Sleep Hygiene September || Take 2 Tips: Make your bedroom an oasis

JULY 26 || HUFFINGTON POST SLEEP + WELLNESS
5 Ways To Make Your Bedroom The Perfect Sleep Sanctuary
"As part of the Angie’s List sleep sanctuary contest, lifestyle and design experts Carter Oosterhouse, Jennifer Bertrand and Mandi Gubler created their versions of the perfect bedroom for sleep. The designers used five tips from Arianna Huffington’s book, The Sleep Revolution, to provide their clients with a space conducive to a good night’s sleep."

AUG 21 || INSTYLE
A 2-Week Sleep Cleanse: Why I Turned My Bed Into a Shrine and You Should, Too
"After raiding my local bodega for some peonies and staging my bedside sleep shrine, I Marie Kondo–ed the clutter (good-bye, agita-inducing parenting books) and unplugged as much as I could: my digital alarm clock, iPad, laptop. My husband drew the line at the flat-screen TV and cable box, so—following Huffington’s advice—I covered the tiny lights with masking tape."

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The Wisdom of Sleep || Dr. Andrew Weil

"Better Night's Sleep" by Adam Sicinski for MindMapArt

"If you have difficulty sleeping or are not getting enough sleep or sleep of good quality, you need to learn the basics of sleep hygiene, make appropriate changes, and possibly consult a sleep expert."--Dr. Andrew Weil

Alternatives: Using sound as a bedtime sendoff

Many people who have trouble sleeping aren't aware of the many options they can try before asking for the over-prescribed (in this writer's opinion) sleeping pill. One of the best solutions for achieving sleep onset and for staying asleep can be found in the use of sound to deliver distraction and relaxation. 

Sleep Music, by A-L-i-E-Nxx

Despite what most people think, the body and brain don't just shut down at night while you are asleep. In fact, your body is always at work somewhere at all times of the day. During sleep, your cells are (ideally) being repaired, your brain is filing away information, your digestive system is working at a different rate based on its own circadian clock, and so forth. Your senses function at varying levels of activity as well.

Visual: Your eyes may be closed, but if there is light in the room, your body still perceives it through photoreceptor cells not only in your eyes, but in your skin.

Taste and smell: Your sense of taste may not be active, but that's because you are not eating. Your sense of smell will slowly shut down, but if someone were to walk into your room with a plate full of freshly cooked bacon while you were in early stages of sleep, you would probably wake up, your mouth would probably water and your digestive system, because of new salivary action, would leap into regular action.

Touch: Your sense of touch will remain somewhat alert. Ideally, you will have a comfortable sleeping environment and not one which keeps you aware of discomfort (poor mattress support, ill-fitting sheets, inappropriate blanket weight, overwarm bed partner, active pets or children in bed, too cool or warm a room, etc.).

Sound is also something the brain processes while you are asleep. This is obvious to people who sleep with snoring bed partners, which could be spouses, children or pets. Noise can pull you out of deeper sleep stages or fragment the stages you are in, which leads to changes in pulse and blood pressure. If you are in the deepest stage of sleep, stage 3 or Delta sleep, you'll be harder to awaken than if you are in early stages of sleep (1 or 2).

In addition, if you are aroused by sound during the night, the way that you deal with it depends a lot on how you regard that sound emotionally. If it's the sound of a door being opened, and you aren't expecting someone to come home in the middle of the night, you will react emotionally with panic or concern. If it's the sound of your cat purring, you'll probably not mind it so much and go back to sleep. If you live in the city but are in a rural environment, you might hear a coyote and the sound of that could increase your stress response and make it harder to fall asleep. Similarly, if you live in the country and hear the same coyote, you'll probably let the sound go in one ear and out the other without much thought. And ruralites, in the city, are infamously known for not being able to sleep against the backdrop of traffic noises outside, while city dwellers can find great comfort in these sounds. Regardless where you live, there will always be the potential for noise pollution from barking dogs, loud parties, construction site racket, crying babies, fog horns, thunderstorms, fireworks, and low-flying jets, as the noise of life happens regardless our best intentions for getting sleep at night.

There are numerous ways to address the control of sound in your sleeping environment as a way to help prevent insomnia or broken sleep across the night.

The most simple way to drown out sound is to block it entirely with earplugs or a noise-canceling headset. This may be all you need, or you might find these items too uncomfortable to wear more than occasionally. Similarly, some people have reported using ski head bands with wide space to cover the ears; they wear the head band over their eyes instead of on the top of their head and keep the ears covered, and this works for them.

