Sleep Hygiene and IBD

Sleep hygiene. Why does it matter, and what does it actually involve?

When I first heard the term sleep hygiene, I assumed it was referring to things we actually know as hygiene. Cleanliness. Actually, sleep hygiene is about good habits which promote a restful night's sleep.

Why sleep matters

Sleep matters, period. The impact of sleep on your overall health should not be underestimated. While we sleep, our body, including our brain, repairs itself. It's imperative for strengthening our immune system, tissue growth, and healthy brain function. Sleep also affects hormone levels and other important chemicals circulating in our bodies. Plus, we all know how connected the brain and gut are!

Sleep deprivation can also influence our mood, such as irritability and stress. Cognitive function is also impaired, which can mean poor memory and inability to concentrate, learn, and process information. Long-term sleep deprivation also increases the risk of developing anxiety or depression.

Why sleep matters even more with Crohn's and ulcerative colitis

It's even more important for people with immune-mediated diseases such as Crohn's and ulcerative colitis. A 2013 study into sleep and IBD says that sleep deprivation can actually lead to increased levels of inflammatory cytokines. You might recognise some of these, such as tumor necrosis factor-α and CRP. "Although not fully understood, the presence of active disease in IBD can lead to sleep deprivation, which then can lead to further immune activation, creating a vicious cycle for patients."¹

So, that's why sleep matters.

Sleep hygiene with IBD

Back to sleep hygiene. What does it actually involve? Well, it's not just those couple of hours before bed to consider. It's a 24-hour thing, starting with getting up in the morning!

Stick to a sleep schedule

Go to bed and wake up at the same time every day, give or take 20 minutes! This helps the body find a regular rhythm, which should ultimately lead to you getting tired at bedtime.

Get outside into the daylight every day

Preferably at the same time. This can make you feel more awake and alert, even on a grey day. Morning is best, to get those cobwebs shaken off in preparation for the day ahead!

Exercise during the day

This can help make your sleep deeper, leaving you more refreshed. A few studies have suggested that exercising too close to your bedtime can actually prevent sleep, so try to do it at least 2 hours before.

Limit caffeine

Enjoy your last caffeinated drink at least 8 hours before bedtime. It really can stay in your system that long!

Don’t eat a large meal close to bedtime

Experts recommend waiting at least three hours, so if you're hungry, opt for a light snack.

Cut blue light 2 hours before bedtime

Most of us know that the blue light emanating from the TV, laptops, and phones can prevent us from getting a good night's sleep. Using an inexpensive pair of blue-light-blocking glasses 2 hours before bed has been shown to improve the duration and quality of sleep.

Create the perfect sleep environment

Cracking a window ensures you have fresh air, increasing airflow and preventing carbon dioxide build-up overnight. In noisy areas, cold seasons, etc., you could use an air purifier that will remove bacteria and odours. A cool, dark, quiet room is recommended.

Try a bedtime routine

You'll need to figure out what suits you. Some options to consider are: taking a bath, decaffeinated warm drink, gentle stretching, meditation, or aromatherapy.

Additional tips for getting better sleep

I have only included the tips that I think we can realistically do. Generally, avoiding naps is recommended, but when you're dealing with poor health and/or chronic fatigue, a nap may be just what the doctor ordered.

How much sleep you need is for you to figure out. There are no concrete guidelines to apply to people with chronic health conditions. This could also change depending on how your health is during certain periods such as flare and remission.

It's important to remember that we are all different, and we need to find a routine that works for us as individuals. You might want to consider including other things such as:

• Only using your bedroom for sleep, or the other thing. This is fine if you have another room in the house that you can really relax in at other points during the day, and coming up to bed time.
• If you can't get to sleep within 20 minutes, leave the room and do something relaxing such as reading a book elsewhere. Preferably with dim lighting so you don’t fully wake yourself again. It’s better to avoid stimulation such as your phone or TV at this point.
• Keeping a diary might also be helpful. I am definitely kept awake frequently by thoughts racing around my head. Jotting them down and knowing that you can then deal with those tomorrow (and you definitely won't forget) can make getting to sleep easier.
• I'm sure I don't need to tell you that substances such as alcohol, cigarettes, and some OTC medications can cause fragmented sleep.

Talking to your IBD doctor

The most important thing to remember is that this is not rigid advice. Mix and match, and find what works for you. If you continually sleep poorly, you can seek help from a doctor who may be able to refer you to a specialist.

Good luck, and sweet dreams!