@PsychToday #ShelbyHarris #Sleep #Insomnia
Shelby Harris, Psy.D., is a clinical psychologist and Director of the Behavioral Sleep Medicine Program at Montefiore Medical Center
Sometimes sleep professionals sound like a broken record, always telling patients to make sure they get enough sleep night after night. The reality is that it can be hard for many people to reach this goal each and every night. Worse, on the nights we decide to prioritize sleep, those precious hours of shut-eye can be harder to obtain than we would like, leading to even more frustration and sleepless nights.
There are a number of sleep stealers—some secret, some not-so-secret—to pay attention to in order to get great nightly sleep. Here’s a list of 10 of the 10 most common that I see in my patients on a daily basis. Fortunately, some simple changes to your lifestyle can help better prepare your body for sleep and greatly enhance the chance that you’ll get a night of quality rest:
- You had a bit too much to drink. This pertains to both alcoholic and non-alcoholic drinks. Let’s face it: Drinks equal liquids, and consuming liquids at night means having to use the bathroom when you’re trying to sleep. But alcohol consumed close to bedtime can also make your sleep lighter and more broken throughout the night. Even though alcohol might initially make you sleepy, it will make the overall quality of your sleep poorer. Try to limit all liquids within three hours of bedtime.
- You’re on medication. Certain medications can greatly impact your ability to fall and stay asleep. Some over-the-counter painkillers such as Excedrin and Midol contain caffeine—make sure to check the ingredients on the box. Certain medications for blood pressure; decongestants; steroids; and asthma medication can also impact your sleep. Most commonly, many antidepressants—in particular, SSRIs such as Paxil, Prozac, and Lexapro—release serotonin on a continuous basis and can be very alerting. Talk with your doctor if you think your medications are impacting your sleep. Sometimes a change in when you take a medication can make a big difference. If that doesn’t work, your doctor might be able to recommend an alternative medication.
- Your room is too warm. Many people like to create a cocoon-likeenvironment for sleep. But while it might feel nice to be warm and cozy at night, a room that is too warm (or cold, for that matter) can cause multiple awakenings at night, leading to more disrupted and less refreshing sleep. The ideal sleeping temperature range is between 55 and 74 degrees Fahrenheit; most people find that the upper 60s is ideal. If you have a radiator that’s hard to control, consider opening your window before you go to sleep—even in the winter—and leave it open a crack throughout the night.
- You took a shower too close to bedtime. Good sleepers tend to have a slight drop in their body temperature just as sleep starts to come on each night. Poor sleepers don’t have as much of a drop. So while taking a hot shower or bath just before bedtime sounds like a good idea, it can actually warm up your body even more. The key is timing: It’s best to take a hot shower or bath one-and-a-half-to-two hours before bedtime, which can facilitate the cooling-off process the body is meant to experience before sleep.
- Your workout ran too late. Exercising within three hours of bedtime can be too stimulating for many people. Exercise wakes up the brain and warms up the body, which can both interfere with sleep. The best time to exercise (in terms of helping you sleep well) is four-to-six hours before bedtime. If that’s too difficult to schedule, consider exercising in the morning—the bright light can help wake you up, and reinforces a good, regular sleep-wake cycle.
- Dinner was too heavy and too late. Heavy or spicy foods, and large meals within three hours of bedtime can be too stimulating for your body. Limit big meals to at least three hours before going to bed—and if you find yourself hungry closer to bedtime, have a small snack that consists of a combination of protein and a carbohydrate, such as a cracker with cheese or a banana with peanut butter.
- You wound down with your TV or tablet. Watching the news or a gripping show can be psychologically stimulating, but the blue light most screens give off make your brain think that it is still daytime. As a result, melatonin—a hormone in our brain that comes out in darkness and makes us sleepy—doesn’t come on as strongly and we aren’t able to get sleepy. Turn off all screens within an hour of bedtime and wind down outside your bed with a book or relaxing hobby in dim light.
- You had afternoon coffee. Caffeine can take as long as 12 hours to leave your body—and keep in mind that it’s not just found in soda, coffee, and tea, but chocolate and many over-the-counter medications as well. Caffeine doesn’t just make it harder to fall asleep; it can also cause disrupted sleep throughout the night. Consider taking a short walk in the sunlight or eating your lunch near a bright window to perk up naturally in the afternoon. The exercise and sunlight can be just as alerting as a cup of coffee.
- You’re overwhelmed. Stress is the number one cause of short-term sleep difficulty. But solutions don’t usually come to us in the middle of the night and so we can get caught up in unproductive worry. If you can’t sleep, get up and out of bed, sit in dim light in another room, and do something quiet, calm, and relaxing that helps take your mind off your worries. Writing a to-do list earlier in the evening can also help clear out your mind. If you wake in the night remembering that you forgot to add something, just put it on the list. Prioritize the list as well, so you know what is most important to get done. And if you keep worrying about the things on your “to-do” list, recite to yourself that you’ve written it down and will handle it tomorrow.
- You’re wound up. Try some relaxation exercises within an hour of bedtime to calm your mind. Deep diaphragmatic breathing and body-scan exercises, in which you become aware of and then relax each body part from head to toe, are excellent ways to relax your body and mind. Many online resources can help you do these exercises. If you wake in the middle of the night, consider getting out of bed and trying some relaxation exercises to take your mind off your worries.
If you’ve addressed all of the above and still can’t sleep, let your primary-care physician know. There are many excellent treatments—not just medication, but cognitive behavior therapy for insomnia—that can help you get a great night’s sleep from here on out.