Sleep or Suffer
At some point, nearly everyone struggles to sleep. Tips on how to get your snooze schedule back on track and on how to avoid sleepless nights.
By November 1, 2003 - last reviewed on June 9, 2016published
Recognize that the sleep system tends to right itself after a few nights of insomnia if you do not adjust your schedule.
- Set a regular bedtime—and keep it. Your body needs reliability.
- Less is more. Keeping your wake-up time constant but going to bed one hour later will help 25 percent of insomniacs within one to two weeks. Prepare to feel sleepy at times and avoid driving then. After two weeks, add back the time in half-hour increments.
- Look on two or three nights of insomnia as a gift—time to get done all that you have to get done. Insomnia may be functional, a signal that you need to attend to whatever woke you up.
- Put sleep in the background of your life. Don't monitor it, don't evaluate it. "Put it in an envelope and don't open it for two weeks," says Spielman.
- If you're an adolescent or student who has difficulty getting up and functioning in the morning, your insomnia may be a sleep-phase problem. Maintain your wake time and immediately apply bright light for at least 15 minutes to reset your body clock. Progressively move your sleep time earlier and follow wake-up with a strong pulse of light.
- Another way to deal with sleep-phase problems: reset your body clock by taking melatonin four hours before bedtime. Again, move up your bedtime a little bit each day.
- If you are an older adult troubled by early morning awakening, you may need to reset biological rhythms and "phase-delay" bedtime by going to sleep one hour later. Do nothing else to correct your sleep problem.
- Get more exercise—physical and mental. It primes the sleep homeostat. It's a myth that exercise at bedtime is bad. (Sex, among other things, is great exercise!)
- Jack up your body temperature with a warm bath before bed. Exaggerating the normal drop in body temperature that accompanies lying down helps sleep.
- Learn simple meditation and practice it before bedtime; it cuts down nervous-system arousal.
- Keep your bedroom dark, especially as you get older. Even small amounts of light and noise can disturb sleep as you age.
- If you awaken in the middle of the night, use the time for creative problem-solving. The "bleeding" of unconsciousness into wakefulness makes thought less rational and freer at this time.
- You can take the sting out of a bad night with the judicious use of modafinil (Provigil®), a stimulant developed to help narcoleptics stay awake during the day. Taking it after a sleepless night helps ease anxiety about insomnia and primes the sleep homeostat.
- Don't fight insomnia. The homeostat makes sleep a self-reparative system—if you stay out of its way.
- Don't worry about the consequences of not sleeping. Worrying about insomnia can create insomnia.
- Don't overheat your environment. Sleep loves cold. Keep your bedroom cold but load up on blankets.
- Don't sleep with your pets! Animal dander can create allergies that manifest only at night, and the movement of any pet on your bed can wake you up.
- Do not sleep late or nap to make up for a bad night. It de-primes the sleep homeostat and reduces the need for sleep the next night, setting the stage for recurrent insomnia.
- For the same reason, don't make up for an acute bout of insomnia by going to bed early.
- Do not try to sleep by drinking alcohol. Yes, it's a great relaxant—but it is metabolized so quickly it creates rebound insomnia; it's so fast-acting you'll be up in four short hours.
- Don't stay in bed waiting for sleep. It's not true that the more time you spend in bed, the more sleep you'll get.
- Don't catastrophize. While you are taking steps to repair your sleep system, abandon the notion that you can't function on less sleep; sleeping less as therapy won't feel good but it will re-prime the sleep homeostat.
- Be careful with caffeine: Limit yourself to one cup of coffee in the morning. At age 18, caffeine has a half-life of 4.5 hours, which increases with age. Gradually eliminate caffeine altogether if you have trouble sleeping.
- Don't hesitate to take a sleeping pill if an acute bout of insomnia doesn't self-correct in a few days.