Expert advice to sleep well every night

Expert advice to sleep well every night

We spring forward to Daylight Saving Time this month

Most of the United States changed to Daylight Saving Time on Sunday March 12 by setting their clocks ahead one hour before going to bed (or when they woke up the next morning.)

By doing so, we usually feel like we “lost” an hour of sleep, since it’s hard to go to sleep an hour earlier if you don’t feel sleepy and sometimes hard to sleep an hour longer if you need to be up to go to work or school.  Changing the clock this way creates jet lag without the fun of travelling.

Your body will tell the difference until your sleep cycle adjusts; I know mine always does.  WebMD offers these tips to make the change easier.

person sleeping on a couch
Sometimes getting a good night’s sleep can be a challenge.

 

What is Chronic Insomnia ?

Most of us have trouble sleeping occasionally, but if you persistently have difficulty with sleep, you may have a medical condition associated with sleep disturbances. These include

  • sleep apnea
  • restless legs syndrome
  • depression and/or anxiety
  • post-traumatic stress disorder

Some people have true chronic insomnia, meaning persistent sleep difficulty alone. There are various criteria to diagnose chronic insomnia but in general include

difficulty falling or staying asleep

at least 3 nights per week for at least 1-3 months

with impairment of daytime function, such as fatigue/sleepiness, poor concentration, irritability, school or work dysfunction

 

How is chronic insomnia treated? 

First step in treatment of chronic insomnia as well as occasional difficulty sleeping  is identifying and treating any underlying medical issues that might contribute to poor sleep. In addition to the ones mentioned above these include

  • pain, of all kinds
  • heartburn (gastroesophageal reflux)
  • congestive heart failure
  • lung diseases like asthma  causes nighttime breathing difficulty
  • menopausal night sweats

 

Sleep specialists recommend non-drug management of chronic insomnia and reserve sleep medications for more resistant cases. 

Sleep meds were one of the 7 drugs that are overused in my previous post.

 

Experts recommend sleep hygiene , basically lifestyle changes, as the initial treatment.  Best results include some combination of

  • Engaging in regular exercise- moderate intensity , tai chi , yoga and low-impact aerobic exercise
  • Avoiding evening large meals
  • Limiting caffeine, tobacco and alcohol
  • Limiting use of the bedroom to sleep and sex
  • Maintaining a regular bedtime-awake schedule
  • Avoid daytime naps
  • Avoid distracting stimuli at bedtime-watching television, using electronic devices, talking on the phone
  • Stay in bed only while sleep

Maintaining a regular schedule helps to set or reset one’s sleep/wake cycle. So go to bed at the same time every night and wake up at the same time every morning. However, if unable to sleep, it is better to not lie in bed awake; get up, do a nonstimulating activity, then return to bed when sleepy.

 

 

woman typing on a laptop keyboard.
Using a computer, laptop, or tablet before going to bed can impair sleep.

 

 

 

Those who still have persistent sleep loss, should seek more intensive therapy by a professional.

 

Cognitive behavior therapy for insomnia , CBT-I , significantly improves chronic insomnia and daytime functioning and is recommended as first line therapy.  CBT-I combines cognitive therapy with sleep restriction, relaxation training and stimulus control.  Treatment typically requires 5-8 sessions conducted by a health professional trained in its use. Patients need to participate by keeping a sleep diary and writing down daily thoughts in a journal, while continuing with the sleep hygiene practices mentioned above.

person writing in a spiral notebook
Writing thoughts in a journal is often encouraged in cognitive behavioral therapy.

 

 

 

 

Insomnia sufferers can also get help from an online web-based CBT-I, Sleep Healthy Using the Internet , SHUTi. One study found 70% of those participating improved their sleep, compared with 43% who received education only.  This can be a good option for those who can’t find a trained therapist or don’t have time for office based therapy.

 

 

A physician, Dr. Wei-Shin Lai had trouble falling asleep after being awakened at night by calls from the ER. Her husband suggested listening to relaxing music to help her fall asleep. She decided to design a comfortable headphone for her own use, and eventually started a company to make and sell them . You can try her SleepPhone  made by her company AcousticSheep.

 

SleepPhones

 

 

If you have  occasional trouble sleeping, relaxation techniques can be helpful, especially if due to stress.  Many people use meditation, yoga, imagery, abdominal breathing and muscle relaxation techniques . These can reduce tension and anxious thoughts that inhibit sleep onset and maintenance.

man with hands folded over a book

 

 

 7 overused medications

7 health habits we need more of in 2016

 

 

 

 

 

 

 

 

 

 

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