Written by: Bonnie Feldman, DDS, MBA, Julia Haarhuis, Ellen M. Martin
Living with a chronic disease is demanding. Chronic diseases, such as heart disease, obesity, depression, and autoimmune diseases, go along with deprived sleep. Symptoms of poor sleep are not always obvious, because even though people may spend at least the recommended minimum 7 hours in bed, they may have trouble falling asleep or don’t reach deep sleep for a long enough time. According to the US Centers for Disease Control and Prevention (CDC), the signs of deprived sleep are as follows (1):
- Feeling tired during the day, even after spending sufficient hours in bed.
- Waking often during the night.
- Experience feelings such as fatigue during the day, difficulties to fall asleep, and waking up during the night.
The American Academy of Sleep Medicine and the Sleep Research Society recommends adults, aging from 18 to 60 years, to sleep at least 7 hours per day (2). However, on average, 30% of employed U.S. adults reported that they obtain less than 6 hours of sleep per night (3). Our health is affected by sleep deprivation, as it can cause sleepiness during the day, deprived cognitive capacity and mood swings (4, 5), and a host of other deleterious effects (see illustration). We want you to be your healthiest self, so we researched the best ways to improve your sleep in a natural way – focusing on sleep routine, lifestyle and movement as alternative options to standard sleep medicines.
Prepare The Way to Sleep
Let’s start with the preparation of your sleep. Sleeping in the right environment can remove some of your sleeping issues. So, how do you create the right environment? A bedroom that is dark (really dark: no tiny electronic lights or half-lighted windows), quiet and at a comfortable temperature will create the best sleeping circumstances. Tools that can come in handy are a sleeping mask and ear plugs. So if you don’t have them yet, these tools could be a worthy investment! Furthermore, restrict your exposure to blue light before bed: turn the TV off at least an hour before sleep time, don’t stare at a cellphone or other screens, and use orange light software (f.lux, is a good one) or orange-tinted glasses.
Additionally, a pre-sleep routine that includes a warm bath or shower might be helpful, it relieves you from stress and the warm temperatures can make you a little more sleepy. Meditation, prayer or affirmations can also be a helpful part of your pre-sleep ritual. Try for example Kundalini Yoga, a good stress-relieving exercise you might want to add to your pre-sleep ritual.
Explore Feng Shui
Less obvious is the importance of your bed’s place in the room, this is called Feng Shui sleeping. Feng Shui is a Chinese sleeping method originating from 6000 years ago. This Chinese method was first used to find safe shelters for families and to find the best burial places for family members. Later its use was extended to the design of rooms and buildings (6).
Feng Shui sleeping also includes the removal of electronic devices, such as your smartphone, TV and laptop. Electronic devices can disturb your sleep and might remind you of your work and can be associated with stress. The best way to avoid being disrupted by your electronic devices is to remove them from your room or turn them off during the night. Even cover the small lights that stay on, like the ones on monitors, power strips and fire alarms. Either position your bed so these are not visible, or cover them up with a bit of black duct tape. A dark folded washcloth makes an easily removable cover for power strips or other items where you need repeated access.
Create your Sleeping Pattern
Make sure that you go to bed at consistent times and wake up around the same time each day – also on the weekends! Once you have a pattern in your sleep and wake times, you will see that you are increasingly tired around bedtime and more awake during the mornings. You can even support yourself by recording your sleep each day, including sleep quality, in a sleep diary. CDC provides an example for a sleep diary on their website, which enables you to control and keep track of your sleeping patterns. You can find the example here. Let’s track if your sleep quality improves!
Cognitive-behavioral therapy (CBT)
CBT is a therapy method based on learning to manage cognitive factors that disrupt sleep, such as ongoing thoughts, worries and emotions. This therapy trains users to address the cognitive factors associated with insomnia, for example the endless to-do lists and tireless project brainstorming that keeps raging through your mind during the night. Sleepio, a personalized app focused on improving your sleep, is based on CBT and supports building healthy sleeping patterns. The app guides you step-by-step to modify your sleeping habits specified for your needs. So, whether your deprived sleep is a result of stress or a result of health conditions, you can set your own goal based on your lifestyle and needs. The next recommendations include filling out a sleep diary, and engaging in various exercises. Dr. Bonnie: “What I found particularly helpful were the in-depth exercises to help calm the racing mind.” Read about CBT in our previous article here.
