I’ve worked with lots of clients on sleep. It is estimate that about 40% of Americans are sleep deprived (let that number sink in). Impaired sleep is one of those things that can be a symptom of mental health problems, but it is also a potential cause all by itself. For example, being awake for 20 hours straight produces the same impairment as drunk driving. And those who have slept only 4-5 hours instead of the recommended 7 are shown to pose the same driving risk as drunk drivers. Additionally, most experts agree that it is useless at best to workout if one is cutting out sleep to find time because the body isn’t really capable of losing weight or building muscle if sleep deprived and you are at increased risk of injury while impaired.

So, if you are motivated to make a change of some kind, here’s a compilation of all of the best sleep hygiene tips I’ve come across. This article is not a substitute for medical advice so any changes you make should be in coordination with your doctor. All tips are descriptions of ideals, so remember that any change is likely better than none, so consider the principles of change when attempting improvements. Achieving “successive approximations to the target behavior” may look like a goal of going to bed at the same time daily and one step in the right direction may be to shoot for waking up between 7 and 9am daily instead of what a person is currently doing, which is waking between 6 and 11am daily.

Find a new place for Fido- sleeping with your pets, while it may seem nice- is actually one of the WORST things you can do for your sleep. Pets often hog the bed or move around at some point during the night. Even if your pet sleeps like a log, if you are anything like me, you wake yourself on accident trying not to squish your pet as you turn over. Alternatives can be as simple as moving your pet to an animal bed next to your bed. If you are hesitant to make this shift, ask yourself why and begin to problem solve. For example, many sleep with their pets for a sense of security and comfort. One may ask “what are the costs of sleeping with my pet?” compared to “are there other ways to love my pet when I’m awake?” and “are there other ways to experience comfort while I’m in bed?”

Emergency contacts- If you are not the emergency contact of anyone living outside your home, you can simply put your phone on airplane mode before you go to sleep. Otherwise, you can put your iPhone on do-not-disturb and either add favorites or turn on the function that allows calls to come through if the same number calls you more than once within a 5 minute span.

Pick a time to sleep and stick with it- our bodies operate on a circadian rhythm, which is a natural oscillation that repeats about every 24 hours. Ideally, a person will initiate and wake about the same time every day. One’s rhythm won’t be disturbed if there is a change of about 30 minutes - 1 hour. Added tip: create a 5-10 minute routine in the morning that helps you get up- read through inspirational quotes, check your schedule for the upcoming day, pray, breath, stretch, etc.

Don’t pressure yourself- remember that you can’t force your body to sleep, so that is not the goal. Setting your body up to be able to sleep is the goal. Therefore, keep in mind to control what you can and don’t sweat what you can’t. Feeling pressured to fall asleep is anxiety or anger producing, both of which amp up your nervous system rather than calming it down to produce the internal state necessary to sleep.

Don’t watch the clock- doing this while trying to fall asleep can have the opposite effect you desire.

Allow for wind down time- your body can’t go from high energy activity to sleep immediately, unless you are exhausted. Make a list of wind down activities that are low-stimulation and save those activities for the 2 hours before bed.

Light- Doing things like turning off artificial light 90-120 minutes before bed can help your body realize it is time to produce melatonin and therefore get drowsy. One easy way to do this is to buy color changing light bulbs or red colored light bulbs and use those during your wind down time. This is because your sense of “daylight” is related to the eyes registering blue light, not red light (different wavelengths of light). And, if you’ve been keeping up with technology lately, you may be aware that our gadgets typically produce blue light. Thus, you can wear blue blocking glasses or turn your phone on “night mode” to reduce the negative impacts of screens. You may also use a Kindle Paper White or another device that is not backlit. There is also a setting on iPhones which allows you to manually turn the brightness down further than normal (settings > accessibility > display and text size > toggle “reduce white point” on. Don’t forget to turn it back off when you wake so you can see your phone screen during the day.) If you choose to use these tips for light, just remember that electronics will still impair your sleep if you do high-stem activities on them so light is not the only reason why screens are discouraged during your wind down time.

One of my favorite wind down activities is a bath because not only is it low-stim, but it also warms me up and then after I get out, my body is actually cooling off (without my toes feeling cold), which induces drowsiness because drops in internal temperature support sleep initiation.

Sleep when sleepy- rather than staying in bed while you are not drowsy, get out of bed after you’ve tried to sleep for about 15 minutes and do a low stimulation activity in low or red light. If you find yourself waking too early, let’s say 4am, go ahead and get up and require yourself to stay up until bed time. While you may be exhausted for a day or a few, your body will begin to learn that it has to get up when it wakes or at a certain time (when your alarm goes off), and therefore, can’t afford to stay up at night.

Work with your body to find out how much sleep you need- most adults need 7-9 hours of sleep per night but ranges can vary over the life span and person to person. It can be helpful to note that you may feel drowsy during the day if you aren’t sleeping enough, but also if you sleep too much. Sleepfoundation.org makes it simple by describing what getting enough sleep looks like: “you fall asleep soon after getting into bed, within 30 minutes or less, you typically sleep straight through the night, waking up no more than once per night, you’re able to sleep the recommended amount of hours for your age group, you fall back asleep within 20 minutes if you do wake, you feel rested, restored and energized upon waking in the morning.” I know when I am getting the perfect amount of sleep when I become conscious right before my alarm goes off. It is also nice because then my alarm is not shocking me out of a dead sleep. If your alarm goes off and you are still having trouble feeling sleepy after 15 minutes out of bed and active (such as getting ready for work or school), you might be sleeping too little. Adjust your routine in 15 minute increments about every 3-5 days for best results.

Your bed is for sleeping (and sex) only. If you stay out of bed for other activities, you will condition your body to understand that bed = sleep.

