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Quality sleep is so important for all of us for so many reasons: emotional health, immune system efficiency, daytime energy, just to name a few. But sleep is especially important for those of you living with Mild Cognitive Impairment (MCI) because bad sleep impacts your thinking efficiency during the day. Not to mention that it contributes to moodiness, fights with our spouses, low motivation, and generally feeling poorly during the day. About a year ago, I posted a two part story on sleep apnea. The first part reviewed the importance of treating sleep apnea--important for many of same reasons it is important to maximize quality sleep in general! The second part provided some tips for adjusting to a CPAP device, which can be tough.
Today, I wanted to provide some tips to maximize the chance of good quality sleep whether or not you have a sleep disorder like sleep apnea. This is sometimes referred to as "healthy sleep habits" or "sleep hygiene". These are habits that essentially tell your brain reliably that it is time to sleep and allow you to naturally experience all phases of your sleep cycle most reliably so you get deep restorative sleep. We discuss these in our HABIT program as our top 10 behaviors for healthy sleep and I'd like to share them with you!
Build a good bedtime routine
These first habits are about building a good sleep routine. Basically the routine about how you get to bed and when:
1.Stick to a sleep schedule. Do your best. If you get to bed late one day--try to make yourself get up as the same time and get back to the schedule the next day.
2.Use the bedroom only for sleep and intimacy. Do you exercise in your bedroom? Watch TV? Pay bills? Try to do as many of these activities as possible in other rooms of your home. The goals is to have your brain pair your bedroom with sleep. That association, along with other good sleep habit routines, will help your brain release melatonin--the sleep hormone--at the right time.
3.No TV in the bedroom. In addition to the reason in #2 above, TV is stimulating and disruptive to the sleep cycle.
4.Have a relaxation activity as part of your bedtime routine. Try listening to relaxing music as you get ready for bed, a meditation activity, a breathing exercise, or saying your prayers (if that is your practice)--these relaxing activities help to lower your sympathetic nervous system (your fight or flight response) and activate your parasympathetic nervous system (your rest and digest system).
5.Discontinue screen time 1 hour before bed. Our brain interprets most light from electronics as sunlight which delays release of melatonin as our brains think it is still day time. However, I have recently seen research articles such as this one that suggest that using amber lenses to block the blue tone light may help.
6. Have a memory notebook handy at the bedside for those last minute thoughts of things that need to get done the next day that might keep you awake. Write them down so that you know you'll be able to deal with them tomorrow. If you find that worrying about things you can't control becomes an issue, you may benefit from seeing a psychologist to help you develop alternative thinking patterns for those times.
Daytime routines to help maximize quality sleep
These last habits are more about how you structure the rest of your day and environment and how that may help improve your sleep.
7. Get physical exercise daily, especially earlier in the day. This is always my #1 tip when my patients tell me they feel tired during the day. Getting exercise in the morning activates your brain and sets it off on the proper cycle. Your body is more ready for rest and sleep with activity in the day.
8. Sunshine in the morning. This is the companion recommendation to avoiding electronics in the evening. Get sunshine in the morning so your brain gets the message it is time to be awake!
9. Check your environment. How long have you had that mattress? Is your pet in the bed with you? Review that the mattress and pillows are comfortable, the temperature is cool enough, you have the right blankets, your beloved Fido or Tiger has their own sleeping space, you have curtains that block out light that might bother you, the TV is off, etc. Pets can certainly be reassuring, but they unfortunately do disrupt the sleep cycle in bed with you. Having them on their own bed in your room, may be a good solution.
10. Avoid alcohol, caffeine, and heavy meals before bed. These all disrupt your body's ability to sleep soundly and move fluidly through all the phases of sleep as desired through the night.
Consider professional help if needed
It can be difficult to implement all of the above tips and you may feel like your sleep is worse before it gets better. There are psychologists who specialize in helping treat sleep problems using cognitive behavioral therapy for insomnia. They will help you implement many of the above routines and more to help you maximize your sleep quality.
I hope you can try out some of these tips---and give them a little time for your body to adjust. Please feel free to comment on your experiences or provide any other tips you've found helpful!
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I found this of real help for me.
Thanks Moyo group for the advice and enlightenment.
