There is a range of strategies to overcome difficulty falling asleep or sleeping through the night. It would be unrealistic to follow all of them. But it will help to consider all the suggestions, and then to select a number to use. The effect of sleeplessness on your energy, concentration, resistance to illness, and feeling of well-being deserves attention.
The following suggestions are organized into 4 categories:
- Overall self-maintenance.
- Patterns of rest and sleep.
- Bedtime ritual.
- Strategies for when you don’t fall asleep.
Strategies involving your overall self-maintenance:
- Set aside a specific time each day to schedule your tasks and obligations.
- Learn a relaxation technique such as progressive muscle relaxation, deep breathing, Tai Chi, Yoga, or meditation. Practice it daily.
- Exercise regularly. Your exercise should be consistent with your physical condition and/or limitations. Brisk walking, swimming, and bicycling are all excellent exercises. Exercise at least three times per week. Make it a priority.
- Do not overuse stimulants such as coffee, soda, chocolates, and cigarettes as these substances over-stimulate the nervous system.
- If you need help with bad habits, unresolved emotions or feeling disorganized, seek help from a psychotherapist. This does not make you weak. It makes you a willing problem-solver.
- Use your bed only for sleep. Do not eat, study, or worry in bed. Reserve your bed for sleep so you will strongly associate bed and sleep.
Strategies involving your patterns of rest and sleep:
Avoid daytime naps. Naps diminish your need for nighttime sleep, and reinforce irregular sleep patterns. As long as you are awake, your body is building up a homeostatic need for non-REM sleep. Daytime naps will discharge this homeostatic need, and may make it more difficult for you to sleep at night.
Establish the same rising time every morning. Do not even vary this by more than an hour or two on weekends. This will establish a rhythmic pattern that will help ensure that you will be sleepy at night so you can be regular in your pattern of wakefulness and sleep.
Make your bedroom attractive and comfortable. Reduce noises and lights, and maintain a comfortable room temperature. Be sure your bed and mattress are comfortable and well suited to you.
Strategies involving a bedtime ritual:
Lie down to sleep only when you feel sleepy. Do not let yourself associate lying in bed with wakefulness, restlessness, and worry.
Use the last 15 – 30 minutes before bedtime for a pre-bedtime ritual. Activities that may be included are: shower, put on night clothes, brush teeth, make tomorrow’s lunch, or listen to a favorite, relaxing musical piece.
Avoid all stimulants for the 4 hours preceding bedtime. Vigorous exercise can be a stimulant, so it may be best to plan your regular exercise earlier in the day.
Avoid heavy meals before bed. A glass of milk or a slice of cheese (food containing calcium) may be helpful. Alcohol is not helpful. It may cause drowsiness but often leads to disturbed sleep and frequent awakenings.
When you go to bed, assume a comfortable position, close your eyes, and use a relaxation method. Imagine a pleasant, relaxing scene, such as lying on a beach, and experience this imagery with all your senses. Think about what drowsiness, heaviness, and sleepiness feel like. Keep your eyes closed and avoid looking at the clock.
Strategies for times when you do not fall asleep:
When you first realize you are not dropping off to sleep, avoid self-defeating thoughts such as “It’s happening again,” or “I’ll never sleep.” Try to take a matter-of-fact attitude. Think, “As long as I lie comfortably with my eyes closed, I am allowing my eyes and body to rest, and my body is building up its homeostatic need for sleep. Sleep is inevitable.”
If restlessness ensues or sleeplessness continues, rise and return to bed later when you are sleepy. When you rise, go to another room and occupy yourself with boring or monotonous tasks. Avoid pleasurable or exciting activities such as eating or drinking. If you read, choose something that will not remind you of work, school, politics, economics or social issues.
If restlessness again ensues after returning to bed, repeat the above procedure as many times as necessary.
NOTE: Persistent insomnia may require medication. Although there is a risk that medication may be habit forming, this risk may be outweighed by the risk to your health and well-being of continued disrupted sleep. The drugs used in over-the-counter sleep medications have been demonstrated to be safe, but may not be effective. If you feel you need medicine, consult a physician and agree on a strategy.
A Special Note about Bedtime Reading
Many practitioners recommend against bedtime reading. A somewhat different approach is recommended here. If you do read before sleep, do not read any suspenseful fiction, as this may motivate you to remain awake “to see what happens.” In addition, do not read anything that will remind you of work, school, politics, economics, social issues or commerce. You may well ask, “What is left?” Answer: Read about the natural world. This is a perfect time to read about astronomy, earth science, dinosaurs, rocks and shells, or the oceans. These topics are fascinating, but not in the same way as a suspenseful novel. Since the information you read will typically be new to you, it has a tendency to tire your mind, without drawing your attention to the types of topics that could stimulate worry or rumination (work, school, politics, economics, social issues or commerce).