Improving your Sleep (Part 1)

Author: Diana Gordon, Psy.D.​

If you’re like many people, you sometimes feel like you don’t get enough sleep. Sleep problems have become so common that it’s become a social norm to reply “tired!” when people ask you how you’re doing. While occasional difficulty sleeping is normal, chronic sleep problems may indicate that you have insomnia. Insomnia doesn’t mean that you don’t sleep at all, but it does mean that you consistently have difficulty falling asleep or staying asleep and/or feel that your sleep is low quality. It can be difficult to do all the things we need to do in a day when we’re tired. The good news is, there are very effective treatments for sleep problems. Best of all, these treatments are drug free and you can see results in just a few weeks.

We can all benefit from what psychologists call “sleep hygiene” techniques. These are behavioral strategies for helping get your body and mind ready for bed. If you have mild sleep problems, these strategies may be enough to get you back on track. Try implementing a few of these at a time and see what works best for you.
If you’d like to try implementing some sleep hygiene techniques in your daily life, here are some of the most effective tips:

• Limit screen time: Turn off TV, computers, tablets, and smartphones one hour before bedtime. These devices emit blue light, which mimics the effects of daylight in the brain. If the use of TV or other devices relaxes you, try moving these activities earlier in the evening. In the last hour before bed, find another relaxing activity such as reading a book or meditating to unwind.
• Avoid caffeine 6-8 hours before bedtime. Caffeine disturbs sleep, even in people who don’t think they experience a stimulation effect. Caffeine is found in items such as chocolate and soda in addition to coffee and tea. Caffeine should be avoided after about 1 pm, and you might consider a trial period of no caffeine at all to see if it impacts your sleep.
• Avoid nicotine before bedtime or when you wake up during the night. While many nicotine users believe that it helps them relax, nicotine is a stimulant. It may produce an initial relaxation effect but as it builds up in your system it has a similar impact as caffeine.
• Avoid alcohol after dinner. Alcohol often promotes the onset of sleep, but as it is metabolized it causes sleep to become fragmented and disturbed which leads to poor sleep quality. In general, alcohol use should be limited to 1 drink per day for women and 2 drinks per day for men.
• Regular exercise has been shown to aid sleep, but the positive effects can take several weeks to become noticeable. Try to avoid exercise within 2 hours of bedtime. Aim for 20 minutes per day of exercise.
• Try taking a hot bath or shower before bed. Spending approximately 20 minutes in hot water may promote sleep.
• Make your bedroom quiet, dark, and temperate to promote sleep. Avoid extreme heat or cold in your bedroom, and dress in layers to make yourself comfortable. Avoid loud noises by using earplugs or a fan to create white noise. Darken your bedroom with window shades, or consider a comfortable sleep mask. Position clocks out of sight so that you don’t worry about the time while you’re in bed.
• A light bedtime snack, such as a piece of cheese or a glass of milk, can promote sleep. Avoid heavy or spicy foods. Also avoid eating if you awaken during the night, as waking might become associated with food. Avoid going to bed too hungry or too full.
• Avoid or reduce naps during the day. The body’s need for sleep accumulates over the course of the day via a mechanism called the sleep drive. Essentially, the longer you are awake the more the desire for sleep builds. When you nap during the day, it takes away from your need to sleep at night. If you must nap, keep it brief (15-20 minutes) and earlier in the day if possible.
• Keep a regular sleep schedule. Waking up at the same time each day allows your body to get accustomed to a particular rhythm. If you wake up at the same time each day, gradually your body will become accustomed to sleeping within a certain time frame, and falling and staying asleep will become easier.
• Follow the “3 S’s rule: reserve your bed only for sleep, sex, and sickness. Avoid eating, watching TV, or doing other activities in bed. Over time, your body will begin to associate the bed with sleep and you will fall asleep more easily.

    In addition to these behavioral changes, it’s also important to manage some of your anxiety and worry about sleep, work, relationships, and other stressors. Often anxiety and stress can keep us awake at night. Reserve some time in the evening to do things that you enjoy and that relax you. Try to avoid working or engaging in stressful activities in the few hours before bedtime. If you find yourself worrying in bed, try doing some deep breathing exercises or a guided meditation to relax. You can also try keeping a pen and paper next to bed and jotting down any concerns that you’d like to address tomorrow. When a worry or idea comes into your head, jot it down and tell yourself that you’ll make sure to revisit it the next day. Try not to worry too much about whether or not you will fall asleep, because this can add unnecessary and unhelpful pressure to sleep. Remember that even if you’re tired tomorrow, you can still make it through the day.
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    It can be very challenging to make some of the changes we’ve outlined above. Good sleep hygiene requires a lot of time and effort. But the results can be dramatic, and getting more sleep can be very rewarding. If you’ve tried the strategies above and they haven't worked for you, don’t be discouraged. If your sleep still isn’t where you’d like it to be, you might want to consider seeing a sleep specialist who is trained in CBT for insomnia. A psychologist who specializes in sleep can evaluate your personal habits and provide tailored recommendations. Many people notice changes after just a few sessions of CBT for insomnia. In part 2 of this blog post, you can learn more about CBT for insomnia and how it might improve your sleep. Don't hesitate to contact us to find out whether CBT-I might be helpful for you.