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4 ReactionsHow does a person know if he/she is getting enough/REM quality sleep? I get into bed at 11:30 PM, and I wake up at 6:30 AM to get up and very slowly walk my 2 dogs for 45 minutes. I do get up one to two times in the middle of the night to use the bathroom, but I go back to sleep within one minute, no kidding. Then I spend a few minutes after the dog walk in front of my computer, but I get sleepy really fast, and by 9:20 AM I am back in bed for an hour's nap. I keep thinking I am not getting enough REM sleep and that is why I need to take that morning nap so badly. I want to stop needing to take that nap. I also think that because at my age, a 78 year old male, I have aches and pains that do not wake me up but take me out of the REM sleep mode. The aches and pains come from back aches (3 bulging disks, slight right-side scoliosis, one fractured vertebrae/healed, 2 sets of vertebrae that are bone on bone), hip joint ache/arthritis, and regular left knee ache from bone-on-bone contact in one silver dollar-sized spot. I have been taking oral HLA for 3 weeks that has helped relieve the pain from the bone-on-bone spot. I had arthroscopic surgery back in April 2025 and it has been slow to heal. I also use a large band aid with Voltaren/diclofenac cream smeared on it and placed under that left kneecap before bedtime to take away the bone-on-bone knee pain. Before I started doing that, I would wake up for an hour or two each night battling that bone pain with diclofenac cream. Am I kidding myself that will ever get to sleep thru the night and avoid that AM nap?
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3 Reactions@laughlin1947 Hello, I have had chronic insomnia for many years; I have a few general suggestions that may help.
1. Try to lessen your water consumption before bed. Those bathroom visits have to impact the quality of your sleep even those you might not think so. Drink large amounts of water when you wake up.
2. I use a free app called “Sleep Cycle”; you can pay for a subscription but I use the basic app which measures my levels of sleep, which I find very helpful. Click the x instead of joining. The app may have changed, but I suggest contacting the app via email to ask about the free version.
3. Is there any chance that you have obstructive sleep apnea? See your primary care doctor for an initial evaluation.
4. I also use the diclofenac nightly, for hip pain for my bursitis.
5. If you feel that your walking stability is unsteady, I would use a walker or at least a cane when you walk your dogs.
6. I’m not sure if knee surgery is a possibility, but have you had a cortisone shot lately?
I am not a doctor, but I do have sleep issues, with knee and hip pain. I have had my total right knee replaced in 2016.
I hope my suggestions may be of help. Exercise is great for the joints, if your walking and balance are steady. Good luck to you.
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3 ReactionsThank you for your information. I'll certainly follow up with the notable ideas. I do feel I may be resigned to having REM sleep disturbances throughout the night for a variety of reasons. Plus, it may be that I just need a full 8 hours of sleep a night. Thanks for idea of the "sleep cycle". I don't mind paying for something that works. I've never tested for obstructive sleep apnea, but I do have a snoring problem for which I use a special snore guard that keeps my bottom jaw jutted out and keeps my airway more open.
I'm trying to avoid cortisone shots lately, but may need to get one for increasingly chronic back pain. I've heard the steroid does some destructive activity on cartilage. I prefer for now to pursue the hyaluronic acid option which has a choice of several grades of HLA. One is a series of 3 shots in a row for 3 consecutive weeks. There is a thicker version that is just one shot, but costs $450. I've had 2 steroid shots in my back hip area, but the effect on my back is brief, a couple of weeks. There's always the 24-shot nerve ablation option for my back to consider. I'll need to see a specialist again to arrange that. Thanks again!
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4 Reactions@laughlin1947
You’re welcome. Please see your doctor about your inability to sleep straight through for 8 hours. I would start there. I had no idea that I had OSA! I had a few in-lab sleep studies which have changed my life. I also wear a Herbst oral appliance to slightly move my jaw forward, during sleep. I have CPAP and the Herbst, called dual therapy.
Good luck to you.
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2 ReactionsThank MAYO? Instead of”normal” people of families, waking up, talke care of kids, working at night??? Come on…
#1 - #6 isn’t possible for me… my wife… and my doggies? NO.
#10 - is great even I don’t drink alcohol, zero. eating, zero drinks - trying to sleep… - ok, the word ZERO is part of drinks, sorry
Who’s marriage? Who’s not? Any kids wake you up? How about your job that works 10pm thru 6 or 7 am? How about mucians by sleeping music? Hearing, feeling, adding to the part of songs, remembering, and others. My wife likes to listen to some music, but it doesnt help me; jazz, blues, country,Rock or R@R -my brain listens and listens…
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