Do You Need a Nap? Let's Talk About Sleep Quality!

Are you sleeping well? Sleep is a crucial period for your body to rest and rejuvenate. Your body undertakes many important processes while you sleep – including creating proteins that are important in your immune response¹. Without enough sleep, you might be more susceptible to infections.

Why is it that so many people have trouble falling asleep? What can you do to help your body sleep well? Are medications really the only option? These are questions we frequently hear at the pharmacy. There are many reasons people may have trouble falling asleep and this article will provide tips on assessing and improving your sleep quality. Medications should always be your last option when it comes to sleep.

Step 1. Assess your sleep quality.

Do you get less than 7 hours of consistent sleep throughout the night?
Does it take you longer than 30 minutes to fall asleep at night?
Do you wake up multiple times throughout the night, and do you find it difficult to fall back asleep afterwards?

If you answered “yes” to any of these questions, read on to learn what you can do to help improve your sleep quality.

Step 2. Assess your sleep habits and environment.²

Keep your sleep schedule consistent, even on weekends. Try to wake up and go to sleep at the same time every day to help regulate your body’s internal clock.
Avoid electronics around bedtime. The blue light used in electronics such as televisions, phones, and laptops can “trick” the brain into thinking it is still daytime and may make it difficult to go to sleep.
Make sure you have a comfortable and supportive mattress and pillows. Keep in mind good mattresses have a life expectancy of about 9 to 10 years. Your mattress may need to be replaced if you have had it for a long time.
Your bedroom should be cool, ideally between 60 and 67 degrees Fahrenheit.
Avoid caffeine in the afternoon. We typically recommend avoiding caffeine after lunch, as caffeine can stay in your body much longer than you might think. It can keep you awake at night, pulling you into a “caffeine-dependent cycle” by making you feel as though you need caffeine to stay awake the following day due to poor sleep quality the night before.
Daily exercise will help you sleep better, but do not exercise right before bed. For an hour before bed, try to engage in relaxing activities as your brain prepares for sleep.
Avoid heavy meals, alcohol, and cigarettes before bedtime. All of these things can disrupt your sleep. We typically recommend avoiding large meals (especially if they are fatty or spicy) for a few hours before sleep, as this can cause indigestion. While some people use alcohol to help with sleep, this effect only helps for a couple of days before it actually makes sleep much worse. Similarly, many people who use cigarettes will smoke a cigarette before bedtime to try to relax before sleep. However, nicotine is actually a stimulant and will tell your body to stay awake.
Using sleep aids such as diphenhydramine (Benadryl) to help with sleep may help for a few days, but is not beneficial to take for longer than a week. Long-term use of diphenhydramine in older adults has even been linked to increased risk of dementia³. If you take a combination product as a sleep aid, make sure you pay attention to what is in the product. For example, Tylenol Ò PM is a mixture of diphenhydramine and acetaminophen. If you take other medications for pain, make sure you are not exceeding the daily maximum amount of acetaminophen, which is 3,000 mg to protect yourself from liver damage.
Keep the room dark near bedtime and expose yourself to light when you wake up. This will help your body manage its circadian rhythm, which is essentially an internal clock which controls your sleep-wake cycle.
Avoid naps. Naps can be healthy, but if you become too reliant on them, it can be detrimental to your nighttime sleep.
- Healthy: Healthy naps are less than 30 minutes long and are used to improve alertness. For example, if you typically sleep for 8 hours but had a busy week which led to only 6 hours of sleep, supplementing with two 30 minute naps (one in the morning and one in the afternoon) can decrease stress, help the immune system, and enhance performance⁴.
- Unhealthy: Unhealthy naps are naps that too late in the day, longer than 30 minutes, or frequent throughout the day. Naps can also be unhealthy if you are already having consistent trouble sleeping. Cutting down on naps throughout the day when you have trouble sleeping can make it much easier to sleep at night.

Step 3. If adjusting your sleep habits does not help within a week or two, consider talking to your doctor or pharmacist about supplements to help you sleep. If you choose to begin using a supplement, always let your healthcare professionals know what you are taking.

As a pharmacist, a supplement I frequently recommend for sleep is melatonin.
- Try melatonin if you have trouble sleeping due to shift work or a recent time change. To get the best benefit out of melatonin, start with lower strengths (such as 3 mg) nightly and take this supplement as it gets dark outside, or at least an hour before you go to bed.

Step 4. If you are still having trouble sleeping, a prescription medication may be appropriate for you. Prescription medications should be the last thing you try to help with sleep, not the first. However, they can be beneficial if nothing else is able to help you sleep. Contact your physician or pharmacist to learn about what prescription options may be appropriate for you.

References:

How Sleep Affects Your Immunity. National Sleep Foundation. 2018.
Healthy Sleep Tips. National Sleep Foundation. 2018.
Gray SL, Anderson ML, Dublin S, et al. Cumulative Use of Strong Anticholinergics and Incident Dementia. JAMA Intern Med. 2015;175(3):401-307.
Napping. National Sleep Foundation. 2018.