General points

1. There are 2 kinds of phases in sleep:

   1. Rapid eye movement sleep (REM) where the brain is relatively active, and you have dreams.

   2. Non-REM sleep where the brain is relatively inactive, and you have deep sleep.

2. Your brain cycles through both the phases throughout the night 5-6 times. There may be up to two instances of mild awakening which is normal.

3. The sleep duration decreases with age. Whereas an infant sleeps for 18 hours a day, toddlers sleep up to 9-10 hours. For adult usual sleep duration lies between 7-9 hours. With elderly however, the sleep duration is less than 5 hours and there might be frequent awakening with few instances of daytime sleep. The dream sleep (REM phase) is also less in elderly and this is normal.

4. A person usually feels fresh in the morning after a sound sleep and does not feel drowsy throughout the day.

Salient points

1. Make your bedroom comfortable. In general, it is better to be slightly cooler than to be warm. Minimize any noise producing device. Tools like ear plugs or white noise producing device may aid the sleeping process.

2. Regular hours of bedtime and arising (e.g. 11 pm till 7 am) helps in setting the biological clock accordingly. Irregularity in lifestyle like progressive sleep deprivation during the week and then erratic schedule on the weekends.

3. Heavy dinner might especially near bedtime might interfere with sleep. Having a light snack is helpful.

4. During daytime it is best to avoid napping and avoid doing any tasks on bed like eating, watching TV or reading a book. If required, try to do all work away from bed like on a chair or mat etc. Staying on bed reduces physical fatigue generated throughout the day which aids in sleep initiation. However, exceptions can be made for the elderly or deliberated and we can minimize the time spent in bed rather than stopping it altogether during day time.

5. As discussed physical fatigue is helpful in sleep initiation. Thus regular exercise daily specially in the late afternoon or early evening. It must be remembered that exercise very late in the evening close to sleep time may also disturb sleep.

6. Avoid caffeine (tea/coffee/cold drink/energy drink) intake and/or cigarette smoking within at least 6 hours of bedtime i.e. after around 4 pm as it activates the brain and causes problem in sleep initiation.

7. Looking at the clock during the night keeps the mind alert and attentive. If an alarm clock is unavoidable then it is better to keep it in drawer by the bed, so that it can be heard but not seen.

8. If there is something that is worrisome while lying in the bed, write it down on a piece of paper and promise to look at the paper in the morning. Let it go until then.

9. Do not take alcohol to help in going to sleep. It may make you sleep early but it disturbs the natural sleep cycle and cause mid sleep awakenings

10. If in spite of going to bed at fixed time you are not able to sleep in the next within 30 mins, don’t keep lying down, you should get up from the bed and go to bed only when sleepy. Reading something like newspaper/book in dim light/ listening to quiet music might help you.

11. Avoid using laptops / television / smart phones atleast an hour before bedtimee. around after 10 pm. You may activate night mode/ blue light filter later in evening on your computer, television, or mobile screen.