Great sleep is a foundation of health—both for healthcare professionals and our patients. Because sleep can be disturbed with the stress of the pandemic, it's important to commit to sleep-promoting habits and routines.
Lifelong Learning in Clinical Excellence | July 14, 2020 | 5 min read
By Logan Schneider, MD, Stanford Medicine
Our body’s daily biorhythms are orchestrated by regularly recurring patterns of environmental, social, and biological signals. From the timing of when we get up in the morning to when we eat and exercise, our daily routine is critical for keeping our internal clock synchronized. When our normal schedule is derailed by significant changes like the current physical distancing mandate, our biorhythms can start to lose their tempo without the metronome of our daily routines. So, it’s important to do your best to give your body the consistent cues it needs to keep your brain and body health on track—who knows this may even be a chance to pick up a new healthy habit! Here are some things to keep in mind in order to support your daily rhythms:
1. Get up about the same time every day.
Make sure that your body clock gets its daily dose of alignment with a regular wake time. It may seem difficult to know what time this should be with no commute pressuring you to get up, so just figure out the earliest time you’ll need to get up for the coming week and lock that in starting Saturday morning. If you need motivation to be consistent on weekends, try to save your favorite show or social media browsing for the morning.
2. Get plenty of bright light exposure (preferably sunshine) right upon waking and throughout the day.
Light’s strongest message to the master clock in our brain (the suprachiasmatic nucleus) happens in the morning. Ensure that you’re getting plenty of bright light within one hour of waking up, so your body is ready for an on-time bedtime. Also, the brighter and more abundant your midday light exposure, the less disruptive evening light levels will be to your sleep. Even though we are needing to keep a healthy distance from our community, a midday walk in bright sunshine (or even working by a window) can help you get your daily dose of light.
3. Schedule social time as a regular part of your day.
Not only can social distancing make you feel isolated, it can also disrupt your normal triggers for biological rhythms. Starting the morning with a “framily” check-in not only provides necessary human contact, it can also help others feel more connected while you’re getting a body cue for a healthy schedule. Consider setting up a social Google Meet or FaceTime for daily “coffee talk,” or try out an online game night with your team on Houseparty or io.
4. Keep a consistent meal plan.
Avoiding the temptation to graze will help keep your body healthy and in sync. When reaching for a snack, ask yourself, “am I actually hungry?” In addition to different dietary opportunities at home, the lack of scheduled meal times can make it harder to stay on track. Make sure to set aside time for scheduled, traditional meal breaks, eating only until no longer hungry (not till you’re full) and filling your diet with energizing nutrient mixes (proteins, complex carbohydrates, and fiber) that will keep you going all day without the problematic ups and downs of refined sugars/simple carbohydrates.
5. Stay hydrated.
While there is no “perfect” amount of water to drink each day, ensuring that you stay hydrated throughout the day is a good way to keep your energy levels up. Keeping a full container of water readily at hand will also prevent mindless snacking.
6. Limit caffeine, particularly within nine hours of bedtime.
Don’t let the time warp of days spent in social distancing disrupt your sleep with unhealthy, continuous caffeine consumption. Caffeine levels in the blood are cut in half about every four and half hours (so a quarter of whatever you drank at 1 p.m. is still in your body at 10 p.m.). If you want to get really scientific about it, create a free account at 2B Alert or try their new PeakAlert app to optimize the relationship between alertness, sleep, and caffeine consumption.
7. Avoid excessive alcohol consumption.
A bit of extra time can make trying out elaborate cocktail recipes enticing. However, despite alcohol’s ability to make you drowsy, it can disrupt the second half of sleep, making it fitful and not refreshing. While research continues to vacillate about the health of “moderate” alcohol consumption, more recent evidence seems to be suggesting that no amount of alcohol is a healthy amount. Regardless of what side of the debate you fall on, remain cognizant of your physical and mental health and ensure that you moderate your consumption and stay safe.
8. Start or maintain a daily exercise routine.
While physical distancing doesn’t prevent you from a daily jog, it may be advisable to get your body moving within the safety of your home. Exercise indoors can be challenging. Fortunately, there are a host of exercise resources around the internet, in apps, or through home exercise equipment networks that you can explore from the comfort of your home. Try to get the recommended 30 minutes of heart-pumping exercise every day. Also, make sure that you set aside a consistent time to exercise (preferably right upon waking or about six to nine hours before bedtime), because your core body temperature is an important signal to your body clock about when to be alert and when to sleep.
9. Separate daytime from nighttime.
Not only is a physical separation of waking and sleeping activities important for telling our brain where wake and sleep should happen, but setting clear limits on our work and personal lives is essential for maintaining a healthy balance and separation in our minds. Simple boundaries, like not doing work in your bed, can help to keep daytime/alertness activities in a designated part of the day, allowing time to unplug and unwind with low-key evening activities, like enjoying a good book, done in relaxing conditions.
It can be hard to transition from work to personal life without a commute. One helpful tool for transitioning away from work is an end-of-the-day alarm to allow time for writing tomorrow’s to-do” list. This will create a psychological and tangible experience that gets work-related thoughts out of your head and onto paper, so that you can set them aside and pick them up tomorrow without fear that something was forgotten.
10. Help your home environment cycle in a natural way.
Lowering bright, blue light in the evening is just as important to sleep-wake cycles as enhancing light exposure during the day. Dark environments allow your body to secrete the sleep hormone melatonin, readying the brain and body for sleep. In addition to dimming the house lights, block out blue light from electronic devices by turning the brightness of the screen to the lowest setting and activating Digital Wellbeing features including apps such as lux (multi-platform), Night Light on Android, and Night Shift on iOS and Macs.