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Listening to Your Body
Perform a simple sleep test. It may take more than one night to determine the results of this test. The next opportunity that you have to “sleep in” for a few days is your chance to perform this test. You may need several nights in a row to get the best results. Step one of the test is to go to bed at a reasonable time. If you are looking for a time when you can sleep in, then that probably means it’s a week-end or a series of days that you have off from your work or school. For the test to work, you have to resist staying up later than normal since you can “sleep in” the next day. Get accurate results from the test by sticking with a routine bedtime each night. Next, do not set an alarm clock. Sleep until you wake up naturally. If you are like most people, you will probably sleep a long time that first night, maybe even 16 hours or more. This is because you are in a situation called sleep debt. If you have a serious sleep debt, then you may have to deal with that before you can get the best results from this test. If your sleep debt is not substantial, then proceed with the test. Keep in mind, it can take 4-5 days to fully repay a sleep debt. After the first night of longer than average sleep, continue with the same bedtime, and avoid setting an alarm. After a few days you will wake up at about the same time every day naturally. Now you know how many hours of sleep your body needs every night. If you have gotten enough sleep, you should be alert and capable of doing monotonous activities without becoming sleepy.
Pay back your short-term sleep debt. Sleep debt occurs when you fail to get the amount of sleep your body needs, and it actually accumulates over time. You are borrowing minutes or hours every time you cut your night’s sleep a little short. This can occur in both the short term and over months. Staying up late for work, play, or study, then getting up with an alarm clock because you have to, is a set-up for adding to your sleep debt. Repay your short-term sleep debt by adding an hour or so to each night’s sleep, and take advantage of opportunities to sleep in or take a nap until you have paid back the amount of sleep you lost over a short-term. This means that you need to keep track of the hours of sleep you lost, therefore you need to know how much sleep you need.
Take a vacation for long-term debt. Longer term sleep debt accumulations may take several weeks, or even longer to pay back and get back on track. Take a vacation with nothing on your schedule, then go to bed at the same time every night and sleep every morning until you wake up naturally. Don’t beat yourself up for sleeping a lot during this vacation. Just pay back your sleep debt and get back on a regular schedule. Once you have repaid your debt and you stick to a regular bedtime, you will reach a point where you no longer need that alarm clock in the mornings. This is provided that your bedtime is early enough to allow your body to get the exact amount of sleep it requires. If you go to bed “early” for you, but you still are tired and have trouble waking up in the mornings, then try an even earlier bedtime. Not everyone fits in the realm of the number of hours considered normal. You may need to naturally sleep a little more. If earlier bedtimes do not help, then talk to your doctor. If you have worked at paying back your sleep debt and you still feel overly fatigued and exhausted during the day, then you may have an underlying medical problem or medication that is contributing to the problem. Make an appointment with your doctor to evaluate your persistent tired and fatigued feeling.
Prevent health problems by getting the amount of sleep you need. Understanding more about the symptoms associated with sleep debt is a great way to realize what happens when you deny your body the sleep it needs. A research study done by the University of Chicago followed a group of volunteers for six days that were only allowed to sleep four hours each night. After only six days of accumulating a sleep debt, the people in the study experienced high blood pressure, increased levels of the stress hormone cortisol, made only half the normal amount of antibodies to a flu vaccine, and developed early signs of insulin resistance, which is the first step in developing type 2 diabetes. Other symptoms observed in people with short-term sleep loss include difficulty concentrating, slower decision making, worsened vision, difficult driving, irritability, fatigue, and problems with memory. Researchers have also evaluated the symptoms developed in people that go for longer periods of time without getting enough sleep. These symptoms include obesity, insulin resistance, stroke, memory loss, and heart disease.
Recognize situations that change your sleep needs. Sometimes stress and physical changes can trigger the need for more sleep. Pregnancy is an example of a physical change that triggers an increased need for sleep, at least during the first trimester. Other situations that may cause your body to need additional sleep include illness, injury, intense physical exertion, difficult emotional situations, and intense mental tasks. Allow yourself a nap or a little extra sleep time at night to compensate for these stressors.
Identify your sleep needs by age. Many professional resources publish charts that provide guidelines for the general sleep requirements divided into age groups. As we get older, the number of hours of sleep we need each night lessen. The extreme ranges include newborns that sleep anywhere from 11 to 19 hours each 24 hours period, with 14 to 17 hours considered the average range, to adults over age 65 that sleep from five to nine hours each night, with the average being seven to eight hours. Realize that every person is unique and has additional factors that may cause him or her to fall outside the recommended ranges without labeling it as abnormal. For example, some people may be on medications or have underlying diseases that cause them to sleep more than the guidelines suggest.
Controlling Your Sleep Habits
Adjust your environment. Make the area where you sleep as comfortable and relaxing as possible. Start by controlling the temperature. Keep the bedroom at a comfortable and cooler temperature. Use your bed for sleep and sex only. Avoid using your bed for other activities, such as studying, reading, playing video games, using any device with a screen, and watching late-night television. Make sure your bedroom is quiet when it is time for sleeping, and as dark as possible. You may need to consider using window coverings to block out any light, and ear plugs or a fan to block out external noises. Be sure your mattress and pillows are comfortable and inviting. If you share the bed, be sure it is large enough to allow for both parties to be comfortable. Try to avoid allowing children and pets to sleep in the same bed. If you work a second or third shift, then follow the same guidelines. Try to keep as consistent a sleep and wake schedule as possible.
