The inability to fall asleep and wake up feeling refreshed is an exceedingly common problem. The reasons behind it are multiple, and often it is a combination of things that interfere with our ability to get good sleep.
Just like everyone else, I have to balance the demands of work and my family. I get home late, so I eat dinner right before bed. I drink caffeine throughout the day. And, there is a TV going in the bedroom and books/journals on the nightstand. Then I wonder why I have trouble getting to sleep at night?!
There are many ways to try and improve our sleep habits and get more restful sleep besides starting medication for a sleep aid:
- Set up a Pattern– Try to stick to a schedule as best you can. Get into a rhythm so that after a couple of weeks your body knows that at the same time each day it is time to start winding down. The same routine of trying to relax and perform the same tasks like brushing/flossing right before you climb into bed help train your body for the arrival of sleep. Just as important as the nighttime routine is the idea of getting up at the same time. A little bit of sleeping in on the weekend is fine, but grabbing 4 extra hours of sleep is disruptive to establishing and keeping your body trained for sleep and in a rhythm.
- Tone Down the House & Your Activity – Try to turn the TV off for a while before bed and let the house get quiet. Read something that while interesting, doesn’t get your heart racing. Tune the radio onto a station playing something relaxing and keep the volume low. Do regular exercise a few days a week, but early in the day or afternoon so your body can calm down and relax after the exertion. Eat at a reasonable hour so your body isn’t working to digest the food while you are trying to get comfortable and off to sleep. Be mindful to avoid caffeine late in the evening whether it comes from coffee, tea, chocolate, or soda.
- No Daytime Naps – Sleeping during the day may be necessary for infants and young children, but not adults. Excessive daytime sleepiness can be a symptom of something more significant like sleep apnea and should be discussed with your doctor.
- Keep the Bed for its Intended Purpose – Too many of us use the bedroom as a multipurpose room. We keep the TV on watching late night television, read books or magazines in bed, do homework, fold the laundry and so on. This teaches the brain that the bed is for more than just rest. The standard teaching is the bed is only for sleep and sex. If you want to watch TV, get out of the bed. If you want to read a few pages from a book or magazine, get out of bed. Keep your mind on the idea that once you get into bed, it is time to sleep.
- Still not Sleepy? – Don’t lie in the bed and keep checking the clock. Peeking at the clock and calculating “how much sleep you can get if you fall asleep right now” only increases your anxiety and keeps you from falling asleep. Get up out of bed, leave the room and go back in after 15 minutes to try again. If you still aren’t asleep in 15 minutes, get up and out of bed again and again until you fall asleep. If you wake up early in the morning the same rules apply, don’t lie in bed if you are not sleepy.
- When Discussing it with your Provider – Before you see your provider for trouble sleeping, try to keep a diary of your sleep habits for about 2 weeks. The diary should note the time you last had anything to eat, the time you laid down, approximately when you fell asleep, any naps you took throughout the day, any alcohol intake, cigarette smoking, any pain you may have, and all medications, vitamins or supplements that you are taking.
In summary, these simple things are the first things your provider will tell you to try when the evaluation for insomnia is being done. Be patient and give it an honest effort for a few weeks. Sleep habits form over your lifetime and will take some time to be adjusted. Sweet Dreams!
-Posted by Graham Dondlinger, MD