has the traditional schedule of 30-hour shifts every third night, and the other limited to a staggered schedule where the longest shift was 16 hours. Interns working the longer shifts made 36% more errors.

A 2009 study found an increased rate of complications among attending surgeons who operate after sleeping less than 6 hours. A 2006 study found that extended hours awake at night caused a 300% increase in preventable mistakes that led to a patient’s death.

Obesity

According to research published by Dr. Jean-Phillipe Chaput of the Children's Hospital of Eastern Ontario, lack of sleep is associated with consuming more calories, a poor diet, and obesity. It increases snacking and the number of meals consumed per day in part because of the production of the hormones leptin (which suppresses appetite), and ghrelin (which stimulates appetite). When sleep deprived, your leptin levels drop and your ghrelin levels increase. This is significant as many people are struggling with their diet, and they feel guilty because they attribute it to a lack of self-control, when in reality they are fighting their biology, in part due to their lack of sleep.

Dr. Chris Winter, neurologist, sleep scientist, and author of "The Sleep Solution: Why Your Sleep is Broken and How to Fix It," references several studies that support the relationship between obesity and lack of sleep. One is a 2015 study from China looking at the habits of over 1 million subjects, Dr. Jinwen Zhang found higher levels of obesity in people sleeping less than 7 hours per night. Another study he references is from 2008 that found that school-age children who slept less than 9 hours per night, or slept erratically were more likely to be obese. In a study from 2015, Dr. Alyssa Lundahl and Dr. Timothy Nelson found that inadequate sleep leads to lower energy levels, which increases the chances of eating more in order to have more energy. And another study by Dr.Laura Asarnow from 2015 focused on chronic sleep loss, looking at 3,300 kids and adults and concluded that on average, for every hour of sleep that someone loses, they gain 2.1 points on the body mass index.

Lack of Self-Control

This is related to research that suggests that lack of sleep leads to a lack of self-control.  Rresearch by Frontiers in Human Neuroscience published by the National Institutes of Health, a sleep-deprived person is at an increased risk of giving in to impulsive desires, poor focus, and compromised decision-making.

Alzheimer's

Dr. Antoine Louveau and Dr. Aleksanteri discovered independently that the brain has a system for removing waste, called the glymphatic system. The main waste product that it removes is amyloid beta, which is the protein that accumulates in people with Alzheimer's. This waster removal system is 60% more active when we sleep than when we are awake (and it looks to be better for side sleepers). A study involving the elderly found that those who slept less or had more sleep disruption had a higher amount of amyloid beta in their brains. Other neurological diseases and decreased memory have been associated with poor sleep, such as Parkinson's disease.

Heart & Circulatory System

According to Dr. Winter, "The effects of poor sleep are probably most damaging to the heart and circulatory system." Researchers from Jichi Medical University in Japan published a review of recent literature on the National Institutes of Health explaining, "Recent epidemiological studies have revealed relationships between sleep deprivation and hypertension, coronary heart disease, and diabetes mellitus."

Mood

Dr. Winter points out that poor sleep can dramatically worsen mood and has been linked to worsened depression and anxiety. For many health professionals, they won't diagnose depression unless there are sleep issues. He adds that circadian-rhythm disorders are frequently associated with mood disorders, and in a 2015 study out of the University of Western Australia, Dr. David Hillman found that for patients with obstructive sleep apnea with depression, the successful treatment of sleep apnea reduced the incidence of depression by a whopping 69%! According to Johns Hopkins Medicine, interrupted sleep may be more powerful on mood than reduced sleep.