If these won't work, then your options generally tend toward the creation of some kind of consistent background noise that masks other smaller household or exterior sounds which might interrupt your sleep.

You may already own a room fan, either on your nightstand, built into the window, on a stand in the corner or overhead. Fans can be useful even in the winter for pushing warm air down by reversing overhead fan blades or by directing conditioned warm air from vents or heaters to the center of the room. They can create just enough background noise to keep the brain from tuning into the tiny sounds of a household, like the refrigerator running or the minor creaks of a house, or of the sound of water in outside gutters.

Soft music is another useful option. You can deliver this in various ways. Tune into a New Age or classical music station on your satellite TV or stereo at a very low volume (but drape a towel over the TV or stereo to block any outgoing light patterns, which can disrupt sleep). Wear noise-canceling headphones or earbuds and listen to very soft, relaxing music from your electronic device (again, turn the device face-down or shut its cover to hide outgoing light patterns). You can use timers to shut off these programs, if available, so that you get just enough soft noise to usher you off to sleep. Avoid listening to spoken word programs, unless they are designed for relaxation, as they tend to command attention and stimulate the brain enough to prevent relaxation.

Sound machines generate different kinds of noise, including white or pink noise, wave sounds, the sounds of storms or rain, and other nature or even manmade sounds (some people like the slow drone of traffic to relax by). They can also generate frequency tones that may help the brain achieve relaxation (see Isochronic tones and binaural beats). If you have a bed partner, you may need to figure out which noise machine sounds work best for the both of you. Interestingly, some people find comfort in the sound of their partner's CPAP machine and are bothered by its absence when their partner is away or not using it.

Isochronic tones and binaural beats are specific kinds of frequencies that may be capable of delivering sleep-friendly tones through a process known as brainwave entrainment. The theory behind brainwave entrainment, generally, is that you can use certain repeated vibrations or frequencies to launch specific kinds of brainwave patterns. Some tones might allow the brain to become more focused (synchronizing with alpha waves), which is desirable for, say, college students, while others could encourage relaxation by creating synchronization with delta wave patterns, which would appeal to insomniacs.

Isochronic tones are defined as specific, carefully spaced pulses of sound that target certain brainwaves that, once processed in the cortex, achieve brainwave entrainment. They are thought by some to be effective without the use of headphones to be heard, unlike binaural beats, which are defined as two slightly different frequencies presented independently to the left and right ear by way of headphones. What the brain “hears” is the subsonic difference between both sounds of a binaural beat, which creates a distinct new "binaural" sound that the brain may then become entrained to.

Theories behind isochronic tones and binaural beats are being researched, but little solid scientific evidence has yet been established to prove their efficacy. However, many people use these particular frequencies in smartphone apps designed to augment meditation and relaxation practices and anecdotally find that these technologies work. While the jury is out, this is still an area of research to watch. It's worth noting that those who suffer from seizures should avoid using these kinds of products until research can prove (or disprove) safe usage for them.

Sound "radio" refers to online radio channels devoted to relaxation music which borrow from theories about brainwave entrainment to offer listeners options for music which can be used for meditation as well as for achieving sleep. They often incorporate isochronic tones or binaural beats. In addition, there are sound relaxation downloads through online media servers like iTunes, and smartphone apps, which can deliver these various options for those who are interested.

Additional resources

The National Sleep Foundation || Listen. Are Noises Keeping You Awake?
Huffington Post || 9 Ways To Block Out Noise And Get A Good Night's Sleep For Once
REDDIT DISCUSSION || The best headphones to SLEEP in? Most comfortable?
Top 10 Reviews || 2015's Best Top Ten Sound Machines
[PRO] Intelegen Inc. || The Science of Audio-Based Binaural Beat Brainwave Entrainment
(supporting brainwave entrainment for sleep)
[CON] Neurologica || Brainwave Entrainment and Marketing Pseudoscience (skeptical about brainwave entrainment for sleep)
Sound Oasis Radio || Listen to 8 Hours of Free White Noise 
Relax Melodies || Free sleep aid application which includes isochronic tones, binaural beats and various white noise options


A friendly reminder that links to websites offering products does not imply endorsement by SleepyHeadCENTRAL.com.

SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.  

Alternatives || Sleep better when you have the flu with these tips

Most people understand that when they have the flu, one of their best defenses is to get some quality sleep. However, between the coughing and the congestion and other symptoms of flu, it's awfully hard to get some quality sleep. Here are some easy ways to help you achieve sleep while you are suffering from flu symptoms.

