• J. Michael Smith, DHSC, PA-C, CAQ-Psych

How is Your Sleep?


So, how has your sleep been? You may have heard that question from friends or family over the last year, or asked that yourself. With the radical changes that have come to our lives over the past 18 months to 2 years, it's no wonder we're all having a hard time sleeping! COVID-19, unemployment, the Presidential elections, rioting and protests, Afghanistan....when will it stop! According to the Texas Department of Public Health, anxiety and depression have increased four-fold in the past year, and with it our sleep has suffered. Adjusting to working from home, caring for children who are not in school, being stuck indoors....these changes in our routine, combined with our increased anxiety and fears have caused many to have trouble falling asleep, or staying asleep, or waking up early and being unable to go back to sleep.


We know that sleep is important so that we can function well, think clearly, and be in a generally good mood. But lack of sleep makes us irritable, feeds depression and anxiety, lowers our immune response, and contributes to making us fat! So, what can we do about it? We can't magically get rid of COVID-19, bring world peace and full employment. We have to begin by changing ourselves and the way we've been dealing with the changes that these situations have brought to our lives. Getting back to the basics of good sleep is so important, and a great first step! So, what are these "basics of good sleep”?


Here's what we should ALL be doing:


1. Go to bed and wake up around the same time every day as much as possible. This reinforces and strengthens your natural “biological clock” and will help you to feel more rested and refreshed. Also, keeping this routine when so many other routines have been altered due to COVID-19, will support a more stable schedule.


2. Strive to get at least 7 72 to 8 hours of sleep a night, not just time in bed. The vast majority of us


require 7 72 to 8 hours for our brains to get adequate rest, and you can't change what your sleep requirement is.


3. Keep your bedroom at a comfortable temperature. Most of us sleep better at a slightly cooler


temperature, but you should definitely not be too warm or too cold at night. Also, keeping the room dark and quiet is important. Some have used eye masks, blackout curtains, ear plugs, or white noise (like from a ceiling fan or white noise generator) to make their room more conducive


to sleep.


4. Avoid daytime napping. Any napping over about 20-30 minutes per day can actually decrease your ability to sleep at night, causing insomnia and unrefreshing sleep.


5. Exercise! This is a proven way to make sleep more solid and less interrupted. Just don't exercise vigorously within 2-3 hours of sleep, which may make it harder to fall asleep.


6. Avoid watching TV, being on the computer or tablet, or your phone close to bedtime. Light from these devices can actually suppress your natural melatonin levels, causing you to not feel sleepy. Instead, start turning down or turning off lights 1-2 hours before bedtime to simulate the outside environment. Read something NOT too interesting or exciting in low light to help settle your mind, meditate, or pray. Write down your plans, “to do” list, or concerns instead of letting them occupy your mind....they will be there in the morning when you want to go over them.


7. Avoid stimulants, especially in the evening, such as nicotine and caffeine. Even alcohol, which many see as sedating and sleep inducing, will cause wakefulness during the night.


8. Don't spend excess time in bed before or after your normal sleep period. Do these other activities outside the bedroom, like watching TV, reading, paying bills, eating, or worrying.


9. A light snack at bedtime helps avoid hunger which can wake you up. Avoid a large meal, which can cause heartburn or interfere with sleep, or excessive fluids which can cause multiple bathroom trips at night.


10. Avoid regular use of sleeping pills...of any kind. Whether they are mild or very potent, all can lead to physical or psychological dependence for getting sleep. Occasional use is probably okay, but you should speak with your medical provider. Cognitive techniques, such as progressive relaxation and others, is much better in the long run, and leads to more natural sleep.


If you need help beyond this, see your medical provider. Anxiety and depression, if left untreated can lead to ongoing sleep issues among other problems. Also, conditions such as sleep apnea and restless legs syndrome may require medical intervention to bring about improvement. Some aspects of our lives may be permanently changed, such as working from home. But we can adjust to these changes and get our sleep back to where it is sound, refreshing and restful by practicing consistent, healthy sleep behaviors.


J. Michael Smith, DHSC, PA-C, CAQ-Psych

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