By David D. Clarke, MD from www.stressillness.com
Habits that make insomnia worse:
- drinking a lot of caffeine
- drinking or smoking before bed
- taking naps during the day
- an irregular sleep schedule
Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your daily Starbucks habit affects your sleep more than you realize. Or maybe you’ve never made the connection between your late-night TV viewing or Internet surfing and your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors contributing to your insomnia.
Adopting new habits to help you sleep
- Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep. Try using a sound machine or earplugs to mask outside noise, an open window or fan to keep the room cool, and blackout curtains or an eye mask to block out light.
- Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends. Get up at your usual time in the morning even if you’re tired. This will help you get back in a regular sleep rhythm.
- Avoid naps. Napping during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 p.m.
- Avoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise; big discussions or arguments; and TV, computer, or video game use.
- Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least 8 hours before bed. Avoid drinking in the evening. While alcohol can make you feel sleepy, it interferes with the quality of your sleep. Quit smoking or avoid it at night, as nicotine is a stimulant.
Preparing your brain for sleep
Your brain produces the hormone melatonin to help regulate your sleep-wake cycle. As melatonin is controlled by light exposure, not enough natural light during the day can make your brain feel sleepy, while too much artificial light at night can suppress production of melatonin and make it harder to sleep. To help naturally regulate your sleep-wake cycle and prepare your brain for sleep:
- Increase light exposure during the day. Take breaks outside in sunlight, remove sunglasses when it’s safe to do so, open blinds and curtains during the day.
- Limit artificial light at night. To boost melatonin production, use low-wattage bulbs, cover windows and electrical displays in your bedroom, avoid bright light and turn off television and computer screens at least one hour before bed. If you can’t make your bedroom dark enough, try using an eye mask.
- Learning to associate your bed with sleeping, not sleeplessness If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep and nothing else—especially not frustration and anxiety.
- Challenge thinking: It’s also helpful to challenge the negative attitudes about sleep and your insomnia problem that you’ve developed over time. The key is to recognize self-defeating thoughts and replace them with more realistic ones.
- Use the bedroom only for sleeping and sex. Don’t work, read, watch TV, or use your computer in bed or the bedroom. The goal is to associate the bedroom with sleep alone, so that your brain and body get a strong signal that it’s time to nod off when you get in bed.
- Get out of bed when you can’t sleep. Don’t try to force yourself to sleep. Tossing and turning only amps up the anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, drinking a warm cup of caffeine-free tea, taking a bath, or listening to soothing music. When you’re sleepy, go back to bed.
- Move bedroom clocks out of view. Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted when the alarm goes off—is a surefire recipe for insomnia. You can use an alarm, but make sure you can’t see the time when you’re in bed.
Challenging Self-Defeating Thoughts That Fuel Insomnia
Remember, replacing self-defeating thoughts takes time and practice. You may find it helpful to jot down your own list, taking note of the negative thoughts that pop up and how you can dispute them. You may be surprised at how often these negative thoughts run through your head. Be patient and ask for support if you need it.
If you feel wound up much of the time and unable to let go of stress at the end of the day, you may benefit from relaxation techniques that take advantage of the body’s natural relaxation response, a state of restfulness that is the opposite of the stress response. Not only do relaxation techniques help you quiet your mind and relieve tension in the body, but they also help you fall asleep faster and get back to sleep more quickly if you awaken in the middle of the night. And all without the side effects of sleep medication!
A variety of relaxation techniques help you achieve the relaxation response, including:
- deep breathing
- progressive muscle relaxation
- tai chi
Relaxation techniques that can help you sleep (Use together or pick one you like):
- A relaxing bedtime routine. As a start to your relaxation practice, develop a calming bedtime routine. Focus on quiet, soothing activities, such as reading, knitting, or listening to soft music. Keep the lights low. The following relaxation and stress management techniques can help you enter a more relaxed state:
- Abdominal breathing. Most of us don’t breathe as deeply as we should. When we breathe deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, it can actually help our parasympathetic nervous system, which controls relaxation. Close your eyes, and try taking deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth. You can try making each exhale a little longer than each inhale.
- Progressive muscle relaxation is easier than it sounds. Lie down or make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold for a count of 10, then relax. Continue to do this for every muscle group in your body, working your way up from your feet to the top of your head.
- Guided imagery Some people imagine a calm scene to help them wind down at the end of the day. There are no rules about what you should imagine, so long as it's calming. Although clouds, the ocean, and mountains are common choices, you can focus on something as general or as specific as you want. Pick a place that feels safe, and, using your imagination, invite any or all of your senses to explore it. "The brain doesn't always know the difference between pretend and real," says Dr. Doner. "If you watch a scary movie, your adrenaline might go up, just as if you imagine eating something vividly enough, you might start to salivate." Guided imagery can be done alone or with a specialist, such as a sleep doctor, cognitive-behavioral therapist, or hypnotherapist, or by using a tape or CD—but even when prompted by an instructor, the patient should still be the guide. "They need to imagine someplace comfortable and peaceful," says Dr. Doner. "I don't know where they need to go; the ocean may seem peaceful for one person, but traumatic for another."
- Counting down While lying in bed, start by gazing upward. "A little eye strain relaxes you," says Dr. Doner. Take an abdominal breath and hold it, and on the out breath, let everything relax. Repeat one or two times. You might then try imagining yourself walking down a flight of stairs or a gentle hill while counting down from 10 or 20, each number signifying your movement to a lower step, exhaling with each imaginary step.