Sleep Hygiene: Creating Conditions That Promote Sleep

Back in 2018, I did a post looking at the sleep hygiene recommendations that I was and was not following. I decided to look back and reflect on what’s changed since then.

What hasn’t changed is that I can’t sleep without medication. I’m not taking anything specifically for sleep, but a couple of my regular bedtime medications (quetiapine and mirtazapine) are sedating. I can usually sleep pretty well with the meds, although when the depression gets worse, I sleep less. Overall sleep hygiene isn’t that big a priority, but it’s still worth doing what I can to promote sleep.

Maintain a regular sleep schedule

I have a very regular sleep schedule, although it’s shifted to a later bedtime in the summer. By later, I mean around 8:30pm. Really.

There aren’t any external factors that would throw off my schedule. It’s been many months since I last worked, plus I don’t socialize, so there’s no reason for evening to even exist in my world. At the time of my post a couple of years ago, I wasn’t socializing then either, but I was working the occasional night shift that would temporarily throw off my sleep.

Avoid naps

I used to really like short afternoon naps. It was a problem when I was in university, because I’d fall asleep in the first class after lunch, whether I wanted to or not.

In the post from 2018, I was having a lie-down regularly in the afternoons, although I wouldn’t usually sleep. Now, it’s rare for me to nap in the afternoon. I just don’t get that after-lunch sleepiness that I used to. Occasionally I’ll lie down for a while to cuddle a guinea pig, but that’s about it.

Don’t stay in bed awake

If I wake up during the night, I usually have a good sense pretty quickly of whether I’m likely to fall back asleep or not. Sometimes lying in bed awake feels restful even if I don’t think I’m going to get back to sleep.

It makes a difference that I don’t really have much to do during the day; I’m not feeling pressured to try to stay in bed and hopefully get some more sleep in order to be rested for the day to come. When I was working night shifts, this was more of an issue because I really wanted to get an evening nap in before going to work, and given the time, getting up and waiting until I was sleepy to go back to bed just wasn’t feasible.

Don’t watch tv or read in bed

I spend most of my time on my bed, and I do just about everything there. Partly, I just like my bedroom, but mostly, it’s because I’m close to the guinea pigs — the girls are in the bedroom, and the boys are in the adjacent bathroom.

Something that’s stayed consistent from the last post is that I have a sitting side of the bed and a lying down side. The sitting side is for daytime use, and the lying down side is for nighttime and the occasional nap. For me, that feels like sufficient psychological separation.

In terms of screen time before bed, I don’t find that the screen exposure makes it hard for me to get to sleep, but what I’m looking at on the screen does matter. Less stimulating content seems to be fine for me.

Avoid substances that interfere with sleep

Any alcohol is usually around lunchtime, which hasn’t changed. I drink tea in the afternoon more often than I used to, but I’ve never found tea wakes me up all that much unless I’m drinking really large amounts.

Exercise regularly

Two years ago, walking was my main form of exercise. I had gone to dance classes before then, but it just wasn’t working anymore because of a few depression-related factors.

I used to walk to the grocery store about 3 times a week. Now, with a combination of COVID and persistent psychomotor retardation, walks are happening a lot less often. And given that I can barely go at a snail’s pace, I’m certainly not getting my heart rate up at all.

Establish a good sleep environment

I like where I sleep. My bedroom is cozy and calm. It’s quiet where I live and the nighttime temperature is usually comfortable. I’ve got blackout curtains, and I don’t have anything producing any unnecessary light.

The guinea pigs are used to my schedule. They’re usually sleeping when I go to bed, or quietly munching on some hay. They can tell when I wake up, I guess because I start moving around more in bed. Sometimes I’ll want to lie in bed for a while, but they’re not prepared to give that the green light, because they want their breakfast.

Establish a relaxing pre-bedtime routine

I guess I have a routine in that I do the same thing most days, but it doesn’t really involve much. I’m on my laptop until I naturally start getting tired, then I take my meds and crawl into bed. When the meds kick in, I go to sleep.

On rare occasions, I’ll think I already took my meds when I actually hadn’t, and I’ll wonder why I’m lying in bed really tired but can’t sleep. After some time has passed, I’ll start to think that maybe I didn’t actually take my meds, but I don’t want to accidentally double-dose, so I wait some more. When it becomes clear that I definitely didn’t take the meds, I take them, and a short time later I’m out like a light. Meds are definitely my friends.

Getting by

Overall, I guess I’m doing so-so in terms of sleep hygiene, but I think I’ve found a good balance of doing the things that matter more for me. I’m definitely very glad to be on meds that zonk me out at night. In the past, getting a half-decent amount of sleep while I was depressed was pretty tough, even with sleep meds like zopiclone and trazodone. Quetiapine may have contributed to making me fat, but it is most certainly my friend.

How do you do with sleep and sleep hygiene?