When it comes to looking after our health, most of us want to do our best. Exercise, nutrition, and even sleep – there are so many areas we need to think about and so much advice out there about what we ‘should’ be doing.
The problem is that it’s almost impossible to follow all the advice perfectly and sometimes the stress of trying to do so can make us feel even worse!
I’m not suggesting that health isn’t important, and as I’ve discussed in a previous article – sleep is integral to optimum health. However, despite being a GP and life coach, I don’t manage to follow all the classic sleep hygiene advice to the letter.
When it comes to sleep there is some advice I actively follow (more about this in my next blog on 14/07/18) but there are also some rules I break occasionally.
Here are the sleep rules I break -and why:
Make sure you sleep for 8 hours each night
I certainly don’t follow this advice – I work shifts and have at least one night a week when I don’t sleep at all!
There are several reasons why I’m not rigid about following this myself.
Firstly the requirement for sleep is likely to vary significantly between individuals. Most adults probably need between 6 and 9 hours. If you generally feel alert, energetic, happy; able to concentrate and are in good health you are probably getting enough sleep.
Secondly, we sleep in cycles of approximately 90 minutes and we generally feel less groggy if we wake naturally at the end of a sleep cycle. It is therefore more logical to suggest that we aim to sleep for 7.5 or 9 hours on a given night.
Thirdly, sometimes life just gets in the way. Now I’m not suggesting that we should allow this to lead us to chronic sleep deprivation – just that we don’t have to worry if we don’t sleep for precisely 8 hours a night.
Some experts disagree about whether we can ‘catch up’ with sleep but studies have shown that the night after a period of sleep deprivation we tend to spend longer than usual in deep sleep and REM sleep. This suggests to me that, at least to some extent, we can catch up with the most important stages of sleep. The old adage that quality is more important than quantity is likely to hold true for sleep.
Personally I aim to make sure that over a period of a week I have an average of 7-8 hours’ sleep per night but I don’t worry if I have a few nights when I sleep less.
I do however, aim to structure my working week so that I minimise tasks such as writing for a couple of days after a night shift so that I have caught up on REM sleep since this is important for creativity. If you have control over how you work you may wish to bear this in mind if work, social or family commitments mean that you have to pull the occasional all-nighter.
Go to bed and wake up at the same time each day.
Although this is sound advice in terms of helping to establish a consistent circadian rhythm, personally I find that shift work and the wish to have a semblance of a social life make it impractical.
If you are experiencing serious sleep difficulties which are having a significant effect on your life, you might wish to consider making whatever changes you need to in order to implement this for a few months.
However, most people can afford a little bit of flexibility with their sleep times.
I believe that problems tend to arise when we take sleep patterns to extremes by burning the candle at both ends all week and then attempting to catch up with a mega lie in at the weekend.
Given that sleep drive tends to kick in after about 16 hours of being awake people who have a long lie in at the weekend may find it difficult to fall asleep the next night meaning that they haven’t had enough sleep by the time the alarm goes on Monday morning.
Many of us have lifestyles that involve getting up at roughly the same time on weekdays although we may have more flexibility about what time we go to bed and may have the opportunity for a lie in at the weekends.
Personally, I generally like to get up at the same time every day including the weekends. Admittedly this is partly this is because I have teenage children and getting up early at the weekend allows me the luxury of a few hour’s peace and quiet (not to mention a bike ride or run on empty roads). However, I find it also helps me to feel alert on waking in the week – probably because my body clock is well primed to wake up at that time.
If work and social life permit I go to bed when I feel tired i.e. bedtime is largely dictated by my sleep drive.
When I’ve had a few late nights I find I automatically compensate with a few earlier nights. I generally need around 7.5 hours (5 sleep cycles) a night to feel good. Although I can survive on less than this, I aim to never allow myself to be more than 2 sleep cycles in deficit at any point in the week – even if it does mean saying ‘ no’ to a night out!
The ‘early night’ is my preferred way of catching up with sleep because I find it fits best with my lifestyle and is least disruptive to the balance of circadian rhythm and sleep drive. If I feel particularly tired and an early night is going to be impossible, I might succumb to a nap (see below). A lie-in is my last resort.
On the rare occasion when I do lie in I make sure I get up within 90 minutes (1 sleep cycle) of my usual waking up time so that I don’t have problems falling asleep the next night.
This may well work for you too if you have a set waking time on weekdays and if you generally don’t have difficulty falling asleep at night.
It is worth noting that however tired you may feel it is sometimes difficult to fall asleep before 9 pm because the body typically doesn’t start to make the sleep hormone melatonin much before this time.
