How Sleep Hygiene Impacts Sleep

Welcome back!

In Part 2 of this blog series on sleep issues, we will be discussing the role and importance of good sleep hygiene. Before we begin, I would like you to take 2 things into consideration.

First, be kind to yourself.

Lifestyle and behaviours changes are difficult and can feel overwhelming. Pick one or two easy sleep hygiene suggestions that you are excited to try and go from there. 

Second, there is NO such thing as PERFECT sleep hygiene.

NO ONE does it perfectly. Some nights you’ll be spot on, and other nights you won’t.

That is okay. Simply do your best the following nights.

What is sleep hygiene?

Sleep hygiene refers to behaviours that are either beneficial or detrimental to our sleep. We hope that by modifying these behaviours we can potentially improve sleep quality and duration (1).

Off the top of your head, can you think of any behaviours you engage in on a regular basis that either has a negative or positive effect on your sleep?

Can’t think of any?

At the end of this post, you will find the  “Sleep Hygiene Index”.

Simply answer the questions and find out your sleep hygiene score. It is scored out of 52; high scores are indicative of poor sleep hygiene.

Why is sleep hygiene important?

Studies have shown that good sleep hygiene is an important predictor of sleep quality (4).

How does sleep hygiene work?

Sleep hygiene helps to maintain or restore our circadian rhythm.

As we discussed in part one, the circadian rhythm (our biological clock) dictates virtually every biological and behavioural aspect of our being. It tells us when it is time to eat, drink, sleep and wake-up. 

Proper sleep hygiene is especially important for those who struggle with Circadian Rhythm Sleep Disorders (CRSD). However, those who struggle with other types of sleep disorders might also benefit from proper sleep hygiene. 

Simply put, sleep hygiene reinforces the message that our biological clock is sending to our body – that it’s time for bed. 

Now let’s get to the good stuff.

Be consistent with your sleep and wake schedule

As much as possible.

Go to bed at a consistent time every night and wake up at the same time every morning. Even during weekends! As we mentioned above, the circadian rhythm is the key player when it comes to our sleep and it requires consistency. 

Imagine that you were responsible for preparing dinner in your home every night. Now imagine that your family never told you when they would arrive for supper. Some nights they arrive at 5 pm other nights at 9 pm or even 12am! You would never know what time to prepare the meals for. 

The same goes for your circadian rhythm. If your sleeping schedule is erratic, your circadian rhythm will not know when it should start sending your body the appropriate signals for bedtime.

Create your sanctuary

We spend on average 8 hours per day in our bed. That’s 2,920 hours per year!! Since we spend so much time in our bedroom and in our bed it is important that it be comfortable, soothing, relaxing and conducive to sleep. 

Our bedroom especially our bed should be a work-free, stress-free, and entertainment-free (especially a T.V. free) zone.

And, as much as possible, should only be used for 2 things: sleep and sexual activity

Here are a few things to consider when  creating your sanctuary.

Mattress and Pillow Talk

Most people understand that a good quality mattress is important for sleep. However, did you know that “many pillows and mattresses are made from synthetic materials like petroleum-based polyester or polyurethane foam” (6)? 

Don’t throw out your mattress yet. You can use a mattress protector or topper made from wool, organic cotton or natural rubber to  create a barrier between you and a polyurethane foam mattress. Toppers are also a great way to increase comfort if buying a new eco-friendly mattress is not possible. 

Did you know that wool naturally repels dust mites and natural latex foam is fire-resistant (6). If you’re in the market for a new mattress, why not choose an eco-friendly mattress that is safe for you and our planet. Visit David Suzuki’s “How to pick eco-friendly pillows and mattresses” for more information. 

As much as possible, choose sheets, pillowcases and comforters/duvets that are made with organic materials. It’s common knowledge that we should try to eat as much organic produce and animal products as possible in order to reduce our exposure to toxic chemicals like glyphosate.

Unfortunately, we forget that crops like cotton (which is used in clothing, tampons and linens)  can be just as heavily sprayed with pesticides and herbicides and can be just as harmful. Since organic bed sheets like organic produce tend to be more expensive, I suggest keeping an eye out for sales.

Declutter

Your bedroom can’t be your relaxing and cozy sanctuary if it’s dirty, cluttered and generally dishevelled.

It’s time to “Marie Kondo” your bedroom!!

No time? At the very least move the clutter to another room and deal with it later. Since you’re moving stuff anyway, might as well move the T.V. out of your bedroom too.

Let there be light darkness!

Exposure to light in the evening can trick our brains into thinking it’s daytime and consequently, suppress the secretion of our sleep hormone, melatonin (5). Dimming the lights in your house and bedroom, a minimum of 1 hour before bed is a great way to signal your brain that it’s time for rest. 

As much as possible block any outside light in your bedroom. Blackout curtains can be very helpful, however, something as simple as a sleep mask can be just as effective. Sleep masks are also helpful for those who have a partner who goes to bed later or wakes up earlier than them. 

Conversely, light exposure within 1 hour of waking for 20-30 min in the morning is very beneficial for supporting our waking AND sleeping schedule.

Some individuals might benefit from using a lightbox, also known as a SAD (seasonal affective disorder) light during the winter months when sunlight exposure in the morning is non-existent.

Electronics and blue-light

Reducing, preferably eliminating, your exposure to blue light 1 to 2 hours before bed is vital. This includes ALL electronics. The blue-light that our electronics emit is quite similar to sunlight, as a result, it can trick our brains into thinking it’s daytime. 

Blue-light blocking/filtering glasses and special bulbs that filter out the light that disrupts melatonin production can also be helpful. Parents and children could also benefit from using these special bulbs during nighttime nursing & diaper changes, bedtime reading, and as a night light. 

