By: Sheila Kun RN, BSN, MS, CPN, FCCP
Salesian Cooperator

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We continue abstracting from  Raymond J. Kotwicki, MD, MPH, Charles B. West Chief Medical Officer’s outstanding article on sleep and brain health.

Medications and Sleep

Sleep medications, thought helpful in some situations, tend to be overprescribed. Unsurprisingly, people often want a quick fix to a problem that really requires an intentional change in behaviors. Sleep medications have a host of problems associated with them, including the possibility of addiction and an increased risk of impulsive behaviors like binge eating or late-night online or TV shopping. Over time, repeated use of sleep medications can lead to cognitive slowing.

In most cases, the better option is to focus on sleep hygiene, a prescriptive set of environmental conditions and behaviors to promote regular, healthy sleep.

Sleep Hygiene

First, we start with where you sleep: the bedroom.

Your bedroom should be:

• Completely dark. Use light-blocking curtains or shutters to protect your bedroom from street lights or other light sources. Turn off or cover any electronics that emit light. Consider a small piece of electrical tape for small indicator lights that stay on even when a device is powered off.
• Slightly cold. Set your thermostat to 68 to 70 degrees F.
• The only activities taking place in your bedroom should be having sex and sleeping. Reading, eating, looking at your phone or tablet, watching TV, should all be done in another room. Only get in bed when it’s time to sleep.

Then, consider what you do to fall asleep.

If you are unable to fall asleep after 30 minutes, get out of bed. Go to a dimly lit room and do something unstimulating like reading something uninteresting, knitting, or drawing or doodling for 20 to 30 minutes. Then return to bed and try again. Repeat the cycle if needed.

Many studies demonstrate that light, particularly LED light from TVs and smart devices, interferes with the sleep-wake cycle.

What to Avoid Before Going to Bed

• Eating or drinking. Avoid eating or drinking two hours before going to bed. The old wives’ tale of drinking hot milk or tea when you can’t sleep is counterproductive to sleep unless you drink it two hours before bed.
• Exercising to raise your core body temperature is actually very beneficial to good sleep. But schedule your workout for no less than two hours before bed.
• Watching TV or Looking at a Screen. Many studies demonstrate that light, particularly LED light from TVs and smart devices, interferes with the sleep-wake cycle. Some studies show it delays the release of the sleep-inducing hormone melatonin. In addition to delaying when you fall asleep, exposure to short-wave artificial blue light may delay the onset of REM sleep and reduce the total amount of time you spend in deep stage sleep. Further, recent studies link regularly falling asleep while watching a screen – a TV, tablet, or smart phone – to a 30 percent greater risk of developing obesity.  Try to avoid screens one to two hours before going to bed. Consider setting a “digital curfew” for your household by setting a nightly “screens off” time.
• Taking a hot shower or bath. Taking a shower can be initially stimulating and raises your core body temperature. If bathing is part of your nightly routine, allow a period of two hours before you go to bed.
• Drinking alcohol. While alcohol may act as a sedative for some people and help you fall asleep, it can also affect your sleep architecture and interfere with restorative sleep. Alcohol can also exacerbate snoring and symptoms of sleep disorders like sleep apnea.

Your homework from the Care Ministry this week: take an inventory of the suggested sleep hygiene, and see if you can use the suggestions to improve your sleep.

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