It’s oh, I don’t know, 3 o’clock in the freaking morning, and I’m lying in bed, staring at the ceiling and wanting to cry with frustration. I'm trying to stay hopeful about my ability to catch a few hours of shuteye before work the next morning, but I’ve been up until 6 a.m. (not by choice) enough times in my life to know the beast of insomnia can’t always be tamed.
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. Groupe de Recherche en Psychologie de la Sante, Laboratoire de Psychologie. Encephale, 2002 Nov-Dec;28(6 Pt 1): 493-502. So for all those seasoned insomniacs out there—and for anyone who occasionally can’t fall or stay asleep—we’ve rounded up some short- and long- term strategies for getting a good night’s rest. And if you’re reading this at 3 a.m. because your mind won’t stop running, don’t worry; we have tips for what you can do right now to improve the chances of getting (at least some) sleep.
Sleep Gap—The Need-to-Know
Insomnia is defined as the inability to fall asleep, remain asleep, or get the amount of sleep an individual needs to wake up feeling rested. Its symptoms include difficulty falling asleep, frequent wake-ups during the night, waking up too early in the morning, daytime sleepiness, difficulty concentrating, and irritability. Insomnia can be acute (lasting one to several nights) or chronic (lasting from a month to years). It’s also the most common sleep complaint among Americans (especially women) Etiology of adult insomnia. Dollander, M. Groupe de Recherche en Psychologie de la Sante, Laboratoire de Psychologie. Encephale, 2002 Nov-Dec;28(6 Pt 1): 493-502.
Trouble sleeping is often a symptom of another disease or condition, such as depression, chronic pain, medications, or stress, which might explain why it’s so common Longitudinal Course and Impact of Insomnia Symptoms in Adolescents With and Without Chronic Pain. Palermo, TM, Law, E., Churchill, SS, et al. University of Washington; Seattle Children’s Research Institute. Journal of Pain, 2012 Sep 29 Assessment of excessive sleepiness and insomnia as they relate to circadian rhythm sleep disorders. Doghramji, K. Department of Psychiatry and Human Behavior, the Sleep Disorder Center, Thomas Jefferson University. Journal of Clinical Psychiatry, 2005;65 Suppl 16:17-22 Treatment issues related to sleep and depression. Thase, ME. Department of Psychiatry, University of Pittsburgh School of Medicine and the Western Psychiatric Institute and Clinic, PA. Journal of Clinical Psychiatry, 2000;61 Suppl 11:46-50. Most often, insomnia stems from a combination of factors, including medical and psychological issues, scheduling issues, relationships conflicts, and behavioral factors (poor bedtime routines, physical hyperactivity, watching TV right before bed, etc.) Etiology of adult insomnia. Dollander, M. Groupe de Recherche en Psychologie de la Sante, Laboratoire de Psychologie. Encephale, 2002 Nov-Dec;28(6 Pt 1): 493-502.
Beyond Counting Sheep—Your Action Plan
1. Keep track. Record how much and when you sleep, fatigue levels throughout the day, and any other symptoms. This serves two purposes: It can identify activities that help or hurt the chances of a good night’s rest, and it’s a useful tool for a doctor or therapist, should you decide to see one. Digital programs like Zeo, YawnLog, and a variety of apps can all make snooze-tracking easier.
2. Try therapy. Cognitive Behavioral Therapy for Insomnia is a pretty common technique. Also called CBT-I, the therapy typically involves self-monitoring, mental strategies (like developing positive thoughts about sleep), and creating an environment that promotes sleep—and it’s been shown to improve sleep quality Self-Help Treatment for Insomnia Symptoms Associated with Chronic Conditions in Older Adults: A Randomized Controlled Trial. Morgan, K., Gregory, P., Tomeny, M., et al. Clinical Sleep Research Unit, School of Sport, Exercise and Health Sciences, Loughborough University, UK. Journal of the American Geriatrics Society, 2012 Oct 4. Learn these strategies with the help of a therapist or with online guidance or books—both are equally effective ways of implementing CBT-I Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia—a randomized controlled trial. Jernelov, S., Lekander, M., Blom, K., et al. Department of Clinical Neuroscience, Karolinska Institutet, Sweden. BMC Psychiatry, 2012 Jan 22;12:5. Not into seeing a therapist? Check out Sleepio, a digital program that helps users learn about and implement CBT practices from the comfort of their own homes.
3. Establish a regular bedtime routine. Find activities that help you wind down before bed, and stick to the same sleep-wake schedule, even on weekends.
4. Use the bed appropriately. Beds should be reserved for sleep and sex—and nothing else. Bringing work into the bedroom is a sure-fire way to discourage sleep quality.
