Mastering the 6 Pillars of Sleep Optimization for Better Health and Wellbeing

Creating Your Slumberland

Our external environment can significantly affect your ability to initiate and maintain deep sleep. Here are the top recommendations:

1. Temperature - your core body temperature must drop to initiate and maintain a deep sleep; this is why it's easier to fall asleep in a cooler versus hot environment. In the winter, a room temperature of 18'C is recommended. With air-conditioning in warmer climates or seasons, 21-23'C is recommended. Adjust your pajamas, bedding and fan/fresh air usage appropriately to encourage your core body temperature to lower.

2. Darkness - increasing darkness towards the end of the day promotes a rise in melatonin, the key hormone that initiates the timing of sleep. A dark room helps to keep melatonin levels high and promote a deep sleep over the course of the night. Consider investing in blackout curtains or a simple sleep-mask to block ambient light. Avoiding screens and technology in the 1-2 hours before bed also helps to encourage melatonin production.

It is also recommended to turn off 50% of the lights in your home at 7 PM and use low-level lighting for the rest of the evening. Melatonin-supporting light bulbs are also commercially available.

3. Quiet - a quiet room and environment helps facilitate falling asleep and minimizes nighttime awakenings. If your space isn't quiet, consider using a white noise machine or app to drown out disruptive noises. Alternatively, ear plugs (even one ear plug worn in the ear that is off the pillow) can significantly reduce noise disruption and promote sleep.

Sleep Schedule

1. Pick a consistent wake up time. This is arguably the most important component to getting your sleep back on track and improving your overall sleep quality. Choose a time that you can reasonably get up each morning of the week, even on weekends. Sleeping later after a bad night's sleep and/or on weekends can have the unintended consequence of making it harder to fall asleep the following night at your desired time and wake up on Monday mornings.

2. Consider setting a bedtime alarm. Often, you may realize there are a number of things that you want and/or need to do before you go to bed. Setting a bedtime alarm gives you time to give these things attention before it's too late in the evening.

3. Get into bed when you are tired enough to fall asleep quickly. You would never sit at a table waiting to get hungry; don't get into bed waiting to get sleepy! By lying awake, you can become restless and frustrated. Use the time between your bedtime alarm and getting into bed to incorporate wind-down and decompression activities to encourage sleepiness.

Bed Behaviors

1. Use your bed only for sleep, sickness and sexual activity. When you use your bed for other activities (ie reading, using your phone/computer/tablet and/or watching tv) you are unintentionally training yourself to stay awake and stimulated in bed. By avoiding these activities while in bed, you will begin to associate your bed with relaxation and sleep only.

2. Avoid electronics and devices that may distract you from sleep. This includes your clock face - remove it or turn it out of view so you do not worry about the time you are taking to fall asleep. The exception to this is if you are using a device to track your sleep (my rule is to have it on Airplane Mode, if applicable).

3. Do not stay in bed if you are awake. If you are having trouble falling asleep or falling back asleep once you awake, get out of bed. Get up and do some relaxing activity (ie listen to a podcast or guided meditation, read under low lighting conditions) until you are sleepy enough to fall asleep quickly in your bed. "Trouble falling asleep" is considered if you have been lying in bed longer than 20 minutes or long enough to think "Why have I not fallen asleep yet?". Getting out of bed can be challenging, but retrains your brain and body to associate your bed with sleep while also decreasing frustration and restlessness.

Destress to Rest

The most common contributing factors to insomnia and sleep disturbances are worry, rumination and anxiety. Creating a bedtime routine gives you the opportunity to unwind from your day, destress and decompress. Ensure the first time you are checking in with yourself all day is not when your head hits the pillow! Here are the recommendations, supported by science, for optimal bedtime routine components:

1. Take a hot bath or shower - this helps to encourage peripheral vasodilation, or bloodflow to your extremities, ultimately dropping your core body temperature. A bath or shower can be therapeutic to help you relax, while the drop in body temperature can promote sleepiness. Adding a few drops of Lavender essential oil to your bath or shower may also help to promote relaxation and sleepiness.

2. Journal - Writing your feelings or to-do list before bed involves a different cognitive process than just thinking about them. Getting these things out of and off of your mind can promote a sense of relaxation and decrease restless rumination. You may also want to consider leaving a notepad by your bed for those things you suddenly remember or idealize in the middle of the night.

3. Meditation - Just 3-5 minutes of meditation can improve relaxation, mood and sleep. There are some great apps available to guide you - recommendations include Calm, Insight Timer, 10% Happier and Headspace.

Fuel Your Sleep Appropriately

When and what you eat and drink during the day ultimately impacts how well you will sleep at night. Follow these nutritional recommendations to fuel your sleep:

1. Restrict caffeine to 12 hours before your ideal bedtime. It takes the average person 12 hours to fully metabolize a serving of caffeine. Working from your consistent wake up time and accounting for at least an 8 hour sleep window, restrict your caffeine intake to 12 hours prior. For example, if your wake-up time is set to 6 AM, your ideal time to fall asleep by is 10 PM. You would then limit caffeine intake to no later than 10 AM.

2. Avoid alcoholic drinks before bed. While alcohol can help you relax, it disrupts your sleep in 3 primary ways. Alcohol raises your core body temperature, making it harder to maintain deep sleep. Alcohol is also a potent-inhibitor of REM sleep, the sleep stage in which we dream and spend most of our time from 1-3 AM onward. Alcohol is also a diuretic, causing increased wakings to urinate. Limit yourself to one alcoholic drink, ideally 4 or more hours before your ideal bedtime.

3. Avoid large meals and beverages too close to bed. A large meal may cause indigestion and the process of digestion is actually thermogenic (meaning it raises your core body temperature), ultimately interfering with sleep. Large beverages can also contribute to frequent awakenings to urinate. Limit these to your tolerance level.

A Good Day's Night

Your level and pattern of activity during the day ultimately impacts how well you will sleep at night. The following have been shown to impact sleep patterns:

1. Exercise & Physical Activity - both are extremely beneficial for overall health and for the purposes of sleep. Burning enough energy throughout the day is key to sleeping well at night. However, exercising too late in the day can increase cortisol (your main stress hormone) levels and body temperature. Try to exercise at least 30 minutes most days but not later than 2-3 hours before your ideal bedtime.

2. Napping - if you are having trouble sleeping at night, avoid daytime naps altogether. This is especially challenging, but important, at the beginning of your treatment plan when you are setting a consistent sleep-wake schedule. Napping, especially after 3 PM, can relieve enough "sleep pressure" to make it difficult to fall asleep at night.

3. Sunlight Exposure - daylight exposure plays an important role in regulating daily sleep and wake patterns. Try to get outside in natural sunlight for at least 30 minutes each day. If possible, wake up with the sun or use very bright lights in the morning.

Improve Your Sleep with Dr. Mariem Idrissi

If you're struggling with insomnia, Dr. Mariem Idrissi can assist you in identifying and treating the root causes of your sleep issues. Here are some ways she can help:

Assessment of Sleep Patterns

• Comprehensive evaluation of your sleep habits

• Identification of factors contributing to insomnia

Personalized Treatment Plans

• Development of tailored strategies to improve sleep quality

• Incorporation of lifestyle changes and behavioral therapies

Ongoing Support and Guidance

• Regular follow-ups to monitor progress

• Adjustments to treatment as needed

With Dr. Idrissi's expertise, you can work towards achieving restful sleep

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