SLEEP

Most of us can benefit from better sleep hygiene. Sleep environment, afternoon and evening activities, coping behaviors, and sleep routine are all part of good sleep hygiene.
1) Maintain a regular sleep schedule:
 Go to bed and wake up close to the same time each day, even on weekends and holidays. This should help regulate your body’s clock, enhance the quality of your sleep-wake time, and give you the best chance of waking refreshed.
2) Preparing the mind for sleep:
 If you are worried, get out of bed. Write down your worries, make a list, and put it aside. The bed is a place for rest, not worry.
 Wait until you are sleepy before going to bed. If you’re not sleepy at your regular bedtime, try to relax your body and distract your mind.
 If you’re worried about getting your work done, make a to-do list for the next day to ensure you have enough time to accomplish what needs to be done. Once the chores that cause stress are down on paper, your mind can relax and think more pleasant thoughts.
 Unglue yourself from false or anxious beliefs about sleep, such as the idea that a single restless night will make you sick.
 Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don't dwell on or bring your problems to bed.
 Practice relaxation techniques before bedtime such as deep breathing and visualization of a soothing scene. Try listening to soothing music.
3) Preparing the body for sleep:
 Avoid caffeine after lunch. The effects of caffeine may last for several hours after ingestion. Caffeine is a stimulant and reaches its peak effect in the first hour but with a half-life elimination of 3-7 hours. Caffeine is a potent sleep inhibitor, and it increases sleep latency, night waking, decreases total sleep time, decreases slow-wave sleep, and impairs overall sleep quality
 Take a warm shower or bath about 90 minutes before bed. A hot bath will raise your body temperature, and it is the drop in body temperature that helps make you feel sleepy.
 Avoid blue light, exciting books, movies, or TV for at least an hour before bed. Can use blue blocker glasses or a blue light filter on computers or phones. Also, you can shift the lighting at night to a dimming mode or red light to prepare for sleep.
 Don’t go to bed hungry or full. Have a light snack before bed. If your stomach is too empty, that can interfere with sleep. However, if you eat a heavy meal before bedtime, that can interfere as well.
 Avoid alcohol of any type within six hours of your bedtime. Alcohol creates the illusion of good sleep, but the architecture of sleep is affected adversely. Sleep is fragmented with deep sleep initially and a rebound of REM sleep later. Alcohol invariably makes your heart rate increase significantly for several hours into sleep.
 Do not smoke or ingest nicotine within two hours of your bedtime.
4) Sleep hygiene during the day:
 Ensure adequate exposure to natural light during the day. Light exposure helps maintain a healthy sleep-wake cycle.
 Sunlight exposure immediately upon waking helps set circadian rhythms.
 Purists believe watching sunrises and sunsets greatly helps regulate sleep patterns and gives greater exposure to beneficial redlight
 Exercise regularly but avoid strenuous exercise within six hours of your bedtime. Exercise promotes restful sleep. However, rigorous exercise close to bedtime circulates endorphins into the body which may cause difficulty initiating sleep.
 Avoid naps if possible. If you have to take a nap, try to keep it to less than one hour and avoid taking a nap after 3 p.m. Naps decrease the ‘Sleep Debt’ that is so necessary for easy sleep onset. Taking naps decreases the amount of sleep we need the next night – which may cause sleep fragmentation and difficulty initiating sleep and may lead to insomnia.
5) Your sleeping area:
 Remove all TVs, computers, and other “gadgets” from the bedroom.
 Use your bedroom only for sleeping and sex (if that’s right for you). The bedroom, and more importantly the bed, is not a place for watching TV, eating, chatting, working, etc.
 Keep your bedroom quiet, dark, and cool. Use curtains or blinds to block out light
 If noise bothers you, consider wearing earplugs or using deep sleep music, a fan, or a "white noise" machine to block out noise.
 If you are a clock watcher at night, hide or get rid of the clock.
 If unavoidable light still bothers you, use a sleep mask and earplugs.
 It is well-studied that a cold room will help enhance sleep by improving the ability to fall and stay asleep. The optimal temperature is 65-68 degrees. You can use cooling sheets, overlays, etc.
6) If having persistent difficulty falling asleep:
 If you are not asleep after 20 minutes, leave your bedroom and find something to relax you enough to help make you sleepy. Don’t stay in bed awake for more than 5-10 minutes. This is called sleep restriction. Lying in bed when you're awake can become a habit that leads to poor sleep. Limiting the amount of time, you spend in bed can make you sleepier when you do go to bed. That way you're more likely to fall asleep and stay asleep.
 If you find your mind racing, or worrying about not being able to sleep during the middle of the night, get out of bed, and sit in a chair in the dark. Do your mind racing in the chair until you are sleepy, then return to bed. No TV or internet during these periods! That will just stimulate you more than desired.
If this happens several times during the night, that is OK. Just maintain your regular wake time and try to avoid naps.
 Sit quietly in the dark. Don't expose yourself to bright light while you are up. The light cues your brain that it is time to wake up.
 Avoid remaining passively awake. This involves avoiding any effort to fall asleep. Paradoxically, worrying that you can't sleep can actually keep you awake. Letting go of this worry can help you relax and make it easier to fall asleep.
 Try keeping a sleep diary. Write down when you go to bed, when you get up, how much time you spend in bed unable to sleep, total sleep time, and other details about your sleep patterns.
7) Supplements:
 Magnesium. Multiple forms of magnesium can be confusing. For sleep, the best options are threonate and glycinate, which should be taken an hour or more before bedtime. Dose Magnesium Threonate at 200-400mg.
 Apigenin- from chamomile, 50mg nightly.
 Tart Cherry- helps promote melatonin availability and provides tryptophan. Drink before bedtime or take as a supplement.
 Melatonin- Micro doses of melatonin can be beneficial, but higher doses than 3mg can wreak havoc on brain neurotransmitters. Best used in small doses or limited to when traveling as a great way to beat jetlag.
 Valerian root- helps relax and promote sleep at 300-600mg prior to sleep.
 L-Theanine- use 200mg to 400mg nightly.
 Glycine- use 2g every 3rd or 4th night.
 Inositol- as an add-on if needed at 900mg 45 minutes prior to sleep for sleep and cognition
 Seditol- use 365mg tablet 1 hour before bedtime to help sleep and slow down an active brain.
 If able, avoid prescription sedatives that negatively affect sleep architecture, such as Ambien, Lunesta, and the more addictive benzodiazepines. All of which have been shown to cause dementia. Trazodone seems to be the safest prescription agent.
8) Sleep Trackers:
 Highly recommend sleep trackers such as the Oura Ring. I feel this is the best tracker that accurately breaks down sleep into stages and gives insights into sleep latency, sleep duration, HRV, temperature, Oxygen saturation, and heart rate.
 Other trackers that are worth trying include the Whoop, Apple watch, and Sleep beds.