Well, I think the approach to sleep should be really simple stuff first. I’m not a physician, so I can’t give advice about which medications to take and when, but the consensus among the specialists I spoke to was that you should try to get your sleep stability right first, and make sure that you’re getting consolidated sleep and not waking up all the time.
It’s tempting to reach for coffee when we’re tired after a poor night’s sleep, but drinking caffeine can make it harder for us to fall asleep at night, creating a vicious cycle. Effects of caffeine on sleep and cognition. Snel J, Lorist MM. Progress in brain research, 2011, Aug.;190():1875-7855. Can’t quit cold turkey? Try limiting caffeine intake to earlier in the day so it’s out of your system by bedtime.
Reducing sleep by as little as one and a half hours for just one night reduces daytime alertness by about one-third. Excessive daytime sleepiness impairs memory and the ability to think and process information, and carries a substantially increased risk of sustaining an occupational injury. Long-term sleep deprivation from sleep disorders like apnea have recently been implicated in high blood pressure, heart attack, and stroke.
It’s well known that babies fall fast asleep when they’re rocked gently back and forth in a carriage or a mother’s arms. Surprisingly, the same trick works with adults. According to a small preliminary study published in Current Biology, when study participants napped in a hammock-like bed, they fell asleep faster and slept more soundly than when they slept in a regular bed. It seems that the gentle swinging sensation primes brain activity that fosters deep sleep. While you can’t exactly doze off in a hammock every night, try chilling out in a rocking chair before hitting the sheets to mimic the motion and help your body feel sleepy.
For those who have difficulty with insomnia, there are a handful of options to help you sleep. One treatment option is sleep restriction. This involves limiting the amount of time that you spend in bed (often to 7-8 hours) so that the time you are there you are more likely to spend asleep. It can also be useful to observe a behavioral change called stimulus control. Stimulus control helps break the association between your bedroom and not being able to sleep.
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.
Abdominal breathing. Most of us don’t breathe as deeply as we should. When we breathe deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, it can actually help the part of our nervous system that controls relaxation. Close your eyes and try taking deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth. Make each exhale a little longer than each inhale.
The best way to find out if you are getting enough sleep is to note the time when you go to bed and when you wake up. If you don’t have trouble falling asleep, you can assume it takes about 15 to 20 minutes for you to fall asleep. Add those 20 minutes to the time you went to bed, and then subtract from the time you wake up. Is it somewhere within the recommended range of 7-9 hours?
Mindful breathing practices have been a part of yoga and Eastern wellness modalities for centuries but aren’t as popular in Western culture. The most well-known champion of the 4-7-8 breathing technique in the U.S., who is somewhat responsible for the prevalence that the technique does have amongst integrative medicine practitioners, yogis, and those in search of stress reduction and overall relaxation, is Harvard-educated Andrew Weil, MD.
Got grandkids? That means you probably have a plastic bottle of bubbles around the house. The benefits of blowing them before bed are two-fold: Bubbles are slightly hypnotic to look at and require a process of deep breathing to blow, said Rachel Marie E. Salas, M.D., a professor of neurology at Johns Hopkins University School of Medicine, in a recent New York Post article. “It’s like a deep breathing exercise, which helps calm your body and mind,” she says. “And since it’s such a silly activity, it can also take your mind off of any potential sleep-thwarting thoughts.”
There is a big difference between the amount of sleep you can get by on and the amount you need to function optimally. According to the National Institutes of Health, the average adult sleeps less than seven hours per night. In today’s fast-paced society, six or seven hours of sleep may sound pretty good. In reality, though, it’s a recipe for chronic sleep deprivation.
If pretending you’re tired sounds like too much work for you, you might want to look into hypnosis. Get that image of a creepy guy swinging his pocket watch back and forth until you bark like a dog out of your head. We’re talking about watching a five-minute hypnosis video while tucked in your bed. (YouTube is full of them; search “hypnosis for sleep.”) It might sound like a bit of hogwash, but researchers from the universities of Zurich and Fribourg beg to differ. Their 2014 study on the subject concluded that hypnosis can actually increase the quality of sleep. Huzzah.
Your bedroom environment plays a big part in how well you fall and stay asleep. Too many people forget to optimize their sleep environment, and it has a real detrimental effect on their rest, says Cralle. Things to keep in mind: "How old is your mattress, what's the temperature like in your room, and is it really dark at night? We really need that darkness to get the melatonin going," Cralle says.
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Probably not all people will be able to fall asleep this quickly all the time, especially on days when you might be upset or anxious near bedtime for whatever reason. Your best bet is not to try just one or two strategies from the article, but as many of the strategies as you can at the same time, and keep up this routine for several weeks or more.
Alcohol is a known sleep saboteur — it may make you fall asleep, but it disrupts normal sleep cycles, causing you to wake up in the middle of the night. Cherry juice, on the other hand, may help ensure restful slumber, because it’s thought to be naturally high in melatonin, a hormone that helps regulate your body’s sleep-wake cycles. A small study of 11 subjects published in March 2017 in the American Journal of Therapeutics found that participants with insomnia who drank tart cherry juice for two weeks increased the amount they slept. Cherry juice is presumably low risk, but if you have a tendency toward elevated sugar it's best to discuss with your doctor before you start.
Unfortunately, some sleep medications can actually make the problem worse. Sleep aids frequently disrupt sleep cycles, causing less restorative sleep. Even if they help you sleep through the night, the sleep is not necessarily deep or restful. People can become dependent on these meds, requiring them to sleep, and many develop a tolerance to sleep meds over time, requiring more medication to get the same effect. These meds can also cause rebound insomnia, meaning it becomes even harder to fall asleep without the medication. So before you pop that pill for your sleep problems, try these methods instead:
Coffee and other caffeine-rich stuff. It might go without saying, but we’re going to say it anyway. Coffee can stay in your system for as long as six hours—which means that even a late afternoon cup could have an impact on your sleep. If you’re aiming to get to bed by 11, avoid coffee and other high-caffeine things like black tea, cola, and dark chocolate after 5pm.
You have a peak moment of awakeness during the morning. After lunch you usually have a glucose spike, especially if you have a big heavy lunch, like a cheeseburger. That glucose spike combined with a circadian dip gives you a period of fatigue between around 2 and 4pm. You’ll then have another spike in alertness right before dinner, and then you’ll start getting tired again closer to bedtime. That’s your 24-hour circadian rhythm, basically.
Other potential health benefits: Melatonin may help to guard against cognitive impairment and neurodegenerative disease. It’s also being investigated as a therapy for some cancers. Supplemental melatonin may be effective at improving sleep quality and sleep quantity in people with ASD, and also may help improve daytime behavior. Melatonin has shown promise as a natural treatment for a range of conditions, including fibromyalgia, menopause, and irritable bowel syndrome.