Fighting Insomnia

Two powerful weapons in the fight against insomnia are a quiet, comfortable bedroom and a relaxing bedtime routine. Both can make a big difference in improving the quality of your sleep.

Make sure your bedroom is quiet, dark, and cool.

Noise, light, a bedroom that’s too hot or cold, or an uncomfortable mattress or pillow can all interfere with sleep. Try using a sound machine or earplugs to mask outside noise, an open window or fan to keep the room cool, and blackout curtains or an eye mask to block out light. Experiment with different levels of mattress firmness, foam toppers, and pillows that provide the support you need to sleep comfortably.

Stick to a regular sleep schedule.

Support your biological clock by going to bed and getting up at the same time every day, including weekends. Get up at your usual time in the morning even if you’re tired. This will help you get back in a regular sleep rhythm.

Turn off all screens at least an hour before bed.

Electronic screens emit a blue light that disrupts your body’s production of melatonin and combats sleepiness. So instead of watching TV or spending time on your phone, tablet, or computer, choose another relaxing activity, such as reading a book or listening to soft music.

Avoid stimulating activity and stressful situations before bedtime.

This includes checking messages on social media, big discussions or arguments with your spouse or family, or catching up on work. Postpone these things until the morning.

Avoid naps.

Napping during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 p.m.

---

Things to avoid before bed:

Drinking too many liquids.

Waking up at night to go to the bathroom becomes a bigger problem as we age. By not drinking anything an hour before sleep and going to the bathroom several times as you get ready for bed, you can reduce the frequency you’ll wake up to go during the night.

Alcohol.

While a nightcap may help you to relax and fall asleep, it interferes with your sleep cycle once you’re out, causing you to wake up during the night.

Big evening meals.

Try to eat dinner earlier in the evening, and avoid heavy, rich foods within two hours of going to bed. Spicy or acidic foods can cause stomach trouble and heartburn which can wake you during the night.

Caffeine.

The American Academy of Sleep Medicine recommends that you stop drinking caffeinated beverages at least six hours before bedtime. People who are sensitive to caffeine may need to stop even earlier.

---

Relieving anxiety that keeps you from falling or staying asleep

The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread going to sleep because you just know that you’re going to toss and turn for hours or wake up at 2 a.m. again. Or maybe you’re worried because you have a big day tomorrow, and if you don’t get a solid 8 hours, you’re sure you’ll blow it?

Agonizing and expecting sleep difficulties only makes insomnia worse. Worrying about getting to sleep or how tired you’re going to be floods your body with adrenaline, and before you know it, you’re wide-awake.

---

Learning to associate your bed with sleeping, not sleeplessness

If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep and nothing else—especially not frustration and anxiety.

Use the bedroom only for sleeping and sex.

With many of us working from home now, it can be difficult to avoid, but if possible don’t work, use your computer, or watch TV in your bedroom. The goal is to associate the bedroom with sleep alone, so that your brain and body get a strong signal that it’s time to nod off when you get into bed.

Move bedroom clocks out of view.

Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted when the alarm goes off—is a surefire recipe for insomnia. You can use an alarm, but make sure you can’t see the time when you’re in bed.

Get out of bed when you can’t sleep.

Don’t try to force yourself to sleep. Tossing and turning only amps up your anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, meditating, or taking a bath. When you’re sleepy, go back to bed.

---

Challenge worries and thoughts that fuel insomnia

It’s also helpful to challenge the negative attitudes about sleep and your insomnia problem that you’ve developed over time. The key is to recognize self-defeating thoughts and replace Remember, learning how to stop worrying takes time and practice. You may find it helpful to jot down your own list, taking note of the negative thoughts that pop up and how you can dispute them. You may be surprised at how often these negative thoughts run through your head. Be patient and ask for support if you need it.

---

What to do when insomnia wakes you up in the middle of the night

Many people with insomnia are able to fall asleep at bedtime, but then wake up in the middle of the night. They then struggle to get back to sleep, often lying awake for hours. If this describes you, the following tips may help.

Stay out of your head.

Hard as it may be, try not to stress over your inability to fall back to sleep, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.

Make relaxation your goal, not sleep.

If you find it hard to fall back to sleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your mind and body.

Do a quiet, non-stimulating activity.

If you’ve been awake for more than 20 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.

Postpone worrying and brainstorming.

If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest.

---

Relaxation techniques that can help you get back to sleep

Abdominal breathing.

Breathing deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, can help relaxation. Close your eyes and take deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth.

Progressive muscle relaxation.

Make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold for a count of 10, and then relax. Continue to do this for every muscle group in your body, working your way up from your feet to the top of your head.

Mindfulness meditation.

Sit or lie quietly and focus on your natural breathing and how your body feels in the moment. Allow thoughts and emotions to come and go without judgment, always returning to focus on breath and your body.

These audio meditations can help.

---

Using sleep supplements and medication wisely

When you’re tossing and turning at night, it can be tempting to turn to sleep aids for relief. But before you do, here’s what you need to know.

Dietary supplements for insomnia

There are many dietary and herbal supplements marketed for their sleep-promoting effects. Although they may be described as “natural,” be aware that sleep remedies can still have side effects and interfere with other medications or vitamins you’re taking. For more information, talk to your doctor or pharmacist.

While scientific evidence is still being gathered for alternative sleep remedies, you might find that some of them work wonderfully for you. The two supplements with the most evidence supporting their effectiveness for insomnia are melatonin and valerian.

• Melatonin is a naturally occurring hormone that your body produces at night. Melatonin helps regulate your sleep-wake cycle. Melatonin is also available as an over-the-counter supplement. While melatonin doesn’t work for everyone, it may be an effective insomnia treatment for you—especially if you’re an extreme “night owl” with a natural tendency to go to bed and get up much later than others.
• Valerian is an herb with mild sedative effects that may help you sleep better. However, the quality of valerian supplements varies widely.