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Sleep Hygiene
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I wrote this yesterday to hand out to my patients who are having trouble sleeping.  So I thought I might add it to my rants.

Sleep Hygiene


Insomnia is a problem for approximately 20% of people in America at any given time.  Unfortunately, many different factors can cause poor sleep, and there are no medications that provide good sleep benefit for more than a few weeks in the average person.  Here are some tips for good sleep hygiene which can really make a difference in tackling this difficult problem.


Sleep Diary

If you are having trouble sleeping, the first thing to do is to keep track of your sleep so you know exactly what part is wrong.  The easiest way to do this is to use a piece of lined paper and make each line each night of sleep.  Start off by marking when you go to bed, then when you fall asleep, then any time you wake up or go to sleep in the middle of the night, and when you get up in the morning.  Track this for a few nights, then start to add pertinent information from your day, such as any naps, exercise, medication, alcohol and caffeine.  After a few weeks, you may figure out that your sleep is great when you take a walk that day, or you always seem to wake up at 3am if you have a late night glass of wine.


No Television or Internet!

Television and the internet overstimulate the brain so it is more difficult for you to fall asleep.  Reading or engaging in crafts, however, does not.  Try to avoid watching TV or surfing the net for an hour or two before bedtime.  Even if you have been going to sleep with the TV on for 20 years, if you are having insomnia, give yourself a weeklong trial without and see if it helps.


Have a Routine

Try to do the same thing in the same order every night before you go to bed put lotion on feet, blow out candle, read etc.  Wear similar pajamas and listen to the same music.  In this way, you can actually train your brain to sleep.



Ive read differing reports on this.  Deep sleep has a lot to do with the temperature of the body once it drops a few degrees, you are getting good, refreshing sleep.  Some reports suggest that taking a late night shower or exercising will raise the temperature of the body, leading to poor sleep.  Other reports suggest that a shower or sweaty exercise will lead to moisture evaporation and body cooling, helping sleep.  My advice would be to experiment with when you shower and exercise.  If a late evening walk makes you need to nap, terrific.  If a shower energizes you, take it in the morning.


Speaking of Naps

Dont take them during the day if you are having trouble sleeping at night.


No Caffeine.  None.

I know.  Some people fall asleep with a cup of coffee on the nightstand.  Turns out we can have varying sensitivity to caffeine throughout our lives.  Maybe it never bothered you before well, if you are having trouble sleeping, no caffeine is the best way to go.  Sometimes some people can get away with one cup of coffee in the morning, but others cannot.  Also, keep track of any stimulating over the counter medications you are taking, such as Sudafed.


Lights at Night

Recent studies have shown that any bright light in the middle of the night can throw off your sleep cycle.  Even people who go to a bright gym at 8 or 9 pm had trouble sleeping until they started to wear dark glasses while working out.  So put a dim nightlight in the bathroom if you tend to get up to go, and leave the pitcher of water on the counter if you like to get a glass at night so you wont face the bright refrigerator.



Loud snoring can be a sign of a condition called obstructive sleep apnea that can lead to health problems in the future, and it certainly has a lot of effects on mood and memory.  If the condition is suspected, you will need a sleep test in a sleep lab to diagnose the condition.