The terms ‘barriers’ and ‘facilitators’ describe actions, habits, and environmental factors which move you away from or towards a goal or target behaviour. For example, a bike path facilitates cycling as transport or exercise whereas without a bike path, a congested narrow road becomes a barrier to cycling. Therefore by identifying the environmental influences that block or encourage good health, we begin to realise how we can change our environment to facilitate good health.
A sleepy Australia
For many of us, our lifestyle demands many more waking hours resulting in interrupted sleep and overall less sleep. 50% of adult Australians and 1 in 5 adolescents suffer from daytime tiredness as a result of poor sleep (Adams et al. 2017); Short et al. 2013). Athletes also report sleep disturbances throughout all training phases impacting on muscular explosiveness and fatigue thresholds (Swinbourne et al. 2016). In 2016, Australian business reported a productivity loss of $12.9 billion directly linked to daytime tiredness as a result of suboptimal sleep (Lallukka et al. 2018; Hillman et al. 2018). Clearly, poor sleep is prevalent and has wide reaching consequences for health, performance and productivity.
Identifying the barriers and facilitators to good sleep
Our sleep environment largely influences sleep latency (how fast your get to sleep) and sleep quality. Environmental cues such as temperature, light and sound regulate our biological drive to sleep. To facilitate sleep your bedroom should be cool, quiet and dark. The use of ear plugs, black out curtains or eye masks, and cooling devices often achieve this.
Working with our biological clock
Like a biological clock, the circadian rhythm regulates wakefulness, alertness and sleepiness throughout a 24-hour cycle by responding to your environment. Further to environmental cues, we can direct our circadian rhythm by having consistent bed and wake time. Changing a bed or waking up time can be done by adding or subtracting 15 minutes until optimal daytime wakefulness is achieved. However for shift workers, night workers and nightly caregivers a consistent sleep schedule is not feasible therefore making use of daytime naps to catch up on sleep will elevate some tiredness. In addition, those with irregular sleep schedules should rely on managing the other factors, listed here, which degrade sleep.
A Night Cap
Alcohol prior to bed is often used as a calmative, reported to relieve tension and encourage sleep. While alcohol can feel like a facilitator of sleep it only reduces sleep latency (the time it takes to get to sleep) while damaging restorative sleep. There are many other options that facilitate the same calm and relaxation effect as alcohol however these do aid sleep. Strategies such as meditation, exercise, reading, or talking with a loved one should be preferred instead of using alcohol to manage stress or get to sleep.
Pillow Rumination
For many of us stress and anxiety delay sleep and reduce sleep quality. Rumination upon laying down to sleep, planning the next day or reliving a conversation you had during the day keep us awake and alert. When you realise that your thoughts are not really happening (ie. you’re laying in bed not actually having a conversation with your colleague) you can begin to introduce strategies that slow your thoughts prior to bed. In addition, stress management and coping strategies help change our relationship with stress and potentially eliminate the burden of stress. It is important that stress stimuli in the hours prior to bed and throughout sleep be lowered or removed. Having effective coping tools for stress and anxiety improves sleep quality and wellbeing.
Drugs
Certain drugs like caffeine are known to increase stimulation and awakeness and therefore should be reduced or eliminated prior to sleep. The effect of caffeine is highly variable between individuals and can take from 1 to 9 hours to reduce strength by half once ingested. Swapping caffeine drinks with other warm drinks after noon will facilitate sleep, in addition to using walking telephone calls, sunlight and exercise to increase alertness. Prescribed medications may also have a wakefulness effect and may be best taken in the morning.
Do not disturb
In our busy lives, the end of the day might be our only time to relax. Spending time with our partner and kids or maybe indulging in a few episodes of your favourite show is crammed into the nighttime hours at the cost of sleep. It is now clear that the use screens (phones, computers, tv screens tablets) before bed are a barrier to sleep, directly impacting on sleep latency and sleep quality. It seems these devices stimulate the biological drives to keep our attention and promote wakefulness. In addition sound or vibration notifications throughout the night bring you out of restorative sleep. By limiting screens and placing your phone on do not disturb prior to bed, you can improve your sleep. Secondly, by increasing our strategies for stress management, spending time with loved ones and relaxing decreases reliance on screens.
Look in the mirror
Take a moment now to reflect on how many apply to you. If you were to generalise, what habits or environments impede your sleep? What one or two alterations could you make this week to improve your sleep? Lastly, could you maintain this action for the rest of your life?
During a Range of Motion Nutrition Coaching consultation, you will undertake a formal process to individualise these strategies. If daytime sleepiness is a burden for you, like many Australians, first focusing on improving your sleep environment will help regulate your sleep. Secondly, employ strategies to decrease stress and arousal to further facilitate a better night’s sleep.
Hillman, David, Scott Mitchell, Jared Streatfeild, Chloe Burns, Dorothy Bruck, and Lynne Pezzullo. 2018. “The Economic Cost of Inadequate Sleep.” Sleep 41 (8). https://doi.org/10.1093/sleep/zsy083.
Lallukka, Tea, Børge Sivertsen, Erkki Kronholm, Yu Sun Bin, Simon Øverland, and Nick Glozier. 2018. “Association of Sleep Duration and Sleep Quality with the Physical, Social, and Emotional Functioning among Australian Adults.” Sleep Health. https://doi.org/10.1016/j.sleh.2017.11.006.
Short, Michelle A., Michael Gradisar, Leon C. Lack, Helen R. Wright, and Hayley Dohnt. 2013. “The Sleep Patterns and Well-Being of Australian Adolescents.” Journal of Adolescence. https://doi.org/10.1016/j.adolescence.2012.09.008.
