You’ve been tossing and turning, watching the hands of the clock move relentlessly forward: 2 a.m., 2:30 a.m., 3 a.m., onward. Your room is dark. You’re certainly not working on your computer in bed — hmmm, but did you have coffee after lunch? Maybe that’s why you’re not sleeping, despite following some of those other standard sleep hygiene practices, like making sure your bedroom is dark, cool and quiet. What more can you do?
For one thing, stop worrying about an inability to fall asleep or sleep through the night if it’s only for a few nights. Sleep is a self-correcting system that has ways of getting back on track if it derails briefly. If, for example, some emergency causes you to be sleep-deprived, natural feelings of sleepiness will help you sleep better once the emergency is over. So don’t take any night, or two, or three, too seriously. Allow the self-correcting nature of sleep to take its course.
On the other hand, if you have chronic insomnia that goes on for weeks on end and you’re continually waking up unrefreshed, then it’s time to take action.
- Get up at the same time every day. And, if possible, get some natural light exposure the first thing in the morning. It’s not enough to simply raise the blinds or open the curtain. Daylight can help train your body to become fully awake at the time you choose.
- Don’t nap. If you do, limit the time to about 20 minutes in the afternoon. Dozing in the early evening is the worst thing to do; it will make it much more difficult to fall asleep at bedtime.
- Do some form of aerobic exercise at a moderate intensity no later than three or four hours before bedtime. If you get revved up closer to bedtime, you probably won’t be able to fall asleep.
- Watch your coffee-caffeine consumption. Avoid drinking coffee or having any other caffeine-containing beverage or food in the afternoon if you’re over age 60; the body’s ability to metabolize caffeine slows down significantly with age, and it can remain in your bloodstream for as long as eight or nine hours. If you’re under age 60, steer clear of caffeine after 4 p.m.
- If you’re still smoking, be aware that having a cigarette when you can’t fall asleep will only keep you awake longer.
- Adjust your alcohol consumption. A “nightcap” can make you sleepy, but it will interfere with your ability to stay asleep. The same is true of a glass of wine at dinner; this often means doing some kind of balancing act, since a daily glass of wine is also associated with some beneficial health effects.
- Use a relaxation technique, like meditation, slow deep breathing or visualization, to help you spend the hour or so before bedtime in a relaxed state. One that I find effective is to inhale deeply and slowly, counting to seven; holding for a couple of seconds; then exhaling slowly to a count of seven. After a few rounds, I generally fall asleep.
- What if you wake up in the middle of the night? Again, try a relaxation technique. If you don’t fall back to sleep within 10 or 15 minutes, try getting up, going into another room with a book light and reading something that’s not too exciting and that’s not work-related. You may fall asleep right then and there.
Although some supplements and herbs, such as valerian, have sedating effects that may help you get to sleep faster, most studies have shown that they have limited effectiveness, at best. If you decide to try them, first check with your doctor to make sure a supplement doesn’t interfere with any medications or other supplements you may be taking. A non-drug approach you might want to try is taking a relaxing, hot bath a few hours before going to bed.
If none of these strategies help get your sleep back on track, consider seeing a sleep specialist — one who is certified by, or has a specialization in sleep disorders, from the American Board of Sleep Medicine or the American Board of Medical Specialties.
When you go for a consultation at a sleep center, bring a copy of your medical records and a sleep diary detailing your sleep problem, when it occurs and how often. Also, make a list of all over-the-counter and prescription medications and supplements you may be taking, and any strategies you’ve tried to improve your sleep on your own.