DECONGEST
If you're congested or experience an increase in mucus, it can make it difficult to breathe while in bed. Try some of the breathing strips or a nasal spray to help keep your airways clear. It's important to breathe through your nose, as mouth breathing can lead to uncomfortably dried out oral passages and coughing.

Elevate the head of your bed or sleep in a recliner, or prop yourself up by pillows behind your back to allow your sinus passages to drain effectively. Avoid just adding one more pillow to behind your head; you might just be pushing your chin further into your chest, resulting in an even more restricted airway. [Curator's note: I often have patients with sleep apnea in the lab for studies who use two or more pillows; when I ask them to reduce their pillows to only one, they sometimes are surprised to discover they have more space in their airway to breathe.]

A humidifier or vaporizer can help restore humidity if your household climate is extremely dry, and this can provide comfort, but be vigilant about keeping your devices absolutely sterile. Unclean humidifiers and vaporizers often just put more allergens and other substances in the air that will further antagonize your condition rather than alleviate it.

Placing your face over a bowl of hot water and covering your head with a towel can also catch steam that can help relieve your congestion. Even a hot shower without washing your hair can do the trick.

Menthol products are also safe and very useful for helping with congestion. Either a menthol chest rub, lip balm or nasal inhaler can be effective in keeping mucus thin enough to expectorate or blow from the nose.

HYDRATE
Drink plenty of water. Water can help flush out the system and rehydrate your passages,and 100 percent fruit juices with some vitamin C content can be helpful. Warm liquids are even better--think of broths and decaffeinated teas. Some people do better to avoid milk products, which may increase unpleasant phlegm, but others like warm milk as it helps them to fall asleep. Warm almond or soy or rice milk might be good options. Avoid caffeine as it also contributes to dehydration and can interfere with sleep.

CHOOSE MEDICINES WISELY
Be wary of over the counter cold medicines. Some of them will interfere with sleep, such as the common decongestant pseudophedrine, which can leave you feeling jittery, and the popular allergy medication, diphenhydramine, which causes jitters in some and sleepiness in others. The alcohol in some liquid cold medicines will also mess with your ability to achieve deep sleep and can lead to dehydration, which can make your airway passages uncomfortably raw while you are running a course of flu.

Stick to simple pain relievers for aches, pains, fever and chills (aspirin, Tylenol) rather than choosing a multi-purpose cold medicine so you don't unwittingly mix medications that, together, might make it harder for you to achieve sleep.

Don't take sleeping pills, as they won't allow you to get the healing sleep you need and may have dangerous interactions with any cold medicines you do decide to take.

PRACTICE GOOD SLEEP HYGIENE
Use several light blankets that you can throw off or pull on depending upon your symptoms. Make sure they are easily washable so you don't "share" your flu with anyone else.

A dark, slightly cool room is perfect for sleeping while you are sick. Too warm a room can contribute to nasal stuffiness and dehydration (overly dry air and sweating). Darker is better because you will wake up less once you do fall asleep; try an eye mask if you can't achieve dimness in your sleeping space during the day.

Finally, try not to sleep too far off your normal schedule. Stay awake and do quiet tasks like read or watch TV during most of daylight; you could unintentionally mess with your circadian rhythms if you sleep all day long and wake up to find you aren't sleepy at all when bedtime rolls around. Of course, let your body be the judge; if you are extremely fatigued, then let your body rest however it needs to rest. But try to avoid long marathon sleeps during the daytime if you can.

Avoid your blue-spectrum light sources (all electronic devices) after the sun goes down. When these specific kinds of light rays reach your eyes, they signal the pineal gland in the brain to stop releasing melatonin, which is critical to sleeping at night. Keep your home dimly lit and avoid stimulating music, video games or television so that your body can naturally fall into its normal sleep rhythm.

A friendly reminder that links to websites offering products does not imply endorsement by SleepyHeadCENTRAL.com.

SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.  

Sleep Hygiene Tip of the Week || Check out Grandpa's sleeping conditions

"Mark Twain, New Hampshire, 1905," by
The New York Times. Public domain.

Sleep health in the elderly can be compromised for any number of reason. Aging itself means less human growth hormone is released because elderly people experience fewer deep sleep stages in their golden years; these are the sleep stages when HGH is produced.

On top of that, chronic health conditions and their medications can disrupt sleep health.

Elderly people who continue with unhealthy lifestyle habits like abusing alcohol, smoking and poor eating habits can expect to see the consequences result in impairments in their sleep health.