5. Choose the right mattress. Uncomfortable bedding has been linked to poorer sleep quality, while a comfortable mattress can up the chances of a satisfying snooze Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Jacobson, BH, Boolani, A., Dunklee, G., et al. Oklahoma State University, Oklahoma. Applied Ergonomics, 2010 Dec;42(1):91-7 Sleep disturbance in patients with chronic low back pain. Marin, R., Cyhan, T., Miklos, W.Physical Medicine & Rehabilitation Service, Department of Orthopedics and Rehabilitation, Walter Reed Army Medical Center, Washington, D.C. American Journal of Physical Medicine and Rehabilitation, 2006 May;85(5):430-5.
6. Don’t smoke. Need another reason to quit? Smokers commonly exhibit symptoms of insomnia—possibly because their bodies go into nicotine withdrawal during the night How smoking affects sleep: a polysomnographical analysis. Jaehne, A., Unbehaun, T., Feige, B., et al. Freiburg University Medical Center, Department of Psychiatry and Psychotherapy, Germany. Sleep Medicine, 2012 Sep 28.
7. See a doctor. If you’ve tried everything and nothing’s worked, it might be time to consult a professional. A doctor can help rule out any sleep disorders and identify lifestyle factors or medications that might be getting in the way of a good night’s rest.
8. Exercise early in the day. Studies find moderate aerobic activity can improve insomniacs’ sleep quality. For best results, exercise at least three hours before bedtime so the body has sufficient time to wind down before hitting the sack.
9. Schedule “worry time” during the day. Spend 15 minutes addressing problems (journaling is a good way to start) so they don’t sneak up when your head hits the pillow. If a particular event or stressor is keeping you up at night—and it has a clear end date—the problem may resolve itself naturally.
10. Limit caffeine. 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., and Lorist, MM. Department of Psychonomics, University of Amsterdam. Progress in Brain Research, 2011;190:105-17. Can’t quit cold turkey? Try limiting caffeine intake to earlier in the day so it’s out of your system by bedtime.
11. Nap the right way. Just 10 to 20 minutes of napping during the day can help us feel rested (and improve our creativity and memory, to boot!) The restorative effect of naps on perceptual deterioration. Mednick, SC., Nakayama, K., Cantero, JL., et al. Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA. Natural Neuroscience 2002 Jul;5(7):677-81 Benefits of napping in healthy adults: impact of nap length, time of day, age, and experience with napping. Milner, C.E., Cote, K.A. Brock University, St. Catharines, Ontario, Canada. Journal of Sleep Research 2009 Jun; 18(2): 272-281 An ultra short episode of sleep is sufficient to promote declarative memory performance. Lahal, O., Wispel, C., Willigens, B., Pietrowsky, R. Institute of Experimental Psychology at University of Dusseldorf, Dusseldorf, Germany. Journal of Sleep Research 2008 Mar; 17(2): 3-10. But try to avoid napping after 3:00 or 4:00pm, as this can make it harder to fall asleep at bedtime Effects of afternoon “siesta” naps on sleep, alertness, performance, and circadian rhythms in the elderly. Monk, TH, Buysse, DJ, Carrier, J., et al. Western Psychiatric Institute and Clinic, University of Pittsburg Medical Center. Sleep, 2001 Sep 15;24(6):680-7.
12. Get outside. Increasing natural light exposure during the day promotes healthy melatonin balance, which can help us get to sleep later in the day.
13. Eat for sleep. Eat foods high in magnesium, like halibut, almonds, cashews, and spinach, and foods high in vitamin B complex, like leafy green vegetables, nuts, and legumes. Some experts also recommend taking supplements of taurine, vitamin B6, and magnesium.
14. Try relaxation techniques. In one study, people who practiced meditation saw improvements in total sleep time and sleep quality. Other relaxation strategies—like yoga, deep breathing, and progressive relaxation—are also effective tools for promoting good sleep.
15. Avoid large meals late in the evening. Jumbo meals pre-bedtime have been linked to trouble falling asleep Etiology of adult insomnia. Dollander, M. Groupe de Recherche en Psychologie de la Sante, Laboratoire de Psychologie. Encephale, 2002 Nov-Dec;28(6 Pt 1): 493-502.
16. Dim the lights two hours before bed. According to one study, exposure to electrical lights between dusk and bedtime might negatively affect our chances at quality sleep. Assuming you don’t want to sit in the dark for hours, find the happy medium by dimming the lights as bedtime draws near. Also consider changing all light bulbs to “soft/warm” varieties with a color temperature less than 3,000 kelvins, all of which can reduce lights’ effects on our nervous systems.
17. Turn off the screens. The artificial (or “blue”) light emitted by screens can disrupt our bodies’ preparations for sleep by stimulating daytime hormones Dubious bargain: trading sleep for Leno and Letterman. Basner, M, Dinges, DF. Sleep. 2009 Jun;32(6):747-52. Reduce exposure by turning off TVs, phones, and computers at least one hour before bedtime. Can’t give up the Daily Show? At least dim a screen’s brightness, either manually or with the help of automated programs.
