My take on sleep hygiene

Stephanie did things “right.” She followed the sleep hygiene rules to the letter—regulating her sleep time, using her bed just for sleep, etc.

Even after several months, none of that helped. She went back to the doctor’s office, but was told she just needed to try harder.

When a patient doesn’t have a medical concern, sleep hygiene (or the more restrictive cognitive behavioral therapy) are usually the only response sleep docs have.

Here’s my take on sleep hygiene, responding to so many questions I’m asked about it.

A little language note here: “hygiene” is such a weird, old fashioned word. But it’s not just a word, it’s also how sleep is approached—as a thing to “wash, rinse, and repeat,” to be kept neat and pristine.

Sleep is more nuanced than that. It’s a combination of behavior, health, and how you relate to yourself and underlying concerns.

Sleep hygiene has some good ideas, underneath the rigidity. The main one is the quest to instill sleep habits. Your habits can make a difference, especially when done with kindness towards yourself (instead of finger pointing with “shoulds”).

Let’s take a look at the sleep hygiene instructions, and my views on adhering to them to the letter.

These sleep habit ideas all make sense:
Reduce caffeine, alcohol, and nicotine. Keep naps short (no longer than 20-30 minutes). Reduce screen time before bed. Make your bedroom quiet, cool and dark.

These are more of a mixed bag:

• Your sleep routines: Go to sleep and wake at the same time each day. By doing that, you’re not out of whack on Sunday night. You’ll also honor the value of sleep—naming the times to make rest your priority. But being rigid doesn’t always welcome sleep.

  My view: Set a routine that makes sense to your body. If you’re not already there, adjust slowly over a month or season to slowly move to those times.

• Don’t sleep in on weekends. Have you heard that sleeping in on the weekends won’t help your sleep deficit? It’s true that if you’re squeaking by on a few hours a night, one night’s sleep won’t miraculously improve your creativity, memory, or your increased chance of Alzheimer’s.

  My view: We’re not just sleep-deprived, we’re seriously dream deprived. Dreams help us work through so much behind the curtain. Waking at the end of a dream cycle, instead of when the alarm goes off, refreshes the psyche.

  Rather than messing up your circadian cycle, give yourself an early night. Or see if sleeping in on Saturday morning (waking early on Sunday) helps your back-to-work night be more aligned.

• Exercise, but… “not within 3 hours of when you intend to go to bed.” This keeps your body and body temperature from getting too revved up before sleep.

  My view: Don’t neglect how moving—a walk around the block, stretches, even a gentle boogie to a song—can get you out of your mental virtual reality, back into your body. Being in your body is where you rest, so it’s worth saying hello to it before you try to sleep.

• Just sleep and sex? A key sleep hygiene rule is to reserve your bed only for sleep and sex. No reading, screen watching, or working, even in the bedroom. Also no staying in bed if you’re awake for more than 20 minutes, says sleep.org. This is to reduce the link between the bed and negative associations with insomnia, to just associate it with sleep.

  My view: Many clients who tried this said they’d spend those 20 minutes time assessing whether to get out of bed, instead of allowing rest and sleep. This rule also supports the idea that sleep is an on/off button, one that only works when you’re totally exhausted.

  Your association with the bed becomes positive when you spend time resting. It becomes a place to connect to yourself and your body, even when you’re awake. So get out of bed if you want to, but also know you can play with options of rest, and welcome sleep with kindness.

Make your sleep habits work for you. Instead of doing sleep hygiene to “get” sleep, create sleep habits that connect you to your body and your home on earth.

Experiment by noticing how you are with yourself at night, and how you respond to demands of the world during the day. Notice who you are and what allows you to rest and sleep.

Stephanie now has consistently better nights. Not all perfect; we’re still unpacking some knots of anxiety. Still, she knows how to embrace tools to help her let go into rest.

She feels her nights are hers again. She has options that resonate with her own sense of rhythms and patterns. She’s feeling more responsible, not blamed, for creating her rest and sleep.