University Teaching Trust Sleep hygiene Turnberg Building Department of Respiratory Medicine 0161 206 3158 All Rights Reserved 2016. Document for issue as handout.
Nothing is more frustrating than not being able to sleep. Tossing and turning. Your mind is racing, going over everything that happened today. Night noises keep you awake. What can you do? There ARE things you can do! Read on and learn some new tricks to sleep well. These tips are also known as Sleep Hygiene. When is the best time to go to bed? Even if you are retired or not working, it is important to a have a regular bed and waking time. Whether you are an early riser or a night owl, fix a regular bed-time and wake-up time, even on weekends. You should lay in bed only when you are sleepy. If you haven t fallen asleep in 15-30 minutes you should get up and go into another room, listen to some relaxing music, read or do something boring until you feel sleepy. This limits the time you are in bed trying hard to sleep. Try to avoid any bright lighting as this will wake you up. Try to avoid having naps during the day. If you sleep during the day you will find it harder to sleep at night. Many people have a sleepy time in the late afternoon. If you do find you need a nap then, only have a maximum of 30-45 minutes. How should I get myself ready for sleep? Create a good bed-time routine- a warm bath, a light snack (such as warm milk and foods like turkey and banana which are high in the amino acid tryptophan which naturally helps make you sleepy), practice relaxation techniques such as deep breathing. Take regular exercise - this can help make you sleep deeper, but don t do any strenuous exercise less than 2 hours before bedtime as this can make it harder to sleep. 1
What if I worry a lot when I am trying to sleep? If you spend a lot of time thinking over the things that have happened today and what might happen tomorrow or what you have to do tomorrow it is hard to fall asleep. Set aside a time in the evening to deal with these issues. It may be helpful to write them down, especially if you have something important to remember. Then you can forget about them until morning. What is the best sleep environment? Your bedding should be comfortable. Make sure your mattress is not too hard or too soft. Cotton sheets tend to be more comfortable than polyester. Make sure your bedroom is the right temperature and well ventilated. A temperature of 16-20 C is ideal, together with enough blankets or duvet to keep you warm. It is hard to sleep in a bedroom that is too hot or too cold. Block out distracting noise. If noises bother you, you could try ear plugs or a white noise machine (white noise Apps are available on most smart phones). Some people find listening to quiet music also helps. Block out as much light as possible. You could use a block out shade or wear a slumber eye mask. Try not to have alarm clocks or other devices with bright LEDs. This will also mean you are less likely to clock watch if you cannot see the time. Keep the bedroom for sleep and sex. Therefore do not have a TV or any work related items in your bedroom. Do not use the bedroom for other activities such as work, study or watching TV. Many people fall asleep watching TV in their room. However, TV can be very engaging and can keep you awake longer than you should be. Being over-tired can make it difficult to sleep. At the set bedtime the TV should be turned off and you should go to bed. If you keep your bedroom only for sleeping when you go to bed your body knows it is time for sleep. What things should I not do before bed? You should not have caffeine, alcohol or nicotine 4-6 hours before bedtime. Caffeine and nicotine are stimulants which wake you up, and make it harder for you to sleep. Some drugs contain caffeine or nicotine, so read the information leaflet or ask your doctor about your medications. Caffeine is found in drinks such as coffee, tea, cola and other fizzy soft drinks as well as chocolate. Although alcohol can make you feel sleepy and drift off to sleep easily, as the levels of alcohol in your blood start to fall, there is a wake-up effect which can lead to a broken sleep pattern. Heavy, spicy or sugary foods can make it harder to sleep. Try not to eat them less than 4-6 hours before bedtime. What should I do in the middle of the night? Most people wake up one or two times a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed trying hard to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, practice relaxation exercises or take a bath. You will generally find that you can get back to sleep 20 minutes or so later. Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television. 2 3
What other things can affect my sleep? Several physical factors are known to upset sleep. These include pain and discomfort from conditions such as arthritis, acid reflux with heartburn, menstruation, headaches and hot flushes. Psychological and mental health problems like depression, anxiety and stress are often associated with sleeping difficulty. In many cases, difficulty staying asleep may be the only sign of depression. Discuss psychological or physical issues that may be affecting your sleep with your doctor. Use sunlight to help set your biological clock. As soon as you get up in the morning, go outside and turn your face to the sun for approximately 15 minutes. This will lower the brain s production of a hormone called melatonin, which is the hormone that makes you sleepy. Many medications can cause sleeplessness as a side effect. Ask your doctor or pharmacist if medications you are taking can lead to sleeplessness. To help overall improvement in sleep patterns, your doctor may prescribe night sedation ( sleeping tablets ) for shortterm relief of a sleep problem. The decision to take sleeping aids is a medical one to be made in the context of your overall health, and should be regularly reviewed with your doctor. Always follow the advice of your doctor and other healthcare professionals. The goal is to rediscover how to sleep naturally. If you require further information please ring us on: 0161 206 3158 or visit the: British Thoracic Society website: www.brit-thoracic.org.uk or the: British Lung Foundation website: www.lunguk.org You can also contact: NHS Direct www.nhsdirect.nhs.uk NHS 111 Service when less urgent than 999 111 Notes 4 5
G16110103W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2016 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: MED 69 (16) Review Date: December 2018 University Teaching Trust For further information on this leaflet, it s references and sources used, please contact 0161 206 5154. Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. Email: InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on 0161 206 1779 Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone 0161 789 7373 www.srft.nhs.uk If you would like to become a Foundation Trust Member please visit: www.srft.nhs.uk/ for-members If you have any suggestions as to how this document could be improved in the future then please visit: http://www.srft.nhs.uk/ for-patients