It is estimated that 50-70 million Americans suffer from sleep problems each year. This can lead to physical and mental health problems, lost work productivity, and impaired relationships amongst other negative sequelae. While sleep medications can help in the short-term, developing proper sleep hygiene is the cornerstone for a good night's rest.
1. IDENTIFY & TREAT UNDERLYING CAUSES OF INSOMNIA.
A. COMMON PHYSICAL CAUSES:
Sleep apnea
Restless leg syndrome
Chronic pain
Acid reflux
Medication side effect
B. COMMON PSYCHOLOGICAL CAUSES:
Depression
Mania
Anxiety
Grief
Post Traumatic Stress Disorder
Substance use disorders
2. MAKE IMPROVEMENTS IN SLEEP HYGIENE.
A. Develop good personal habits:
Choose a regular wake time and bedtime so your body gets used to going to bed at a relatively fixed time each night.
Don’t nap during the day, especially naps longer than 20 minutes.
Reduce caffeine intake, especially 6-8 hours before bedtime. This includes caffeinated and decaffeinated coffees and teas, chocolate, and many sodas.
Get regular exercise, but not right before bed.
Avoid heavy, spicy, or sugary foods close to bedtime as this can interfere with your ability to stay asleep.
Avoid alcohol close to bedtime. While alcohol can have an initial sleep-inducing effect, blood alcohol levels fall a few hours later which produces a stimulating "wake-up" effect.
B. Establish a bedtime routine:
Gentle stretching or yoga helps unwind tight muscles.
Practice relaxation techniques such as progressive muscle relaxation, deep breathing, and meditation can relieve anxiety and reduce muscle tension.
Pre-sleep rituals like a warm bath or a few minutes of light reading can prepare the body and mind for sleep.
Don't take your worries to bed!
C. Optimize the bedroom environment:
Use comfortable bedding and the appropriate pillow for your preferred sleeping position.
Find a comfortable sleep temperature.
Block out light with heavy blinds or curtains.
Filter out distracting sounds with a white noise machine or fan.
Reserve the bed for sleep and intimacy only. Let your body learn that the bed is for sleeping, and not a place for work, study, or recreation.
Don't watch TV or use smart phones, tablets, or laptops in bed. Light from electronic devices have an unwanted stimulating effect on the brain.
Don't stay in bed awake for longer than 15-20 minutes. If you cannot fall (or fall back) asleep quickly, try doing a quiet activity in another room until you feel tired again. Do no engage in challenging, engaging, or physically strenuous activities. Do not watch television or use electronics.