Reprinted with permission from Be Well by Dr. Frank Lipman.
Although we may not like to admit it, many of the sleep problems we experience are the result of bad habits and behaviors. We stay up late or sleep in late. We eat foods that disagree with us or enjoy a drink late at night, oblivious to their disruptive impact on our sleep rhythms. Over time, we teach our body not to sleep and for relief we often turn to sleeping pills, which mask rather than solve the problem, and can lead to addiction. Ultimately for real success, with insomnia as with any chronic problem, one must look for the underlying imbalances and root causes and address those.
Here are the common sleep “mistakes” I see in my practice and their solutions.
We often think we can make up for lost sleep by going to bed extra early another night but the body clock’s ability to regulate healthy sleep patterns depends on consistency. We stay up late on weekends, expecting to make up sleep later or use the weekend to make up for lost sleep during the week. Both practices disrupt bodily rhythms and late night weekends in particular can cause insomnia during the workweek.
SOLUTION: Create a routine and stick to it. Getting up and going to bed around the same time, even on weekends, is the most important thing you can do to establish good sleep habits. Our bodies thrive on regularity and a consistent sleep schedule is the best reinforcement for the body’s internal clock. Waking and sleeping at set times reinforces a consistent sleep rhythm and reminds the brain when to release sleep and wake hormones, and more importantly, when not to.
Long naps during the day especially after 4pm or even brief nods in the evening while watching TV can damage a good sleep rhythm and keep you from enjoying a full sleep at night.
SOLUTION: Nap for no more than 30 minutes. If naps are absolutely necessary, make sure you only nap once a day and keep it under 1/2 hour and before 4 pm. In general, short naps may not hurt sleep and in fact a short siesta for half an hour after lunch or a 20 minute power nap before 4 pm works well for many people.
Expecting the body to go from full speed to a standstill without slowing down first is unrealistic. Our bodies need time to produce enough sleep neurotransmitters to send feedback signals to the brain’s sleep center, which will result in the release of sleep hormones to allow you to sleep.
SOLUTION: Take the time to slowly shift into sleep. Create an electronic sundown: By 10 pm, stop sitting in front of a computer screen (or TV screen) and switch off all electronic devices. They are too stimulating to the brain and will cause you to stay awake longer. Dim the lights an hour or more before going to bed, take a warm bath, listen to calming music or soothing sounds, do some restorative yoga or relaxation exercises. Getting your mind and body ready for sleep is essential. Remove any distractions (mentally and physically) that will prevent you from sleeping.
Our bodies depend on signals to tell them when to fall asleep and wake up, the two most fundamental ones being darkness and light. But we live and work in artificially lit environments and often miss out on the strongest regulatory signal of all, natural sunlight. When we go to sleep and our bodies need complete darkness for production of the important sleep hormone, melatonin, our bedrooms are not pitch dark, thereby interfering with this key process.
SOLUTION: At night, keep the room as dark as possible. Look around your bedroom: the alarm clock read-out that glows in bright red; the charging indicator on your cell phone or PDA, the monitor on your computer, the battery indicator on the cordless phone or answering machine, the DVD clock and timer. Even the tiniest bit of light in the room can disrupt your pineal gland’s production of sleep hormones and therefore disturb your sleep rhythms. Conceal or move the clock, cover all the lights of any electronic device and use dark shades or drapes on the windows if they are exposed to light. If all of that is not possible, wear an eye mask. If you get up in the middle of the night, try keeping the light off when you go to the bathroom. Use a flashlight or night light.
These are metabolic disruptors which raise blood sugar and overstress the organs involved in hormone regulation throughout the body. This hormone roller coaster can affect sleep cycles by waking you up at odd times during sleep as the hormone levels fluctuate.
SOLUTION: If you have to eat, have a high-protein snack. It is better not to have anything before bed but at least a high protein snack will not only prevent the hormone roller coaster, but also may provide L-tryptophan, an amino acid needed to produce melatonin.
