Psychological stressors like deadlines, exams, marital conflict, and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to "turn off" all the noise from the day. No way around it. If you work right up to the time you turn out the lights, or are reviewing all the day's events and planning tomorrow (sound familiar?), you simply cannot just "flip a switch" and drop off to a blissful night's sleep.
There are several different types of prescription sleeping pills, classified as sedative hypnotics. In general, these medications act by working on receptors in the brain to slow down the nervous system. Some medications are used more for inducing sleep, while others are used for staying asleep. Some last longer than others in your system (a longer half-life), and some have a higher risk of becoming habit forming.
Cognitive-behavioral therapy (CBT) is a form of psychotherapy that treats problems by modifying negative thoughts, emotions, and patterns of behavior. A study at Harvard Medical School even found that CBT was more effective at treating chronic insomnia than prescription sleep medication—but without the risks or side effects. CBT can help to relax your mind, change your outlook, improve your daytime habits, and set you up for a good night’s sleep.
Sleep issues can often be traced back to an underlying issue. When we asked Dr. Breus for his first choice in treating sleep issues, he told us, “It’s never a pill. I would want to know the root cause. There could be an anxiety component where cognitive behavioral therapy could be helpful.” If you face sleeplessness regularly, it’s well worth speaking to your doctor about underlying causes.
REM sleep first occurs about 90 minutes after falling asleep. Your eyes move rapidly from side to side behind closed eyelids. Mixed frequency brain wave activity becomes closer to that seen in wakefulness. Your breathing becomes faster and irregular, and your heart rate and blood pressure increase to near waking levels. Most of your dreaming occurs during REM sleep, although some can also occur in non-REM sleep. Your arm and leg muscles become temporarily paralyzed, which prevents you from acting out your dreams. As you age, you sleep less of your time in REM sleep. Memory consolidation most likely requires both non-REM and REM sleep.
When it comes to feeling tired of feeling so tired, I'm certainly not alone. Insomnia is incredibly common in the U.S., with 30 to 40 percent of American adults experiencing some symptoms of insomnia each year. [Etiology of adult insomnia]. Dollander M. L'Encephale, 2003, Mar.;28(6 Pt 1):0013-7006. So for anyone out there who has developed an expertise in fruitlessly counting sheep, we've rounded up a few strategies for finally catching those long-lost Z's when you can't sleep. And if you’re reading this at 3 a.m. because your mind won’t stop racing, don’t worry; we have tips for what you can do right now to improve the chances of getting (at least some) sleep.
One of the key strategies that sleep specialists employ to help patients overcome behaviors that contribute to chronic insomnia is stimulus control therapy. This approach includes tactics such as removing yourself from the bedroom if you can’t fall asleep and not watching television or surfing the internet while you’re in bed. Instead of staring at the clock, get up and do a boring. Only return to bed when you’re sleepy.
Finally, we checked our remaining contenders for any deal breakers. Was the bottle impossible to open? Were the pills too big or too oddly shaped to swallow? Most of our finalists passed these tests with flying colors, but several natural options fell short on one critical metric — smell. A pill that smells unappetizing is a turn-off, and most of our valerian supplements had an old-sock odor that might discourage us from ever opening the bottle.
The brain stem, at the base of the brain, communicates with the hypothalamus to control the transitions between wake and sleep. (The brain stem includes structures called the pons, medulla, and midbrain.) Sleep-promoting cells within the hypothalamus and the brain stem produce a brain chemical called GABA, which acts to reduce the activity of arousal centers in the hypothalamus and the brain stem. The brain stem (especially the pons and medulla) also plays a special role in REM sleep; it sends signals to relax muscles essential for body posture and limb movements, so that we don’t act out our dreams.
Similarly, if you’re having sleep troubles, limit your cell phone use around bedtime. One study found that people who spent more time on smartphones, especially close to bedtime, were more likely to have shorter sleep duration, poorer sleep quality and take longer to fall asleep (PLoS One, Nov. 9, 2016). So, turn off your cell phone, computer and television at least an hour before bedtime. (See the chart for other behavioral changes you can make to improve your sleep.)
Time to bust some long-held myths: Waking up early does not make you a better person. The early bird does not always catch the worm. Your circadian rhythm is your internal body clock, and it’s going to look different to your neighbor’s. When you go to sleep and wake up in accordance with your body’s natural circadian rhythm, you’ll sleep better, and be more alert and productive during the day. Dr. Michael Breus, a clinical psychologist and sleep expert, identified four sleep chronotypes (aka your circadian rhythm personality). These are:
What I Did: Every night, I wrote down the time I ate dinner, when I turned off electronics, and what time I turned out the light. The next morning I added my wake up time and a brief note about how I slept. Even after only a week or two sleep journaling, I saw some interesting patterns (or lack of patterns) and knew what I needed to work on to get better sleep.
You’ve got an early day tomorrow, and you know you should be asleep — but instead you’re just lying there, wide awake, watching the minutes tick by on the clock. It’s called sleep-onset insomnia, and the irony is, the more you worry about falling asleep, the less likely you’ll be able to. But there are some easy things you can do to break the cycle. Below we discuss simple changes to your lifestyle and your sleep environment that can help you fall asleep faster and get a more restful night’s sleep.