Insomnia, bad sleep? 10 tips on how to sleep better
Whether you have chronic insomnia, a bought of sleep difficulty during a stressful time, or the occasional night of poor sleep, most of us can relate to the frustrating feeling of spending a night tossing and turning, wishing for sleep to come. Fortunately sleep scientists have been studying what promotes sleep and which factors interfere with sleep and how to combat them. These tips form key components to Cognitive Behavior Therapy for Insomnia (CBT-I), which is the gold-standard, empirically supported treatment for insomnia. These suggestions are also incorporated into many other scientifically-backed therapies ranging from Dialectical Behavior Therapy (DBT) to CBT for Chronic Pain (CBT-CP).
When we talk about improving sleep, generally there are two types of changes psychologists suggest: stimulus control and sleep hygiene. Stimulus control is based off of the concept of associative learning. Long story short, when people spend a lot of time in their bed doing things other than sleep (such as tossing and turning, watching TV, reading, snacking, or endlessly counting sheep), their bodies start to associate their bed with physiological arousal and/or emotional distress rather than sleep. We want the bed to be associated only with sleep so that your body and mind quiets when you get into it. Therefore, several of the tips below focus on unpairing the bed with anything other than sleep or sex.
Sleep hygiene refers to behaviors that are shown to increase fatigue, improve sleep quality/ quantity, and interrupt variables known to interfere with sleep. These include choices that one can make during the day (e.g., adding in exercise, choosing the timing of meals, making deliberate choices about what you consume), as well as at bed time.
Here are 10 top suggestions from CBT-I:
Use your bed for nothing but sleep or sexual activities. This is a hallmark of stimulus control. You don’t want your brain to associate bed with anything but those two activities.
If you are awake in your bed for more than 20(ish) minutes, get up, leave the bedroom if possible, and engage in a calming activity. This may seem counterintuitive but this is a key to retraining your brain! The longer you lay awake in bed, the more your body starts to associate bed with being awake. The 20-minute rule is a rough guideline- generally you should get up when you have that sense that you’re not going to fall asleep soon so you can avoid looking at the clock.
No clock watching! I know, it is tempting to roll over, look at the time, and calculate how many hours you have left before your alarm goes off. But absolutely avoid checking the clock during the night. Knowing what time it is in not going to magically make you go to sleep or change the number of hours in the night, it will only increase your anxiety, promote physiological arousal, and decrease your odds of shut eye.
No caffeine after 2 pm. Caffeine binds to a neurotransmitter called adenosine, blocking it’s action. Adenosine regulates in our sleep drive, helping us develop a “hunger” for sleep. Caffeine has a half-life of 10 hours so the general guideline is to stay away from coffee, tea, soda etc. after about 2 pm.
No Napping!!!!! No matter how tired you feel, do whatever you can to avoid sleeping during the day (unless, of course, it is necessary if you are concerned about safely driving if you are tired). Naps interfere with our sleep drive; it is like eating a snack at 5:00 pm and wondering why you aren’t hungry for dinner at 6:00 pm.
Avoid alcohol or do not drink less than three hours before bed. Many folks have had the experience of feeling sleepy after drinking and a lot of people will go for the bottle to try to sleep. However, alcohol interrupts our sleep architecture, interfering with getting the deep sleep we need to feel refreshed. It also can create a rebound effect which actually creates physiological arousal.
Create a comfortable bedroom environment. To the best of your ability, create an environment that is quiet, somewhat cool (not frigid), and dark. Consider white noise machines or eye masks if it is hard to control for sound and light. If darkness and/or quiet causes you anxiety, consider a low wattage night light and a playlist of soothing sounds.
Turn off the screens! One of the biggest regulators of sleep is our circadian rhythm, or the sleep-wake cycle. Our circadian rhythm is driven by melatonin and body temperature. Research has shown that the light from electronic back-lit devices (e.g., smartphones, tablets, and TVs) emit blue light, which tricks our brains into thinking it is daytime and suppressing melatonin. If you must scroll before bed, see if your device has as blue light filter. E-readers, such as Kindles and Nooks, also emit blue light, but to a lesser extent. If you use an E-reader before bed, turn down the screen as much as is comfortable so that you limit the blue light exposure.
Move during the day. Getting some exercise- be it a walking, yoga, dancing in your kitchen, or biking- enhances sleep. If it is possible, psychologists recommend not exercising within 4 hours of bedtime, as the release of endorphins from exercise can rev you up rather than wind you down.
Create a bed-time ritual. A nightly ritual about 30 minutes before you get into bed, often called a buffer zone, signals your brain to start shift your body into wind-down mode. An example of a bedtime ritual can be having a cup of tea and listening to calming music, washing your face, and brushing your teeth, changing into your PJs, and giving your dog a belly rub. Don’t fret if it the buffer zone doesn’t work immediately- it takes some time for your brain to engage in the associative learning that will help pair this pre-bed routine with sleep.