Avoid stimulants like caffeine and nicotine after at least 4-6 hours before bed. Avoid intake of these at least 90-120 minutes after waking because they interfere with your body’s natural release of cortisol (which helps you feel awake) soon after waking. Studies indicate that the best time to drink your morning caffeine is likely between about 9:30 and 11:30am, but not before because the body’s natural cortisol spike is already happening at about 8:30 on average. Those who drink their caffeine too early may notice more afternoon drowsiness. So morning caffeine too early is likely redundant at best, inhibitory at worst. If you are using stimulants in order to get up in the morning, you might consider other things in this article as ways to problem solve.

Avoid using depressants like alcohol to help you fall asleep. They only help you feel drowsy, while simultaneously wrecking the quality of your sleep (there is a difference between sleep and restorative sleep) and make it harder for your to learn how to fall asleep without sedative help.

Some supplements such as Magnesium and the combination of Calcium and vitamin D (taken in the evening since magnesium induces a feeling of relaxation and calcium induces a feeling of drowsiness) have been proven to aid with sleep without any adverse side effects. St. John's Wort has also been proven to aid with sleep, but some researchers question if there might be adverse side effects. Zinc is the natural building block for your body to make Melatonin so some have suggested taking it in the morning will support a natural release of Melatonin at night.

Exercise 30 minutes per day- but know that as little as 10 minutes of aerobic (high heart rate) exercise has been proven to improve sleep quality. Important note: avoid doing this right before bed. Workout at least 3 hours before you go to sleep for best results.

Stretch- This is proven to aid in relaxation and blood flow, both of which will help you drift off. You can YouTube or internet search specific yoga or stretching positions that are helpful to use in bed as you fall asleep.

Eat (and avoid) the right foods before bed- avoid foods that are rich, fatty, fried, spicy, citrus, or carbonated before bed… these are difficult for many to digest while sleeping. However, if you get hungry before bed, feel free to eat a snack of healthy fat (your brain eats ONLY healthy fats- did you know that?) with a little protein (especially proteins that are easier to digest), which can help your body have the fuel for REM sleep. Think avocado, nuts, eggs, fish, tofu, lean chicken, turkey, or beef, chia seeds, or full fat yogurt or milk. If you have special dietary concerns, like diabetes, consult with your doctor about how to manage your PM diet.

Control your physical environment.

The average person gets the best quality of sleep in a room between 60 and 68 degrees, with sheets and blankets to adjust the temperature.

Consider your pillow and mattress- if you wake up sore, this is a sign that your body is asking for a different setting.

Ensure that you are sleeping in darkness (you may use blackout curtains or a sleep mask to help with this) and waking up to adequate natural light- the human body relies on natural light to signal the natural release of melatonin at night as well as the cessation of this in the morning. Sunlight viewing in the morning can also help with waking (https://www.hubermanlab.com/newsletter/using-light-for-health).

Find your preferred noise level- some like to sleep in complete silence- earplugs can help with this if you need help, and there are specific ones made for sleep (an internet search can help with this). Others like a low level of noise- a white noise machine, a fan, or other calming sounds.

Daytime naps: 20-45 minutes max. Most scientists agree it’s best if you don’t take naps but this time limit will allow the nap to energize you without you falling into deep sleep and making you feel sleepy upon waking. Limit naps to before 4pm.

Personalize your alarm- there are tons of options- some that require solving a math problem, some that require you to get up and chase it around to turn it off, some that wake you up using increasing volume or increasing soft/natural light. You can also make it impossible to reach your alarm while you are still in bed- simply plug it in across the room or in a different room. Most experts recommend that you avoid using your phone for your alarm to avoid receiving phone calls, texts, alerts, etc., and also to prevent using your phone to read the news right before you go to sleep or right after you wake up (there are other choices of wake up routines that are MUCH better for your mental health!) DO NOT use snooze to get 15 more minutes of sleep- it will only make you more sleepy. The only helpful way to use the snooze function is to press snooze upon waking and only turn your alarm completely off when you are physically out of bed. This can help prevent any accidental falling back asleep.

Figure out how to coax yourself out of bed- A few months ago, I had trouble getting out of bed for three days in a row. It was winter and I didn’t want to get out of my warm bed. So, I decided to lay out my clothes for the next day right beside my bed. The next morning, I literally got dressed under my covers while my husband laughed at my ridiculous strategy for helping myself get out of bed. It totally worked by the way. I’ve known others who put their breakfast by their bed (think electric hot water pot and oatmeal, or fruit, or a protein bar, or even milk in a thermos and cereal), or threw their covers off their bed when their alarm went off- whatever worked for them to get up and out of bed.

Practice relaxation! Guided meditations and other forms of meditation can help you learn to focus your attention or calm down your mind, which is necessary for falling asleep.

Keep a notepad on your nightstand. When my mind is still running at night, two questions help me calm my mind down- “Is it true?” “Is it necessary to think about now?” Almost always, I answer at least one question “no” and can then think about it later. However, when I remember something important that I don’t want to forget, I write it on my notepad to see tomorrow morning and can then let it go from my mind.

Set aside a specific “worry time” (including a start and end time) to think about all of the things that keep your mind racing as you are trying to fall asleep. If you schedule time to think about the things that are on your mind during the day, they won't be so intrusive at night. And, you can always remind yourself that you can think about whatever it is during your next worry session.

If you have come to the end of this list and implemented everything on the list for 2- 4 weeks, it is time to schedule an appointment with a primary care physician and/or a counselor. You may be suffering from medical conditions, such as sleep apnea, that may be discovered by a sleep study. You may also have some mental health challenges that will remain despite your good sleep hygiene until you address them.