Sleep Soundly Every Night, Feel Fantastic Every Day (37 page)

Will you do what you can to champion your sleep health as an example to others? When someone compliments you on your vitality and positivity, tell them how well you sleep and how you changed what wasn't working for your rest. Remember that 70 million people need an example of your boldness to stop what isn't working and start learning how a night of deep, fulfilling sleep can improve health. While this is the conclusion of this sleep book, it is the first step in your journey to better sleep, calmer emotions, and excellent health. Sleep well!

 

 

Tools to support better sleep hygiene and to evaluate how you sleep:

Better Sleep Quick Reference

Attention Deficit Hyperactivity Disorder Checklist

 

 

Good sleep practices are necessary to have normal, quality sleep time, and full alertness during the day. I recommend these better sleep guidelines:

  
1.
 
Get up and go to bed at the same time each day.

      
This practice may be difficult at first, especially given our busy and often erratic schedules. Yet those scheduled activities for work, school, exercise, errands, and family also help to regulate your internal body clock's time to go to bed at the same time each night. Adhering to a sleep routine helps to regulate our circadian rhythm. Be sure to stick with the schedule on the weekend, too. Staying up until 3:00 a.m. on Saturday night and sleeping in on Sunday may throw off the rhythm you established throughout the week.

  
2.
 
Make your bedroom conducive to sleep.

      
Studies show that it is easiest to fall asleep in a cool, quiet, and dark environment. I recommend your bedroom temperature remain around 68°F. Be sure to eliminate as much noise and light as possible. If it gets too warm, make sure you adjust the temperature and use a fan or air conditioner so that the heat does not wake you up in the middle of the night.

  
3.
 
Keep the electronics out of the bedroom and don't use them right before sleep.

      
It is very important to avoid television, electronic games, and computers right before going to bed. In fact, they should be kept out of the bedroom altogether. These things stimulate the brain and make it much more difficult to fall asleep. Even the light of a computer screen can keep your brain from relaxing. The same is true of
your cell phone. Even if the ringer is off, the light from the phone or the sound of it vibrating can interrupt your sleep. The light hitting the retina suppresses the production of your sleep hormone melatonin.

  
4.
 
Avoid caffeine, alcohol, and nicotine four to six hours before bedtime.

      
It's not good enough to avoid that late night espresso. Any caffeine ingested in the late afternoon or early evening can affect your sleep. Remember that this stimulant is not only found in drinks such as coffee, soda, and tea, but it is also found in certain foods, such as chocolate.

         
Some people are surprised to learn that nicotine and even alcohol can disrupt sleep. While alcohol might make you feel drowsy initially, it just as easily interrupts the stages of sleep, even to the point where you get up in the middle of the night. As alcohol is metabolized and leaves your body, it causes a slight withdrawal characterized by an increase in activity of the sympathetic fight-or-flight nervous system and an elevation of the stress hormone cortisol.

  
5.
 
Take a power nap for 30 minutes.

      
If you are sleep-deprived at night, you might want nothing more than to lie down during the day. Taking naps disrupts the natural drive to sleep at night, so in reality, you will only be perpetuating the cycle of insomnia. If you must nap, then take a power nap of no more than 30 minutes and not after 4:00 p.m. Otherwise, naps will decrease your brain's drive for sleep that night.

  
6.
 
Remove the television from the bedroom.

      
Your bedroom should be a place for calmness and rest where you sleep or connect with your partner, only.

  
7.
 
Exercise each day, but avoid doing it four hours before bedtime.

      
Daily workouts have been shown to improve the quality of our sleep. But when you exercise within a few hours of bedtime, it will give you an energy boost that may prevent you from falling asleep. Exercising before sleep raises the core body temperature and elevates levels of cortisol and adrenaline, all of which prevent you from falling asleep.

  
8.
 
Create a healthy bedtime ritual.

      
Nightly relaxing rituals can help prepare the body and mind to get ready for sleep. Take at least 15 minutes at the end of each day to read a book, listen to relaxing music, or soak awhile in a warm bath.

  
9.
 
When you have trouble falling asleep, don't stress out.

      
Everyone has tossed and turned a few nights in their life. But if you are sleep-challenged, one of the worse things you can do is to force the issue. Eventually, you will associate bedtime with anxiety and that can actually make the problem worse. The best thing to do is to get up, go to another quiet area of the house, and try to relax. When you feel ready to fall asleep, then head back to the bedroom.

10.
 
Stop eating and drinking a few hours before going to bed.

      
You can be in the deepest sleep of your life, and still wake up from a full bladder. Also, if you have digestive problems such as heartburn or acid reflux, you are more likely to have an attack if you lie down so soon after eating.

