Photo Credit: Tommaso79

In a previous article on a trusting patient-physician relationship, I introduced some of the ‘homework assignments’ that I prescribe to patients as I support their journey to health, happiness, and understanding of the “good life”. These assignments usually begin with a focus on the following four areas: good sleep, good nutrition, good exercise or physical activity, and good work-life balance. My ensuing four columns will focus on these four pillars of health.

The Importance of Good Sleep

If asked which of these aspects of health is most fundamental, I will respond with good sleep without reservation.

Several adages regarding sleep help put its importance in context:

“A well-spent day brings happy sleep.” – Leonardo da Vinci.

“We are such stuff as dreams are made on, and our little life is rounded with a sleep.” – William Shakespeare.

“Many things – such as loving, going to sleep, or behaving unaffectedly – are done worst when we try hardest to do them.” – C.S. Lewis.

Defining Good Sleep

So, what is good sleep? Why is sleep important? How can we help our patients experience good sleep?

Sleep requirements rely on both time and quality of sleep. Consensus recommendations of the American Academy of Sleep Medicine and Sleep Research Society specify that adults aged 18-60 years should sleep seven or more hours per night regularly. The National Sleep Foundation recommends 7-9 hours for adults aged 18-64 and 7-8 hours for those aged 65 and older. As healthcare professionals, we understand that these are general recommendations; specific scenarios may require a patient to achieve more extended hours of sleep. We also understand that quality sleep should be refreshing with minimal awakenings during the sleep period and should minimize inadequate sleep-induced fatigue, tiredness, irritability, cognitive difficulties, and even immune dysfunction for our patients. Clues to different sleep disorders (ie, chronic insomnia, sleep apnea, restless leg syndrome) can be understood through a thoughtful patient history and evaluation.

Practical Tips for Achieving Good Sleep

While the former quotes above describe the importance of sleep, the latter may be most helpful in helping our patients understand how to achieve restorative sleep. Namely, sleep should not be a chore or something we fixate on achieving but rather a natural process that is derived from creating a subconscious routine and an environment that fosters this essential bodily function. While recommendations for achieving good sleep are tailored to the patient at that moment in time, the following advice can help improve sleep when practiced consistently and subconsciously.

• Set a regular sleep schedule with consistent bedtime and waking time, even on weekends.
• Create a bedtime routine that begins a couple of hours before it is time to sleep and includes a wind-down routine, such as dimming the light and avoiding the blue light of electronics, to promote natural melatonin rise.
• Avoid the use of stimulants such as caffeine after noon.
• Modify your sleeping environment to minimize disturbances. This includes a comfortably cooler, dark room, with minimal exposure to external noise.
• Minimize the amount of time spent in bed, and not If you cannot sleep, do not look at the clock. Get up and go to another room to relax until you feel sleepy enough to return to sleep.
• Form a relaxing image that helps prevent intrusive thoughts.
• Practice progressive relaxation of muscle groups from head to toe if needed to relieve muscle tension.

Achieving good sleep is a fundamental pillar of overall health and well-being. It relies heavily on cultivating consistent, healthy habits and creating an environment conducive to restful sleep. While there are instances where medication may be necessary, it is crucial to understand that these should not replace the foundational practices of good sleep hygiene. Educating our patients about the potential side effects of prolonged medication use and the importance of seeking specialized help for chronic sleep issues is essential. By prioritizing good sleep, we empower our patients to enhance their physical health, emotional resilience, and overall quality of life. In the journey toward optimal health, let sleep be the cornerstone upon which all other habits are built.