Poor sleep hygiene is becoming a global problem with our busy lifestyles, which affects the health and if it persists for a long time it leads to diseases such as chronic fatigue syndrome, fibromyalgia, recurring infection, etc.
Sleep hygiene is a key in management of chronic fatigue. Usually, most patients with chronic fatigue syndrome have poor sleep hygiene. There is sleep irregularity either in timing, duration of sleep or has sleep interruption. After a period of time with ongoing chronic fatigue, they adapt to a different sleeping pattern and at times sleeping at irregular hours. This in turn affects the health in the long run and is a vicious cycle that needs to be stopped.
The normal sleep onset should be around 9:00 pm to 10:00 pm and waking up around 5:00 am to 6:00 am. Generally, waking up around 6:00 am will improve overall health, but itself in the long run improves the metabolism, digestion process, eliminating of excreta, decreasing anxiety, and sense of wellbeing.
Most of the patients with chronic fatigue initially resist this kind of change as their sleeping pattern has changed. The circadian rhythms in the brain are already changed or adapted to new time and needs to be changed where it is like re-programming a computer. Once it is done slowly and adequately, there is gradual improvement.
Unless sleep hygiene is not improved until then, the improvement of having chronic fatigue syndrome symptoms will be less. “The number of hours you sleep before midnight are the good hours” is an old English saying and it is true as “eating an apple a day keeps the doctor away.”
One needs to focus on improvement in sleep hygiene. If it is gradually done after many months or a year or two, he/she may see a gradual improvement. If irregular sleeping habits have been present for many months or years, it will take time to improve.
The sleep hygiene generally takes 6 to 12 months to improve and at times, 24 months or longer in some patients we have seen in our practice. This needs to be first, mentally accepted by the person with poor sleep hygiene that it needs to be improved and then the person can work on that. We have seen in our practice that patients who resist these changes have persistence of chronic fatigue symptoms. It does become difficult for patients who are working night shift or rotating shift.
The improvement generally is very slow and gradual, and if it happens, it remains with the health for a long time unless it is interrupted by infection, stress, medications or other medical conditions. If this happens then re-synchronizing sleep cycle may further help. Doing regular pranayama or breathing exercises or yoga may further help the process gradually. It may be beneficial if done in the morning and before bedtime to relax.