A Detailed Guide on Sleep Hygiene-The Key to Proper Rest

Contemporary approach to sleep is often one of a necessary evil. We enjoy staying up late at night to party and hang out with friends, and do it to complete school or work assignments even when we don’t want to. Sleep really is our last priority, and that isn’t healthy or fair to our bodies.

Do you exactly know why you need sleep?


Question as old as time; just why do we sleep? It makes little sense to the lay science buff why an evolutionary world would lead to a system where all the more developed animals all spend hours in inactivity, lying motionless and vulnerable at varying times in the day. But it turns out, evolution really knew what it was doing when it allowed this.

Sleep can be taken as a necessary sacrifice for a complex brain capable of higher function. Or it can be seen as a mark of advanced brain and body function. It is always interesting to note how complex and diverse sleep and its manifestations are in the animal world. Dolphins can sleep one brain hemisphere at a time, giraffes and rabbits barely sleep a few minutes since they have to keep running around, and gerbils being so small hardly sleep at all!


Human beings too have been slept differently in history, and they have approached sleep differently across cultures. While Rome and the Romans despised sleep and resorted to it only when it couldn’t be contained any more, often looking down upon it, the Egyptians treated it as divine, a period of communication between the person and the gods and spirits that guided them. Up till the Renaissance, people slept in two phases, getting up in the middle of the night to do chores, pray or just sit about. We now sleep in a single phase, but our sleep habits remain diverse across families and communities and cultures.

Regardless of how we sleep, the science behind sleep remains the same. Virtually all of it comes from the analysis of monophasic sleep (ie, sleeping in one constant stretch), which is the kind of sleep most people take.

what does your brain do when you sleep ?

The science of sleep doesn’t restrict itself to one field, as is often the case with phenomenon as complex as it. It derives from a diverse range of fields, which includes neurology, psychology, anatomy and even sociology.

The cogs and axles of sleep are primarily covered in the field of Sleep Physiology. As per contemporary understanding of sleep, most people sleep with brain and body activity lying in 5 distinct phases. The most crucial and also the most sung about phase is REM, or Rapid Eye Movement sleep, from the distinct eye movement patterns that first helped people identify it as separate from the rest of the sleep. The 4 other are known as non-REM or NREM, and they have a progression where you go from stage one through two, then to three and then in four, before you land in REM. Once REM sleep is achieved , you stay in the phase for some time before your brain climbs back to stage one. This cycle repeats a few times during a sleep episode, and it has its own peculiarities.

why brain need sleep


Any stage that goes missing outside of what is normal can indicate a sleep disorder. But how did scientists arrive at this classification?

You have a monkey to thank for it. In 1875, Polish physiologist Adolf Beck experimented on a monkey’s brain to detect and record electrical activity[1]. In 1929, Hans Berger recorded electrical activity from the scalp in human subjects. These were the beginning of laying the foundation on which modern science of sleep today rests. These EEGs (Electroencephalographs) helped scientists identify 
REM and NREM sleep, as well as all the stages in the latter.

REM And NREM Sleep

Let’s quickly browse through the details of each stage of sleep so it becomes easier for us to grasp the functions and the effects of lack of sleep.

REM Sleep:
About 25% of the time each night, one has REM sleep. It is named so because of the quick motion of eyes that were first used as pointers to differentiate it from other phases of sleep. During REM sleep, your brain gets active while your muscles relax. This is incidentally also the time when most dreams occur.

NREM Sleep:
The other 75% of the time, your eyes don’t move so rapidly, and this phase is therefore called Non-Rapid Eye Movement. But there are more complexities to it.

  • Stage 1 NREM sleep is the most delicate states of rest. You aren’t fully asleep but you aren’t awake either, in laymen’s terms. It is easy to wake someone from this sleep.

  • Stage 2 NREM is when your mind lets go of what’s happening around it and your body cooperates. Breathing, heartbeat and body temperature are all lowered gradually and comfort steps in.

  • Stage 3 NREM Your body begins to go into deep sleep at this point. Stage 3 is really a transition into stage 4, but it is salient enough to have its own category.

  • Stage 4 is the deepest part of sleep, and also the most restorative part of it. Called Delta Sleep after the waves in the EEG that are recorded at this point, It is hardest to wake someone up from this stage. Blood pressure and breathing rates are lowered and muscles inch into fully relaxed modes. This is also the point where your body is currently believed to repair itself, since blood supply is increased and hormones are secreted.

How much one must sleep at night? (by age analysis)

A variety of people often quote a myriad of numbers, some quoting science while far more using personal anecdotes to arrive at conclusions. Till a few years ago, most people accepted that everyone needs 8 hours of sleep once they’re not teenagers anymore. However, that isn’t true as science now tells us.

