stress management – Page 2 – watercress words by Dr Aletha

Sleep Practices for Restful Nights

In this post I review options to improve our sleep. Daylight Saving Time can disrupt sleep, akin to jet lag. Chronic insomnia involves difficulty sleeping regularly, potentially linked to medical conditions. Treatment begins with addressing underlying issues and adopting sleep hygiene practices, such as exercise and routine. Cognitive Behavioral Therapy for Insomnia (CBT-I) is effective for persistent cases.

updated March 7, 2025

If you live somewhere that observes Daylight Saving Time, you may notice a disruption in your sleep for a few days after we “spring forward” in March and when we “fall back” to standard time in November.

Like jet lag from travel, these time changes can interrupt our sleep schedule for a few days. And if you already have trouble sleeping, it’s even more of a problem.

Here’s a review of what sleep professionals recommend to help. But for persistent or severe problems, see your own doctor to get started.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

This content is for your “information and inspiration”, and does not imply my endorsement or recommendation.

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

(Affiliate links are used in this post. You don’t pay more to shop through these links; this blog may earn a small commission, which funds its existence. )

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 not due to some other cause. 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 can you sleep better with chronic insomnia?

The first step for chronic or occasional insomnia is to identify and treat any underlying medical issues that cause poor sleep. In addition to the ones mentioned above these include

painful conditions
heartburn (gastroesophageal reflux)
congestive heart failure
lung diseases like asthma cause 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.

a bed with ornate headboard — photo by Dr. Aletha- at the Hemingway house, Key West, Florida

(Read more about Ernest Hemingway’s preserved Florida home at this post)

Hemingway’s study- chaos and creativity

Behaviors for better sleep

Experts recommend sleep hygiene , basically lifestyle changes, as the initial treatment. Some people have developed bad habits in regards to sleep that need to be unlearned and new behaviors put in place.

For optimal sleep, you should

Engage in regular exercise- moderate intensity , tai chi , yoga and low-impact aerobic exercise
Avoid evening large meals
Limit caffeine, tobacco, and alcohol
Use the bedroom only to sleep and for sex
Maintain 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

Dim the lights for better sleep

The light from electronic devices- clocks, thermostats, televisions, monitors-can disturb your sleep even after you turn off your phone and tablets. This light can be blocked by stick on light blocking covers than can block out the majority of it.

Light from my clock made it hard for me to fall asleep before I discovered these products. With them I fall asleep easier, and can fall back asleep if I wake up.

Maintaining a regular schedule helps to set or reset your sleep/wake cycle. So go to bed at the same time every night and wake up at the same time every morning.

However, if you can’t sleep, rather than lie in bed awake, you should get up, do a non-stimulating 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.

If you have persistent sleep loss, consider 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.

Available on Audible on Amazon, 30 day free trial (affiliate link)

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. (photo from the Lightstock.com collection)

SleepPhones

Natural Sleep Aid Created By A Doctor. A family physician created SleepPhones to help patients fall asleep faster and stay asleep longer without resorting to drugs.(affiliate link)

SleepPhone

Manage stress, learn to relax

If you have occasional trouble sleeping due to stress, relaxation techniques can help you. Techniques include meditation, yoga, imagery, abdominal breathing and muscle relaxation techniques. These can reduce tension and anxious thoughts that inhibit sleep onset and maintenance.

exploring the HEART of healthy sleep

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Most viewed post #4 -5 steps to manage stress and strain

Read the 4th most viewed post on my blog this year about managing stress #stressmanagement

In the 4th most viewed post I offered some personal reflections.

I developed the post idea after reading a medical journal article about ways to help patients dealing with depression with or without medication. The article offered advice helpful to anyone dealing with a crisis, or even the ordinary stress of life.

When I wrote the post, I was dealing with a personal health crisis, so I had the chance to take my own advice. (We physicians tend not to do so.) Now, the crisis is resolving, but I intend to continue to practice the

5 steps to manage the stress and strain of life

As a college graduation gift, I gave a friend’s son a gift certificate to Barnes and Noble Bookseller. He earned a mechanical engineering degree and will work as a rocket structural engineer.

He sent me a nice handwritten thank you note (which few people do these days) and said he plans to use it to buy a book that other structural engineers recommend. The book is Roark’s Formulas for Stress and Strain.

Wouldn’t it be nice if there were a formula for handling the stress and strain of life?

Many health issues would resolve or be easier to manage if life stressors would just go away. Three fourths of the patients treated by primary care physicians have problems aggravated by emotional, social, or behavioral issues.

