Although sleep is one of the most basic human needs, many people treat it as optional. We’ve all had the occasional sleepless night. But when tossing and turning in the night or having trouble falling asleep becomes chronic, you’re likely suffering from insomnia.
Lost sleep can have serious consequences. Studies have found that sleeping less than 7 hours per night is linked to a higher risk of high blood pressure, diabetes, stroke, heart disease and death. Not sleeping enough also increases the risk of accidents on the road, in the workplace and elsewhere.
Many insomnia sufferers seek relief with sleeping pills, among the most commonly prescribed medications in the US. However, these rarely help the situation, adding less than 35 minutes of sleep per night – and they often create new issues, according to the American Academy of Sleep Medicine.
Sleeping pills can be addictive and may lead to even worse sleep once you stop taking them — there’s a rebound effect. They can also cause drowsiness during the day and other problems like dizziness, hallucinations, sleepwalking and sleep-eating.
Behavioral Therapy Beats Sleeping Pills
Fortunately, there are lots of other ways to improve sleep without the side effects seen with medications such as Ambien (zolpidem). For example, studies have found a type of counseling called cognitive behavioral therapy (CBT) to be the best treatment approach for insomnia.
CBT is the “gold standard treatment for insomnia, in which patients meet with a sleep behavioral psychologist to complete an individualized plan involving behavioral changes to improve sleep,” explains Rachel Marie E. Salas, MD, MEHP, FAAN, an associate professor of neurology and nursing at Johns Hopkins Medicine. CBT helps people improve sleep-related behaviors and addresses negative ways of thinking that can make matters worse — like “If I don’t fall asleep soon, there’s no way I’ll make it through the day tomorrow.”
In 2016, the American College of Physicians issued a guideline that CBT was better than sleeping pills for treating insomnia. The professional group noted that CBT was more likely to lead to longer-lasting effects compared to sleeping pills, which are only meant to be taken for 4 to 5 weeks at most.
It’s also important to deal with ongoing stress or anxiety, says Eddie Reece, MS, LPC, DCC, a psychotherapist in private practice near Atlanta. “I think most people with insomnia, including me, are fairly anxious people.”
He points out to patients that “it’s not just what you’re doing during the night that matters — if you’re revved up all day until it’s time to go to bed, it’ll be difficult to get to sleep.”
Additionally, people are often unaware of how their surroundings and habits may be affecting their sleep. Amy Rothenberg, ND, a Connecticut-based naturopathic physician, asks patients with insomnia to first adopt regular sleep and wake times that they should follow every night, including weekends, and to make sure that their mattress and pillows are comfortable. If noise is a common problem, a fan or white noise machine can be helpful.
Turn Those Electronics Off!
She also advises patients to turn off all electronics at least 1 or 2 hours before bedtime. “This is extremely challenging for many people, but research now confirms that constant screen time, especially late into the evening, may interfere with the quality and quantity of sleep,” she notes. “The light from devices will have your brain thinking it’s not time for bed. Then the stress of reading emails or watching shows adds cortisol to the bloodstream, which further interferes with sleep.”
Unplugging in the hours before bed has made all the difference for Rich Mallard, a customer service rep who used to stay glued to his laptop right up until he turned off the lights — and often ended up tossing and turning for half the night. Since he started shutting the screen down a couple of hours before bed, he says, his sleep has improved dramatically.
Dr. Rothenberg also recommends regular exercise of just about any type — walking, running, swimming, dancing, biking — which is associated with better sleep.
Apps or online resources that guide you through breathing exercises or mindfulness meditation may also help calm your mind to prepare you for a good night’s sleep. UCLA’s Mindfulness Awareness Research Center has free guided meditations you can download.
Reece teaches patients various techniques like these, and has them pick the ones they like best and practice them when they have sleep trouble. “Then, when they’re not sleeping, instead of that being a bad thing, it’s great because now they have time to practice,” he says.
He also encourages patients to focus more on rest than sleep, which can help ease the anxiety that arises from not being able to sleep. “You have much more control over resting than you do going to sleep — and it just so happens that if you rest well at night, you might just fall asleep!”
Natural Remedies to Promote Sleep
As for natural remedies, the herb valerian has long been used as a mild sedative that can help with sleep problems. “We generally recommend standardized extracts, which are available at health food stores, with 1 to 2 caps taken before bedtime,” says Dr. Rothenberg. “Valerian is gently relaxing — it won’t knock someone out like a pharmaceutical sleeping aid, and it should not cause morning grogginess.”
Another natural substance that may be helpful is melatonin, a “hormone that helps to keep biorhythms including the wake/sleep cycle in good working order.” The recommended dosage varies for each person, as some need more while others need less.
In addition, Dr. Salas offers the following tips to improve your chances of sleeping well:
- Make your room darker. Light interferes with a person’s circadian rhythm. He recommends using lamps and dimmers in the evening, and to remove glowing bedside clocks.
- Limit caffeine after noon.
- Wash bed sheets every 1 to 2 weeks.
- Create a bedtime routine. For example, take a warm shower or bath, don your PJs, and do some relaxing reading.
- Keep your room somewhere between 65 to 69 degrees, which is an ideal range for most people. (Being too hot or too cold can interfere with sleep.)
- Spicy or fatty meals may cause you to wake up with indigestion. Eat 3 hours before bed. Same goes for alcohol. If you’re hungry before bed, a light snack such as yogurt or cereal is okay.
- Lastly, talk with your healthcare provider. Insomnia is interesting because while it can be a sleep disorder itself, it can also be a symptom of something else that often can be treated. If improving your sleep practices, behaviors, environment and patterns does not improve your sleep, it is time to seek medical advice.
Tori Rodriguez, MA, LPC is an Atlanta-based journalist, psychotherapist & health coach