Trouble sleeping? The best ways to catch some zzz's
We've all been there. Tossing and turning all night, feeling like no matter how hard we try, we can't get to sleep. So what are the best ways to get to sleep? You might feel like you know all the sleep hygiene tactics and it just doesn't work. So now what?
So what is insomnia anyways?
Most humans at some point in their life will experience a sleepless night. This can be due to a variety of reasons. Things like stress, a change in environment (say camping or having a newborn at home), or diet can all impact sleep. For us to diagnose insomnia, we have to meet a few basic conditions. First, you need to have troubles sleeping at least three nights out of the week. Second, you have to have these problems sleeping for at least three months. And finally, the sleeping problems have to significantly impact your life, like your functioning at home or school. Even if you don't meet the formal criteria for insomnia, you still will benefit from proper sleep practices.
Why do I really need sleep?
Other than most of us just feeling pretty terrible without it, there are plenty of reasons that your brain and body need the rest!
Sleep is important for some of the following reasons:
Concentration and attention: When we don't get enough sleep we have more problems paying attention, learning new things, and recalling things we learned in the future.
Lowers our risk of mood disorders: One study showed that a chronic lack of sleep led to a 5x increase of depression and a greater incidence of anxiety and panic as well
Lowers our physical health risk: Getting adequate sleep has been linked to heart health, blood sugar control, our immune system, and weight control
How can I make sure I get a good nights sleep?
The first thing to always look at are your sleep habits. Many individuals think that they have great sleep habits but when we really look into it closely, we see that there are many things that may be impacting sleep quality.
So what are some good sleep habits? The following are some (but not all!) suggestions:
Set a consistent sleep schedule. More important than when you go to sleep is when you wake up. Try to wake up as close as possible to the same time each morning, even if you barely got any sleep the night before.
Avoid naps. I know this is a tough one for many and for individuals who don't have any sleeping difficulties, naps can be great! However, if you are having any troubles with insomnia, it's really best to avoid any naps so you can focus on getting good sleep at night.
Avoid or limit caffeine. For most individuals with sleeping problems, I would recommend cutting out caffeine altogether (decaf coffee, anyone?). I know this one can also be tough but the results will be worth it
Avoid nicotine. Many people are surprised to hear that nicotine is stimulating, especially since it can make some feel more relaxed.
Avoid alcohol. Try to avoid alcohol at least 4-6 hours before bed time. It causes our sleep to be more restless and can cause nightmares and vivid dreams, despite being a depressant
Only use your bedroom for sleep. Try to avoid watching TV, answering emails, or eating in bed. The goal is for your brain to associate the bedroom with sleep, not with stress or activities
Avoid electronics for at least 30 minutes prior to bed. This is the one that is hard for most individuals I know but is something that I highly recommend. You will be surprised at the impact it has on sleep
What if I've tried all of those things and I still can't sleep?
Don't give up on your sleep habits even if you aren't sleeping well yet! It's important to keep up all of those good routines that you established. Thankfully, if those aren't completely resolving your sleep issues we have options to help.
Our gold standard and first line treatment for insomnia is called cognitive behavioral therapy for insomnia (CBT-I) and it is recommended before prescription medications.
CBT-I is done by a qualified therapist through a structured program. There are also some online programs and apps for CBT-I that can be helpful as well.
It is also very important to treat any underlying mental health concerns which can impact sleep like depression or anxiety. Meeting with your individual therapist and medication provider is a good place to start.
Physical health can also play a role. If you have certain symptoms or risk factors, your provider may recommend you get a sleep study to rule out any underlying causes that could be worsening your sleep, such as obstructive sleep apnea (OSA).
Medications also can be a helpful tool for sleep, especially in the short term. For the long term treatment of insomnia, behavioral modifications (such as through CBT-I) will likely be your best bet for remission.
Often in practice, we use a combination of all of the above treatment recommendations. It's best to work with your provider to find the best approach for you and your symptoms.
Happy sleeping!
Show References
Sateia MJ, et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2017;13:307.
Insomnia: Safe use of sleep aids. National Sleep Foundation. https://sleepfoundation.org/insomnia/content/safe-use-sleep-aids
Bonnet MH, et al. Treatment of insomnia in adults. https://www.uptodate.com/contents/search
Sleep Hygiene. Sleep Foundation. https://www.sleepfoundation.org/sleep-hygiene