A well-built building starts with a strong foundation

You might have heard of sleep-hygiene. For those who haven’t, it’s not getting into bed after you’ve showered and into freshly washed linen to boot.

I always say it doesn’t matter whether I prescribe the Kim Kardashian or Rolls Royce of sleeping tablets, it won’t help much if you’re using it on a shaky foundation. Note, the author does not believe Kim = a Rolls. Furthermore, there is no such thing as a top-of-the-line sleeping tablet, only treatment (not necessarily medication) tailored to your specific needs.

What is this foundation I am talking about? Well, it’s basically a set of behaviours we teach ourselves over time that tells our body when to fall asleep. We are, after all, creatures of habit.

The challenging thing is that most of us want immediate results. Sleep hasn’t caught up with modern times. Most of us suffer from this desire for instant reward. If we want to know what the capital of Bulgaria is, we google it (it is Sofia); if we want to speak (read: chat) to someone, we instant message; if we are hungry, we click a few buttons and sushi arrives at our doorstep. By now you should understand what I am trying to convey here. Changing behaviours aimed at increasing your quality and quantity of sleep sometimes takes a bit more time to pay dividends, but oh boy does it pay dividends! Whatever changes you implement, try and be consistent by giving it a week or two before you dismiss its effects on your sleep. Going to bed at the same time isn’t so important as getting out of bed at the same time each day. If you have severe insomnia, go to bed when you are tired to help break the cycle and to improve your sleep efficiency (time spent in bed vs. time actually spent sleeping).

Some people simply spend too much time in bed! The bed is only for two things. Sleep and Sex. If you aren’t doing either of those things, it’s time to get out of bed. Most authors agree if you’re lying awake in bed for longer than 25 minutes you are basically teaching your brain that the bed isn’t a place for sleep. Tossing and turning is stressful and anxiety provoking. That is not a state that is conducive to good sleep. There are plenty of things you should rather be doing instead. Go to a dimly lit room and meditate, read a book or listen to relaxing music until you are tired enough to fall asleep. Avoid too much light (especially white/blue light) exposure within 2 hours of bedtime. Think about the effects that scrolling through an endless stream of social media posts on your phone around bedtime would do to your sleep! This type of light can suppress the effects of melatonin, the body’s natural sleep hormone.

Tomes could be written about the effects of caffeine, diet, alcohol, exercise (too much, at the wrong times, or too little of it) and light exposure. In time I’ll cover all of these topics. In the meanwhile, I encourage you to review my sleep hygiene handout (2 pages only!) at goodsleep.co.za

In summary:

  • Have a routine, get out of bed at the same time each morning (avoid sleeping in, even over weekends)
  • If you have insomnia, go to bed when you are tired
  • Don’t toss and turn (the bed is only for sleep and sex)
  • Limit caffeine intake and consume only before midday
  • Get early morning bright light exposure if possible
  • Exercise in the first part of the day, not close to bedtime
  • Avoid daytime naps (unless there is a safety concern)
  • Avoid smoking close to bedtime (nicotine put men on the moon!)
  • Don’t give up hope.
These aren’t just celebratory cigars, but nicotine to help stay awake! Nicotine is a potent nervous system stimulant.

Wishing you good sleep,

Dr Schalk Wiehan Van Der Merwe

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