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LISTEN IN AS AN AUSTIN PSYCHOLOGIST TALKS ABOUT CBT - COGNITIVE BEHAVIORAL THERAPY

October 8, 2010

Getting the Sleep You Need: Tips for a Better Night's Rest



Getting a good night's sleep is an integral part of mental health. When we get too few hours of sleep or wake up feeling as though we haven't had enough rest, especially on a regular basis, our emotional and physical wellbeing can suffer dramatically.  Too many sleep deprived nights and we are at risk for depression, panic disorder, and persistent insomnia, to name a few long term problems.  Below are many changes and sleep hygiene tips often recommended to those struggling to get to sleep.

TIPS FOR BETTER DAYTIME HABITS

Do not nap during the day - you will throw off your body clock and make it even more difficult to sleep at night. If you are feeling especially tired, and feel as if you absolutely must nap, be sure to sleep for less than 30 minutes, early in the day.

Limit caffeine, alcohol and nicotine. Avoid drinking caffeine or alcoholic beverages for several hours before bedtime. Although alcohol may initially act as a sedative, it can interrupt normal sleep patterns. Nicotine is a stimulant and can make it difficult to fall asleep and stay asleep. Many over-the-counter and prescription drugs disrupt sleep, especially decongestants (examples: Sudafed, phenylpropanolamine).

Expose yourself to bright light/sunlight soon after awakening. This will help to regulate your body's natural biological clock. Likewise, try to keep your bedroom dark while you are sleeping so that the light will not interfere with your rest.

Exercise early in the day. Twenty to thirty minutes of exercise every day can help you sleep, but be sure to exercise in the morning or afternoon. Exercise stimulates the body and aerobic activity before bedtime may make falling asleep more difficult.

Check your iron level. Iron deficient women tend to have more problems sleeping, so if your blood is iron poor, a supplement might help your health and your ability to sleep.

TIPS FOR A BETTER PLACE TO SLEEP

Keep your bedroom peaceful and comfortable. Make sure your room is well ventilated and the temperature consistent. And try to keep it quiet. You could use a fan or a "white noise" machine to help block outside noises.

Your bed. Make sure your bed is large enough, and comfortable. If you are disturbed by a restless bedmate, switch to a queen- or king-size bed. Test different types of mattresses. Try therapeutic shaped foam pillows that cradle your neck or extra pillows that help you sleep on your side. Get comfortable cotton sheets.

Your bedroom. Make your bedroom primarily a place for sleeping. It is not a good idea to use your bed for paying bills, doing work, watching tv, etc. Help your body recognize that this is a place for rest or intimacy.

Your clock. Hide it. A big, illuminated digital clock may lead you to watch the time. You end up feeling stressed and anxious worrying about how many hours sleep you will, or will not, get. Place your clock so you can't see the time when you are in bed.

TIPS FOR A BETTER PRE-SLEEP RITUAL

Keep a regular schedule. Try to go to bed and wake up at the same time everyday, even on the weekends. This will help your body expect sleep at the same time each day. Don’t oversleep to make up for a poor night’s sleep – doing that for even a couple of days can reset your body clock and make it hard for you to get to sleep at night.

Turn down the lighting in the evening. The closer you are to bedtime, avoid bright or blinking lights. Late night internet browsing is a big cause of insomnia. If you must use the computer at night, turn down the contrast button on your monitor. The television and video games are other sources of blinking lights that disrupt your body's ability to move toward sleep mode.

Relax for a while before going to bed. Spending quiet time can make falling asleep easier. This may include meditation, relaxation and/or breathing exercises, or taking a warm bath. Try listening to recorded relaxation or guided imagery programs.

Incorporate bedtime rituals. Establish a routine. Turn down the lights, listen to soft music, sip a cup of herbal tea (caffeine free), put on PJ's, brush teeth, wash face, etc., A routine cues your body that it's time to slow down and begin to prepare for sleep.

Don’t eat a large, heavy meal before bed. This can cause indigestion and interfere with your normal sleep cycle. Try to eat your dinner at least two hours before bedtime.

Light bedtime snacks can help. An amino acid called tryptophan, found in milk, turkey, and peanuts, helps the brain produce serotonin, a chemical that helps you relax. Try drinking warm milk or eating a slice of toast with peanut butter or a bowl of cereal before bedtime. Plus, the warmth of the food may temporarily increase your body temperature and the subsequent drop may hasten sleep. Light carbohydrates can help. Crackers in bed, anyone?

Jot down your concerns and worries. Anxiety excites the nervous system, so your brain sends messages to the adrenal glands, making you more alert. Write down your worries and possible solutions before you go to bed, so you don't need to ruminate in the middle of the night. A journal or "to do" list may be very helpful in letting you put away these concerns until the next day when you are fresh.

Go to sleep when you are sleepy. When you feel tired, go to bed.

Avoid "over-the-counter" medication sleep aids, and make sure that your prescribed medications do not cause insomnia. Over-the-counter "sleep aids" can be effective in the short term but can lead to long term, harder to treat cases of insomnia. In some cases, there are safety concerns. Antihistamine sleep aids, in particular, have a long duration of action and can cause daytime drowsiness. Always talk to your doctor or healthcare practitioner about your concerns.

Nutritional supplements. Check with your doctor, pharmacist or health care professional before trying nutritional supplements. Some people find that a relaxing, natural sleep aid does wonders.  A list of five supplements commonly recommended for insomnia can be found here.  

TIPS FOR GETTING BACK TO SLEEP

Try guided meditation and/or visualization. Focus all your attention on your toes or visualize walking down an endless stairwell. Imagine yourself in your favorite vacation spot. Use all your senses: imagine what you can see, feel, taste, smell, and touch. Thinking about repetitive or mindless things will help your brain to shut down and adjust to sleep. There are many guided mediations available online.  Meditation Oasis is a great resource.  Lots of meditation podcasts to choose from.  You will never regret learning to quiet your inner mind. 

Try deep breathing for relaxation. Focus on full inhales followed by emptying exhales. Repeat calming statements upon exhales, such as, “I feel peaceful” and “I am floating” and "I can let myself feel calm."  Make up your own.  Breathing exercises can be found here.  For added help, watch and practice deep muscle relaxation (aka, progressive muscle relaxation), here.  

Get out of bed if unable to sleep. Don’t lie in bed awake. Go into another room and do something relaxing until you feel sleepy. Reading something quiet, calming and a little on the boring side is best. Worrying about falling asleep actually keeps many people awake. We call that insomnia about insomnia. 

Don't do anything stimulating. Don't read anything job-related or watch a stimulating TV program (commercials and news shows tend to be alerting) or read an intense thriller. Don't expose yourself to bright light. The light gives cues to your brain that it is time to wake up.

Consider changing your bedtime. If you are experiencing sleeplessness or insomnia consistently, think about going to bed later so that the time you spend in bed is spent sleeping. If you are only getting five hours of sleep at night, figure out what time you need to get up and subtract five hours (for example, if you want to get up at 6:00 am, go to bed at 1:00 am). This may seem counterproductive and, at first, you may be depriving yourself of some sleep, but it can help train your body to sleep consistently while in bed. When you are spending all of your time in bed sleeping, you can gradually sleep more, by adding 15 minutes at a time.