Other Impacts of Sleep Deprivation

There are many systems that are negatively affected by sleep deprivation, which include:

  • Short and long-term memory
  • Focus and thinking
  • Immune system
  • Blood pressure
  • Sex drive
  • Balance and coordination

Signs of Sleep-Deprivation

According to the Centers for Disease Control and Prevention, 30% of Americans get less than 6 hours of sleep per night. Sleep loss is generally defined as having less than the average need of most adults of 7-8 hours per night. But you could be sleeping 8 hours or more per night and not be getting quality sleep and be sleep-deprived. Many who are sleep-deprived don't realize it because they mask the signs of being tired with caffeine throughout the day, keeping themselves from feeling tired. The most obvious sign of sleep deprivation is to be tired, but there are many other signs that you're aren't getting enough quality sleep:

1. Constant Snacking

The Wisconsin Sleep Cohort Study found that short sleep duration is associated with reduced leptin and elevated ghrelin levels and increased body mass index levels. Leptin is the hormone that's produced by fat cells and signals the brain to inhibit hunger, and ghrelin is the hormone that is produced in our gut that stimulates appetite and promotes fat storage. There are many people that are struggling to stick to a diet because they're fighting with their biology due to a lack of sleep.

2. Poor Memory

Researchers at the Center for Translational Neuromedicine at the University of Rochester Medical Center in New York found that a good night of sleep increases the space between brain cells, allowing the brain to flush out toxins that accumulate during the day.

3. Lack of Emotional Control

Have you ever noticed that you're more sensitive or even snippy when you're tired? Researchers at Tel Aviv University found that even one night of sleeplessness can result in a lowered ability to regulate emotions and increased anxiety, due to heightened activation of the amygdala. Dr. Talma Hendler, who led the study, explains "It turns out we lose our neutrality. The ability of the brain to tell what's important is compromised. It's as if suddenly everything is important.” A study from Johns Hopkins University found that waking up several times during the night is more detrimental to people's positive moods than getting the same shortened amount of sleep without interruption.

4. Clumsiness

Lack of quality sleep can impair your motor control, resulting in dropping things, bumping into things, tripping, and making more typos while at work. This can result in poorer athletic performance and poorer performance at your job. Dr. Chris Winter, of Charlottesville Neurology and Sleep Medicine in Virginia, says "When you're tired, there's a lapse in how you neurologically function in general." With lowered reaction time and concentration also comes more difficulty with movement."

5. Reduced Focus & Ability to Think

Scientific literature shows a strong relationship between sleep deprivation and decreased attention as well as higher-level cognitive functioning. Planning and complex decision making are handled by the prefrontal cortex, and when sleep deprived that part of the brain doesn't function as well. Combined with the higher likelihood to be impulsive as well as take risks when tired, you're more likely to make bad decisions when tired, which can affect your finances, your career, your relationships, and all aspects of your life. And to make the problem worse, sleep deprivation makes us less likely to have the awareness to know that we're in a state where we're more likely to make bad decisions.

6. Reduced Immunity

In a 2009 study, researchers found that their volunteers in the study that slept less than 7 hours per night were three times as likely to develop a cold than those who got 8 hours. Your body produces cytokines while you sleep, which are proteins that protect you against infections and inflammation.

7. Microsleeping

Microsleeping is when you fall asleep for a few seconds and you don't even realize it. The most dangerous and common instance of this is sleeping while driving, which is responsible for over 2% of all fatal car crashes.

8. Dark Circles

Lack of quality sleep can cause blood vessels under your eyes to dilate. But dark circles can also come from your genetics, smoking, excess alcohol, excess salt, excess caffeine, allergies, an allergic reaction to makeup, too much time in front of a computer screen, or something more serious, such as kidney, liver, or thyroid disease.

Other Tips to fix Your Sleep

Sleep Restriction

This is a Cognitive Behavioral Therapy for Insomnia (CBTI) technique developed by Arthur Spielman. It was designed for people to eliminate prolonged middle of the might awakenings, yet people with other sleep issues have used it to retrain their brains to sleep deeper and longer.

There are several variations on this technique, and you can talk to your doctor about their recommendation, but the basic technique is for a week try sleeping only for 6 hours. As 6 hours of sleep isn't enough sleep, you need to then gradually increase the amount of sleep you're getting by 15 to 30 minutes, and you do this for a week. Every time you add another 15 to 30 minutes, you hold to that schedule for a week.

