Sleep 101

The benefits of adequate and restful sleep

Getting enough good-quality sleep is one of the most important things you can do to enhance and maintain optimal health. Its benefits include:

• Sleep helps you feel rested, alert, and energized each day.
  
• Sleep allows your mind, memory, body, and immune system to all work the way they are intended to.
  
• During sleep, your mind consolidates and reorganizes your memories, spurring creativity and problem-solving.
  
• Sleep allows your body to perform well when you exercise or compete.
  
• Sleep plays a role in emotion regulation; when you sleep, your brain sorts through the stresses and negative emotions you experienced during the day, which lessens their negative impact. This can enable you to cope better with stress in the future.

Our society treats sleep as a luxury, an indulgence. It's time to start looking at sleep — and other healthy lifestyle behaviours — differently. Getting the sleep you need is not about being your "best." Rather, sleep allows your body and mind to function at your baseline, your "normal." When you are sleep deprived, you go through your day with the burden of exhaustion on your body and mind, and can't accomplish what you could have otherwise.

More about the benefits of sleep.

Strategies to get a good night's sleep

There are numerous behavioural and cognitive strategies that can help you have restful and restorative sleep.

Behavioural strategies

Healthy sleep habits, sometimes called sleep hygiene, are behaviours and routines that help a person to have quality sleep and to feel fresh and alert during the day.

A lot of these behaviours are "common sense," but click on each one to learn more about how it can look in your life. And be truthful with yourself: are you sincerely and consistently practicing these behaviours? If you realise that you are not, you can set them as a health goal and work through the steps of goal setting, just as with any other health goal!

• Establish a regular sleep routine
  
• Ban screens from your bed
  
• Avoid substances that stimulate, especially in the evening
  
• Avoid late meals and liquids in the evening
  
• Avoid alcohol in the evening
  
• Avoid long naps
  
• Take time to wind down before going to bed
  
• Make your bedroom sleep friendly
  
• Use your bed only for sleep, sex and when you're sick
  
• Manage your worry
  
• Use relaxation techniques
  
• Engage in good health habits
  
• Associate your bed with sleep

Cognitive strategies

Sometimes a person's thoughts can interfere with getting a good night's sleep. It is difficult to fall and remain asleep when you are worried, stressed or anxious.  In these cases, changing your thinking can help you sleep better.

Examining your thinking can help you:

1. Identify unhelpful and unrealistic automatic thoughts (called "cognitive distortions") that affect your ability to sleep. These cognitive distortions include: 
   • Misunderstanding the cause of your insomnia (e.g., "My sleep problems are due to a chemical imbalance")
   • The belief that the consequences of disturbed sleep will be more severe than they actually are (e.g., "If I don’t get eight hours of sleep, I won't be able to function tomorrow")
   • Unrealistic expectations about sleep (e.g., "I must have eight hours of sleep to function")
   • The belief that you can't change it (e.g., "There is nothing I can do to make this better")
     
2. Learn how to replace these thoughts with thoughts that support good sleep. You explore the validity of your automatic thoughts by exploring the evidence that support them and the evidence that refute them. Then a new thought that supports good sleep can be developed. Eventually, it replaces the old thoughts and leads to better sleep.
   
3. Address other mental factors that contribute to disturbed sleep, such as excessive worry, depression or anxiety.

A structured treatment program called Cognitive Behavioral Therapy for Insomnia (CBT-i) uses these approaches to help you get better sleep.

Another important cognitive strategy is to change your attitude toward sleep, to make sleep a priority and find ways to protect and defend your sleep time! You can learn more about building commitment to your health goals, including the goal of getting the sleep you need, by taking a look at our behaviour change section.

What about sleeping pills?

A variety of prescription medications are available to help a person fall and remain asleep. Unfortunately, sleeping pills do not address the reason for the sleep difficulties. There may be a medical or mental disorder, a sleep disorder, poor sleep hygiene, excessive worry or other reasons for poor sleep. It is best to address the cause of sleep problems rather than medicate. Sleeping pills do not cure insomnia. In fact, they can make it worse. These medications are only meant to be used for a short period of time.

Research shows that cognitive behaviour therapy and other problem-solving approaches are more effective in the long run than medications. If the underlying problem has not been resolved by the time a person stops taking sleeping pills, the sleep problem will likely return.

Using medications to help with sleep (either prescription or non-prescription, such as Gravol or antihistamines) can have some negative consequences including:

• Drug tolerance: You may have to take more and more of the sleep aid for it to work, which can lead to more side effects.
• Drug dependence: You may come to rely on the medication to sleep and will be unable to sleep (or have even worse sleep) without it.
• Withdrawal symptoms: If you stop the medication abruptly, you may have withdrawal symptoms, such as nausea, sweating and shaking.
• Side effects: Side effects of sleep medications include drowsiness the next day, confusion, forgetfulness and dry mouth. These side effects can be severe and can have tragic effects, such as an increased risk for car accidents.
• Drug interactions: Sleep medications can interact with other medications you are taking. This can worsen side effects and be dangerous with medications like prescription painkillers and other sedatives.
• Rebound insomnia: When you stop taking the medication, sometimes the insomnia can become even worse than before. 

There is no reliable evidence to support the use of supplements such as melatonin to improve sleep.