Sleeping pills mask sleep problems and do not resolve the underlying cause of insomnia. Many sleep studies have concluded that sleeping pills, whether prescription or over the counter, over the long term, do more harm than good. They can be highly addictive and studies have found them to be potentially dangerous. For short term use, there may be indications for sleeping pills, but over time, sleeping pills can actually make insomnia worse, not better. If you have been taking them for a long time, ask our doctor to help you design a regimen to wean yourself off them.
SOLUTION: Learn relaxation techniques. Aside from physical problems, stress may be the number one cause of sleep disorders. Temporary stress can lead to chronic insomnia and circadian rhythm sleep disorders. Many people tell me they can’t switch off their racing minds and therefore can’t sleep. Do some breathing exercises, restorative yoga or meditation. These will calm the mind and reduce the fears and worries that trigger the stress.
Because of alcohol’s sedating effect, many people with insomnia drink alcohol to promote sleep. Alcohol does have an initial sleep inducing effect, but as it gets broken down by the body, it usually impairs sleep during the second half of the night leading to a reduction in overall sleep time. Habitual alcohol consumption just before bedtime can reduce its sleep-inducing effect, while its disruptive effects continue or even increase.
SOLUTION: Take nutrients that calm the body and mind, getting you ready for sleep. Don’t drink alcohol to help you sleep. Look for a calming formula that has some of the following: amino acids, L theanine, taurine, 5 HTP and GABA, and herbs like lemon balm, passion flower, chamomile and valerian root. Taking the minerals, calcium and magnesium at night is also helpful. For some people, especially we folks over 50, melatonin can be helpful too. This is because the body produces less melatonin with advancing age and may explain why elderly people often have difficulty sleeping and respond well to melatonin.
Because we have no trouble at all falling asleep in the living room in front of the TV many of us watch TV in bed to fall asleep. But when we fall asleep in a bed watching TV, we invariably wake up later on. This sets up a cycle or conditioning that reinforces poor sleep at night. I have had many patients over the years develop insomnia due to this type of conditioning.
SOLUTION: Get the TV out of the bedroom. Don’t watch TV in bed, the bed should be associated with sleep (and sex).
If you can’t fall asleep within 30-45 minutes, chances are you won’t for at least another hour, and perhaps even longer. You may have missed the open “sleep gate” or missed catching the sleep wave. A “sleep gate” is the open window of time your body will allow you to fall asleep. Researchers have found that our brain goes through several sleep cycles each night where all sleep phases are repeated. These cycles last from 90 minutes to 2 hours, and at the beginning of each cycle, the body’s ‘sleep gate’ opens. You won’t be able to fall asleep when your sleep gate is closed.
SOLUTION: Catch the sleep wave. If you find you can’t fall asleep within 45 minutes, get up and get out of the bedroom. Read a book, do a restorative yoga pose or do some other calming activity for another 1 -1.5 hours before trying to sleep again. Staying in bed only causes stress over not sleeping. It is like surfing, you need to catch that sleep wave. Haven’t you noticed that you can be exhausted and yet you avoid going to sleep and then a few hours later when you are ready for bed, you are suddenly wide awake? You missed the wave.
Often just thinking about sleep affects your ability to fall asleep. What happens frequently is that the way you cope with the insomnia becomes as much of a problem, as the insomnia itself. It often becomes a vicious cycle of worrying about not being able to sleep which leads to worsening sleep problems. Like so many things in life, it is about letting go, going with the flow. Sleep needs to become a natural rhythm like breathing, something that comes automatically and you don’t think about.
SOLUTION: Let go and go with the flow. Use the time to practice breathing exercises or meditation and to become aware of how what you eat, what medications you take, what behaviors or certain activities can affect your sleep cycle. Increase your awareness by paying attention to your body and becoming conscious of how you react to different foods and situations. Use this time productively instead of getting upset that you can’t fall asleep.
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