Sleep Requirements for Babies Through Young Adulthood



Age


Number of Naps


Total Hours of Naptime Sleep

Hours Awake Between Sleep Periods


Total Hours of Nighttime Sleep


Total Hours of Nap and Nighttime

Newborn

3-5*

4-7

1-2 (usually 1)

9-14

16-18**

1 Month

3-4

6-7

1-3

8.5-14

15-17

3 Months

3-4

5-6

2-3

10-11

15

6 Months

2-3

2-4

2-3

10-11

14-15

9 Months

2

2.5-4

2-4

11-12

14

12 Months

1-2

2-3

3-4

11.5-12

13.5-14

18 Months

1-2

2-3

4-6

11.25-12

13-14

2 Years

1

1.5-3

5-6.5

11-12

13-13.5

3 Years

0-1

1-2

6-8

11-11.5

12-13

4 Years

0-1

0-2

6-12

11-11.5

11.5-12.5

5 Years

0-1

0-2

6-12

11

11-12

6 Years

0-1

0-2

8-14

10

10

10 Years

0-1

0-2

8-14

10.5-11

10-11

17 Years

0-1

0-3

8-16

8.5-10

8.5-10

Adult

0-1****

0-1.5

8-16

7-9

7-9


*Number of naps will vary immensely between babies and will depend on the hours of nighttime sleep they get

**Hours of nap and nighttime sleep may not add up correctly since each will vary depending on the other

***These hours don’t signify unbroken stretches of sleep; sleep is cumulative in babies, so it’s the total that’s important

****Napping after age 5 is a sign of sleep deprivation; older children will continue to nap to make up for sleep lost at night

Sleep deprivation may result in people who don’t rest adequately. But how do you know how much you’re supposed to rest? When you’re told you should rest between 7-9 hours, should you sleep 7, 9 or err on the side of caution and sleep an extra hour to make a healthy 10?

A good way to find out is to see if you’re sleepy after your usual night. If you are, you’re probably sleeping too little. If you’re groggy but slept quite a bit, you might have overslept. Good sleep usually makes you wake up refreshed and ready to take on the day.

Sleep deprivation has varyingly attributed to be a cause of mental illness as well as a symptom. While we’ll discuss the first possibility in a minute, if you think you’re suffering from a mental health issue, or too much stress, it can help to seek professional help so you can manage your stress and anxiety in your daily life.

Sleeping less as you age? Here’s how sleep changes as years go by

Why does age influence our sleep requirements so much?

A big part of growth of the body and brain happens in the first 20 years, first during the growth from infancy to childhood, and then through puberty. Fighting off infections, making bones strong and repairing and developing muscle tissue is just some of the stuff bodies are doing at this crucial phase in life, and so it becomes easy to see why people in this age group need more sleep.

...if an infant misses naps or is chronically overtired due to extended nighttime wakeups or short naps, it can lead to increased nighttime wakings. The average infant under 1 year of age needs approximately 14-15 hours of sleep (naps + nighttime), and this only decreases to around 13 hours of total sleep after 1 year of age. At 4 years of age, children still need between 11 and 12 hours of sleep at night.

The importance of developing healthy sleep habits is well documented and recent studies show that these practices lead to improved memory and learning abilities in children, as well as lower rates of obesity and hyperactivity.  In addition, Human Growth Hormone peaks 1 hour after onset of sleep, so chronic sleep deprivation can lead to decreased linear growth in infants and children[2]

                                                                                                                                                                                -Katie Williams RN, BSN, Sleep Consultant
                                                                                                                                                                                                                                                 
BabyMuse.org


As people grow up into full adults, the need for sleep tends to fall. For most adults in the age group 25-55 years, 8 hours seems to be a good enough amount of sleep, subject to individual factors.

But sleep is not just dependent upon age. There are a lot of other important factors that can help or prevent people from sleeping, causing a variety of effects to follow from this sleep deprivation. A prominent factor as many will affirm is stress. Most find it hard to sleep when they’re anxious about something. Diet is another factor which can make or mar nights; a cup of coffee with your dinner is not the best idea, as many will attest.

what lack of sleep does to your body

Sleep is just as crucial as staying awake. Yet the prime focus of our discourse is always centred on what we do when we’re awake, not how we rest and recuperate from the toil and labour in our lives. That is extremely unfortunate, because lack of proper sleep can pretty much ruin our lives.

In an experiment on rats, sleep deprivation over the course of weeks led to unhealthy levels of weight loss despite increasing diet, inability to control body temperature, heat seeking behavior and eventually, death. Sleep has on other occasions been linked to lowered immunity and thus high risk of infection. In humans specifically, lack of sleep has been associated with reduced mental faculties, reduced memory and even hallucinations.

