Environmental Manipulations for Improved Sleep

Environmental Manipulations for Improved Sleep

When most of us think about our overall health and wellness, two words likely come to mind: diet and exercise. Consuming more whole foods and less proceeded foods is an important aspect of our health, as is engaging in daily physical activity. However, even the healthiest of eaters and most consistent exercisers will likely have deficits in their overall health and wellbeing if they are unable to get adequate sleep each night.

A good night's sleep is important for a multitude of reasons; disruptions in sleep have both short- and long-term consequences that negatively impact our overall health. Examples of short-term consequences of sleep disruption include “increased stress levels, somatic pain, reduced quality of life, emotional distress, mood disorders, and cognitive, memory, and performance deficits,” (Medic et al., 2017). Examples of long-term consequences of sleep disruption include “hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer", (Medic et al., 2017).

According to the Centers for Disease Control and Prevention (CDC), approximately 50-70 million adults in the United States have a sleep disorder. The CDC also notes that one-third of adults living in the United States reportedly get less than the recommended seven to eight hours of sleep each night. Ensuring you get an adequate amount of sleep each night can help protect your mental health, physical health, overall quality of life, and safety. Sleep helps us maintain a healthy balance of hormones that control hunger or fullness. Sleep affects how our bodies react to insulin – the hormone that controls our blood glucose levels, – supports healthy growth and development, and helps ensure our immune system stays healthy. Individuals who are sleep deprived are often less productive at work and school, take longer to finish tasks, and have a slower reaction time.

When trying to improve the amount of sleep you get each night it is important to think about your current “sleep hygiene” routine. The American Council on Exercise refers to sleep hygiene as “habits that help promote adequate high-quality sleep.” When examining this through a behavioral lens, improving our sleep hygiene routine often involves manipulating antecedent events. Some antecedent manipulates that may help increase sleep are listed below.

1. Developing a consistent sleep routine and schedule:

If you have trouble “winding down” at night, it can be helpful to identify a few behaviors that help you to relax and engage in these behaviors prior to bedtime. My sleep routine typically involves turning off all the lights in my bedroom except my miniature reading light and reading a book or watching a television show (HGTV is my guilty pleasure). I also recently got into the habit of setting my phone to “do not disturb” starting at 8:00 pm which means I won’t get any notifications unless someone calls me several times. Everyone’s bedtime routine will look a little different. For some, taking warm showers or baths may do the trick. For others, it may be meditating or listening to calming music. The key is to consistently engage in a chain of behaviors that work for you.

It is also equally important to consistently go to sleep and wake up around the same time every day, including weekends. While it is certainly tempting to “sleep in” on the weekends, doing so actually disrupts your circadian rhythm. When properly aligned, your circadian rhythm can promote consistent and restorative sleep, however, when disrupted, it can create significant sleeping problems, including disturbed sleep.

2. Refrain from using electronics after a predetermined time:

It is important that we limit our exposure to bright light from cellphones or other electronic devices when trying to go to sleep. The light given off from electronic devices interferes with our melatonin production, a hormone that makes us tired. Time can also get away from us when mindlessly scrolling on social media accounts or catching up on emails while lying in bed. What starts out as a quick check-in with Facebook or Instagram can easily turn into 30 minutes of more of “mindless” scrolling.  If you find yourself constantly scrolling before bed, try keeping your cell phone or computer on a piece of furniture that is not within arm’s reach. This will help increase the response effort required to use your device and reduce distraction before bedtime.

3. Refrain from completing work-related tasks after a predetermined time:

If you are having trouble falling asleep, I highly recommend “turning off” from work at a predetermined time each night. When I struggled the most with sleep disturbances, stopping all work-related activities at least three hours prior to my predetermined sleep time helped me go from tossing and turning to falling asleep almost immediately. Some of you reading this may be able to turn off “work mode” and turn on “sleep mode” instantly, and therefore completing work right up until the time you plan to go to sleep may not be an issue. However, for those of you who do have trouble, I encourage you to try systemically stopping work for various periods until you find a time that works for you. Try refraining from work for 30 minutes before bed during week one, then 45 minutes or one hour before week two, and so forth until you find what feels right for you. It is also helpful to refrain from doing work in your bedroom. If it is at all possible, try and get your “work space” and “sleep space” completely separated.

4. Avoid caffeine and alcohol after a predetermined time:

If you are an avid consumer of coffee, soda, or energy drinks and having trouble falling asleep, the caffeine may be affecting you more than you think. Just like you should systemically determine your “sweet spot” for turning off work before bed, you may also need to collect some data regarding the time you last consumed caffeine, the amount consumed, and your difficulty falling asleep. Of course, just like anything else caffeine affects us all differently. I can actually drink espresso and then fall asleep ten minutes later, however, if my husband did the same, he would be up all night. Not sure if caffeine is the culprit? When in doubt, collect data!

If you are having trouble falling asleep you should also monitor the number of alcoholic beverages consumed. Consuming alcohol before bed may assist you in falling asleep faster, however, doing so often disturbs our sleep cycle and may leave you feeling groggy upon waking up instead of well rested.

5. Try and separate from your thoughts:

If you are anything like me, the second you rest your head on the pillow is the second you start thinking about that observation you have to do tomorrow, the behavior plan you meant to modify, or the IEP meeting coming up. I’m not sure why I always seem to think about my never-ending “to-do” list as I am trying to fall asleep, but I have found that having a piece of paper and pen next to my bed and writing down the thoughts that are keeping me up has been helpful. Prior to writing down my thoughts, I used to stay up all night stressing about various things on my list. However, once I started writing them down it was like they were out of my brain for the night and I could finally relax.

Cognitive defusion exercises are also a good way to help you separate from the thoughts that are keeping you awake when you are trying to sleep. Examples of defusion exercises include “Leaves on a Stream,” (Hayes, 2005) or “Thanking your Mind,” (Harris, 2008) and are described in detail books provided in the references.

This list is not extensive of sleep hygiene ideas but does give you a starting point regarding simple environmental modifications you can make to help improve your sleep.

If you are suffering from serious sleep issues it is best to seek out medical -advice from a doctor or other medical professional.
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Sarah Burby is a Board Certified Behavior Analyst, Certified Health Coach through the American Council on Exercise, and Level 1 Precision Nutrition Coach. Sarah is a Behavior Consultant at Brett DiNovi & Associates and Owner of Small Changes Health, Wellness, and Nutrition Coaching where she utilizes the science of Applied Behavior Analysis and Acceptance and Commitment Therapy to help individuals reach their health and wellness goals.

References

Harris, R. (2008). The happiness trap. Robinson Publishing.

Hayes, S. C., & Smith, S. (2005). Get out of your mind and into your life: The new Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.

Matthews, J., Bryant, C., Skinner, J., & Green, D. (2019). The professional’s guide to health and wellness coaching. American Council on Exercise.

Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and science of sleep, 9, 151–161. https://doi.org/10.2147/NSS.S134864