Ah, sleep. Such an elusive thing for Americans these days, even when we try to make the time for it. We all know the profound impact that quality sleep – or lack thereof – can have on our health, which means that when it doesn’t come easily for us, we get doubly stressed.
We all know the effects of sleep or lack of sleep on our health. We know about the injury risk, about the clouded judgment, the mood swings, the blood pressure and hormone changes – not only because it’s so well published in the literature and in the media, but because we’ve all experienced it to some degree! I’m not going to focus on that here (As Jeff Moore said in one of his recent PTonICE podcasts, summarizing information and spitting it back out is of limited value!).
I’m also not going to focus on the literature, as I usually do. The reason is two-fold: one, the literature on sleep deprivation primarily utilizes sleep deprivation trials in which subjects are made to stay up all night. That’s not reality for most of us (side note: all nighters are for high school and college students who haven’t figured out how to manage their time properly. Still pulling all nighters in graduate school or as a working adult? It’s not your workload, I promise – it’s your time management. Look into it). Most of us either sleep for limited hours, or get poor quality sleep – maybe it takes us awhile to fall asleep, or we toss and turn, or we wake up too early and can’t get back to bed. That’s reality, but it’s not how most researchers design their studies.
The second reason is that I have an MSK practical on the knee tomorrow so….ain’t nobody got time to do a lit search right now.
Instead, I’ll focus on what’s worked for me. I’ve been in graduate school for four years now (a master’s degree and 2/3 of PT school), and I struggled with recurring insomnia for many of those years. I’ve tried a lot of the conventional advice, but to be honest, what’s worked for me is just a small mindset adjustment that most of us rarely think about.
So….what do you know about “sleep hygiene”? Here is what most media, books, and literature would suggest you do for optimal sleep:
-Practice mindfulness and/or meditation
-Avoid blue light/no electronics before bed
-Keep your room cool, dark, and quiet (or use an eye mask and ear plugs)
-Use essential oils like lavender and Frankincense
-Practice deep breathing
-The bedroom is for sleep and sex and nothing else. NOTHING.
-Avoid caffeine at least five hours before bedtime
….and so on and so forth.
Here’s the thing. Those are all great ideas, and many of them work for many people. But sleep isn’t something that we’re supposed to engineer – it’s supposed to just happen. I’ve found that the more I try to do with my sleep, the more trouble I have getting there. I stress about it, can’t fall asleep, and enter a vicious cycle. And I think that’s an important lesson to learn – the more obsessive you get about your sleep hygeine, the worse quality sleep you’ll likely get. It’s an added stress!
A lot of the above recommendations don’t work for me. Essential oils? I love the smell of lavender as much as any other basic white girl out there, but when it’s on my pillow, so close to my nose? It’s like an olfactory assault. It doesn’t make me calm, it just gives me a headache. If you’re very sensitive to certain scents, this recommendation may not be for you.
Avoiding blue light? meh….there’s some decent research behind blue light, but personally I haven’t noticed a difference in my sleep quality on nights when I choose to watch netflix on my laptop as compared to the nights I choose to read before bed. I think that in part, “no technology” before bed might really be taken best as “NO WORK” right up to bedtime. Still agonizing over emails or lecture videos ten minutes before bed? Of course you’re not going to sleep – your mind is wired. Getting your mind to relax is key, and for some, a mindless TV show (How to Get Away With Murder is really excellent btw) is better than a book. If that’s the best, most effective tool for getting your mind to quiet before bed, then I think the blue light may not matter as much for you.
yes that’s my family….we love our evening laptop time LOL
A quiet room? While I do sleep best when it’s dark (sleep masks are necessary when you live next to a hospital!) and somewhat cold, I actually can’t have quiet. If it’s too quiet, my mind will start to wander and we all know how that goes. I actually need to have our bedroom fan running – I’ve found that if I can simply concentrate on the noise, and let that fill my head, the stressful thoughts fade away and I’m asleep within minutes.
Which brings me to the point of mindfulness and meditation. And breathing, because the point of a breath practice isn’t so much your breathing – it’s about being mindful, being present (at least at night – there are some breath practices that do truly focus on your breath mechanics but that’s a topic for another day). The key to good sleep is a calm, empty mind. Complete PRESENCE in the current moment. For some, guided meditation via apps like Headspace are a good option. I like to use these during the day, but I find that the electronic connection necessary to use apps really does interfere with my sleep. The point, of course, is to get good enough with meditation that you don’t need an app to guide you, but if you’re not at that point and you find technology distracting, then again…this may not serve you well.
Mindfulness and an empty mind are important though, but you know what the most important thing is?
I mean….duh, right? But if you think about it, a lot of us are going to bed when we’re not tired. Maybe we have to wake up at 5:00am tomorrow, so in order to “get 8 hours of sleep” we try to go to bed at 9…when we’re accustomed to an 11pm bedtime. Is it any surprise, then, that you won’t sleep well? This is also where caffeine comes in – if you’ve still got some in your system from that 4pm espresso (please….just don’t), you are not going to feel tired at bedtime. Also, if you’re not getting enough physical activity – though you may feel mentally fatigued, physically your body likely has some energy it wants to get out.
So – my number one recommendation for good sleep? Don’t stress about it! If you currently fall asleep while watching TV on your laptop in your bed in a kind of hot room after having coffee with dinner then why change it? Do what works for YOU, and don’t work yourself into a tizzy trying to figure out the right blend of essential oils or the perfect thermostat setting. If you’re not tired, it’s okay to stay up until you do feel your eyelids start to droop. If you have to wake up at an early hour each morning but don’t get tired till quite late at night, then don’t sweat it- your body is smart. It will adjust.