Your goal is to find your "sweet spot" for the amount of sleep you need. You find this by calculating your sleep efficiency score, which is the amount of time you spend sleeping divided by the amount of time you're in bed, then multiply that number by 100. If you slept 4 hours and you were in bed for 8, your sleep efficiency is 50% (terrible).

Sleep efficiency ratio=hours asleep/hours in bed * 100

If your sleep efficiency is 85% or more, you need to add more time. If you're below 80%, then you need to restrict your sleep.

Dr. Winter explains "Sleep is a primary drive and that no pills are needed." He claims that those who endure the short-term pain can enjoy the long-term benefits, but those who try sleep restriction can find daytime sleepiness a problem.  He recommends adding 15 minutes per day to your sleep until your daytime sleepiness goes away.

Sleep Debt

When many people learn about the dangerous effects of being sleep-deprived over a long period of time, they often wonder if they can make it up. The research seems to say that in the short term you can, but long term you can't. So for example, if you stayed up too late on Sunday night and were really tired on Monday, getting good sleep on Monday night, or a short nap on Monday afternoon can help you make up your sleep deficit. But if you were sleep deprived regularly for 20 years, it's probably too late.

Journaling

It may be one thing or several things that are preventing you from getting quality sleep. If you can’t seem to figure it out, start doing a daily sleep journal, such as the better sleep project. It will make you more aware of your habits that affect your sleep and can help you figure out where you’re making mistakes. Or you could make your own journal online or in a notebook where you track some of the most important criteria, such as:

  • when you got into bed
  • how long it took you to fall asleep
  • how many times you woke up during the night
  • how you felt when you woke up (well rested, not rested)
  • amount of caffeine ingested during the day and the last time you had it
  • level of stress during the day/evening
  • did you expose yourself to blue light via tv or a screen without a blue light filter within an hour of bedtime?
  • any notes about what might have affected your sleep that night
  • if you took any naps, noting when and for how long
  • temperature of the room

If you start journaling, you'll start getting some really good data to pinpoint what your issue or issues are. You may find through experimenting with the temperature, for example, that you sleep best at 69 degrees. Though that's higher than what most sleep experts have recommended, you can see from your data that you slept best at that temperature. Another benefit of journaling is that if you stick with it, you'll start altering your behavior because you know you'll be accountable for it. For example, if you have a tendency to go to bed at different times every night, you know that every morning your noting that you're breaking a cardinal rule, and if you're not happy with your sleep, you're more likely to get more consistent bedtimes.

Sleep Apps

There are many sleep apps that you can download on your phone with a range of functions and features. It's a personal choice as to what will help you the most, but I have experimented with several free apps and so far my favorite is Sleep Cycle (available for Apple and Android). It's my favorite for several reasons. The first being that it gives me a hypnogram of my sleep for the previous night, and it saves all of your previous nights so you can look back at them. The chart it creates is also referred to as sleep architecture.
sleep app hypnogramA normal, healthy night sleep will show you going through 4-5 sleep cycles. Each cycle has 5 stages, with stages 1-4 being non-REM sleep, and stage 5 being REM sleep.

Stage 1: this is light sleep where you can be awakened easily.

Stage 2: Your heart rate slows, body temperature drops, eye movement stops, and brain waves slow down.

Stage 3: Your brain mostly produces delta waves, which are very slow brain waves, and occasional faster waves. This is the stage where people talk in their sleep, or experience other parasomnias such as bedwetting, sleepwalking, or night terrors.

Stage 4: Your brain produces delta waves almost exclusively.

Stage 5: This stage is commonly known as the REM or rapid eye movement phase where your eyes move rapidly from side to side and your brain waves are similar to your waking state. This is when you dream. In this state you're paralyzed so you don't act out your dreams.

