The previous post on PTSD and Sleep presented 10 Reasons PTSD May Cause Problems Sleeping. When we lose sleep, the brain keeps an exact accounting of how much sleep is owed in order to get caught up. This is called our sleep debt. The effect of each successive night of partial sleep loss is carried over, and the effect accumulates. The strength of the tendency to fall asleep is progressively greater during each successive day. If we miss three hours one night, we must sleep 11 hours the next night in order to feel alert throughout the day. In fact, we don’t work off a large sleep debt by getting just one good night’s sleep.
Fortunately, you can do a number of things to improve the quality and amount of sleep that you get. In this companion post you’ll find 9 recommendations from sleep researchers about steps you can take to improve your sleep quality.
1. Exercise during the day
Do aerobic exercise regularly, but not close to bedtime. This can take various forms such as a routine like walking, jogging, aerobic classes, various workout routines, and vigorous work that raise your heart rate for a half hour or longer. However, try to avoid exercise within four hours of your bedtime. Reading boring material helps with calming down after exercise.
2. Keep to a Regular Sleep Schedule
Try to stick to a regular sleep schedule. Over millions of years our bodies have developed a remarkably precise biological clock that regulates sleeping and waking. The nighttime – daytime cycle is represented in miniature within our cells. It also synchronizes a vast array of biochemical events in our bodies such as chemical, hormonal, and nerve cell activities that promote our daily fluctuation in feelings and actions.
Bright light, like sunlight can reset the night/day (circadian) cycle. Light is the most powerful time cue our bodies have. The use of electric lights in the evening, which we previously thought had no effect, can have a profound effect in lengthening our biological day and shifting our clocks. Even doing email or reading at night has the potential to fool our bodies into delaying our biological onset of sleepiness. Being surrounded by electric lights in the evening pushes our biological clocks around, so that our clocks start lagging about an hour every day.
Also, be aware that your infant’s sleep patterns may reflect your evening activities such as going to a mall in the evenings – exposure to bright lights. For more regular sleep, prefer a more routine and less light-stimulated evening schedule.
3. Avoid Heavy Meals before Bedtime
Avoid eating heavy meals before going to bed; however, make sure that you do not go to bed hungry. To increase your chances of a good night’s sleep, have a milk product or light carbohydrate snack shortly before bedtime. Don’t sweeten your warm milk with artificial sweetener. Food additives in general and artificial sweeteners in particular tend to increase alertness, which interferes with sleep.
Consume carbohydrates and fats as evening snacks if you eat snacks after dinner. Avoid beans and other protein-rich foods, raw onions, cruciferous vegetables (broccoli, cauliflower, cabbage), and spicy foods shortly before bedtime.
4. Limit Alcohol, Caffeine, and Nicotine Consumption
Alcohol consumption reduces the relative amount of time spent in REM sleep; therefore, sleep following alcohol consumption is not as restful as alcohol-free sleep. The more alcohol we consume, the less REM sleep we get and the less rested we are in the morning. It’s best to avoid consuming alcohol within three hours of your bedtime.
Also, reduce the amount of caffeine and nicotine that you consume during the day. Because caffeine and nicotine are stimulants, avoid drinking caffeine after lunch time, and do not smoke just before going to bed.
5. Avoid Naps after 3 PM
The ideal time for a nap, according to sleep researchers, seems to be 12 hours after the midpoint of one’s previous night’s sleep. So if you sleep from 11:00 PM to 6:00 AM, your nap urge should be around 2 PM. The ideal length seems to be 30 minutes. Evening naps appear to interfere with sleep.
The effects of napping are different for the sleep-deprived and the non-deprived. For the sleep-deprived, napping improves performance but not mood. For normal sleepers, napping improves mood but not performance.
6. Change Tactics after 30 Minutes of Trying
Trying to force yourself to fall asleep often fails. If you are having a hard time falling asleep after 20 to 30 minutes, get up out of bed and try to do something relaxing (for example, drinking warm milk or a calming herbal tea, reading a book). If you can’t quiet your thinking, try writing down what’s on your mind. Return to bed when you feel drowsy.
7. Make Your Bedroom Quiet, Dark, and Cool
Try to make your bedroom a relaxing place, and try to limit your activities in the bedroom. For example, do not eat, watch television, check e-mail on your laptop, or talk on the phone in bed. Your bedroom should be associated with sleep. Utilize a white noise machine, ear plugs, or an eye mask to help block out any distracting noises or light. Try to keep your bedroom at a cool and comfortable temperature.
8. Use a Relaxation Routine
Practice relaxation before or after going to bed. Relaxation routines are designed to release muscle tension, stop thinking about activities, and slow down your breathing. A technique called progressive relaxation is very effective. Start by focusing your attention on your feet and ankles and release all the tension in them. Then, focus your attention on the muscles from your ankles to your knees and release all the tension in those tissues. Keep working your way up your body this way. The next segment is from your knees to your hips. Then from your hips to your waist. Next, from your waist to your shoulders. Then your arms, hands, and fingers. Then your neck, jaw, and face. Notice that the tissues in each segment are completely relaxed and at ease before going to the next segment. This is also good for getting back to sleep when you wake at night.
9. Use Medications for Sleep Cautiously and Only Under a Physician’s Supervision
In his book titled The Owner’s Manual for the Brain, Pierce J. Howard, Ph.D. provides some guidelines for using the over-the-counter medication called melatonin. He recommends taking melatonin only in the evenings, unless you are taking it for help with sleep problems associated with changing work shifts. In that case, take your dosage two hours before desired sleep onset, regardless of the time of day.
He notes that people in their 20’s should take melatonin infrequently and only for insomnia. Those in their 30’s to 50’s may take it more frequently for insomnia; those over 60, daily. Begin with 0.5 mg of melatonin two hours before desired sleep onset, and increase by 0.5 mg until desired sleep quality is attainted.
For jet lag associated with travel involving time-zone changes, try 1 mg of melatonin for each time zone crossed. Take your dosage a few hours before bedtime at your destination. Do the same again when you return.
He emphasizes consulting your physician if you are taking other medications, or if your dosage of melatonin exceeds 10 mg.
Those of us with Operation Pegasus help people understand posttraumatic stress and how to self-administer the symptom management skills of the Trauma Resiliency Model (TRM). Family members are invited to participate. Get control and get relief. Call or email us today. We’ll get started right away.