Ask Dr. Pat

Dr. Pat Consults: Ten Solutions for Poor Sleep

In addition to addressing possible health issues that impact your sleep, changing your behavior can also improve your chances of getting a good night’s sleep. These include a number of factors.

  1. Set the stage for success: Keep your bedroom quiet and cool. Similarly, minimizing noise helps facilitate sleep.  Although you may become accustomed somewhat to sounds at night—the constant low hum of traffic, for example—studies have shown that our bodies’ arousal system continues to respond to nocturnal noise, resulting in sleep disruption. Employing earplugs and white noise have both been shown to help. Finally, your body temperature goes down slightly during sleep, and a cooler room facilitates that; 65 degrees F tends to work for most people.
  1. Dim the lights: Your circadian rhythm is the roughly 24-hour internal cycle that helps create your sleep patterns.  Light exposure at night can disrupt your circadian rhythm and make it more difficult to fall asleep.  You may want to invest in a decent set of curtains or a sleep mask to cut down on street light. In addition to seeing that your room is dark, it’s important to reduce your light exposure even before going to bed.  With all of us glued to our screens late into the evening, this exposure to blue light may be partially to blame for some of our sleep troubles. Experts recommend reducing screen time before bed. If turning off your devices isn’t an option, there are programs that reduce the blue light produced by your devices at night.
  1. Skip the afternoon coffee break:  Caffeine begins acting within 15 minutes of your first cup and lasts for hours in the system; 6 hours after you finish that cup, half the caffeine you consumed is still active. Caffeine works in the brain by blocking the action of one of the key molecules that are involved with sleep. Thus it is best to avoid caffeine in the late afternoon and evening.  Even if you think caffeine doesn’t affect your sleep, it’s worth going without—studies have shown that people tend to underestimate the impact of caffeine on their sleep. Something to note is that “decaffeinated” is not the same as being completely caffeine-free. Decaf coffee still actually contains caffeine, although in fairly small amounts.  Instead of decaf coffee, you may try switching to herbal tea, which really is caffeine free.
  1. Abstain from alcohol: Although alcohol may help you fall asleep, it has been shown to decrease sleep quality. While some may tolerate a drink or two without significant effect, for others this can pose more of a problem. Consider going without a drink for a week or two to see how it impacts your sleep. For heavy users, trouble with sleep can continue even after they quit, and the sleep problem may take a while to improve.
  1. Exercise regularly: Regular, moderate exercise has been shown to help with sleep.  Although it is generally thought that exercise right before bed is not a good idea, that hasn’t necessarily been borne out in studies.  So, ideally, hit the gym earlier in the day, but don’t let the time of day stop you from exercising.
  1. Begin a weight loss program for life:  Obesity and poor sleep are often intertwined. Obesity can cause breathing problems such as OSA that worsen sleep, and the poor sleep changes hormones that actually impede weight loss by increasing hunger.  Poor sleep causes daytime fatigue and interferes with the energy and motivation to exercise. Thus, by focusing on healthy diet choices along with exercise, you can both lose weight and improve your sleep.
  1. Manage your stress: Stress reduction techniques may help you put your worries on the shelf for the night and help you get to sleep. If you tend to lie in bed worrying, cutting off these worry loops and replacing them with relaxation techniques such as mindfulness and breathing exercises can facilitate sleep.
  1. Keep the rhythm: Your circadian rhythm is just that—a rhythm.  You will likely find it easier to fall asleep and stay asleep if you keep a regular sleep/wake schedule. When you switch around your schedule—staying up late on the weekends and sleeping past noon the following day, then trying to wake up at 6 a.m. on Monday—this variability throws off your body’s natural tendencies and makes sleep more difficult.  Maintaining a regular schedule can be helpful in decreasing sleep problems.  Ideally, this means that you keep a sleep/wake schedule on the weekend that is similar to the one you have during the week.
  1. (Maybe) skip the nap: Generally, people are advised to avoid naps if they are having trouble with sleeping. However, data on this is not strong, and few studies have looked directly at the effect of an afternoon nap on nighttime sleep.  One study in younger adults found that naps negatively impacted sleep that night, while another in older adults showed that naps helped with evening alertness and did not significantly affect their sleep.  Maybe it’s a difference of age, but the jury is basically still out with regard to napping.  If you take one, try to keep it to 30 minutes or less, as these seem to do the most to improve mood and alertness without leaving you groggy.
  1. Create a calming ritual: With our children, we create bedtime rituals—the evening snack, the bath, the bedtime story—but as adults we tend to go-go-go until we realize how late it is, and then we want to be able to fall asleep at the drop of a hat. Take the time to wind down, whether that calls for herbal tea, a hot shower, or half an hour with a good book. Avoid things—like the evening news or an intense movie—that are likely to get your adrenaline flowing.   

If you optimize your sleep habits and are still struggling, you may want to consider seeing a provider who specializes in cognitive behavioral therapy for insomnia (CBTi).  CBTi takes a closer look at the behaviors and thought processes surrounding sleep, and has been shown to be effective for those with sleep issues.

Quality sleep is important for our overall health and well-being.  By making some changes to your sleeping habits, you can set the stage for a restful night’s sleep.

Megan Riddle, M.D./Ph.D.

 

Resources

Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2014). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Med Rev.

 

 

 

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