I believe proper sleep is the single biggest contributing factor to our healthy mental and physical functioning or lack thereof bar none.

Thus, IF there is nothing wrong with you medically and you find yourself sad, depressed, irritable, emotionally labile and/or cognitively slow and foggy — one quick check is whether or not you are getting 7–9 hours of good quality sleep!

I realize others would choose relationships or work related matters but if you’ve ever tried to maintain warm caring relationships and work at high levels on little sleep, I’d like to see the scientific research comparing these factors related to how they impact our wellbeing. In my professional opinion, until we figure out a healthy sleep hygiene routine and be able to stick to it on a consistent basis, we might as well hold off on other matters related to our wellbeing.

We Americans are notorious for taking our sleep for granted. In fact, one in three Americans report not getting enough sleep, seven or more hours, on a regular basis to ensure optimal health and wellbeing is possible (CDC 2016). In my practice, I regularly run across individuals tied to the business world who seem to wear their dark rings around their eyes as if they’re badges of honor. Lore holds that if you want to get ahead in certain segments of business you need to work as many hours as possible, including nights and weekends. I’ve even had a graduate student immersed in a full blown panic attack in my office wearing a t-shirt with the catch phrase “sleep is for the weak” emblazoned on it. When I suggested there might be a connection between his recent bouts with mood swings and panic attacks, both atypical for him historically, and the inscription on his shirt, he was none too amused. He scoffed, proclaiming he was a night owl and that the bulk of his most important intellectual ideas came to him in the wee hours of the night. Don’t they all when we are young I gestured light heartedly.

He continued his poor sleep habits and fought against the idea that his sleep deprivation had any causative link to his current emotional problems. It wasn’t until his panic attacks worsened and he believed he was having a heart attack that he called 911 and went to the emergency room. Thankfully, a medical attendee after performing several medical and health checkups, who was likely sleep deprived herself, had seen this situation many times over conveyed there wasn’t anything wrong with his heart. My patient was sent home after being given a prescription of Ativan with the medical advice, “go home and get some sleep.” Thereafter, he began taking his sleep hygiene more seriously, and not surprisingly, his emotional bouts with moods swings and panic attacks dissipated exponentially.

Name any psychological and/or physical problem and chances are sleep deprivation either contributes to it or exacerbates its severity. The healing process is helped by proper sleep as it helps clear out bodily toxins and allows our body to adequately decompress. Sleep deprivation can cause problems with our immune system causing an increased risk for viral infections, inflammatory problems and even damage our genes. Other medical problems increase as sleep deprivation mounts: cancer, type 2 diabetes, high blood pressure, increased cortisol levels that regulate stress, digestive and gastrointestinal issues, obesity, increased food cravings, impaired sexual functioning, hearing problems, increased pain sensitivity, focus and memory problems, motivation, decision making and processing impairment, mood disorders including depression, anxiety, irritability, bipolar disorder, and ADHD (Harvard Health Publishing, 2019).

When all is said and done, a decent night’s sleep helps contribute to our mental and emotional wellbeing and the reverse, sleep deprivation, contributes to heightened negative mentation states and emotional dysregulation. On the mental health front, what we find is that when the combination of stressors and lack of sleep mount, negative psychological emotions increase to the point where it becomes harder to distinguish reality from fantasy and their relationship to one another.

Tips to better manage our sleep hygiene.

1) Most people need to get between 7–9 hours of sleep a day and I’d advise going to bed and rising at the same time everyday. Move your sleep times around until you know when the best 7–9 hours of sleep is that allows you to feel your best. Even with the same amount of hours of sleep most people have a specific timeframe in which they feel better to initiate their sleep cycle than others. It’s not just quantity of sleep but more importantly the quality of those 7–9 hours of sleep.

2) Come up with a sleep/relaxation ritual and devote 20–30 minutes to decompression activities prior to your lights out time. This can be reading a book for pleasure, listening to relaxing music, doing light stretching, taking an epsom salt bath or listening to a guided meditation podcast.

3) Consider spending 10–15 minutes journaling prior to your sleep time. Write down any bothersome thoughts or worries you may have so that you can get them out of your head and focus on them tomorrow. Write up a short to do list to help you organize your coming day. Afterwards, spend a few minutes writing down things that you are thankful for. Do them in this order so that you move from the worrisome, to the practical to the thankful aspects of your life. We want to end our day on a positive note, releasing positive feel-good hormones to leave our minds and bodies in a more peaceful place prior to drifting off to sleep.

4) Avoid caffeine, stimulants, dietary supplements that contain stimulants, alcohol, over consumption of heavy carbohydrates and sugar or other ingredients that have been known to impede the quality of our sleep. The time between ingesting food and allowance of restful sleep is different for all of us but 2–3 hours often suffice. Pay attention to the quality of your sleep on the days you ingest any of these ingredients just prior to going to sleep.

5) Keep your room free of electronic devices such as televisions or laptops, use of late night screen time, background noise and especially light as it tends to reset our biological clocks to match new light inputs. Consider using earplugs, fans, humidifiers and a white noise machine to cancel out any background noise that tends to impede sleep.

6) If you wake in the middle of night don’t reach for your laptop or cellular device to check the news, emails or connect with the outside world. If you have to go the bathroom or get a drink of water do so but get back in bed thereafter so as not to activate your mind with tomorrow’s to do items. Save them for the morning!

7) Catnaps — consider taking 1–2 short 15–20 minute catnaps throughout your day prior to 3pm. They’ve been shown to help with relaxation, reduce fatigue, increase alertness, improve mood, and improve memory and performance (Mayo Clinic, 2018).

*If you’ve tried these tips and your quality of sleep still remains off, consider doing a sleep study to see if you have sleep apenea, restless leg syndrome or narcolepsy. Consider consulting your primary care physician for a medical checkup and or seeing a psychotherapist to discuss any possible life stressors that can contribute to sleep diffficulties.