18. Don’t drink alcohol right before bed. Booze might seem like an obvious choice for calming down pre-bedtime, but it can actually disrupt sleep cycles later in the night. You don’t have to give up the good stuff completely; just drink it with dinner (around 6 o’clock) and skip the nightcap.
19. Don’t use your brain before bed. Don’t work, watch stimulating TV shows, read complex material, or think too hard—about anything—before bedtime; working out the brain keeps the body awake.
20. Have sex or masturbate before bed. Hey, anything for a good night’s rest. Getting our “O” face on pre-bedtime can help us fall asleep.
21. Keep it (dark and) cool. A dark, cool bedroom environment helps promote restful sleep. Program the thermostat so the bedroom’s temperature is between 60 and 75 degrees Fahrenheit (experiment to find what works best for you), and use heavy curtains, blackout shades, or an eye mask to block lights. Also be sure to charge phones and laptops outside the bedroom—even this tiny bit of light can disrupt sleep. If you live in a studio or can’t get away from blue lights for any reason, consider making a (very small) investment in blue light blocking glasses.
22. Consider natural supplements. Valerian and melatonin are two of the most highly recommended supplements (though their efficacy is still under review) Melatonin treatment effects on adolescent students’ sleep timing and sleepiness in a placebo-controlled crossover study. Eckerberg, B., Lowden, A., Nagai, R., et al. Leksand School Health Organization, Sweden. Chronobiology International, 2012 Nov;29(9):1239-48 Use of valerian in anxiety and sleep disorders: what is the best evidence? Nunes, A., Sousa, M. Medicina Geral e Familiar, Unidade Local de Saude de Matosinhos, Portugal. Acta Medica Portuguesa, 2011 Dec;24 Suppl 4:961-6. Some other sleep aids can be effective, too.
23. Don’t try to sleep unless you’re sleepy. Yes, it sucks when it’s 2 a.m. and you still don’t feel tired, despite knowing you need rest. But climbing into bed when you don’t feel ready for sleep is setting yourself up for failure. Instead, engage in relaxing activities (like gentle yoga and meditation or listening to soothing music) until you get the strong urge to snooze. If sleep hasn’t come within 20 minutes, get back out of bed and try relaxing activities again until you’re sleepy enough to give it another go.
24. Minimize disturbing noises. If external noises are beyond your control (a busy street outside the window, a neighbor’s barking dog), cover them up with the sound of a bedside fan, a white noise machine, or other sounds that help us sleep.
25. Vent stresses. If designated worry time earlier in the day didn’t fully do the trick, spend some extra time writing down anxieties. Loose-leaf paper works, but if you scrawl your sorrows in a journal or notebook, you can literally close the book on your worries (at least until morning).
26. Brew some chamomile tea. Studies find the humble herb can reduce anxieties, getting us into a better head space for sleep.
27. Try a hot bath or shower. Stepping from warm water into that pre-cooled bedroom will cause body temperatures to drop slightly, which can trigger sleepy feelings by slowing down metabolic activity.
28. Sip some hot milk. Science doesn’t necessarily back the idea that milk facilitates snoozing, but conventional wisdom might be strong enough that our minds still believe moo milk lulls us to sleep.
29. Do some leg exercises. We know; we told you not to exercise before bed. But apparently some easy leg lifts, squats, or your leg exercise of choice can help divert blood flow to the legs and away from the brain. This can help quiet the mind, making it easier to slip into dreamland.
30. Seriously: Count some sheep. It might not work for everybody, but focusing on one thing can help the brain settle down, making sleep more possible. Not a fan of our wooly friends? Focusing on your breath (in, out, in, out) is also an effective way to chill out. Or bust out some of those relaxation techniques you practiced earlier in the evening—they're just as good of a resource in the wee hours.
31. Visualize yourself asleep. Imagine yourself drifting in a blissful slumber while practicing deep breathing and progressive muscle relaxation Treating insomnia with a self-administered muscle relaxation training program: a follow-up. Gustafson, R. Department of Social Sciences, University of Orebro, Sweden. Psychological Reports, 1992 Feb;70(1):124-6. Starting at one end of the body and working up or down, clench and then release each section of muscles for instant all-over relaxation.
32. Accept insomnia for what it is. Judgments (“I should be asleep”), comparisons (“my BF/GF/roommate is sleeping; why can’t I?”), and catastrophic thinking (“If I don’t get eight hours’ sleep tonight, I’ll mess up that presentation tomorrow, lose my job, and die tired and alone”) don’t do us any good. Make the night easier by accepting it for what it is, letting go of judgments, and being gentle with yourself. The silver lining? You just might get to see a glorious sunrise.