In addition, many elderly folks deal more regularly with the loss of loved ones; bereavement itself can be hazardous to good sleep.

Some of these things can't be changed easily for elderly people by their loved ones. However, there are other things that families can do to help out grandparents who might not be practicing the best sleep hygiene (or who might not have the opportunity to do so).

Take a look at these options when you next visit your elderly loved ones, whether they live independently or reside in a nursing facility or retirement community where they have access to services.

1. Consider the quality of the actual mattress they are sleeping on. Do they need more support? Is their bed hard for them to get in and out of? Sometimes elderly people choose an uncomfortable couch for sleeping over an inaccessible bed. Neither option is acceptable. Also consider whether they need additional pillows, a wedge to help them sleep more upright or risers for the head of the bed; elevating a bed at the top can make sleeping much more comfortable. Sometimes elderly folks prefer a reclining chair to a bed; you might discuss this option. Finally, make sure they have comfortable, clean sheets and an adequate amount of blankets.

2. Look at the light sources in the room. The elderly do need additional nightlights in the evening so they can be safe walking from one room to the next. However, rooms with too much additional light (from house lights outside or streetlamps or traffic) can make it harder for them to fall asleep do to lack of melatonin production. Some facilities have regular visits from ambulances and aid cars in the evenings, and the added light from these vehicles can also disturb the sleep of residents. Consider adding appropriate window treatments and/or nightlights to fix lighting problems in your loved one's living quarters.

3. Listen for noise. Not all elderly people are hard of hearing. Many hear just fine, and that means they can hear their neighbors' television sets (especially if their neighbors are hard of hearing!), the traffic outside, the noise coming from nearby businesses during the evening. If they can use earplugs in a noisy environment, encourage them to do so. Setting up a white noise machine can also help block out noise at night so they can sleep better.

4. Ask if they are always cold or always hot. Sometimes, facilities and community housing have less than ideal temperature controls, especially if the structures are older. While it's not unusual for elderly people to have a very limited bracket of comfort when it comes to ambient temperature, sometimes it's a matter of adjusting thermostats, blocking drafts, using carefully placed fans or having layers of blankets on hand.  In addition, make sure to review medications regularly and consider their side effects and interactions if your elderly loved one is complaining about being too hot or cold all the time. Finally, keep in mind seasonal changes. What we as adults can tolerate can be far too extreme for our grandparents. Ultimately, a sleeping space that is too hot or too cold for them will be hard for them to sleep in.

Sleep Hygiene Tip of the Week || Stay Cool!

"Kawasaki Electric Fan," 2004. Credit: CC BY-SA 3.0

It may seem obvious that warm weather makes it hard for many to be comfortable enough to sleep during the summer, especially if they don't have air conditioning or good air circulation in their homes. But keeping a proper temperature in your sleeping space at every time of year is important for more than just comfort.

Part of your body's circadian system relies on your body's careful regulation of its temperature. A general reduction in core temperature helps to facilitate sleep. You achieve your lowest core temperature about four hours into your sleep period and this low point helps reset your rhythms for the day.

By no means does this suggest you make your efforts at body temperature reduction extreme, as being too cold can also keep you from sleeping. But generally speaking, the human body has a thermal pattern that includes a cooling off period at night which helps make you sleepy.

So there's a heat wave on where you live. What then? If the ambient room temperature in your sleeping space is uncomfortably high, you will end up sweating, tossing and turning because your body isn't going to achieve the lower core temperature required to become drowsy.

While there isn't a perfect room temperature conducive to sleeping for all human beings, being in a sleeping space that's 54-75 degrees Fahrenheit is one's best bet. Therefore, if you don't have air conditioning or even a fan to help move air and make you feel cooler, and it's very warm in your sleeping area, you may need to cool your core temperature with cold fluids at bedtime or even take a sponge bath using cool (not icy) water to help cool yourself off before going to bed.

Research has shown that insomniacs generally have a higher core body temperature, no matter what time of year, which could be part of their sleeping challenge. One way to help drive that drop in core temperature for them might be to take a hot bath right before bed. I know, it seems counterintuitive! But once out of the hot bath, the body naturally cools in a cooler space and this could lead to the drowsiness that can elude some insomniacs.

Also, if you wear too many blankets at any time of year and sweat a lot during the night because of it, this could hamper your efforts to more quickly fall asleep, so you might think about turning down your room temperature if you can't get rid of the blankets, or try for lighter blankets so you can better facilitate your own good sleep.