With this app you don't need to memorize the stages; they are labeled as awake, sleep, and deep sleep. Stages 3 and 4 are the deep sleep stages, and this is where you get most of the restorative benefits of sleep. Human growth hormone is released, and your immune system is restored.

The app tracks your movement in bed by the microphone, which will track your sleep stages through sound, or the accelerometer which will track you by feeling movement. The default setting is the microphone which works great for me, and doesn't seem to pick up my wife's movements. Make sure you follow the directions and point your microphone towards you and that the phone is close to your bed.

You can set your phone on airplane mode and set the time that you want to wake up, and the app will wake you up at the lightest phase of your sleep around that time with gentle music.

If you use the app for a while, you can review lots of other data:

  • sleep quality average for each day of the week
  • what time you went to bed every night (great to see if you're being consistent which is extremely important), and if there are certain days that you have a habit of going to bed at a different time
  • the amount of time you spend in bed
  • when you wake up
  • your sleep quality per day of the week

It will also compare all of your scores to the averages for the United States, as well as give you the extremes from other countries, such as the average for when I go to bed every night:

My average: 00:41

United States: 23:32

Earliest: South Africa, 22:47

Latest: Iran, 01:17

There are other options in Settings that are off by default and can be really helpful as the app will collect this data:

  • Sleep notes: the defaults are "drank coffee," "ate late," "stressful day," "worked out." You can delete these or add your own. I added "ate sugar" as this is one of my weaknesses and greatly impacts my sleep, as well as "took nap" to see if the days that I take 15-20 minute naps in the afternoon is affecting my sleep at night.
  • Wake up mood.
  • Snore detection (this is on by default).

Analyzing the Data

The most important thing to look at is if you're going to bed and waking up at the same time every night. If you're not, you may notice that there are certain days of the week that you're off schedule. And if you're using the sleep notes, you may find correlations between something you do during the day and your sleep.

You can also see if you're taking a long time to go to sleep every night, not hitting deep sleep, or waking up a lot throughout the night. For me personally I realized after using this app that I was waking up 4-5 times per night because I drink a lot of water throughout the day. Now the later in the evening it is, the less I drink, and it has made a big impact.

How I Improved my Sleep

For years I slept poorly without making an effort to improve my sleep. After doing a lot of research, getting a sleep study, and speaking to several experts, I found that I was doing a lot of things wrong! My sleep problems included:

  • taking a long time to get to sleep
  • waking up multiple times throughout the night
  • waking up super hot throughout the night
  • having really low energy throughout the day, poor memory, poor focus, and felt irritable (but tried not to show it)
  • waking up early and not being able to get back to sleep
  • feeling like I got hit by a truck when I woke up in the morning!

A couple years ago my wife told me that I had sleep apnea. She said that when she wakes up during the night, she would find me not breathing for long periods of time. The thought of having to wear a cpap machine was a little bit depressing to me, but part of me hoped that I did have sleep apnea because I wouldn't have to suffer anymore from poor sleep. I knew several people that said they went from tired all the time to feeling like a normal person after they started using a cpap machine.

I spoke to my doctor and he gave me a prescription for a local sleep clinic. They gave me a take-home contraption that I was to wear overnight and then return to them the next day and they would let me know the results. The technician strangely told me that most people have sleep apnea. But when I got the results, he told me I didn't have sleep apnea.

Falling Asleep Faster

The first changes I made were to not eat high sugar foods at night (I was often drinking orange juice right before bed, or occasionally eating ice cream). My bathroom lights were really bright, so I changed my simple on/off switch to a dimmer switch. After I changed the light I found that turning on the hallway light gave me enough light to brush my teeth before bed (you could use a night light as well). I also reduced my tv and phone time before bed. I installed f.lux on my computer and used the blue light filter on my cell phone.  I also stopped doing intense exercise within 2 hours of going to bed.

