In accordance to the latest research, about two-thirds of the population, complain about difficulty sleeping when asked by their doctors. Among this group, there is a high incidence of misconception, including: misconceptions about the cause of insomnia, Perspectives on sleep, misattributions about the consequences of insomnia, unrealistic expectations about sleep, and mistaken beliefs about sleep promoting behaviors. Although insomnia is more commonly reported in females than males, both genders show an increasing tendency for this type of sleep difficulty with aging
Among the proven factors affecting sleep are:
Individual problem:, pain, stress, health concerns, age, menopause, “not enough hours in the day”, misconception about sleep, shift work, etc..
Medical: mental health problems medical conditions, side effect of medication, psychological issues, effect of drugs and alcohol, etc.
Environmental: wrong temperature on the room, comfortability of the bed, amount of light in the room, etc.
Whatever the factors, dysfunction in sleep, a sleep that allows us to wake up refreshed, commonly affects our behaviours, our memory capacity, out daily functioning, and our capacity to be effective in what we do.
One more area of understanding has been the effect of arousal in sleep. Hyperarousal is experienced by a person even throughout the day and this continues at night (possibly hyper-vigilance) which leads the person to experience difficulty falling and staying asleep. Hyper-arousal is an increase in the activation of the autonomic nervous system. A person experiences sleep disturbances due to an increase in heart rate, metabolic rate, body temperature and many other changes in the body. Hyper-arousal can simply be described as the person is in a fight-or-flight response whereby the brain detects some danger and is then on guard for any potential danger. Research shows an increase in sleep difficulties with the increase in arousal.
We have divided the sleep studies in 4 areas that provide guidance on improving sleep. These areas are: sleep schedule, daily activities, food and substances use, and sleep environment.
One set of recommendations relates to the timing of sleep. For adults, getting less than 7–8 hours of sleep is associated with a number of physical and mental health deficits, and therefore a top sleep hygiene recommendation is allowing enough time for sleep. Clinicians will frequently advise that these hours of sleep are obtained at night instead of through napping, because while naps can be helpful after sleep deprivation, under normal conditions naps may be detrimental to nighttime sleep. Negative effects of napping on sleep and performance have been found to depend on duration and timing, with shorter midday naps being the least disruptive. There is also focus on the importance of awakening around the same time every morning and generally having a regular sleep schedule.
Exercise is an activity that can facilitate or inhibit sleep quality; people, who exercise experience better quality of sleep than those who do not,] but exercising too late in the day can be activating and delay falling asleep. Increasing exposure to bright and natural light during the daytime and avoiding bright light in the hours before bedtime may help promote a sleep-wake schedule aligned with nature's daily light-dark cycle. This effect of the light is also evidenced in the rays from the computer and smart phones, as they had been found to affect sleep negatively.
Activities that reduce physiological arousal and cognitive activity promote falling asleep, so engaging in relaxing activities before bedtime is recommended. Conversely, continuing important work activities or planning shortly before bedtime or once in bed has been shown to delay falling asleep. Similarly, good sleep hygiene involves minimizing time spent thinking about worries or anything emotionally upsetting shortly before bedtime. Trying purposefully to fall asleep may induce frustration that further prevents falling asleep, so in such situations a person may be advised to get out of bed and try something else for a brief amount of time. Also, psychotherapy is recommended to aid in the reduction of worries and improvement of emotional difficulties.
Also, people who spend less time in bed have a deeper and more continuous sleep. So clinicians will frequently recommend eliminating use of the bed for any activities except sleep (or sex).
Foods and substances use.
A number of foods and substances have been found to disturb sleep, due to stimulant effects or disruptive digestive demands. Avoiding nicotine, caffeine (including coffee, energy drinks, soft drinks, tea, chocolate, and some pain relievers), and other stimulants in the hours before bedtime is recommended by most sleep hygiene specialists, as these substances activate neuro-biological systems that maintain wakefulness. Alcohol near bedtime is frequently discouraged by clinicians, because, although alcohol can induce sleepiness initially, the arousal caused by metabolizing alcohol can disrupt and significantly fragment sleep. Smoking tobacco products before bed is also thought to reduce one's quality of resting by decreasing the time spent in deep sleep, leading to sleep fragmentation and nocturnal restlessness. Both consumption of a large meal just before bedtime, requiring effort to metabolize it all, and hunger have been associated with disrupted sleep; clinicians may recommend eating a light snack before bedtime. Lastly, limiting intake of liquids before bedtime can prevent interruptions due to urination.
Arranging a sleep environment that is quiet, very dark, and cool is recommended. Noises, light, and uncomfortable temperatures have been shown to disrupt continuous sleep. Other recommendations that are frequently made, though less studied, include selecting comfortable mattresses, bedding, and pillows, and eliminating a visible bedroom clock, to prevent focusing on time passing when trying to fall asleep.
In 2015, a systematic review of studies on mattresses concluded that medium-firm, custom-inflated mattresses were best for pain and neutral spinal alignment.
The strength of research support for each recommendation varies; some of the more robustly researched and supported recommendations include the negative effects of, alcohol consumption in the hours before sleep, engaging in mentally difficult tasks before sleep, and trying too hard to fall asleep. There is a lack of evidence for the effects of certain sleep hygiene recommendations, including getting a more comfortable mattress, removing bedroom clocks, not worrying, and limiting liquids. Other recommendations, such as the effects of napping or exercise, have a more complicated evidence base. The effects of napping, for example, seem to depend on the length and quality.
While there is inconclusive evidence that sleep hygiene alone is effective as a treatment for insomnia, some research studies have shown improvement in insomnia for patients who receive sleep hygiene education in combination with cognitive behavioral therapy practices provided within the psychotherapy sessions.