“Health is the first muse and sleep is the condition to produce it.” –Ralph Waldo Emerson
It is rare that a person comes to my office and doesn’t have a problem with sleep. And it’s not just my patients—it seems to be a pervasive problem in our culture.
How many of us work long, stressful days, and then come home with almost no time to wind down before we’re supposed to go to bed? Or sit in front of our computers well into the evening? Or need coffee to wake up in the morning and sleeping pills to fall asleep at night?
Many factors have converged to create an epidemic of poor sleep in this country. We consume stimulants, spent too much time in front of screens, and have ambitions about what we want to accomplish in our days that exceed the time we have to do it. We spent most of our time indoors, exposed to artificial light, and disconnected from the natural rhythms of nature.
But sleep is important—really, really important. Insufficient sleep (less than 7-9 hours a night for an adult, depending on the individual), is associated with a whole host of problems, including traffic accidents, poor memory and learning, weight gain, a weakened immune system, and deficient production of neurotransmitters necessary for a healthy mood.
And—terrifyingly—a recent study found that long-term use of the most commonly prescribed class of sleep medications, the sedative-hypnotics (including zolpidem, zaleplon, and benzodiazepenes such as temazepam) was associated with an increased risk of cancer and death not explained by sicker people getting more prescriptions. It is also well-established that benzodiazepenes impair learning and memory.
If you want to stay away from the meds and still get a good night’s rest, here are some safe, effective ways you can improve your sleep, naturally.
1. Make the bedroom a relaxing place that you associate with sleep. Use the bed only for sleep and sex, and not for watching TV, using your computer, or even reading. Keep the room cool and make your bed comfortable. If you’re tossing and turning, get up and do something else relaxing until you get tired again. You don’t want to associate the bed with anticipatory anxiety about not being able to sleep.
2. Create a calming evening ritual. An hour or two before you go to bed, dim the lights, turn off the computer screen, and do something relaxing to wind down. Take a bath, light some candles, write in your journal, or read a novel (just not in bed!). Practice fun, relaxing, and peaceful activities. You want to train your body to wind down as it’s getting close to bedtime.
3. Maintain a regular sleep schedule. It’s very common to get up early during the week and then sleep in on the weekends, but this habit can actually impair your sleep. When you sleep in, you won’t get tired until later that night, and then when Monday morning rolls around and you have to get up early for work again, you’re already sleep deprived. Instead, on the weekend try to wake up within an hour of when you normally would.
4. Cut out stimulants, including coffee. Yes, I know you love your coffee, but if insomnia is a chronic problem, you should seriously consider completely eliminating caffeine. Some people are more sensitive to its effects than others, and may feel wired into the evening even if they only drank a cup or two in the morning. If you’re unsure if coffee is impacting your sleep, do an experiment and cut it out for a month and see how you feel–you may be surprised to find this completely solves the problem.
5. Get out into nature. Nothing will help reset your circadian rhythm better than connecting with the natural cycles of dawn, daylight, dusk, and dark. Get outside during the day, do something active, and get lots of natural light exposure (especially in the morning). When evening comes around, enjoy it. Watch the sunset, dim your lights, and let night be night. An hour or so before bed, go outside and sit quietly in the dark under the stars for 10 minutes.
6. Try meditation. Mindfulness is a wonderful practice for learning how to slow down and calm your mind. I recommend sitting 5-10 minutes in the morning to help start your day, and 5-10 minutes in the evening as you’re starting to wind down.
Sit in a comfortable position and let your attention rest on your breath. When your mind wanders, gently note “wandering” or “thinking” and bring your attention back to the breath. If you have a tendency toward anxiety, it can be helpful to write down all your worries before you meditate—check out an article I wrote on how to alternate worry journaling with meditation to decrease stress.
7. Get exercise early in the day. Twenty to thirty minutes of daily aerobic activity can help improve sleep. It doesn’t matter what kind of exercise you’re doing, as long as you’re getting out and moving around. Try to keep your exercise sessions to the morning, midday, or afternoon, though, because strenuous exercise at night can impair sleep.