The result is that I started falling asleep within 10 minutes of laying down. This was a huge change as I used to be really frustrated that I would be falling asleep on the couch at 11:30 at night, then after my nightly routine 15 minutes later I would be lying awake tired, but totally unable to sleep. Over time I started turning off my computer a couple hours before bed, and I found that reading books before bed was much better for me than a screen, even with a blue light filter.

Sleeping Through the Night

I used to drink lots of water throughout the day, and now the later it is during the day, the less I drink. My dad also has a habit of getting up at night multiple times during the night, and I definitely have my dad's sleep genes ( I wish I had my mom's she has zero sleeping issues). I now usually get up once throughout the night.

Not Waking up hot

My really expensive Tempur-Pedic bed that I bought a few years ago was causing me to wake up really hot several times through the night. After sleeping on a "Heavenly Bed" at a Westin Bonaventure hotel, I found that I woke up with no back pain. My back pain that I had for years wasn't helping me sleep well, so I bought a cooling mattress topper and that made a big difference. I started waking up without my back being really tight, and I wasn't getting hot. Soon after I did buy a new mattress that said it slept cooler, and I still use the mattress topper. The combination of cooling mattress, cooling topper, and turning the temperature down or using a fan at night fixed the issue.

Stop Waking up After 4 or 5 Hours of Sleep

After journaling my sleep for a while,  I found that 3 things will cause me to not get my 7-9 hours:

  1. too much sugar during the day, especially if I've been eating a lot for a few days in a row (I love dark chocolate so this is a shame!)
  2. not eating enough at night or eating dinner too early
  3. too much stress

I have a tendency to not eat a lot at night because that keeps me from sleeping good, but if I ate really early, I'll have something small right before bed, like a little bit of cereal, popcorn, cherries, or almond butter on toast.

Regarding my sugar addiction, I try to eat more fruit instead of chocolate, and to not eat it at night (unless it's one of the foods that help you sleep, like cherries or bananas), which seems to help.

The stress issue has been the hardest to remedy. The best habits that I've developed to reduce stress is to meditate more before I go to bed, journaling for while before I go to bed about anything that comes to mind, and reducing me stress during the day. I found that were some things that I was doing that regularly got me adrenalized, such as showing up for a 6 pm appointment at 5:58. If there was any traffic and I thought I'd be late, I would start freaking out. Now I arrive at 5:40.

Other Tips That Helped me

This took a while to get consistently. The times I was able to do it in the past, I had followed the recommendation of nutritionists and homeopathists that had given me recommendations for supplements to help me sleep. The issue is that they would work for a few months, then gradually not be as effective. After reading Dr. Winter's book, The Sleep Solution: Why Your Sleep is Broken and How to Fix It, I decided that I needed to get to the point where I didn't need anything to help me sleep.

There were two things that he emphasized that made a huge difference for me. The first was to go to bed at the same time and wake up at the same time each day. I struggled to do that at home, but on a week-long meditation retreat I found that I was sticking to a schedule because we had early morning meditations every day, and I was sleeping great.

The second recommendation was to not be over-concerned about sleep. He said that people who sleep well don't worry if they're going to sleep well or not, and if they sleep bad, they don't feel sorry for themselves all day. I started not fixating on how well I slept, and I started sleeping better.

When I was sleep deprived, I got into the habit of taking naps. They often really helped me make up my sleep deficit, but if I took a nap too late, or for too long, it would hurt my sleep at night. Now I take naps around when people take siestas, 1 or 2 pm, and for no more than 20 minutes.

