According to the National Institutes of Health, 60 million Americans experience sleep problems, ranging from occasional to chronic. That’s roughly 20% of people in the United States alone. Needless to say, I treat a lot of insomniacs in my daily work.
The causes of sleep problems are many and can be biological or psychological. Either way, sleep hygiene may be able to help. Sleep hygiene is a routine you create that sends a message to your brain that it’s time for sleep. The ritual is somewhat individualized and is created with physical and psychological elements. Below is a list of various ideas for sleep hygiene. Pick a few ideas that you think might work for you and start there.
- Make sure your bedroom is quiet, dark and cool. The ideal temperature for sleep is about 65 degrees. If this is just not doable for you, get as close to that temperature as you can.
- Aim for the same bedtime and waking time each day. Each hour by which you modify your sleep can take your body days to recover.
- Get some exercise a few hours before bed. Of course, exercising too close to bedtime can have a stimulating effect and may make insomnia worse.
- Give yourself time to wind down by doing a relaxation exercise, such as tensing and releasing each muscle group from your forehead to your toes. There are also numerous relaxation applications for smart phones that can aid in sleep. Andrew Johnson has several free applications that can be used to create a relaxation script. You can adjust the amount of narration to a level that suits you.
- Drink a glass of warm milk. That’s not an old wives’ tale.
- Make sure you’re not hungry. Don’t eat too much before bed such that you’re uncomfortable, but a light snack may help you sleep.
- Create a preparation ritual. For example, take a bath, read, change into pajamas and brush your teeth.
- Take a warm bath.
- Try aromatherapy, using scents such as lavender.
- Drink hot, decaffeinated herbal tea with lavender and/or chamomile.
- Use white noise in your bedroom to help drown out other noises, like a car driving by, the house shifting or the cat knocking something over. Using noise while you sleep may seem counterintuitive, but your brain will tune into the steady sound and not the interruptive ones.
- Try a later bedtime, starting with a half hour. Rather than be sleepless for an hour, stay up an hour longer.
- Use the bed for sleep and sex only. Don’t read, watch TV, knit, balance the checkbook, write, argue with your spouse or plan your next patent. These wakeful activities can cause your brain to associate the bed with being awake. That’s the last thing you want!
- Avoid naps and oversleeping on weekends. If you’re tired, stay awake during the day and then go to bed early. This is more likely to get your sleep cycle re-regulated.
- Wake at the same time every morning, regardless of your bedtime the night before. This helps with getting your sleep cycle back on track. The longer you stay in bed, the shallower your sleep.
- Remember that sleep is like relaxation and urination—you cannot make it happen. That’s why it’s called “falling asleep.” Like a fall, it happens naturally. If you’re lying in bed and not falling asleep, you can try what’s called negative practice. This is a paradoxical technique based on the idea that trying to stay awake is likely to make you feel sleepier, just as trying hard to fall asleep is likely to make you feel more awake.
- Don’t use caffeine (coffee, tea, soda, energy drinks, supplements) after lunchtime. If you’re having frequent sleep problems, you should consider giving it up altogether, at least until your sleep is back on track. Be aware that caffeine is also found in chocolate and some supplements and meal replacement shakes. Caffeine disturbs sleep even in those who feel it does not.
- Avoid nicotine, as it is also a stimulant. If you’re not ready to quit, at least stop using well before bedtime.
- Don’t drink alcohol before bed. Though it may help you fall asleep, your sleep quality will be poor because of how it’s processed by the body. Seeing it as a toxin, the body tries to fight it. This can result in fragmented sleep and premature waking.
- If your brain won’t turn off, get up and get paper and a pen. Trying to remember the things you’re thinking about can keep you up. So, make a list of the errands and other tasks you are thinking about. Across from each item, make a note of how you will take care of it. Then, put the list “to bed” by putting it in a drawer and shutting it while telling yourself that you are finished and things are taken care of.
- Another method to try for a brain that won’t turn off is visualization. This is a form of relaxation or self-hypnosis that involves activating all 5 senses. First, take several slow deep breaths, in through your nose and out through your mouth. Try a count of 4 in, pause and 4 out. Then, close your eyes and create a “happy place” in your mind’s eye. Be as specific as possible. As an example, let’s use the beach. Here are some elements to consider:
- Sight: blue ocean in front of you, white sand all around you, jetties with big, dark rocks, puffy white clouds in the beautiful blue sky, birds flying by, seashells in the sand
- Sound: waves rhythmically crashing, birds chirping, water splashing in a jetty
- Touch: warm, soft sand on your skin or between your toes or fingers, cool water on your feet, sun on your skin
- Smell: salty ocean air, flowers, tropical fruit
- Taste: salty air, refreshing drink, fresh fruit from the area, maybe pineapple, banana, coconut, papaya or mango.
- If you’re lying awake in bed for 15 minutes, get up and do something relaxing with as little light and activity as possible. This means no screens of any kind because the brightness tells the brain that it’s time to wake up. You can stretch, practice deep breathing, do progressive muscle relaxation (tensing and releasing each muscle group in turn, from your head to your feet), pray, read by a dim lamp, meditate and so on.
- If your sleep problems are due to a work shift change, known as “delayed sleep syndrome,” try going to sleep later and later until your sleep cycle normalizes. This could take two to three weeks.
- Be aware that anxiety and depression can cause sleep problems. Consider an appointment for an evaluation with a licensed therapist. Exploring and tackling the possible underpinnings of your sleep issues can help more than you might think. Your therapist can also work with you to create customized relaxation and sleep preparation rituals, as well as guided imagery.
- Certain neurological and respiratory conditions can cause sleep impairment, so consider talking to your doctor about a referral to a sleep clinic for evaluation.
- Keep a sleep log, making note of when you tried to go to sleep, how long it took you to fall asleep, how often you woke up during the night and how many hours you actually slept. There are actually apps for your phone, such as Sleep Cycle, that can keep track of these things. Also keep a daytime log to gather information about possible causes of sleep problems. Make note of work issues, family problems, whether you took an afternoon nap, if you drank caffeine or alcohol before bedtime and so on. Then, compare the two logs to look for any patterns or connections between events and sleep issues. Experiment with the things that seem to cause problems, taking out one at a time.
- If all else fails, ask your doctor about a sleep aid. There are some natural remedies and supplements that may work for you, or you may need a prescription for a medication. Be aware that frequent use of these, whether over-the-counter or prescription, can cause dependency or addiction and interfere with alertness. Always check with your doctor first, as these drugs may interfere with supplements or medications you are taking, as well as certain conditions.
There may be some trial and error as you try to find the elements of sleep hygiene that work for you. Be patient with yourself; it could take days or even weeks to get your sleep on track. Sweet dreams!