8. Avoid alcohol right before bed. I know that many people have a drink or two to help wind down and fall asleep, but the problem is that alcohol impairs REM sleep as well as the deeper, restorative stages of sleep. You may fall asleep, but find you wake up through the night and don’t feel rested in the morning. If sleep is a problem, try cutting out alcohol for a bit and see if it helps.
9. If you need a little help, try natural herbs. Kava, valerian root, chamomile, passionflower, lavender, and lemon balm can all help promote relaxation and good sleep (although kava has been associated in rare cases with liver failure, so check with your doctor if you have liver problems). These herbs can be taken as capsules, tinctures, or teas, and lavender and lemon balm can be used as aromatherapy.
10. Try Cognitive Behavioral Therapy (CBT) for insomnia. If all else fails, CBT for insomnia is a brief, extremely effective therapy that can resolve chronic insomnia in a few months of weekly sessions.
The basic procedure is:
- Create a sleep journal to evaluate your sleep habits.
- Determine how many hours of quality sleep you get a night, minus waking up and tossing and turning (for example, 4 hours).
- Create a schedule where you go to sleep very late and wake up very early so that you are only sleeping this many hours a night (i.e. bedtime at 2am, wake up at 6am). Oh, and no napping!
- Gradually extend this time as you consolidate your sleep and are better able to fall asleep and stay asleep during the designated time.
Make sure to find a therapist who is experienced with CBT and has done CBT for insomnia before, or if you are motivated, you can do the regimen yourself following a book or online guide.
I hope these tips help you on your quest for better sleep. Remember that sleep is crucial to healthy functioning, and bad sleep can be an indicator that there is something in your life that needs to be changed or attended to. There may be a medical problem that needs to be addressed, or psychological distress that needs attention, or anxiety and worry that’s been created by a too-hectic lifestyle.
Let sleep be your canary in the coal mine, and listen to its wisdom.
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Photo by RelaxingNature
Kyla says
These are great ideas! I don’t like that medications are so overused, especially when it comes to sleeping well. We should be searching for natural remedies first instead of turning to prescriptions.
One thing I would disagree with is reading in bed — this always helps me sleep well! I have a nightly ritual where I read a few pages of a book in bed and I begin to feel sleepy almost immediately. I think the key here is to choose a book that has “lighter” content, with nothing too graphic or intense. For me, reading is very relaxing and I usually sleep very well if I read for just 10-15 minutes at night.
Elana says
Hey Kyla, if reading a novel helps you nod off, then go for it! It’s important to respect your own individuals tendencies and preferences. I usually read nonfiction how-to books, which can be a bit more activating, so I need to peel myself away from the books before it’s too late or I will definitely have some trouble sleeping. Thanks for your comment!
Pedro says
I’ve been trying to get my girlfriend to try some of these techniques for years, but she doesn’t believe they work. She usually just pops a couple of Ambien, then wonders why she feels out of it the next day. Hopefully after I show this to her, she’ll modify her habits. It takes a doctor to change her mind these days, she doesn’t listen to me anymore. I’m glad there are medical doctors out there who are finally lending credibility to these centuries old traditions. Sleep well!! ; )
Sean Cox says
Thanks Elana. I heartily agree with your suggestions–what a wonderful list!
I’ve worked with folks over the years with this difficult sleep issue. I’ve been amazed at how many times people have been resistant to follow such simple, smart suggestions as the ones you’ve given here. Yet, they seem to be the quickest to keep complaining!
Especially that “no TV in the bedroom” suggestion. People just love their bedroom TV’s!
I was recently married–happy to say no TV in the sleeping quarters 🙂
Elana says
Thanks for the comment, Sean! Yes, so often I have people asking me for sleeping meds who shutter at the thought of changing their sleep hygiene habits. Taking a pill is definitely the easier way out, but not a good long-term solution. I’m a big believer that people need to take responsibility for their health, and can’t expect doctors to solve lifestyle problems by prescribing a pill.