Pay attention to your eating habits. Eating a healthy diet helps your body to function more efficiently in all areas including a healthy sleep cycle, but there are some specific things you can do to help improve your sleep quality. Avoid heavy meals late at night and just before bedtime, and avoid going to bed hungry. Limit how much you drink in the evening to prevent frequent awakenings during the night to go to the bathroom. Limit your intake of caffeine throughout the day, and try to stop drinking caffeinated beverages by 2pm each day. Stop smoking or avoid smoking close to bedtime. Nicotine acts like a stimulant and can prevent you from falling asleep. Avoid consuming alcohol close to bedtime. The initial response to alcohol is to feel sleepy, but in a few hours it changes and acts like a stimulant which can cause you to have trouble sleeping.
Modify your activity throughout the day. This includes everything from exercise during the day to getting exposure to natural sunlight. Exercise according to the recommended guidelines, which include at least 150 minutes of aerobic activity each week. Keep your exercise routines during the daytime or early evening. Avoid exercising just prior to bedtime. The link between proper exercise and sleep is well-documented. Studies have shown that moderate aerobic exercise, such as walking, can significantly reduce the amount of time that individuals with insomnia take to fall asleep compared to no exercise at all. Take advantage of daytime natural light exposure. Sunlight provides the body with important vitamins and helps to regulate a healthy sleep-wake cycle. Limit your exposure to light closer to your bedtime. If you need a nap, do not nap too close to bedtime and try to limit the nap to 20 to 30 minutes in the mid-afternoon.
Develop a relaxation routine before bedtime. This would include activities that take your mind off the stressors of the day. Some people like to read, others do crafts like knitting or painting. Consider taking a warm bath or shower, or listening to soothing music or nature sounds. Whatever works for you is great. If possible try to lower the lights during your relaxation time. Develop healthy ways during the day to relieve stressors. Give yourself permission to take breaks throughout the day to relax, talk about something fun, and enjoy a laugh with friends. By managing your stress during the day you are helping to relieve that build-up of things to worry about just before bed.
Stick with your schedule. Go to bed at the same time every night and get up at the same time every morning, including weekends and holidays. Even if you do not feel tired or sleepy, try maintaining your scheduled bedtime. If you have difficulty falling asleep quickly for several nights then you may need to adjust your bedtime. Some guidelines suggest that you not go to bed until you feel sleepy or tired, while others recommend sticking with that scheduled bedtime. By maintaining the bedtime routine and schedule, you may feel sleepy once you are in bed and you allow yourself to relax. If you do not fall asleep within 15 minutes of going to bed, then get up. By doing so, you avoid adding worry about not being able to sleep to your stressors. Get up and move around or do something relaxing for a few minutes, then go back to bed. Avoid watching the clock. Relax, think of positive things from your day or relaxing activities that you enjoy, and try not to think about going to sleep.
Seeking Medical Help
Talk to your doctor if you continue to have difficulty. There may be an underlying medical reason or medication that is contributing to your difficulty sleeping. Medical conditions can sometimes contribute to difficult sleeping. Examples of problems that may need to be evaluated by a psychiatrist or psychologist include depression, insomnia, ADHD, bipolar disorder, post-traumatic sleep disorder, and problems with nightmares or other emotionally disturbing sleep problems. Examples of other medical conditions that are commonly related to sleep problems include sleep apnea, Alzheimer’s disease, dementia, chronic pain, restless leg syndrome, COPD and other breathing related disorders, allergies, epilepsy, fibromyalgia, chronic fatigue syndrome, GERD, and multiple sclerosis. Some sleep problems are caused by disorders directly related to sleep. Examples of these disorders include circadian rhythm sleep disorders, delayed phase sleep problems, narcolepsy, cataplexy, sleep walking, sleep talking, REM sleep disorders, and shift work sleep disorder.
Pay attention to changes in your sleep patterns. Sleep disorders can occur from a wide range of both medical conditions, mental health concerns, and disorders of sleep. Symptoms of sleep disorders include excessive sleepiness during the day, lingering fatigue, irregular breathing or increased movement during sleep, difficulty sleeping when you are tired and it is time for sleep, and abnormal sleep behaviors, which can include things like sleep talking and walking in your sleep. The length of symptoms associated with every possible condition that may be contributing to your sleep difficulty exceeds the capacity of this article. Talk with your doctor sooner rather than later. It is not in the best interest of your overall health to delay addressing problems you may be having with your sleep. Your doctor will help you to get answers to all your questions as well as the proper treatment for the cause of your sleep problems.
Review your medications. Many medications can cause either excessive sleepiness and fatigue or problems with getting enough sleep. Do not adjust your medications on your own. If you think a medication is causing or contributing to your sleep problem, talk to your doctor. In many cases, the dose can be adjusted or another drug can be prescribed in place of the medication that is causing the problem. Hundreds of medications have excessive sleepiness as a listed side effect. That list is too lengthy to reproduce here. Everything from antihistamines, to blood pressure medication, to pain meds can cause problems with alertness and sleepiness. Talk to your doctor or pharmacist if you think one of your medications may be interfering with your sleep. Medications can also prevent you from sleeping well. While this list is also lengthy, it is probably shorter than the list of medications that cause drowsiness. Still, many drugs can possibly disrupt your ability to get a good night’s sleep. Talk to your doctor if you feel any medication you are taking is preventing you from sleeping.
Take a sleep aid. If you continue to have difficulty establishing and/or maintaining sleep, there may be an underlying reason, such as depression, or you may just need to re-establish a healthy sleep pattern. Some agents are available over-the-counter that can help you to fall asleep easier. All sleep agents available without a prescription are intended for short-term use. If your sleeping problem persists, talk to your doctor about prescription medications that may prove helpful.
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