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Editor’s note: The following column is part 2 of a two-part series on sleep. The first installment ran on May 7.

Benjamin Franklin popularized the saying, “Early to bed and early to rise makes a man healthy, wealthy and wise,” although work, school, and family pressures often inhibit a healthy sleep routine. Sleep experts recommend that adults aim for seven to eight hours nightly, and even more for children and teenagers.

I know that I feel better after a good night of sleep. My husband, Robert, gets up before me and tiptoes around because he likes me better when I am well-rested. Those long hours of sleep recalibrate our emotions, replenish our immune system, consolidate memories, slow the effects of aging, regulate appetite and boost productivity. Some of us have the desire to improve our sleep patterns, but still struggle to get adequate sleep. What do we know about the mechanisms of sleep to help us improve our routine?

Humans have an internal clock, based on a day-night cycle. Our circadian rhythm controls the timing of hunger and meals, urine production, mood and emotions, metabolic rate, hormone release and body temperature. Melatonin, a hormone released soon after dark from the pineal gland, signals the body to go to sleep. As its level decreases with morning light, it alerts the body to wake up. A second factor is the homeostatic sleep cycle, involving the neurotransmitter adenosine. As the hours of wakefulness increase throughout the day (usually after 12 to 16 hours), it peaks and says, “You are groggy. Sleep!”

Normal, healthy sleep patterns can be disrupted in several ways. As we age, we may experience a decrease in both sleep quantity and quality. We may be in bed for eight hours, but only sleep for four. We may have to get up to urinate several times a night. Caffeine, a staple in the American diet, interferes with adenosine’s ability to make you tired and can last up to ten hours in the body. Hot flashes during menopause and stress can negatively impact the quality of sleep. Of course, leaving yourself only four to five hours for sleeping means you will never get enough rest.

Sleep experts recommend consistency in sleep, often recommending that we set an alarm clock to both wake up and go to bed about the same time each day, reserving time for eight hours of nightly sleep. Although a mid-day 20 to 30 minute nap can be beneficial and a boost to productivity, long afternoon naps may interfere with falling or staying asleep at night. Exercise increases deep sleep but should be done earlier in the day. Exercise right before bed increases body temperature and may negatively impact sleep.

Recommendations for getting to sleep also include limiting television time, electronics use, and light exposure in the evenings because they distort your natural sleep cycle. A cool, dark, quiet bedroom helps facilitate sleep. A comfortable sleep mask can also block unwanted room light. And if your partner snores, ear plugs may be required (let them know it isn’t personal).

Follow a nightly routine as you prepare for sleep. I read a book for a few minutes while my eyes get tired. A hot bath before bed is also a good idea, because it radiates heat out to your extremities, and your core temperature drops, preparing you for sleep. We shouldn’t go to bed overly full or overly hungry. A light snack may help. Although a nightcap is believed to be a sleep enhancer, it actually decreases the quality of your REM (rapid eye movement) sleep, which is essential for memory consolidation, problem solving, creativity and emotional stability.

If you experience insomnia, experts recommend that you get out of bed and do something quietly until you feel sleepy, then return to bed. Watching the clock increases anxiety. Try to stay calm, deep breath, and relax. The goal is to build confidence in self-generating sleep that is healthy and sound.

It may seem that sleep habits are too hard to manage, but there are very realistic ways to improve your sleep patterns. Don’t think that sleep medications are the answer. Although these drugs are heavily advertised as an easy solution, they can have negative effects, including addiction and rebound insomnia. According to some studies discussed in Matthew Walker’s book, “Why We Sleep: Unlocking the Power of Sleep and Dreams,” even occasional use can lead to detrimental health issues.

Come up with a sleep plan. Get your whole family on board. Have confidence that your body will figure it out. Be positive. I wish you a good sleep tonight and every night.

Caroline Shugart is a nurse, dietitian, and personal trainer. Her new grandson gives her even more reason to live a long and healthy life.

Caroline Shugart is a nurse, dietitian, and personal trainer. She can be reached at

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