Sleep health


12 Steps to Getting a Better Night’s Sleep

Baptist Health Miami Cardiac & Vascular Institute

It’s the decidedly dull term for what should be happening in your bedroom: sleep hygiene. But while it may not sound exciting, it is absolutely essential.

As we mark Sleep Awareness Week and "springing forward" an hour, it’s important to note that your sleep routine has an important connection to your overall health. To underscore that, the American Heart Association recently added sleep to its list of crucial components for optimal adult cardiovascular health.

“Having a good quality and good quantity of sleep is of paramount importance,” says Harneet Walia, M.D., medical director of sleep medicine at Baptist Health Miami Cardiac & Vascular Institute. “It’s not a luxury, it’s a priority. Maintaining healthier sleep habits can help manage health factors such as weight, blood pressure or risk for type 2 diabetes more effectively.”

According to new research published in the Journal of the American Heart Associationsleeping an inconsistent number of hours each night and falling asleep at different times may increase the risk of developing atherosclerosis, the hardening of the arteries due to buildup of fatty deposits known as plaque.

Harneet Walia, M.D., medical director of Sleep Medicine and Continuous Improvement at Baptist Health Miami Cardiac & Vascular Institute.

Variations in sleep duration of more than two hours a night within the same week showed an impact on adults in one of the first studies to link irregular sleep habits with atherosclerosis. The study offers new evidence that your sleep routine may play an important role in preventing cardiovascular disease — hence the need for sleep hygiene.

So what, exactly, is sleep hygiene? It’s the term used to describe the habits that promote a good night’s sleep — preferably between seven and nine hours nightly.

“If somebody is not able to get proper sleep quality and duration, one could start with incorporating simple measures into regular, day-to-day life,” Dr. Walia says.

Still, she notes, sleep issues can be complex. “It’s important to maintain good sleep hygiene, but some people may try to improve their habits and continue to struggle with sleep, daytime alertness and fatigue. If that’s the case, they should seek medical attention.”

Your behaviors during the day, and especially before bedtime, can have a major impact on what happens when you go to bed. Here are some suggestions from sleep experts and the U.S. Centers for Disease Control and Prevention:

• Wake up at the same time every day. Sleeping in on weekends may feel good in the moment, but it perpetuates disruptions in your sleep patterns and will leave you feeling miserable on Monday morning when you have to get up early again. The best way to set your body clock is with consistency: Establish a regular bedtime and time to awaken, and stick with it. If you absolutely must sleep in, keep it to no more than an extra hour.

• Get a dose of bright light first thing in the morning. When light enters your eye and hits your retina, it sends signals to your brain’s master clock. This is a cue to your circadian system, which regulates your sleep-wake pattern over the course of a 24-hour day, that it is time for wakefulness and activity. Getting a dose of sunlight first thing in the morning can help you reset your internal clock if you do it consistently.

• Dim exposure to bright light at night. Our bodies were designed for natural light in the day, and darkness at night. But with all the artificial light in the modern world, our inner clocks can be thrown off. The more exposure you have to light at night, the greater impediment you may have to your body’s signal that it time to sleep.

• Engage in a nightly digital detox. Do yourself a favor by dimming your screens, wearing blue-light blocking glasses or, better yet, going screenless after a certain time in the evening. Electronics emit blue light waves, which can suppress melatonin production and disrupt your sleep. Your body’s circadian clock responds with a signal to be awake. Most experts recommend avoiding the use of electronics for 30 minutes or one hour before you go to sleep.

• Keep your bedroom cool. Temperature plays a huge role in how well we sleep. Cooling things down works alongside the patterns of our core body temperature and the body’s circadian rhythm. A cooler sleeping environment promotes higher production of melatonin, a hormone that encourages sleep onset and more restful sleep.

• Avoid large meals before bedtime. When we eat late at night, the muscles that digest and metabolize food must keep working when they should be resting. Eating also prompts the release of insulin, a hormone that helps turn food into energy. This process can shift your body's sleep-wake cycle and delay your ability to fall asleep. Also, eating a big meal may exacerbate acid reflux and cause heartburn while you sleep. If you’re hungry in the evening, reach for a small, healthy, low-fat snack.

• Skip the alcohol. Alcohol has sedative effects that can induce feelings of relaxation and sleepiness, but its consumption — especially in excess — has been linked to poor sleep quality and duration, according to the National Sleep Foundation. As alcohol is metabolized, it causes disruptions to the normal phases of deeper and lighter sleep we go through every night. Studies also have shown that alcohol consumption can exacerbate sleep apnea.

• Avoid clock watching. If you’re lying in bed and you feel you’re unable to sleep within 20 minutes or so, don’t just lie there getting frustrated and anxious. “Leave the bedroom and do something boring,” Dr. Walia says. However, avoid bright lights and electronics during this time. “Come back to bed only when you're sleepy.”

• Move more during the day. Activity, even just a walk in the morning or after dinner, will consume some of your energy reserves, not to mention improve your cardiovascular and metabolic health. But it’s important not to work out too late in the evening, as exercise increases the body’s core temperature and causes it to release hormones that may delay sleep.

• Cut out long naps. Taking a nap, especially in the later part of the day, can alter your circadian rhythm. It’s best to avoid naps if you are having trouble falling asleep. If you can’t get through the day without a snooze, keep your nap to less than 20 minutes and take it in the earlier part of the day, Dr. Walia says. 

• Try not to stay up too late. If burning the midnight oil is part of your routine, retrain yourself by gradually retiring earlier. Being a night owl has health consequences, regardless of how many hours of sleep you get, research shows. People with what is known as evening chronotype — that is, a pattern of staying up and waking later in the day — have more than four times the risk of cardiovascular disease and six times the risk of type 2 diabetes than so-called early birds. “There is emerging research about circadian rhythms,” Dr. Walia says. “The time we go to bed and wake up can have a lot of implications.”

• Avoid the regular use of over-the-counter sleep aids. Reliance on medications to help you sleep can have serious side effects for your health. While they may provide temporary relief for occasional sleeplessness, they do not solve long-term problems. Regular use can also mask sleep issues and keep them from being properly diagnosed. Before you resort to taking anything to get more shut-eye, talk to your physicians and get a complete evaluation.

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With internationally renowned centers of excellence, 13 hospitals, more than 23,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.

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