Worth the Work: Healthy Habits and Practices for Good Sleep

by Lisa Green, LPC-MHSP, Executive Director

There are many daily practices that support our health and wellbeing- both physical and emotional- but few can impact our health as profoundly as sleep. For something that we spend a quarter to a third of our lives on, sleep can be a real struggle for many of us. Especially under stress, or at other times of life changes across a range of circumstances- from big life transitions to jet lag, pregnancy, menopause or other health events- quality rest is often the thing that suffers. And when our sleep suffers, so do we! In fact, sleep and mental health influence each other in both directions. Stress, anxiety, depression, and trauma can disrupt sleep, and poor sleep can make each of those conditions harder to manage. Supporting healthy sleep is an important part of promoting well-being.

For something so important to our health, it can be easy to get off track with the habits and practices that enable our best chances at good sleep- some of which are intuitive, and some less so. Utilizing the available research, we can also learn practices that improve our chance of falling and staying asleep. And while sleep can’t be forced, we can do our best to create the conditions that will promote it well.

Circadian Rhythms

We set the stage for quality sleep with support for our internal body clock, otherwise known as the circadian rhythm. These practices help regulate the systems throughout the brain and body that enable our overall health and daily functioning, including sleep.

Early light exposure– Creating conditions for good sleep can start as soon as you wake up in the morning! Upon waking, it’s ideal to expose your eyes to sunlight, outside. Without getting too technical- light reaching specialized cells in the retina signals the brain’s master clock, helping regulate daily rhythms in alertness, hormone release, body temperature, and the timing of melatonin production later that evening. Regular exposure to natural daylight is also associated with improvements in mood, alertness, and overall health. For those of us that live in climates that lose a lot of daylight during the winter and see how it affects our moods, that’s easy to believe.

The amount of time needed depends on your environment and light brightness. Looking towards (not at) early morning sun on a sunny day may only require 5-10 minutes to be effective. Indirect/shaded viewing may take 10-20 minutes. On very cloudy days, 30+ minutes is more ideal. Realistically, any natural light exposure early in the day is good, and will benefit your health and help set your circadian rhythm.

Have a regular eating schedule. The more you can set your system up with a predictable rhythm, including mealtimes, the more consistent the signals your circadian clock receives, and good rest can be a benefit of that regularity. Large meals right before going to bed may interfere with good rest for some people, especially if you suffer from reflux or indigestion.

Exercise is great way to use energy, reduce stress, improve your mood, and maintain physical health that contributes to quality sleep. And though a workout any time in the day (except the last 2-3 hours before bedtime) is good for your sleep, doing it at a regular time is a way to cue your body’s internal clock.

Avoid caffeine later in the day. Because of caffeine’s long half-life, many sleep specialists recommend avoiding caffeine within eight to ten hours of bedtime. Caffeine blocks adenosine receptors, and adenosine is part of what makes you sleepy. Additionally, because of the long half-life, caffeine can interfere with the quality of sleep you get- so even if you’re able to drink a coffee at 8PM and fall asleep at 11PM, the caffeine may still be affecting the quality of your rest. If you find you have a late afternoon slump that you would normally treat with caffeine, try a short walk and more sun exposure instead, a nap that lasts less than 20 minutes, or another physically stimulating activity.

Start limiting your exposure to light by early evening, and particularly any bright light, including from a screen or overhead lighting. If possible, limit screen use in the hour or so before bedtime, more so if the content is stimulating. Dimming the lights in your home in the evenings is good practice- try a few lower intensity bulbs in lamps, rather than bright overhead light, as your photoreceptors can especially be disrupted by overhead light. Limiting this light exposure tells your brain to secrete melatonin, a natural hormone that enables you to fall asleep.

Have a bedtime routine to start signaling your system that it’s time to wind down; about an hour before bedtime you can do a few simple things to send those cues to your body. Your hygiene and skincare routine, a warm bath or shower, some stretching, deep breathing, meditating or any other relaxing activity are all good ways to use the time before bed- and off your screen- to prep for sleep. This is also the time your body is starting to naturally lower your temperature to fall asleep, and a warm shower or bath can naturally aid you to cool down (counterintuitive, I know- but research backs it up).

Now it’s time for bed, and your circadian clock knows it. Here’s how to set the scene for a great sleep.

Keep a regular sleep/wake schedule. Try to go to bed around the same time (within 30-60 minutes), and get up around the same time every day, including weekends, to maintain a healthy sleep rhythm. If you go to sleep later one day for unavoidable reasons, still try to get up within the same normal wake time. While an occasional extended sleep won’t do you any harm (and possibly much good), the goal is overall consistency.  

Keep your room cool. The core temperature of your body naturally drops a few degrees when asleep and a cool room helps support your natural nighttime temp. It can depend on what you are adapted to, but most experts recommend a room temp between 15 and 19 degrees Celsius (60 to 67 F). Of course, getting too cold when asleep can disrupt your Zzzz- so covering up under a blanket is fine. You may have a partner with different temperature needs and can consider the Scandinavian practice of having separate duvets, so each of you have a cover that suits your own comfort.

