Feinsinger column: Tips for better sleep

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The past several columns have been about sleep, based on the book sleep scientist Matthew Walker, PhD’s book “Why We Sleep.”  A third of Americans fail to get adequate sleep, which leads to mental and physical health problems, accidents, and poor school and work performance. Today’s column lists several tips for better sleep.

  1. Make sleep a priority by setting aside 7-9 hours every night for sleep.
  2. Go to sleep and get up at the same time every day, no matter what day of the week it is and how much you slept the night before.
  3. Exercise helps you sleep better as long as it’s not within 2-3 hours of going to bed.
  4. Avoid caffeine and nicotineAVOID CAFFEINE AND NICOTINE, which are stimulants with long half-lives. Keep in mind that chocolate contains caffeine.
  5. Avoid Alcohol in the evening, because it hampers REM (rapid eye movement) sleep. It can also affect breathing, and as it wears off during the night it causes awakening.
  6. Avoid large meals late at night.
  7. Avoid fluids after 6 or 7 p.m., because evening fluids lead to waking up to empty your bladder.
  8. Avoid prescription or over-the-counter medications that can interfere with sleep — there are many, so check with your pharmacist or PCP.
  9. Naps are fine but not after 3 p.m.
  10. Relax for at least an hour before bed to unwind.
  11. Avoid screens for at least an hour before bedtime, including cell phones, tablets, and computers (TV screens are okay as long as they’re dim and what you’re watching isn’t disturbing).
  12. Avoid bright lights and especially LED blue light for at least an hour before bed, because they interfere with melatonin and other sleep-inducers. Make sure you don’t turn on bight lights to brush your teeth right before going to bed.
  13. Keep your bedroom dark, cool and gadget-free. Ideal temperature is around 64 degrees. Use an eye mask and ear plugs if necessary. Use a comfortable mattress and pillow.
  14. Take a hot bath before bed. The drop in body temperature when you dry after bathing helps you feel sleepy.
  15.  Sunlight exposure is important to support natural circadian rhythms. Wake up with the sun, or use very bright lights in the morning. Try to get outside in natural sunlight for at least thirty minutes every day—60 minutes of early morning sunlight is particularly important if you have difficulty falling asleep.
  16. Don’t lie in bed awake. If you can’t sleep, don’t watch the clock—get up and do something relaxing using a dim light until you feel sleepy.
  17. Don’t let yourself fall asleep watching TV, because if you do it will interfere with good sleep during the night.
  18. Sleep apnea? If you snore, if you are told you sometimes stop breathing while sleeping, if you don’t feel refreshed upon awakening in the morning, or if you feel sleepy during the day, talk to your PCP about getting a simple overnight oximetry to screen for sleep apnea.
  19. Special tip for the elderly:  As people age their circadian rhythms change and they start producing the “sleep hormone” melatonin earlier in the evening. They then end often falling asleep watching TV, resulting in poor sleep during the night. According to Dr. Walker, “Plentiful late-afternoon daylight will help delay the evening release of melatonin, helping push the timing of sleep to a later hour.” Prescription melatonin also helps this age group—in contrast to younger age groups for which melatonin is usually not helpful.

Next week’s column is the last in this series on sleep, and will be about the pros and cons of sleep aids.

Dr. Greg Feinsinger is a retired family physician who started the non-profit Center For Prevention and Treatment of Disease Through Nutrition. For questions or to schedule a free consultation about nutrition or heart attack prevention contact him at gfeinsinger@comcast.net or 970-379-5718.