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Nothing Shall Be Impossible

Doc Talk: Dr. Kelly Carden explains why your sleep habits are as important as diet and exercise

Few things are more frustrating than not being able to sleep.  Your mind is racing and you can’t shut it off.  You toss, you turn.  Then even if you get sleep, you know it is not going to be enough.  You know the next day is going to be difficult.  Then you are back to frustration!

Just about everyone has experienced difficulty falling sleep or difficulty returning to sleep once awake at some point in their lives.  For most of us it is a transient problem.   For others, it can be a longstanding problem.  There is something that you can do! Cleaning up your habits can help.  Although it is a funny phrase, the sleep medicine world calls these recommendations “sleep hygiene.”  Optimization of these habits is important for all of us, not only those with difficulty sleeping.

The standard recommendations include:

  • Got to bed only when sleepy

If you body is not ready for sleep, you can not force it to sleep.  Many people are on the go all day, including right up until bedtime.  If you are not sleepy, but jump into bed expecting to sleep, you are likely to be disappointed and frustrated.  If you go to bed when sleepy, you will reduce the time you are awake in bed and reduce the frustration.

  • Develop sleep rituals

Develop a ritual to let your body know to prepare for bed.  Make sure the ritual includes things that you enjoy and that relax you.  Listen to relaxing music, read a book or short story for 15 minutes, or have a cup of caffeine free tea.   Relaxation techniques such as stretching, yoga, and deep breathing may also help relieve anxiety, reduce muscle tension, and allow you to fall asleep easier.

  • If you can't fall asleep to the point of becoming frustrated, get up and do something boring until you feel sleepy

Go back to your nightly ritual to give your body a cue to wind down.  Do not expose yourself to bright light while you are up.  This is a stimulus to your body that it is time to be awake.  Do not perform activities that wake you up more.  Avoid work-related activities, cooking, cleaning, use of the computer, or television.

  • Don’t take your worries and responsibilities to bed.

If you are worried about something or making “to do” lists in your head as you try to sleep, you may have trouble falling asleep.  Try to leave your worries about your work, school, and family behind when you go to bed.  It might be useful to find time before bed to think about these issues and make your lists. 

  • Take a hot bath 1-2 hours before bedtime

A hot bath will raise your body temperature, but as your body temperature comes down it is a signal to your body to become sleepy.  Some people find that taking a bath as part of their ritual helps their overall sleep.  

  • Have a light snack before bed

If your stomach is empty and growling, it can interfere with sleep.  Make sure the snack is not too big as a heavy meal can interfere with sleep.  Also make sure that the snack does not contain chocolate as it has stimulant properties and may prolong sleep.  Just think, your mother was right about that warm glass of milk. Warm milk and foods high in the amino acid tryptophan, such as bananas and turkey, may help you to sleep.

  • Stay away from caffeine, nicotine and alcohol at least 4-6 hours before bed 

Caffeine and nicotine are stimulants that interfere with your ability to fall asleep, your sleep quality, and your ability to stay asleep.  Coffee, tea, soft drinks, hot cocoa, chocolate and some over-the-counter medicines contain caffeine. Cigarettes, cigars, and some drugs contain nicotine. Although alcohol may help you fall asleep, it significantly interferes with the quality of your sleep and often makes you wake up more in the second half of the night.  

  • Get up and go to bed the same time every day 

The human body likes regularity in most everything, including sleep.  Keeping yourself on a regular schedule (even on the weekends) will keep your sleep in a natural rhythm.  You will fall asleep easier and feel better!

  • Don't take naps

If you nap throughout the day, is it any wonder that you might have trouble sleeping at night?  The avoidance of naps will help keep your body in rhythm and ensure that you are appropriately sleepy at bedtime.  It is normal for humans to feel sleepy in the late afternoon but most people can avoid falling asleep.  If you feel that you absolutely can not make it through the day without a nap, make sure that it is at least six hours before bedtime and lasts less than 45 minutes.  If you are having trouble sleeping at night, eliminate naps completely.

  • Refrain from exercise at least four hours before bedtime 

Regular exercise is recommended for your overall health, but can also help you sleep better.  The time you exercise is important though!  Exercising in the morning or early afternoon will not interfere with sleep.  Exercising late in the evening can make it more difficult to fall asleep.

  • Only use your bed for the three “S” activities

The bed should be for sleep, sickness, and ………intimacy only.  It is best to leave all other activities for the other rooms of your home.  Refrain from using your bed for watching TV, paying bills, eating, doing paperwork, using the laptop, or prolonged reading.  Let your body "know" what the bed is for.

  • Optimize your sleep environment

Make sure your bed and bedroom are quiet and comfortable.  Noise and light can interfere with sleep.  If you live in a noisy area, earplugs, heavy curtains, or a white noise machine might help.  If you are sensitive to morning light, make sure your curtains are heavy enough to block light in the morning or try wearing an eye covering.  The temperature of your room is important as well.  A hot room can be uncomfortable and force you to rearrange the bed covers, toss and turn, sweat, or change your sleepwear.  A cool (not cold) room with appropriately warm bed covers is recommended.   An uncomfortable mattress or bedding can also interfere with sleep.  Evaluate your sleep environment and make sure it is the best it can be… deserve it!

  • Do not watch the clock

Many people who are having difficulty sleeping check the clock to see how long it is taking to fall asleep, how long they have been asleep, or how much longer they have left to sleep.  This can be a source of frustration and should be avoided. 

  • Use sunlight to set your biological clock

When you get up in the morning, try to get exposure to bright light, preferably sunlight.  Light is the signal to your body that it is morning and you should wake up fully.  Getting 15 minutes of sunlight exposure in the morning can make your entire day better and brighter!

Sleep is not an option.  The average American does not get enough quality sleep.  All too often our own habits get in the way.  So be good to yourself.  Your health, happiness, productivity and even safety depend on how well you meet your body’s need for rest and quality sleep.  Optimize your sleep habits just the same way you take care of yourself with diet and exercise.  Your body will thank you for it!

Dr. Kelly Carden with Sleep Medicine of Middle Tennessee sees patients at Saint Thomas Midtown Hospital and Saint Thomas West Hospital. To make an appointment at Midtown, 300 20th Ave. N., please call 615-284-7533. To make an appointment at West, 4230 Harding Road, please call 615-284-7533. 


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