Takeaway
By understanding the interplay of environmental factors, physiological responses, and cognitive habits, clinicians can help patients cultivate personalized routines that should result in more restful nights.
Lifelong Learning in Clinical Excellence | February 4, 2025 | 2 min read
By Molly Atwood, PhD, Johns Hopkins Medicine
As many as one-third of Americans report poor sleep that can negatively impact their physical health and emotional well-being. Unfortunately, many aspects of modern life can be disruptive to a good night’s sleep. Because quality sleep is integral to our health, promoting practices that optimize sleep can also improve how patients function during the day. Here are some helpful tips:
1. Keep the bedroom cool and free from light and noise
Noise
A noise-free sleep environment reduces the likelihood of waking during the night. Noise that doesn’t cause awakenings may still affect the quality or depth of sleep. Carpeting, insulated curtains, closing the door at night, and white noise machines or apps can all help to filter out noise.
Light
The body’s circadian rhythm—or internal clock—tells it when it’s time to be asleep and when it’s time to be awake. This clock is “set” by biological, social, and environmental timekeepers, including the light we’re exposed to. Bright blue/white light such as that emitted from electronics boosts alertness, whereas darkness is a cue for the body to naturally produce melatonin, which prepares the body for sleep. Dimming lights in the evening and either avoiding electronics or using blue light blocking apps like Night Shift can help with sleep onset and quality.
Temperature
When we sleep, our core body temperature drops. It’s important to avoid taking a hot bath immediately before bedtime. Instead, taking a warm bath two to three hours before bedtime can improve sleep quality. This is because raising body temperature at this time permits an increased cooling effect by bedtime.
2. Reduce sympathetic activation that interferes with sleep
The “fight or flight” response is designed to keep us awake when there is danger. But it can also keep us awake when there’s no real danger.
Don’t take problems to bed
It’s easy to fall into the habit of working late, checking emails, or problem solving at night. However, this can interfere with falling asleep and lighten sleep. It is helpful to take time earlier in the evening for planning and problem solving.
Avoid clock watching
We all fall into this trap from time to time. We have trouble sleeping and start watching the clock. We begin to worry that we’ll feel exhausted the next day. Frequently checking the time often leads to frustration, anger, and worry, that in turn makes it more difficult to fall asleep. Encourage patients to set an alarm and turn the clock face so they can’t see it.
Take time to wind down before bed
Setting aside at least 30 to 60 minutes before bed to engage in relaxing and non-productive activities is important for reducing sympathetic nervous system activity at night. This could include enjoyable but relaxing activities like reading or TV, as well as physical relaxation exercises like deep breathing and muscle relaxation.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.