A smattering of substances I’ve tried to improve my sleep.
I've never been a great sleeper. When people brag about how they've slept "like a baby," I get incredibly jealous of them, and also of the baby. I've tried many methods to improve my sleep, but whether it was a herbal remedy, a glass of red wine, melatonin, ibuprofen PM, or Sleepytime Extra tea (with calming Valerian!), each item seemed to replace my sleep problem with another one: paranoia, stained teeth, a softcore drug addiction, and mentally exhausting melatonin nightmares.
Of the all the sleep coverage, stories about sleep hygiene—"behaviors, environmental conditions, and other sleep-related factors that can be adjusted as a stand-alone treatment" for insomnia—interest me most. Be careful about caffeine intake. Keep a journal. Don't exercise late at night. Avoid large meals before sleep.
Adhering to these rules should improve the quality of your sleep. But what about the hours you're awake? At what point are you optimizing your time spent awake to improve the time you're spending unconscious?
I wanted to figure out what exactly good sleep hygiene means for me. I spoke with multiple doctors to design a sleep routine that would help me finally heed the advice of all those articles I'd read.
During my nine-day stint all I could think about was sleep. Not because I was tired, but because I was obsessed
Dr. John Rodrigues, a pulmonologist and sleep medicine specialist of avuncular relation, recommended Dr. William C. Dement's book (widely considered a sleep research pioneer) The Promise of Sleep. This book became my guide throughout my "experiment."
The first step seemed easy: I would stop using my phone and laptop by 8 PM each night, to reduce my exposure to blue light.
Blue light suppresses the body's production of melatonin, disrupting your sleep cycle. Even in Dr. Rodrigues' sleep center, he's seen patients bring their iPad or iPhone into their sleep study and use it until they're asleep. Unsurprisingly, these patients usually have a greater sleep latency, the time between laying down and falling asleep.
"Light is the strongest stimulus to the reticular activating system," Dr. Rodrigues told me, referring to the system that regulates your sleepiness/wakefulness.
For my experiment, I'll power down my computer and cell phone two hours before bedtime.
Dr. Rodrigues recommends to limit caffeine intake after 12 PM, as the half-life of caffeine (the time to eliminate half of caffeine consumed) varies greatly per person. For example, oral contraceptive steroids (birth control) increase the half-life of caffeine, while tobacco uses shortens half-life. "[Patients] may still fall asleep easily, but will have trouble after getting a couple hours of sleep under their belt," he said.
I am a two-coffee-per-day person, once in the morning and once after lunch. I decide to cut out my second cup to avoid any lingering caffeine when it's time to get unconscious.
Dr. Rodrigues noted that many people rely on a nightcap to ease themselves to sleep, but alcohol actually decreases REM sleep and delta, or deep, sleep.
"Sleep architecture (the way sleep cycles are distributed) really gets affected with alcohol," he said.
It's not entirely uncommon for me to have one or two drinks during the week and a few more on weekend. Fortunately, I already happen to be a "dry January" participant. (Note: I decided to start 2016 by abstaining from alcohol, and only realized through this article that I was unwillingly part of this temporary club.)
Dr. Rodrigues noted exercise is good for sleep, but too late in the day and it the adrenaline produced from a workout could increase sleep latency. He recommends to his patients finish their workouts no less than three hours prior to hitting the hay. For me, this means I have to go in the morning.
Per the doctor's guidance, I would have my dinner no later than three hours before my target bedtime of 10:30 PM. Late night meals disrupt your circadian rhythm, which is your body's internal clock, in turn contributing to poor sleep.
Dr. Rodrigues emphasized sleep regularity as the most important part of proper sleep hygiene. While sleep regularity refers to both your bedtime and waking time, Dr. Rodrigues placed an emphasis on maintaining a constant waking time.
This was a departure from my usual routine, where I set an alarm five to six hours from the time I am getting to bed. In The Promise of Sleep, "Keeping a regular schedule is one of the most important behaviors for healthy sleep." So I decided I would get to bed by 10:30 PM, and wake up at 6:00 AM sharp.
I documented my journey with a picture every morning, as a pseudo-scientific way to represent my sleep quality. At the very least, they prove I was waking up early every day. Through this exercise, I've noticed my left eye droops in congruence to my lack of sleep.
Day 1 Monday 1/04 6:17am
Day 2 Tuesday 1/05 6:10 AM
Day 3 Wednesday 6:06 AM
Day 4 Thursday 6:29 AM
Day 5 Friday 7:09 AM
Day 6 Saturday 6:44 AM
Day 7 Sunday 6:02 AM
Day 8 Monday 6:04 AM
Day 9 Tuesday 1/12 6:11 AM
9 days of following proper sleep hygiene rules un-drooped my left eye.
On my first day, I woke up at 6 AM.
Tried to work out at the gym before heading to work. I was very sluggish and weak, and felt like I had "morning strength" throughout my workout. My only caffeine was a small Americano at 10:30 AM. I packed my lunch and ate it, but then bought another lunch two hours later. Just as I learned in my high school psychology class, my body's hormones for regulating appetite (leptin and ghrelin) were all fucked up from my poor sleep.