11.
 
Ignore your to-do list.

      
Have you gone to bed and then suddenly remembered that important thing you forgot to take care of?
If you're one of those people who get out of bed to tackle the task, it's time to stop! Sleep must be your priority now. Realize that only so many things can get done in one day. Of course, if the task is important enough that
not
doing it will keep you awake, then take care of it as quickly as possible. Also, though recreation is important, be sure to limit any activities that would infringe on the new sleep schedule. Your first priority right now should be to get your sleep regulated, if only because being well-rested will enable you to enjoy your waking hours all the more.

 

 

If you believe that a child in your family may have attention deficit hyperactivity disorder (ADHD), this very simplified checklist provides the behaviors most observed in children who eventually receive this diagnosis. ADHD is one of the more common neurobehavioral disorders in which children have trouble paying attention, controlling impulsivity (i.e., they may act without thinking about what the result will be), and in some cases, are overly active. Please note that at least half of the symptoms should be observed in one child before sharing the results with your doctor. A child with ADHD might have the following symptoms:

  
1.
 
Has a hard time paying attention.

  
2.
 
Daydreams a lot.

  
3.
 
Does not seem to listen.

  
4.
 
Is easily distracted from schoolwork or play.

  
5.
 
Forgets things.

  
6.
 
Is in constant motion or unable to stay seated.

  
7.
 
Squirms or fidgets.

  
8.
 
Talks too much.

  
9.
 
May not be able to play quietly.

10.
 
Acts and speaks without thinking.

11.
 
Has trouble taking turns.

12.
 
Interrupts others.

 

 

Actigraphy
—monitoring a patient's rest and movement periods through a small actigraph, which measures gross motor activity, worn on the patient's dominant arm.

Advanced Sleep Phase Syndrome (ASPS)
—occurs when a person's “body clock” (i.e., circadian rhythm) is set to fall asleep very early in the evening. People who have ASPS tend to wake up very early, or in the middle of the night, and can't go back to sleep.

Antidepressants
—drugs used to treat moderate or severe depression.

Apnea
—complete cessation of airflow at the nose and/or mouth and lasting about 10 seconds.

Arousal
—a physiological and psychological state of being awake or reactive to stimuli.

Attention-Deficit Hyperactivity Disorder (ADHD)
—a common childhood, neurological disorder that can continue through adolescence and adulthood. Symptoms can include difficulty in staying focused, paying attention, controlling impulsivity, and hyperactivity.

Biological Clock
—the groups of cells that regulate biological rhythms of sleeping/waking, reproductive cycles, and other aspects of biological timing.

Central Sleep Apnea (CSA)
—a sleep-related disorder in which the effort to breathe is diminished or absent, typically for more than 30 seconds, either intermittently or in cycles called Cheyne–Stokes respiration, and is usually associated with a reduction in blood oxygen saturation.

Cerebral Cortex
—the brain's outer layer of gray tissue that is responsible for higher nervous and cognitive functions.

Chronic Insomnia
—a sleep disorder in which there is an inability to fall asleep or to stay asleep, or has early morning awakenings lasting at least three months and occurring a minimum of three days per week.

Chronobiology
—the biological study of natural cycles (solar, lunar) and how one's circadian rhythms adapt.

Circadian Rhythm
—24-hour periods or cycles of biological activity or function.

Circadian Rhythm Sleep Disorders
—circadian rhythm disorders are disruptions in a person's circadian rhythm—a name given to the “internal body clock” that regulates the (approximately) 24-hour cycle of biological processes. The circadian sleep disorders refer to a continuous or occasional disruption of sleep patterns.

Cognitive Behavioral Therapy (CBT)
—a psychotherapy approach that addresses dysfunctional emotions, maladaptive behaviors, and cognitive processes and contents. CBT refers to the combination of cognitive therapy and behavior therapy.

Cognitive Therapy
—therapeutic approach used for transforming faulty beliefs and attitudes about sleep, insomnia, and the next-day consequences. The goal is to control intrusive
thoughts at bedtime and prevent excessive monitoring of the daytime results of insomnia.

Complex Sleep Apnea (CSA)
—a form of sleep apnea in which central apneas persist or emerge during attempts to treat obstructive sleep apnea with a continuous positive airway pressure (CPAP) or bi-level BiPAP device.

Confusional Arousal
—a disorder associated with non-REM sleep in which a person appears mentally confused or demonstrates disoriented behavior during or following arousal, usually from slow-wave sleep.

CPAP
—continuous positive airway pressure, a method of respiratory ventilation used primarily in the treatment of sleep apnea.