Additionally, lowered social performance due to sleepiness can cause you to be perceived as unkempt and unpresentable, as well as deprive you of opportunities by preventing you from giving your best. It sure does seem like sleeping at night is a better option in general as compared to burning the midnight oil.

Why you are not satisfied on your sleep

It is startling to note how many people around us are sleep deprived. The Centre for Disease Control and Prevention even goes on to call it a public health hazard, pointing out high incidences of people accidentally falling asleep during the day, and worrisome incidence of people falling asleep while driving!

There is no denying that lack on sleep is potentially hazardous. Why do people neglect sleep? Is it deliberate neglect or are other factors at play?

There are quite a lot of factors, it turns out. Perhaps the easiest culprit for most to point out is stress and negative emotions; everyone has had a sleepless night when they were anxious or slept little when they were dealing with a major source of grief. There are more factors too, however. For example, diet, the lighting in the room, the mattress you’re lying of and the ambient noise all influence your sleep in some or the other way.

Negativity begets negativity: Stress and Poor Sleep

Stress is almost an epidemic in contemporary times. When it prevails for a short time, stress can help boost performance; it tells your body to shift priority from usual function to the situation at hand to ensure survival and sustenance. While tasks may be achieved as a result, essential body functions like sleep and diet often reduce in priority. Not only is this harmful in itself, but if the stressful situation lasts, reduced sleep and other body function can aggravate the situation by marring your cognitive ability and further leading to situations where you have more stress.

Anxiety is another culprit which is fairly easy to identify. Stress and anxiety often lead to long term sleeplessness or improper sleep, which can cause trouble and even turn into insomnia. Some medication might cause sleeplessness as well as a side effect. People who self medicate are often at risk of medication-related sleeplessness, which only adds to the already long list of reasons self medication is potentially hazardous.


TheSleepApneaGirl writes:

- Set worries aside—write down your concerns, or list the things you have to do tomorrow. Decide when you will address any worries—then     put them out of your mind.
- Take a warm bath to relax
- Listen to quiet music, or read under soft light.
- Try relaxation exercises, such as deep breathing or progressive relaxation (tensing and then releasing one group of muscles at a time,            starting at the feet and working up).

                                                                                                                                                                                                                   TheSleepApneaGirl.com
                                                                                                                                                                                                                        Long Beach, CA 90815-1145
                                                                                                                                                                                                                                   Phone: (562) 420-7353
                                                                                                                                                                                                                                         Fax: (562) 420-7350

Negative thoughts and practices are major causes of sleeplessness or improper sleep. Lack of rest can unfortunately complicate these even further and cause chronic stress and even result in mental health issues. It is therefore wise to nip problems in the bud and give yourself enough rest, placing all other concerns on the backburner.

what exactly the "SLEEP hYGIENE"  IS ?

Proper practices relating to rest and sleep are known as sleep hygiene. While personal and environmental hygiene certainly contribute directly or indirectly, sleep hygiene is different and much more expansive than the usual definitions of hygiene.

Among the many things proper sleep hygiene is about, the most important ones can be categorised into three categories; proper environment, proper bedding and proper sleep habits. Further, some factors are more important for sleep hygiene in kids, such as presence of electronics and TV sets, while others like diet and bedding material may have more visible effects in the middle aged and the elderly.

the effect of electronic boom

There are electronic devices everywhere. You have TVs that are slimmer and brighter and wider than they were, you have mobile phones that buzz and light up to tell you when someone’s sent you a funny GIF, and there are alarm clocks and coffee machines and a hundred such gizmos in every space that are purported to serve us but which end up making our minds eager to answer each beck and call. (link to medium post of app design and endorphin guy).

Sleep experts often recommend keeping all phones and TVs and even digital alarm clocks outside the room where you sleep. The room should be pitch dark when you lay down to sleep and should remain that way for the duration of your sleep.


Grigor M. Harutunian from LAneurology.com, Board Certified Neurologist and Clinical Neurophysiologist has the following recommendations about electronics:
Make sure the room is pitch dark. Try to eliminate all light sources. This includes alarm clock lights or cell phone charger light, etc. Avoid watching TV or reading in bed. Bedroom should be very quiet.

                                                                                                                                                                                                                                       Glendale, CA 91204,
                                                                                                                                                                                                                                                 (818) 937-9944

It is not sufficient to cover the screens of the devices you’re sleeping with; it’s not just their light that bothers people. Buzzing and notification sounds can bring you back to the awake state when you’ve painstakingly managed to attain Stage 1 NREM sleep on a sleepless night. Even if you switch off the internet, you can still receive SMSes and phone calls that can disrupt your sleep. Airplane mode or other such non-transmissive modes are the only admissible compromise.