Life’s interruptions and disruptions won’t disappear, but you can make them less of a strain on your time, energy, and resources. There’s usually no quick fix but 5 steps can lessen their impact.

I’m learning the value of these steps now as I deal with the stress of a foot fracture that is not healing as expected. I’m now facing surgery to correct it, and a longer convalescence than I expected. For someone who is used to being active, this prolonged inactivity stresses me both physically and emotionally. These 5 steps were already a part of my life, but consciously choosing them now helps me cope with what would otherwise cause frustration and sadness.

5 steps to manage life’s stress and strain

1. Create and maintain a routine and schedule.

Having a plan for your time helps you feel more in control of your life. Resist the tendency to become socially isolated or avoid activities you usually enjoy.

a smartphone lying on a calendar page with a planner and cup of coffee — from Lightstock.com (affiliate) stock photo site

Times of crisis, loss, or illness may leave you feeling disconnected and adrift, but having a schedule provides structure and connection. When you are busy, you are less likely to feel overwhelmed and hopeless.

2. Recognizing and reaching out to social supports

Your family and friends are your first line of support during times of stress and duress. It’s nice if we don’t have to ask for their support, but their lives are busy too, so don’t be hesitant to ask for help if you need it. If they don’t call you, call them.

2 women talking over coffee with open bibles — Conversation over coffee can be therapeutic. graphic from the Lightstock collection( affiliate link)

Other sources for help include your healthcare professionals; don’t be embarrassed to share that you need social and emotional support. Your doctor can help you identify and get connected with community resources.

Look for help from your or your spouse’s job, your religious community, organizations you belong to, your school, and online resources for support- educational sites, forums, support groups. Although not as personal as face to face support, these are helpful if you are geographically isolated or mobility is difficult.

3. Reframe by refocusing on the positive rather than the negative.

Recognizing and emphasizing the positive in life makes the problems less overwhelming and distressing. Look for something to be grateful for, or that brings a little joy into your day. It may be as simple as flowers blooming in your yard, your favorite tea and sweet, a funny story in a magazine.

balloons-get well IMG_2269.jpg — Balloons are nice, too.

Remembering and observing happy events, occasions, and celebrations can also be sources of renewed joy.

Norma, a woman facing terminal illness, reframed her crisis by finding joy in small things, like jigsaw puzzles, new foods, and a “good perm”. Read more about her at

Driving Miss Norma- a book review

4. Stay active mentally and physically

Physical activity doesn’t have to be a chore, boring, or expensive. Many things can be done at home or in your neighborhood-walking, bicycling, cardio, yoga. If exercise isn’t your thing, try dancing, gardening, swimming.

If your physical mobility is limited, try something stimulating mentally-sewing, crafts, games, puzzles, writing, cooking are just a few possibilities.

5. Nurture your inner self

Sometimes we need to withdraw from outward activities and stimulation for times of quiet rest and reflection.

You may find help from mindfulness, meditation, prayer, devotional reading, music, journaling, or a combination of these approaches.

Breathing exercises can lessen anxiousness and tension.

Free Loose Leaf Tea Filter and Free Shipping with any Mighty Leaf Wellness purchase. (affiliate link)

In this post, a retired nurse blogger uses gardening for both exercise and mindfulness.

The Zen of Gardening

“But what I like most about gardening is how I can get lost in the moment of whatever I’m doing; whether it’s planting, weeding or pruning. It truly is a togetherness of body and mind.”

Tyndale House Publishers offers spiritual and devotional books.

Try their free Reader Rewards Club at this link.

Affiliate disclosure; some of the photos in this post are from Lightstock, a source for photos, videos, and graphics. With a free account, you can get a weekly free photo.

Learn more at this link.

cheesy-free faith-focused stock photos — Please visit Lightstock.com for quality photos, graphics, and videos (an affiliate link)

RoboForm Password Manager. (this is an affiliate link)

You’re likely reading this post on a computer, tablet, or mobile phone, so you visit sites that require a password. How do you remember them all? You don’t have to if you use RoboForm Password Manager.

a sketch of various electronic devices — RoboForm Everywhere to manage your passwords

My husband introduced me to RoboForm years ago and I am glad he did. I have used it continually to remember my passwords so I don’t have to. It syncs to both my computer and my phone so my passwords are always available. It will even generate passwords for me.

Go to this link to try RoboForm Free; if you like it you can upgrade to RoboForm Everywhere version with all the features I mentioned above. With Roboform, you will have one less thing to feel stressed about.

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