Balance, mindfulness, and mental wellness are essential to a healthy lifestyle.
Get Your Zzzs: Sleep Tips and How to Get Back on Track
One of my favorite holiday traditions is driving up to Portland for “second Thanksgiving.” My wife and I head up early with a homemade pie and some wine. We eat, drink, and talk with friends late into the night. None of this is ideal for sleep, but I happily make this decision year after year.
I assume that many of you reading this will find yourself in similar situations, so I have included some techniques for managing fatigue during the day and for getting your sleep back on track once the holidays are over.
The standard recommendations for healthy sleep are still good, like go to bed at the same time each night, get out of bed if you can’t sleep, wake up at the same time each day, etc. In the Behavioral Sleep Medicine program at Rhode Island Hospital I encourage patients to follow these guidelines literally every workday, but everyone will violate these rules from time to time.
Fortunately, our sleep biology has been shaped to withstand these temporary challenges and you can always get back on track with these tips.
Tip 1: Mess your sleep up as little as possible.
When it comes to sleep, your body loves stability. A consistent bedtime and wake-up time help your body’s clock know what to expect so you sleep better at night and feel better during the day.
Over the holidays, your schedule is likely to change, but the less severely you disturb it, the easier it will be to fix it later. For example, you may be aware that alcohol interferes with good sleep, but one glass of wine will not harm your sleep as much as five margaritas. When you decide to do something that you know will hurt your sleep, make sure it’s really a trade you want to make. When I go to second Thanksgiving, I don’t regret having a bit of wine and talking until 1:00 a.m. But, I’m sure if I stayed up until 4:00 in the morning drinking bourbon, I would desperately wish I had just stayed home.
Tip 2: Wake up at your normal time in the morning (or close to it).
Let’s assume you gave it your best effort, but things just didn’t work out and now your sleep schedule is way off. You are going to want to get back on track as quickly and painlessly as possible.
The first step toward fixing your sleep is to wake up at your normal time, not to go to bed at your normal time. So, let’s assume that your normal sleep/wake schedule is 11:00 p.m. to 7:00 a.m., but last night you were up until 2:00 a.m. picking up a family member at the airport. Today you slept in until 9:00 a.m., so what time should you try to go to bed tonight? Probably not 11:00 p.m. because you haven’t been awake long enough.
The trick is to stay up until you feel sleepy, even if it’s 2:00 a.m. again. Then set your alarm to get up at 7:00 a.m. and get going as quickly as you can. The reason this works better is that you can’t control when you fall asleep, but you can control when you wake up. Going to bed too early can set you up for even worse sleep because you will just lie in bed for a few hours wishing you could fall asleep. If you get anxious or frustrated, that will keep you up even longer.
Tip 3: Generate energy during the day by using “countermeasures for fatigue.”
When you wake up early after going to bed late, you will be tired during the day. There is no substitute for sleep. If we discover one, you will definitely hear about it. Until then, you need to get through the day without doing anything to make your sleep worse.
The best thing you can do is engage in activities that generate energy during the day. Don’t try to rest up or take it easy because that usually just makes you more aware of how tired you are.
Tips for managing fatigue during the day come from scientific studies designed to help shift workers and those involved in jobs that require long hours, like nurses, doctors, EMTs, and astronauts. If the recommendations work for these folks, they can work for you. These strategies are often called “countermeasures for fatigue.” Following are three of these strategies I’ll highlight here:
- Exercise: The overall best way to help yourself stay awake after not getting enough sleep is to exercise. It doesn’t have to be intense; almost any physical activity will work. Even standing up helps you feel more alert than if you’re sprawled out on a couch. If you think you are “too tired” to exercise, try doing just a little bit and you’ll probably notice that you have more energy when you move a little, not less. Your body is not a machine with a gas tank that runs out—it’s an elegant and dynamic system shaped by millions of years of evolution. It will let you walk even if you only slept four hours last night.
- Caffeine: It is impossible to talk about waking up without talking about caffeine. If you don’t already use caffeine, I’m not recommending that you start, but if you are someone who uses it anyway, it’s helpful to know how to use it right. The important thing here is to time it right so you feel more awake during the day, but not into the night when you need to be sleeping. Most people will be OK if they don’t have any caffeine within about six hours of bed, although some people are more sensitive to caffeine than others. To be safe, avoid coffee or other caffeinated food or drinks after 3:00 p.m. Also, it is not a good idea to drink a bunch of caffeine all at once. It’s much more useful to spread out caffeine across the morning. Getting around 20 mg of caffeine per hour has been shown to provide improved alertness in healthy adults. A cup of coffee has 150 to 200 mg, according to a paper on caffeine and its impact on sleep and daytime sleepiness published in Sleep Medicine Review. So, drink your coffee slowly and avoid getting very high-caffeine drinks. Anything called a “turbo shot,” “sledgehammer,” “eye opener,” or “death wish” should be avoided. Also, energy drinks are a bad idea because they can include very high doses of caffeine (up to 500 mg) or extra ingredients that interact with caffeine and cause unpredictable responses.
- Napping: Finally, it is important to discuss naps as a way of coping with sleepiness. If you suffer from chronic insomnia, you should probably avoid naps, but for everyone else, naps can be very helpful if you follow a few key guidelines:.
- First, naps seem to work best if you can sleep around lunch time or a little after. Most people have an internal clock that lets them get pretty good sleep around this time. Keep your naps short -- less than 30 minutes is ideal.
- If you take a long nap, don’t be surprised if you have trouble falling asleep at your normal time later that night. After taking a nap during the day, be sure you don’t go to bed until you feel sleepy. Then, wake up at your normal time the next day to avoid drifting later and later over multiple days.
I hope you find this brief overview of principles of sleep helpful during this holiday season and beyond. Try to balance the need for sleep with all the other demands and desires of the season. One final word of caution: please don’t drive if you are very sleepy. If you notice your attention wander while driving, or you notice head drops or brief sleep episodes, please pull over and have someone else drive.