For kids, however, a complete ban on electronics in the bedroom may be profitable in the long run. You don’t want your 3 year old to be awake till 1 playing cartoon games on the iPad, and then be cranky the next morning.

Why mattress play an important role in sleep

The bed and bed linen are pretty salient; nobody wants to sleep under a scratchy blanket or on a lumpy bed. While a whole variety of bed linen and blankets can be availed for cheap at your local mart, a mattress can cost quite some money, enough to not be something to change on whim.

It becomes important to pick a mattress wisely, and make sure there are return policies in case the one you buy isn’t good for you. A good mattress isn’t dented and keeps your back straight, supporting its curves appropriately. There are few people who can sleep on a mattress that sags in the middle, and it is in fact bad for your health. People prone to back ache and neck pain should especially consider getting a good mattress with appropriate support.

Additionally, it can help to have a mattress that cools quicker, especially if you feel hot in your bed. Getting a mattress topper instead of a whole new mattress can help save you some money.

Sleepless nights cause exhaustion in babies

Staying on a proper sleep routine is paramount with babies. Babies need a schedule to followed by their parents with utmost strictness. Missing the bed time by about an hour is usually fine, but any later, the baby can start showing signs of overtiredness. An overtired baby is desperate for rest, and the discomfort of being too tired makes them cranky and hard to tuck into bed. They may display behaviors of seeking comfort, such as clinging to their caregivers, sucking their hands or rubbing their eyes.


The greatest habit for a good night's sleep in infants and children is consistency. Creating a routine and sticking with it is key. After you have established a nice routine that works for your family, ensure your children are getting enough sleep at night and, if they are still napping, during the day as well. If you miss a nap or go to bed too late one night, try to make up for it with an earlier nap or bedtime the next day! Remember sleep begets sleep!

                                                                                                                                                                                                                      Nicole Janse Van Rensburg,
                                                                                                                                                                                                                    
Sleepy Lion Consulting, LLC,
                                                                                                                                                                                                                                 Phone:(832) 953-5396

What changes can be made to better sleep

There are other changes to include too. For example, skipping coffee and alcoholic beverages is often recommended by doctors and sleep hygiene experts. A light meal is recommended for dinner, especially for people prone to acid reflux at night.

Reducing the amount of noise in the room can be beneficial. If your bedside window faces a busy street, it may help to close the window and draw some heavy curtains so any noise is either reflected to absorbed.

How to improve sleep hygiene?

Making an assessment of the room you sleep can be a good starting point to bettering one’s sleep hygiene. Move the TV to a different room, and get a noise-less analog clock that doesn’t tick-tock audibly at night. Modifying the room is only the first step, however.

The bed and bed linen are good to tackle next. A change of linen and a thorough vacuuming and cleaning of the mattress can help remove bad odors, kill bacteria and make the bed more comfortable. If the mattress and the pillow need to be changed, it is best to get that done.

Next one must evaluate one’s sleep habits. What you do before sleeping is crucial, just as much as how you wake up and what you do immediately afterwards. Sleep Hygiene experts recommend avoiding things like reading, eating or watching TV in your bedroom. Sexual activity is fine, but apart from that, the bedroom is to be reserved exclusively for rest and sleep. Waking up with a jolt often comes with a sharp spike in parameters like pulse and blood pressure, which is not very healthy. Instead, waking up in a gentle and relaxed environment can help. Similarly, diet and exercise can help you sleep better if tackled rightly.

If you have problems deciding if you’re sleeping OK, it can help to use this Sleep Diary chart from the website of Centre for Clinical Interventions, Australia. Filling it in daily for a few days can help you identify areas where you need to work on to make the best of the time you’re putting aside to rest at night. In the long run, resting well by maintaining good sleep hygiene can help you be more productive, healthy and socially desirable.

Additional Resource: Do you have insomnia?

Lack of sleep is different from insomnia. While you may have difficulty sleeping due to poor sleep hygiene, insomnia is a chronic condition where people find it hard to sleep, the difficulty lasting over a long period on time and becoming a major hindrance in one’s daily life. You can find more information about insomnia from CCI’s document linked here, or specifically learn about adult insomnia and its solution through Behavioral Sleep Medicine here

References:

1 Coenen, Anton; Edward Fine; Oksana Zayachkivska (2014). "Adolf Beck: A Forgotten Pioneer In Electroencephalography". Journal of the History of the Neurosciences. 23 (3): 276–286.

2 Santos IS, Bassani DG, Matijasevich A, et al. Infant sleep hygiene counseling (sleep trial): protocol of a randomized controlled trial. BMC Psychiatry. 2016;16(1):307. doi:10.1186/s12888-016-1016-1.


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