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Don't Just Sleep, Sleep Well: The Challenge of Good Sleep Hygiene

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In theory, the thirsty seek water, the hungry seek nourishment and the tired seek rest. Reality, however, rarely keeps it that simple. From day to day, the choices we have multiply, packaging glistens, and our time shrinks. Cravings, memories, peer pressure, aromas, proximity, actors, shelf height, shiny plastic and any number of little cartoon bears all conspire to muddy the clarity of our basic needs. We form habits that diminish the stress of decision-making, and if we're careful in forming those habits, we consistently provide ourselves with reasonable approximations of the water, nourishment and rest we need. While it's widely agreed that a diet of snack food and soda is not a healthy substitute for a schedule of square meals, there is less understanding, and in turn, less concern and agreement about the habits that promote good sleep health.

The silhouette of good sleep health is simple enough to trace, but fleshing that silhouette out can be a challenge. We know that good sleep health is achieved through regular, high-quality sleep, and that regular, high-quality sleep is achieved by maintaining good sleep hygiene. Sleep hygiene refers to one's sleeping habits and covers everything from bedtime to bed partner and beyond. For example, falling asleep in a dark, quiet, climate-controlled environment at the same time each night for at least six (and no more than about nine) hours epitomizes good sleep hygiene. Oppositely, passing out in front of a television following a pizza and a six-pack constitutes poor sleep hygiene. While most of us have habits that fall somewhere in the middle of these extremes, even small improvements in our sleep hygiene can make a surprising difference in the way we feel throughout the day and how effectively our body functions.

Sleep hygiene is composed of two main parts: environment and routine. In terms of environment, the goal should be to maintain a setting conducive to sleep. In a perfect world, that setting is dark, comfortable and quiet. For most of us, the "dark" and "comfortable" components of this environment do not present much trouble, provided we can bring ourselves to hit the "off" button. Remember that excessive light, especially the erratic sort generated by a television, tends to fragment sleep, and prolonged exposure disrupts circadian rhythms. Turning devices off also deepens the mental association between the bedroom and sleep. If this association breaks, insomnia often ensues. Unfortunately, keeping things quiet is rarely as easy as flicking a switch. We can't always control pets, neighbors or children, and at times they leave us wondering why we tried. When the world is irresistibly noisy, ear plugs are always a good first line of defense. Of course, if the noise is coming from the nose of your bed partner, encouraging him/her to consult a physician could improve sleep for both of you.

The second half of good sleep hygiene is to develop a regular, healthy routine that involves a consistent sleep and wake time. Meals, caffeine and intense exercise should all be avoided in the hours leading to sleep. Certain medications will significantly disrupt sleep, so be sure to discuss all side effects with your physician. Long naps during the day will naturally delay your sleep onset at night, which can dramatically undermine the effort to maintain a consistent schedule. Note that while a total sleep time of eight hours is a standard recommendation, one should take that with a grain of salt as adults may need as little as six hours or as many as ten hours depending on age, health condition, etc.

On some level, the fundamentals of sleep hygiene that I have outlined here seem intuitive. Many of us learn these things at a very young age, even if we are not sure why these habits are good for us. Still, at some point, we leave home and the idea of a regular bedtime, of turning all the lights off, of not eating a fourth meal at midnight (sorry, Taco Bell) becomes a soft echo drowned in an urgent cacophony of work, family and school. Naturally, strong undercurrents of dedication, love or even just boredom may draw us into unhealthy patterns. The trick is that we not let the occasional late-night movie turn into a home theater in the bedroom. At end of the day, we do not need to just sleep -- we need to sleep well.

Sam Cross, registered polysomnographic technologist, is the lab manager for Parkway SleepHealth Centers, a comprehensive sleep health facility and innovative leader in the diagnosis and treatment of sleep disorders. Parkway SleepHealth Center allows patients to be observed and assessed during overnight sleep sessions to determine the cause of their sleep problems; patients may also participate in daytime sleep testing when appropriate. In his role, Cross conducts all of the home and daytime testing for the sleep clinic's patients and maintains the standards, equipment and personnel of the sleep lab. In addition, he is responsible for reviewing the recorded data of each study performed.

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