Keep it dark and quiet. Light can set the stage for good sleep, but falling and staying asleep takes being in the dark. Bright or ongoing light at night or too early in the morning and intermittent noise can signal to your brain that it’s time to become more alert, making it harder to stay asleep. Use an eye mask or ear plugs to create a dark, quiet environment if needed, or a white noise machine or app to block out excess noise. These are helpful especially when traveling, and you’re less in control of your environment.

Don’t do a lot of extra things in your bed. To cue your brain that it’s time to sleep when you climb into bed, avoid doing a lot of other stimulating things there like working on your computer, scrolling social media, etc. If you like reading before bed, choose something relaxing rather than very engaging- for instance, this is likely NOT the time to read the news.

Understand that sleep happens in cycles, and includes different stages throughout the night. For instance, deep sleep, which is important for our physical restoration, usually happens in earlier cycles. REM and light sleep happen throughout the night, and each of these are important for our mental recovery and feeling rested. You may have heard of 90-minute cycles, and though they typically vary more than that in reality (more like 80-110 min), most adults need about 7-9 hours of sleep to move through enough cycles.

Trouble falling and staying asleep

Having trouble falling and/or staying asleep can be incredibly frustrating when you know you’re tired and still unable to drift off. This can be a combination of different things, and many of the hygiene tips above should help address core issues that may keep you from sleep- from temperature and timing, to calming and readying your brain and body for bedtime in the right ways. One poor night’s sleep rarely ruins the day as much as we fear, and the frustration and anxiety we feel about poor sleep may be more disruptive than the actual loss of sleep. Nonetheless, when you’re lying in bed awake and wishing you were asleep, here are some things to try.

• Don’t keep looking at the clock. Often, when we realize we’re not falling asleep (but I’m so tired, why not??) we keep looking at the clock, and calculating the dwindling amount of time we have left until morning. Ironically, this often makes us more anxious, which is counterproductive to falling asleep. Instead, give your brain something else to focus on that is less stimulating and anxiety producing such as:
• Deep breathing exercises. This can calm both your brain and body. If both are too stimulated or active to let you fall asleep, focusing on a breathing exercise even for just a few moments can bring enough calm and quiet to help you drift off. 
• Progressive Muscle relaxation exercise. In the same way, giving your brain something calming to focus on, and taking steps to release physical tension can help you relax enough to sleep.
• Listen to a low-key audiobook set on a timer, or a sleep meditation like the ones on the Abide Meditation app (also available on YouTube at https://www.youtube.com/@AbideMeditationApp)
• Don’t force it. If after trying these, you’re still not able to drift off, instead of tossing and turning get out of bed and do something else (still in dim light, and not overly stimulating- do NOT pick up your phone). Do this for a period of time, until you feel sleepy and ready to try again.     

Supplements, like melatonin, which has the best research for jet lag or circadian rhythm support, or other (less researched) supplements that are popular like magnesium, glycine, and l-theanine can be helpful, particularly for short term sleep issues, or during periods of disruption. It’s important to note that in most countries, supplements are not regulated as strictly as prescription medications, so product quality can vary considerably.

Sleep medication can be very helpful in some situations, but many experts recommend using them as a short-term aid while addressing the underlying causes of insomnia whenever possible. Always consult a knowledgeable physician about any sleep medication, even over the counter aids, especially when using long-term because of the potential risks for dependence and side effects.

If the problem is persisting, and significant sleep problems occur at least three nights a week for three months or more, cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment by major sleep medicine organizations. CBT-I teaches practical techniques for changing behaviors and thoughts that interfere with sleep and has been shown to be at least as effective as sleeping medications in the short term, and even more effective in maintaining good sleep over time.

When should I see a doctor? If you experience the following regularly, then it is worth discussing these symptoms with a healthcare professional, as they may indicate a treatable sleep disorder:

• snore loudly
• stop breathing during sleep
• wake gasping
• have severe daytime sleepiness (even with sufficient sleep time)
• have restless legs
• act out dreams
• have insomnia lasting more than three months despite steady sleep habits

Good, or even great sleep isn’t about achieving perfection every night- everyone has occasional restless nights, especially during stressful seasons of life. The goal is not to sleep perfectly, but to build consistent habits that give your body and mind the best opportunity to rest. Small, consistent changes- such as getting morning light, keeping a regular wake time, reducing evening stimulation, and using relaxation practices to help when you can’t sleep- can have meaningful benefits not only for your sleep, but also for your mental health, resilience, relationships, and overall well-being.

Want to take a deeper dive? Explore these resources for more information:

Sleep Education: https://sleepeducation.org/

National Sleep Foundation: https://www.thensf.org/

“The Insomnia Coach” app (based on Cognitive Behavioral Therapy for Insomnia (CBT-I))

Why We Sleep, by Dr Matthew Walker

Beyond Tired: A Sleep Physician’s Guide to Solving Your Child’s Sleep Problems for Good, by Dr Funke Afolabi-Brown