A 10:00 PM bedtime seemed like an endeavor that would require me to sit in bed for hours, waiting to be sleepy. But after getting my last bits of screentime in by 7:45 PM, I was wiped, and struggled to stay up. I read to pass the time, and passed out by 10 PM. I attribute most of this to my limited caffeine consumption. If you start a diet and kick a drug addiction at the same time, it would be wrong to attribute withdrawals to your increased carrot intake. Similarly, I'm not going to blame my new sleep habits with my coffee-precipitated issues.
My second day was not much more refreshing. I went to the gym again before work. This time did not feel as weak. However, I did forget to bring my notebook, which I used so I could enter any data points I thought of close to my bed time, when no screens are allowed. I also forgot to pack the lunch I prepared. I am still feeling extremely sluggish, and I think it is partial caffeine withdrawal. I had two servings: an espresso shot at 7 AM and an Americano at 9:15 AM. I didn't have the unhinged appetite from the previous day. This is when I realize caffeine is not just an effective stimulant, but also a great appetite suppressant.
After the first couple days, I quickly slipped into a routine. While it was relatively easy, it clearly wasn't sustainable. During my nine-day stint all I could think about was sleep. Not because I was tired, but because I was obsessed. I was planning my meals around bedtime. I worried about not getting enough sleep, because then I wouldn't be able to go in the gym in the morning. I was declining plans with my girlfriend so I didn't miss bedtime. I'd ask people if anything exciting was going on in the Internet, in my "screenless" hours, only half-joking. My bedtime reading was The Promise of Sleep. I read about sleep before going to sleep.
My sleep diary, where I attempted to track my relevant habits, sleep time and wake time.
I thought I'd just feel well-rested the whole week. But I didn't actually feel that great at first. I got sick on my second day and took four days to get over my flu-like symptoms. However, by the end of the week, I felt a measurable difference in my overall well-being. I didn't fiend for a mid-day cup of coffee. Instead of my alertness ebbing and flowing with my stimulant intake, it was steadier, higher level of alertness.
Rising from bed the same exact time every day forced me to be more efficient with my time. There is much more urgency in the day, as the minutes are counting down until bed time. It's refreshing, and motivating, until I realize the same is true for death (the ultimate bedtime) and then it's a bit heavy.
A week of following sleep hygiene rules has also made me much more senior citizen-like in my sleep habits. I get extremely tired if I stay up past 10:00 PM. I don't drink coffee past 12 PM, just in case. I've started to view coffee as "treating the symptom" instead just being well-rested. I'm horrible. Why did I do this experiment? The experiment made me old, I jokingly told my girlfriend. She quickly noted that it also made me irritable, and mean. So I had become a better sleeper, but seemingly not been that great of a person.
I spoke with another doctor, Dr. Darius Zoroufy, medical director at Swedish Hospital Sleep Center, to justify my experiment. Dr. Zoroufy noted that any major changes made in my sleep routine would show in a week, confirming my experience.
Zoroufy emphasized three things when making lifestyle changes to improve sleep: use of technology, sleep schedule, and mind/relaxation.
Like Dr. Rodrigues, Zoroufy recommended regularity as the key to better sleep. "If it's one thing [for improving sleep] it's planning ahead. Setting a time to go to bed, and starting two hours before, starting to settle down."
Sleep was something you needed to prepare for, Zourufy explained. "If you're going to work for 9 AM, you don't leave at 8:55. At 8:40 you're not still standing in your pajamas with your hair all messed up."
I've held onto the concept that the human body will adjust to amount of sleep you give it, i.e. my body was used to five to six hours of sleep, and didn't need more. Dr. Zoroufy confirmed I was an idiot.
"If you're a POW and you're given starvation rations, you'll optimize the nutrition you get from bread and water," he said. "You'll feel very hungry at first, and then you'll feel less hungry, even though you're starving. The same is true with tiredness."
I realized my baseline for what I considered a "good night's sleep" was much lower than it should've been. Obviously, I was surviving, but it was less than ideal.
Improving your sleep doesn't have to be as monk-like and boring as my journey. "I don't think people should avoid technology completely, because you won't," Dr. Zoroufy told me.
Improving your sleep doesn't have to be as monk-like and boring as my journey
If you're going to make changes to improve your sleep, they have to be easy, he noted. You already have enough stress. He was not opposed to using devices at bedtime. He maintained it was important to avoid "interactive apps and things that stimulate the brain, such as social media." He noted it's OK to break sleep hygiene if you have tickets for a great show, or if you have to take care of a sick child. Dr. Zoroufy himself noted he will sometimes will drink coffee up until he goes to sleep. He mentioned that people sometimes fall asleep to YouTube meditation videos, "and they're pretty good" he added.
I was shocked, and inspired. Here was a professional sleep doctor, going against the sleep hygiene guidelines I interpreted as commandments. If I was being a bigger sleep hygiene nerd than a licensed professional, I'd lost perspective. It's possible to get a great night's rest, and have a healthy relationship with your significant other or go out for dinner—maybe even both!
Tips for improving sleep "shouldn't necessarily be taken as dogma," Dr. Dement warns in The Promise of Sleep. I wish he hadn't buried this advice on the 397th page. It took nine days, a book, some research and two conversations with two separate medical professionals, but I realized you can improve your sleep without being an asshole about it.