In addition, I highly recommend charging and storing ALL of your electronics outside of the bedroom.

If you use your cellphone as an alarm clock consider using a traditional alarm clock. There is some evidence that suggests that high-frequency electromagnetic fields could potentially impact sleep by suppressing REM sleep (7).

I recommend finding an alarm clock that uses light-cues, vibrations and soothing sounds instead of a blaring beeping sound. 

Shhhhhhh!

Our relationship with nighttime sounds is a complicated one. For example, some sounds we consider disruptive (e.g. snoring), while others are comforting and even sleep-inducing (e.g. cicadas).

Sometimes a room that is “too-quiet” can have a similar negative impact on our sleep as a noisy room.

If you are having issues with noise consider using a white noise machine or earplugs. Many things can be used as a white noise machine. The key is that it produces a consistent sound; that way your brain can eventually tune it out. For example, a ceiling or floor fan can easily be used as a white noise machine. A white noise machine can be especially beneficial for those who sleep next to a snorer.

Smell

Our sense of smell is one of our most potent senses and can easily impact our mood and state of alertness. Diffusing calming essential oils in your bedroom, like lavender and chamomile can help you unwind and prepare for sleep.

Temperature

Temperature is also important for proper sleep. Our bedrooms should be moderate-to-cool in temperature.

Create your nighttime routine

Creating an environment that is conducive to sleep is very important. However, creating a night time routine can be even more impactful on your circadian rhythm and your sleep. 

Try incorporating a basic night time routine like this one:

1. One to two hours before bed, turn off ALL electronics such as your cell phone and television.

2. Dim all the lights in the house. 

3. Get ready for bed e.g. wash, change into your pajamas etc…

4. Engage in a relaxation practice, for example: 

• Deep breathing and meditation 
  • https://www.meditationoasis.com/podcast
• Journaling
  • The 5-min journal 
  • Gratitude journaling 
• Gentle yin yoga or stretching. No strenuous exercise at least 1 hour before bed. 
  • http://yogawithadriene.com  
  • https://www.yogawithkassandra.com
• Read a book
• Draw in a colouring book
• Knit

5. Turn on your essential oil diffuser, put on your mask and go to sleep.

The wrap-up

A study from 1986 found that “insomniacs” had more general sleep hygiene knowledge than good sleepers, but practised it less often (2). Despite being over 30 years old, I think that these results likely still hold true. Simply knowing this information won’t magically improve your sleep, you actually need to practice it. 

Thank you for reading!

Stay tuned for the final part of this sleep series where we will discuss natural therapies that can be helpful for sleep issues. 

Sleep Hygiene Index Items (3)

Rate the following behaviors on the following scale :

Never = 0	Rare = 1
Sometimes = 2	Frequently = 3
Always = 4

1. I take daytime naps lasting two or more hours.
2. I go to bed at different times from day to day.
3. I get out of bed at different times from day to day.
4. I exercise to the point of sweating within 1 h of going to bed.
5. I stay in bed longer than I should two or three times a week.
6. I use alcohol, tobacco, or caffeine within 4 h of going to bed or after going to bed.
7. I do something that may wake me up before bedtime. For example, do you play video games, use the internet, or clean?
8. I go to bed feeling stressed, angry, upset, or nervous.
9. I use my bed for things other than sleeping or sex. For example, do you watch television, read, eat, or study?
10. I sleep on an uncomfortable bed. For example, do you have a poor mattress/pillow, or have too much or not enough blankets?
11. I sleep in an uncomfortable bedroom. For example is it too bright, too stuffy, too hot, too cold, or too noisy?
12. I do important work before bedtime. For example, do you pay bills, schedule, or study?
13. I think, plan, or worry when I am in bed.

**The score is out of 52. Higher scores are indicative of more maladaptive sleep hygiene status

Disclaimer

The information presented in this blog is NOT intended to prevent, diagnose or treat any disease.

The suggestions and ideas presented are for information only and should NOT be interpreted as medical advice.

The information in this document does NOT replace the services or instructions of a medical doctor or naturopathic doctor. Please consult your health care provider before beginning any new protocols.

Resources

1. Michael L. Perlis, … Wilfred R. Pigeon, in Principles and Practice of Sleep Medicine (Fourth Edition), 2005
2. Lacks, P., & Rotert, M. (1986). Knowledge and practice of sleep hygiene techniques in insomniacs and good sleepers. Behaviour Research and Therapy, 24(3), 365–368. doi: 10.1016/0005-7967(86)90197-x
3. Mastin, David & Bryson, Jeff & Corwyn, Robert. (2006). Assessment of Sleep Hygiene Using the Sleep Hygiene Index. Journal of behavioral medicine. 29. 223-7. 10.1007/s10865-006-9047-6. 
4. Lebourgeois, M. K. (2005). The Relationship Between Reported Sleep Quality and Sleep Hygiene in Italian and American Adolescents. Pediatrics, 115(1), 257–265. doi: 10.1542/peds.2004-0815h
5. Tähkämö, L., Partonen, T., & Pesonen, A.-K. (2018). Systematic review of light exposure impact on human circadian rhythm. Chronobiology International, 36(2), 151–170. doi: 10.1080/07420528.2018.1527773
6. How to pick eco-friendly pillows and mattresses. (n.d.). Retrieved March 16, 2020, from https://davidsuzuki.org/queen-of-green/picking-eco-pillow/
7. Mann, K., & Röschke, J. (1996). Effects of Pulsed High-Frequency Electromagnetic Fields on Human Sleep. Neuropsychobiology, 33(1), 41–47. doi: 10.1159/000119247