Sleep Tips Summary

  1. Don't expose yourself to bright lights (specifically blue light) within 1-2 hours of going to bed.
  2. According to Dr. Winter, the most important piece of advice regarding sleeping better is to pick a wake-up time and stick to it. Find a time that is realistic for you and be consistent. Go to bed and wake up at the same time every night (including the weekends).
  3.  Expose yourself to sunlight early in the morning and throughout the day, and exercise early in the morning outside if possible.
  4. Limit your naps to 20 minutes at the most, and don't nap late in the day. The best time is around 1-2 pm if you're tired.
  5. Respect your chronotype or tendency to go to bed earlier or later when figuring out the best time for you to go to bed every night.
  6. People who exercise regularly sleep better at night, and the more vigorously you exercise, the more you benefit.
  7. Exercise regularly and if possible, early in the morning.
  8. Journal your sleep quality every night and experiment to see how when you work out affects your sleep quality. Most people do better with morning or afternoon workouts, though you could be one of the more rare group that sleeps better after an evening workout.
  9. Use sleeping pills for a limited amount of time or not at all.
  10. Avoid eating a lot at night; a small snack with protein and carbohydrates is best.
  11. Avoid caffeine late in the day and nicotine entirely (both are stimulants).
  12. Be careful with alcohol and marijuana consumption. You may fall asleep faster, but the overall quality of your sleep suffers.
  13. Be careful with sugar, it can prevent quality sleep, especially when consumed later in the evening.
  14. Sleeping pills should only be used for a short period of time, if at all.
  15. Do your best to reduce your overall stress in your life. Your state during the day will affect your state at night.
  16. Do relaxing things before bed, and avoid stimulating activities (such as work).
  17. Have a relaxed attitude toward sleep. Tell yourself that if you don't sleep good one night, you'll make it up some other time.
  18. Adopt a pre-sleep ritual that helps calm you down and tells your brain that it's time for sleep.
  19. If you can't sleep, don't stay in bed. Get up, do any calming activity, and go to bed when you're sleepy.
  20. Make sure your room is really dark. If you can't get it dark, wear a sleep mask.
  21. Your room should be quiet. If it isn't, wear earplugs, use white noise, and/or add items to your walls and room to deflect and/or absorb sound.
  22. Your mattress shouldn't be making you got. If it is, get a cooling mattress topper or change your mattress to a cooling mattress.
  23. Make sure that your mattress is the right firmness. Try sleeping on different mattresses (like if you travel and sleep in a hotel) to see what works best for you. Or you could take advantage of many mattress companies 100 night in-home trial.
  24. Experiment with different pillows to find the one that works for you.
  25. Consider the air quality of your room, especially if you have any breathing issues such as asthma or allergies.
  26. The best time for you "siesta" is 1 or 1:30 for early risers, and 2:30 or 3 for late risers.
  27. Nap for no more than 20 minutes in order to wake up refreshed and not groggy. If you're sleep deprived, sleep for a full 90 minute cycle, just be careful that it doesn't harm your evening sleep.
  28. There are several things you can do to acclimate your system to a new time zone:
    1. Set your watch to the new time zone while you're on the plane. Let your brain know what to expect for the next day.
    2. When you wake up in the morning the first day, exercise early, outside if possible, and expose yourself to sunlight. Remember light and temperature are the two main ways your circadian rhythm is set.
    3. If you need to sleep earlier than you feel tired, take melatonin.
    4. Follow sleep hygiene rules as best as possible. If you're staying in a hotel, which could be noisy and the rooms may have too much light, keep a sleep mask and earplugs in your travel bag.
    5. If you're tired at your destination, a 15-20 minute nap can help make up your sleep deficit.
    6. Before you fly, you can gradually start altering your sleep and wake times to match your destination's times.
  29. Talk to your doctor about sleep restriction to retrain your brain to sleep and to find the best amount of sleep for  you.
  30. Consider starting a sleep journal and/or sleep app (such as Sleep Cycle) to see how you can improve your sleep hygiene.

Sleep is a vast topic that has been researched extensively, yet we still have so much to learn because there are so many factors that influence it, and it involves one of the great mysteries of science, the brain. If there's anything you've found that has helped you sleep better, please let us know in the comments below.

Comments

  1. This is the best guide I’ve seen on sleep on the internet. The idea of taking caffeine right when your nap starts is genius. I didn’t know that it took 20 minutes to take effect. I am going to try that today.

    Do you have any experience with polyphasic sleeping?

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