8 Helpful Tips for Optimal Sleep Health
by Tim Waanders, DPT, PT
Do you have trouble falling asleep or staying asleep at night? If so, you are not alone. According to the Centers for Disease Control and Prevention (CDC), 50-70 million Americans suffer from chronic sleep dysfunction and the CDC has declared insufficient sleep a public health problem. Sleep is vital not only for rest and relaxation, but for restoration of all bodily functions. Our bodies rely on sleep in order to heal tissues, to modulate pain, and to improve sport performance, motor skill learning, and cognitive function. Without routine proper sleep, your risk of injury increases as your endurance, speed, and accuracy levels decrease. Response times, working memory, and visuospatial awareness also decline and can make it more difficult to train and rehab effectively. Below are 8 evidence-based tips to help you fall asleep and stay asleep through the night so you can wake up feeling energized and ready to tackle any workout, race, or activity you have ahead of you!
- Set a sleep schedule. Going to bed and waking up at the same times every day is important to set your biological clock, also known as your Circadian rhythm, on the right track. When you fall into a routine sleeping schedule, it becomes much easier for your body to wind down and allow you to fall asleep and stay asleep, while waking up with the energy you need to make it through the day. Remember that the average adult needs 7-9 hours of sleep every night, so plan your schedule accordingly.
- Getting natural light exposure early in the day is key. Research has shown that between 2-10 minutes of sunlight exposure as close to your wake-up time as possible helps your body kick start the natural release of cortisol in the brain. Cortisol is a hormone which plays a vital role in your body & mind becoming more awake and alert. This sunlight exposure is also important for the Circadian rhythm, since the earlier your cortisol kick begins during the day, the easier it will be for you to fall asleep at night when your cortisol levels are at their lowest. Natural light works best because of the way the sun angle in the morning hits certain cells in the retinas of our eyes, but it is believed that bright, artificial light like ring lights can also do the trick. So go for a walk, run, or just sit outside with a cup of coffee as early as you can! On the opposite hand, it is also important for you to limit the amount of light exposure you get after the sun goes down. Blue light coming from phone and computer screens, for example, can trick your brain into thinking it is still daytime and will not allow for your cortisol levels to wind down. Thus, you will have a more difficult time falling asleep. Blue light glasses and nighttime settings on your devices can be helpful if you want to continue to use your screens at night, but they should ONLY be used at night so that you do not confuse your system by limiting that same light used to keep you alert during the day.
- Time in your bed should be limited to your sleep time. Many people will tend to hang out in their bed to watch TV, eat a meal, or catch up on work. This may especially be true now that so many of us have been working from home over the past year and a half. However, it is important that you limit your time spent in your bed to when you want to sleep so that your brain does not associate it with other activities that will end up keeping your body awake for longer than it wants to be. If your brain associates your bed specifically with sleep, it will naturally become much easier for you to fall asleep at night. If you cannot fall asleep within 20 minutes of being in your bed, get up and go into another room to do something else until you are sleepy. You may also utilize relaxation techniques, such as deep breathing, apps like Headspace that offer mindfulness practice, or Youtube videos that provide Yoga Nidra scripts that are meant to help relax your body and mind.
- Try to exercise during the day within the first 11 hours of waking up. Research has shown there are 3 ideal times to exercise during the day: 30 minutes after waking, 3 hours after waking, or 11 hours after waking. In the first 30 minutes after waking up, your cortisol kick has begun to take effect, so your body and mind are awake and alert. 3 hours after waking is when your core body temperature begins to rise, and 11 hours after waking is when your core body temperature peaks. Exercising when your core body temperature is already rising or at its highest point allows for the drop in core body temperature later in the day to coincide with your sleep schedule and make it easier to fall asleep when you want to. Despite what the research says on timing your exercise, though, the most critical aspect is that you exercise during the day. Routine exercise in adults who report sleep disturbances has been shown to improve sleep quality, shorten the time needed to fall asleep, and reduce the use of sleep aid medications.
- Avoid caffeine, alcohol, and smoking within the 4 hours leading up to your bedtime. Each of these substances are considered stimulants in their own ways, but most especially caffeine. Caffeine is an antagonist to adenosine, which in our body is what dictates our sleep drive (working opposite cortisol); meaning, the more caffeine present in your body, the less adenosine there will be that will help your body wind down and prepare to sleep. That is why caffeine is great in the morning to help you wake up and feel more energized faster but is not ideal when your body is trying to prepare for sleep at the end of the day.
- Avoid taking sleep aid medications or unprescribed pills. One of the most popular substances that people take to help them fall asleep is melatonin. While melatonin does have benefits to help you feel drowsy and fall asleep, its effects on the hormone system actually are not helpful in letting you stay asleep. Many people eventually realize that long term use of melatonin also eventually wears down its efficacy and, in the end, does not help you solve your sleep problems.
- Limit daytime naps to 20 minutes. Naps that last longer than 20 minutes usually lead to the brain entering deep sleep. This can lead to an alteration in your internal clock, tricking your body into believing you are sleeping during nighttime, and when you wake up you will begin another cortisol kick. That cortisol kick will have to naturally play out over time, but because it occurred later in the day, it is likely you will have trouble sleeping at night because the body has not been able to wind down properly. Allow us to introduce a helpful idea, the “coffee nap”: if you normally have a cup of coffee in the afternoon, drink it right before your post-lunch nap. It takes about 20 minutes for caffeine to begin working in the body, so once you wake up from your nap you will feel perfectly energized to finish out the rest of your day without affecting your ability to fall asleep later on that night.
- Be wary of sleep tracking data from wearable devices. As Apple Watches, Garmins, WHOOP bands, and other wearable devices become more popular, it is important to note that there is insufficient evidence on how reliable the sleep tracking data that comes from these devices are. Studies have found that these watches tend to overestimate total sleep time and underestimate the number of awakenings that occur after sleep onset. If you tend to rely on this data, you may believe your sleep habits are healthy even when you may actually be suffering from sleep apnea or some other sleep disturbance that you may not even be aware of. Your body is the most important indicator of how well you are sleeping; if you wake up feeling energized and well-rested every morning then you likely do not have to worry. But if you wake up every morning feeling groggy or “out of it,” despite your watch data telling you otherwise, you should pause and consider what may really be going on. While these wearable devices are great if they are increasing your awareness of the importance of sleep and getting you to pay closer attention to your sleep habits, don’t rely solely on the sleep tracking data to tell you whether you are getting good sleep.
If you have concerns about your sleep health, reach out to a healthcare provider you trust, including any of our physical therapists! As PTs, we can assess your overall sleep health and your risk for sleep disorders, as well as refer you to the appropriate medical professionals for additional assessments if deemed necessary. We can offer sleep education, like the tips provided above, that are specific to you and your needs. And most importantly, we are the best qualified professionals to provide you with an appropriate exercise program that can target any musculoskeletal or neuromuscular impairments that affect your ability to get proper sleep through the night.