If you have more flexibility about what time you wake up or if tend to have late evening commitments you may find that lying in (although I recommend you don’t sleep in by more than 90 minutes ) or napping works better for you if you need to catch up with sleep.
In order to transition from night shifts to day shifts, I sleep for 3-4 hours in the morning following my last night shift (as this reduces sleep drive sufficiently for me to function) and aim to go to bed an hour or so earlier that night. This helps me to resume my normal circadian as quickly as possible.
Avoid Daytime Naps
This is very good advice for people who struggle to fall asleep a night since napping during the day can reduce sleep drive at bedtime and can be disruptive to circadian rhythm. However sometimes a daytime nap can have its uses.
Personally I find it preferable to sleep during night time hours and stay awake during the day – but sometimes this isn’t possible. I tend to use daytime naps when I feel tired and know that I won’t be able to go to bed early (or at all) that night. That way I know that I won’t be risking reducing my sleep drive come bedtime.
I time naps for between 1pm and 3pm to take advantage of the body’s natural slight fall in body temperature at this time of day as this helps to promote sleepiness.
If I need to be alert during the afternoon I keep a nap to around 20 minutes to avoid falling into deep sleep since naps of longer than this can be associated with reduced concentration on waking, known as sleep inertia. This can last for up to four hours.
Many highly successful people reportedly use the ‘power nap’ technique. Most famously, perhaps, Einstein, who allegedly allowed himself to nod off holding a key, so that as he transitioned into deep sleep and his muscles relaxed, he would drop the key to the ground and the noise would wake him up!
If I have the luxury of sleeping for longer I typically allow around 90 minutes so that I can wake naturally at the end of a sleep cycle. I take longer naps on my bed because of the psychological association with sleep.
This can be particularly helpful before a night shift as research has shown that a nap before a night of sleep deprivation can help to offset the concentration lapses that can happen as a result of micro-sleeps.
There is some controversy about the pros and cons of having a nap during a night shift. Some experts suggest that whilst a nap might help night shift workers to feel better there is a risk of sleep inertia after even a short nap. This may because shift workers are often sleep deprived to start with.
Personally I avoid night shift naps (Usually I wouldn’t have the chance for a nap even if I wanted one!).The nature of my work is such that I never know when I might be called upon and I need to be alert.
However if you work night shifts and have a scheduled break you might find that a short nap of up to 20 minutes can help you to feel more alert, although it might not actually improve your performance. If you do take a nap at night, it is important to be aware of possible sleep inertia and avoid activities requiring high levels of concentration for an appropriate period after waking.
Keep a sleep diary
People who are having serious sleep problems and who seek professional help may well be asked to keep a sleep diary to help with diagnosis and /or monitor treatment. If this applies to you – please go ahead and keep a diary.
However, many other people now wear electronic devices to monitor their sleep and keep quite extensive notes. Whilst there may be some truth in the saying that ‘we mange what we monitor’, I worry that this trend may lead to an increase in the numbers of people suffering with insomnia.
Whilst I would certainly encourage people to take their sleep seriously – there is a fine line between taking something seriously and obsession.
A common underlying problem in people suffering with insomnia is the tendency to hold unhelpful beliefs about sleep.
People who have difficulty sleeping typically underestimate the amount of time they spend asleep and overestimate how much this will impair their daytime functioning.
A study of people with sleep difficulties found that those who worried about their sleep were far more impaired than those who didn’t worry even if the non-worriers had had a poor night’s sleep.
This suggests that worrying about being tired is more harmful to productivity than tiredness itself.
Personally I tried keeping a sleep diary for a while as part of my research for this series. I’d wake up feeling pretty good and then find that, according to my sleep tracker, I’d not had such a good night’s sleep after all.
I’d start the day with a nagging feeling that somehow I’d ‘failed’ and I’d start to feel a bit tired and cranky. Come the evening I’d feel under pressure to get to bed extra early and then I’d worry if I didn’t fall asleep straight away.
This was a novel experience for me as I’ve always considered myself to be a ‘good sleeper’ despite the fact that, as a doctor with on-call responsibilities, my work patterns have not always been conducive to this.
I decided to ditch my tracker and go back to allowing how I felt to be the barometer of whether I’d slept enough. My sleeping difficulties resolved faster than you can say ‘count sheep’.
That said, if you are tracking your sleep and finding it reassuring and helpful by all means carry on.
In fact, if you are sticking to any of the sleep hygiene tactics mentioned in this article and it’s working for you then I’m certainly not suggesting that you need to change!
If however, you’re finding it difficult to stick to all the sleep advice – and particularly if you’re lying awake worrying about it – then perhaps you too might sleep better and feel better if you allow yourself to break some of these ‘ rules’ occasionally.