Better Sleep for Physical + Psychological Health

By: Brandon Dreiman, Coordinator of Firefighter Wellness & Support at Indianapolis Fire Department

We all know that sleep is vital from both a physical and psychological standpoint, but the reality for firefighters is that someone has to be up at night! Combine that job-related demand for nighttime wakefulness with the chronic stress of the job, and you’ve created a very difficult recipe for sleep.

Given that, are there any easy suggestions for improving sleep quality at home and on duty? There are. The first and most basic recommendation is a simple two-parter:

1 - WHEN YOU’RE TIRED, GO TO BED.

2 - WHEN YOU WAKE UP IN THE MIDDLE OF THE NIGHT, TRY TO GO BACK TO SLEEP.

TIPS FOR BETTER SLEEP:

FIND THE DARKNESS

Darkness stimulates melatonin production, helping you to fall asleep quickly and keeping you asleep as you complete all sleep cycles. Darkness also helps you to relax, so make your bedroom a sleep cave. Turn the alarm clock face down or cover its face – you don’t need that light in your bedroom, and you certainly don’t need to watch the minutes tick past. Install room darkening shades and if you have a gap between your curtains, use clothespins to close it. If the light comes under your door, fill the void with a towel and consider wearing an eye mask.

TUNE OUT THE NOISE

Many people are soothed by sound machines or apps that cover annoying background noise. Try a few to see which one relaxes you best. Or consider earplugs to block those background noises.

LOWER THE TEMPERATURE

To sleep well, your core body temperature needs to drop by approximately two degrees Fahrenheit, so sleeping in a cool room wearing minimal clothing is essential. Another great sleep hack is to take a hot shower or bath about an hour before bedtime to allow the hot water to raise your core temperature, which will then drop after you get out. When the bath or shower is taken at night, the body recognizes that darkness has fallen and that your core temperature is also dropping and is “tricked” into becoming sleepy.

TIME YOUR NAPS

Most of us have a natural drop in core temperature in the early afternoon – one reason we’re often sleepy after lunch. If you want to nap, do it before 4 pm and for no more than 45 minutes. Napping without entering deep sleep is important to feeling rested and helps to avoid throwing off your nighttime sleep schedule.

REIN IN THOSE ELECTRONICS

Your optic nerve has an area called the suprachiasmatic nucleus (SCN) that wakes you when it detects sunlight and encourages sleepiness when it doesn’t. The SCN can’t tell the difference between sunlight and the blue light from electronics, so if you’re on your phone or iPad at midnight, your SCN will tell your brain that there’s daylight so it’s time to wake up. Turning off electronics at least an hour before bed allows the SCN to process that it’s nighttime, which triggers the sleep process.

THE 30/30 RULE

If you have been lying in bed for what feels like 30 minutes (don’t check your clock – just estimate), get up, go to another room and relax for 30 minutes. After 30 minutes, go back to bed. If you simply lie in bed struggling to sleep, you’ll begin to associate your bed with being awake, which makes the problem even worse.

CUT THE CAFFEINE

Stop consuming caffeine by lunch time – or better yet, by 10 am. Here’s why: when you wake up in the morning, your body ramps up energy but also begins to produce adenosine, a naturally occurring substance that relaxes and dilates blood vessels. Your body has receptors where adenosine attaches, and as it builds up through the day, you become drowsy. Caffeine competes with adenosine to attach to these receptors and when it does, the caffeine wakes you up. Caffeine build-up from drinking coffee throughout the day can disrupt things for up to 30 hours. So try to have your last cup of coffee by 10 am and beware of sneaky foods that contain caffeine including black tea, green tea, colas, energy drinks, and dark chocolate.

FORGET THE OTC REMEDIES

Over the counter (OTC) remedies for sleep are very popular, but as a rule, should be avoided. Melatonin can be great, but only if you use what your own body produces. If that melatonin production is sub-optimal, it’s likely because you’re doing something (like late-night blue light exposure) that is interfering. Rather than treating the symptom with melatonin pills, it’s better to figure out the cause. While short-term use of melatonin for jet lag can be effective, long-term use as a sleep aid isn’t recommended.

Diphenhydramine, another OTC remedy, is an antihistamine used in many “nighttime” medications. It has two drawbacks – the first being that it can shift the sleep-wake cycle which only causes more problems. Secondly, it’s an anticholinergic that binds to acetylcholine, which is used by the brain to form memories. A major study examining the relationship between long term anticholinergic use and memory issues noted that “higher cumulative anticholinergic use is associated with an increased risk for dementia.” Enough said. Try to avoid using diphenhydramine to sleep.

WHAT ABOUT CBT-I?

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a standardized, multi-week program specifically designed to assist people who have chronic issues falling asleep or staying asleep. It’s the evidence based treatment of choice for insomnia and produces clinical improvement in 75 percent of insomnia patients. Topics discussed during CBT-I are things like negative sleep thoughts, sleep restriction, weaning off sleeping pills, relaxation techniques, and sleep hygiene practices. Depending on who provides the CBT-I, it may be covered by insurance. Regardless, CBT-I tends to be fairly cost-effective even if paid out of pocket. And who can put a price on a great night’s sleep?

As you can see, there are a wealth of options to improve sleep. Choose one or two from the list and try them for a week. If you notice a difference in your sleep, you’ll know what’s working.