Sleep Routine

When you hear the words “sleep hygiene,” do you think of clean sheets? If so, you are not wrong, but sleep hygiene is much more than that.

Sleep hygiene is a group of habits that can improve your chances of falling asleep, staying asleep, and sleeping well. Clean, comfy sheets are only one part of sleep hygiene.

How are sleep and NMO connected?

If you have neuromyelitis optica spectrum disorder (NMO), you already know that your symptoms and treatments can get in the way of a good night’s sleep. Steroids, a common treatment for NMO, may cause sleeplessness, especially when used long-term.1

Poor sleep is another common issue for people with NMO. This happens when someone gets enough hours of sleep but the sleep is not restful. Poor sleep quality can happen when someone is in pain or has mental health issues like depression.1,2

Plus, certain sleep disorders are more common in people with NMO, especially periodic limb movement disorder (PLMD) and sleep apnea. PLMD is a sleep disorder in which people repeatedly jerk or twitch their lower limbs during sleep.1,2

All of this is why it is worth it to try and improve your sleep quality when you have NMO.

The good news is there are a series of lifestyle choices that can improve your sleep. Most people must experiment to find the combination of sleep habits that work best for them.

Eating and drinking

Many people see sleep as something separate from the rest of their day. The fact is, what you eat and drink during the day impacts how well you sleep at night. Here are some common ways to improve your sleep through dietary choices.

Late-night eats

Eating heavy, rich, or spicy foods at night can trigger indigestion or heartburn that makes it hard to get to sleep or stay asleep. Other dishes that should be avoided close to bedtime are fried or fatty foods, citrus, and carbonated drinks. If you are hungry at night, eat foods that do not keep you up.3,4


Caffeine is a stimulant found in coffee, tea, soda, chocolate, and some pain relievers. If you have trouble sleeping, start tracking how much of these items you have each day and when. You may need to cut back. Or, you may need to stop eating or drinking these things 6 hours before bedtime.3


It is true that a drink close to bedtime can make falling asleep easier. However, this same drink can wake you up midway through the night as the body processes the alcohol. Avoid drinking at night. Some people with NMO cut out drinking completely, both for weight control and because alcohol can make sleep apnea worse. It may also interfere with many medicines.1-4


Tobacco is another stimulant that can get in the way of a good night’s sleep. Smoking may make sleep apnea worse. It can also worsen the long-term health effects of sleep apnea since both reduce the amount of oxygen in the body.1-4


A 30-minute walk each day is a good goal, but even 10 minutes a day of activity can help you sleep better at night. However, if you find that vigorous exercise in the evening keeps you up, move your exercise time to earlier in the day. Strenuous exercise gets the heart rate and body temperature up, which can make it harder to fall asleep.3,4


You may need to nap during the day to manage your fatigue. However, too much daytime napping can make it harder to sleep at night. That is why you should limit your naps to 20 to 30 minutes early in the day. A short nap can help improve your mood, energy, and concentration. Long naps late in the afternoon can keep you up at night.3,4


The human body naturally wakes up when light becomes brighter in the morning and winds down in the evening as it darkens. Exposure to natural light helps your body maintain its circadian (sleep-wake) rhythms. If you tend to spend all day indoors, try to grab a few minutes outside each day. In the evening, limit your exposure to overhead lights and the lights from electronics.4

Environmental options

Your bedroom can be a calming place that encourages sleep, or it can be a noisy carnival of sensations that make sleep difficult. To improve your chances of getting good-quality sleep, your bedroom should be as quiet, cool, and dark as possible.

You may need to invest in blackout curtains or eyeshades to block light. Earplugs or a white noise machine may help reduce sounds that disrupt your ability to sleep. If a pet wakes you up at night, consider making it sleep elsewhere.

Finally, make sure your mattress, pillows, and bed linens are comfortable. If your mattress is more than 10 years old, your sleep may improve if you replace it.4

Sleep routines

It may sound simple, but your body needs a sleep-wake routine. This means going to bed at the same time every night and waking up at the same time every morning, weekends included. It may take some time, but eventually, your body will be trained to sleep and wake at certain times.4

If you do not fall asleep after 20 minutes, do not try to force it. Get up and find a quiet, relaxing activity until you are sleepy again.4

An evening routine can also help you sleep. An hour or 2 before bedtime, turn down lights and turn off all electronics. De-stress by reading or listening to music. Many people find it helpful to perform a gentle yoga routine, stretch, meditate, or breathe deeply.4

Finally, if you snore or kick during sleep, talk to your doctor about treatment.

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Written by: Jessica Johns Pool | Last reviewed: September 2021