Conquer Your Bad Habits
Multiple studies have shown that smoking can lead to less stable sleep, as tobacco use can lead to airway inflammation, resulting in disordered breathing during sleep (2). Thus, to improve your sleep quality, we advise minimizing smoking.
“It might seem hard if these are one of your habits, but sometimes being healthy requires persistence!”
Drinking alcohol is another bad habit that should be taken into account if you want to improve sleep quality, especially when alcohol is consumed before bedtime. However, an epidemiological study in 1420 adults who were participating in the Wisconsin Sleep Cohort Study, showed that overall alcohol use can also contribute to disordered breathing – regardless of consumption time. Interestingly, this study showed that the odds of disordered breathing onset increased with 25% for every consumed alcoholic beverage in men (7).
If you were already trying to quit your bad habits, this will hopefully motivate you even more. You could begin with cutting down on smoking and/or drinking alcohol a few hours before going to bed, to keep the nicotine and alcohol levels down prior to sleep. It might seem hard if these are one of your habits, but sometimes being healthy requires persistence! You will thank yourself later!
Another life style factor that might contribute to improving your sleep is food. What about a glass of cow’s milk – you must have heard about this old trick before – to fall asleep faster? Research has shown that it indeed works, in this article about Food Therapy to improve your sleep we explain why! Besides cow’s milk there are other sleep-promoting food products, which we will tell you about in that article.
Surprisingly, also the way you breath is important. In this article about oral posture, we talk about oral posture and we help you to find out whether you are a mouth breather or a nose breather. Being a mouth breather can cause an elongated face and even lead to more restricted airways, which is associated to sleep apnea. So, when you are not talking or chewing, the best way to maintain a healthy oral posture is to keep your mouth closed, teeth lightly touching, and tongue pressed to the roof of your mouth.
Now our last – but certainly not least – advice to improve your sleep quality: movement therapy! In our Guide to Movement Therapy we talk about the importance of movement to manage the symptoms of your autoimmune disease. Research associates poor physical activity with sleep deprivation. Also, exercise is shown to decrease sleepiness during the day. An analysis of 6 studies found improvement of sleep quality in adults after they exercised, especially in patients diagnosed with insomnia. Exercise also reduces breathing disruption during sleep (5). Cardio, strength training and yoga will probably be beneficial for your sleep quality (8).
Now you know what to do to improve your sleep without the use of pills and medicines. The right lifestyle and exercise can get you there. Additionally, there are some sleep-promoting foods and foods to avoid before going to bed to improve your sleep – hang in there, because a new article on this will be posted soon! You will see: once you improve your sleep quality, your overall well-being will improve too, like being in a better mood and feeling less fatigue during the day. Life can be tough when you live with a chronic disease, but these natural methods will help you to reduce some of your symptoms. What is your experience with these methods? Keep us updated about your progress and leave a comment below, we would love to hear your experiences!
For more information, read our next post on sleep: “How To Use Food Therapy To Improve Sleep”, about sleep-promoting foods and which foods to avoid prior to bedtime!
- CDC. How Much Sleep Do I Need? Last visited on July 8th, 2019, https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html
- Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research SocietyCdc-pdfExternal. Sleep. 2015;38(6):843–844.
- CDC. Short Sleep Duration Among Workers — United States, 2010. Last visited on July 8th, 2019, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6116a2.htm
- Taveira, KVM, Kuntze, MM, Berretta, F, et al. Association between obstructive sleep apnea and alcohol, caffeine and tobacco: A meta‐analysis. J Oral Rehabil. 2018; 45: 890– 902. https://doi-org.ezproxy.library.wur.nl/10.1111/joor.12686
- Kline, C. E. (2014). The Bidirectional Relationship Between Exercise and Sleep: Implications for Exercise Adherence and Sleep Improvement. American Journal of Lifestyle Medicine, 8(6), 375–379. https://doi.org/10.1177/1559827614544437
- Feng Shui Society. History of Feng Shui. Last visited on July 8th, 2019, https://www.fengshuisociety.org.uk/history-of-feng-shui/
- Peppard, P. E., Austin, D., & Brown, R. L. (2007). Association of alcohol consumption and sleep disordered breathing in men and women. Journal of Clinical Sleep Medicine, 3(03), 265-270.
- National Sleep Foundation. The Best Exercises for Sleep. Last visited on July 10th, 2019, https://www.sleepfoundation.org/articles/best-exercises-sleep