7 Solutions To Your Sleep Problems
Make an effort to maintain a consistent pre-bedtime routine. This
can include turning off stimulating activities (including electronic
gadgets) at least an hour before sleep; utilizing relaxation rituals,
such as breath work and progressive relaxation techniques. Keep
a regular, reasonable schedule get to bed as close as possible
to the same time every night (ideally by 10:00 p.m.) and wake up
at roughly the same reasonable time each morning. Sleep docs actually
do call this consistency "good sleep hygiene." Of course,
everyone knows that mothers are the best sleep hygienists in the
world, but what follows are my best tips that even your mother may
A Good Pillow
This is an easy change that can make a huge difference. The first
thing I tell everyone to do is evaluate the pillow situation.
A pillow is supposed to support your head so that your neck, airways,
and spine remain in a natural position with good alignment throughout
the night. A very convincing 2001 German Sleep Medicine Lab study
found that changing to a medium-firm pillow (the firmest
was of no advantage) significantly improved both non-REM and REM
sleep for people who have trouble sleeping without other underlying
conditions or causes.
Bottom line: A pillow should support
your head, not bury it.
Pillows also frequently contribute to allergies, which is a big
no-no when it comes to getting a good night's sleep. A crucial
first step in improving sleep is to scrutinize your pillow for
allergens, the source of which can be the filling (down and feather
allergies are very common) or it can be dust mites inside the
filling. I highly recommend that you examine the range of nonallergenic
foam pillows on the market and get one. When you find one that
suits you, place it inside a dust-mite blocking pillow protector
that goes under the pillow case. But you also want to toss your
pillow in the dryer every few months to kill dust mites. Change
your pillow every couple of years as its unwavering service of
eight hours each day gives it a relatively short life span.
A Better Mattress
When it comes to mattresses, observe the Goldilocks imperative
(not too hard and not too soft); medium-firm is your best
bet. If a mattress is too hard it bites back and can cause pain
and even numbness (limbs falling asleep) at pressure points; likewise,
if a mattress is too soft it becomes more work to move around
and can cause muscle and joint strains. The best mattresses support
all of your body parts equally; even at the heaviest points, your
hips and shoulders.
Unfortunately, couples often have different mattress preferences,
primarily because body weight is a big factor in mattress support.
Sometimes the issue can be resolved with a topper. You can actually
have a firmer mattress with a soft feel by purchasing a bed with
large quilting on the surface or by using a cushioned mattress
pad. Because people over the age of 40 lose elasticity in their
skin, they have less tolerance for a firm mattress surface. Memory
foams, the current darlings of the market, can bring harmony to
the bedroom by adjusting for the individual body type, but many
people find these mattresses to be exceptionally warm, which is
especially unwelcome if you're suffering hot flashes.
As much as I hate to break this news, a recent study from the
Musculoskeletal and Human Physiology Research Lab at Oklahoma
State University showed that price does make a difference. Changing
from a cheaper to a moderately high-priced mattress significantly
improves sleep quality. Another similarly rigorous study showed
that by switching to a better mattress (in this case an adjustable
air-spring/box-spring combination) a full 95 percent of study
participants with chronic low back pain reported reduction in
pain, and 88 percent reported a better nights sleep. This
data was supported by a Consumer Reports survey that found more
than two thirds of people with high-end mattresses were "very
or completely" satisfied with their purchase compared to
one-third of conventional mattress owners. You may want to
take a look at spending priorities: Spending less on bedding and
more on the mattress could be a sleep-inducing strategy.
You can use artificial full-spectrum lights in the morning to
help reset the body clock so you can get to sleep at a more appropriate
time in the evening. In the past decade, pioneering research lead
by Columbia University investigator Michael Terman, Ph.D. established
that the circadian rhythms that help set your sleep patterns are
highly susceptible to changes in exposure to light rays
whether from the sun or from bulbs that mimic the full-spectrum
of sunlight. By exposing the eyes to specially designed fullspectrum
lights (10,000 lux fluorescent bulbs) for 30 minutes in the early
morning, scientists have helped people get to sleep earlier and
stay asleep longer. It is thought that regular exposure to such
light in the morning triggers a more advantageous nighttime release
of melatonin, the hormone that governs your body clock, but the
mechanisms are not fully understood. You may be more familiar
with light therapy for its use in treating seasonal affective
disorder (SAD), a type of depression that shows up in winter months
and stems from sunlight deprivation. Studies have shown that a
course of light therapy treatments can have a dramatically positive
effect on both sleep and symptoms of depression.
Light therapy can truly work wonders for people who find it difficult
to fall asleep before midnight and are sluggish in the morning.
Rapid improvement in falling asleep earlier is often experienced
after just a few days of 30 minutes of exposure to a light therapy
box upon awakening in the morning (see www.cet.org for more information
on the boxes). For people (even teenagers) with more severe insomnia,
who regularly stay awake until 1:00 a.m. or longer, shifting sleep
patterns can involve sensitive timing. So while the procedure
can be done at home, it is a better idea to work with a sleep
specialist to devise the treatment program for serious insomnia.
The treatment also usually requires waking up a little earlier
each morning, which takes real commitment. But if you are miserable
from insomnia, it's worth trying.
On the research forefront are special dawn-simulating sleep masks
with embedded lights that turn on gradually four hours before
the end of sleep. One might think leaving the shades open will
do the same thing, but bare windows raise the possibility that
your bedroom will be flooded with ambient nighttime light, which
poses its own set of problems that are conveniently the subject
of the next discussion, Dark Therapy.
If exposing your eyes to light in the morning helps you fall asleep
earlier and sleep longer, it should come as no surprise that blocking
exposure to light at night can positively influence sleep. Scientists
digging further into the sunlight-melatonin connection have discovered
that the blue spectrum of light has the greatest impact on melatonin
and circadian rhythms. If you are exposed to blue light late at
night from a computer or television screen or a digital
clock near your bed it can wreak havoc with your body clock
making it harder for you to get to sleep and to get up in the
morning. Keep your room pitch dark at night, covering all digital
clock or DVD player readouts. Interestingly, a 2008 study from
the Corvallis Psychiatric Clinic in Oregon showed that using ambertinted
glasses blocked the excitatory blue spectrum of light commonly
encountered during television and computer viewing. Using amber
glasses during evening screen-watching time had a significant
effect in inducing and promoting a good night's sleep.
Here's the Catch-22 of sleep psychology: worrying about not
getting enough sleep can stop you from getting enough sleep. Sleep
docs have even developed a protocol of behavioral modification
that's been shown to work 70 to 80 per cent of the time for people
who can't sleep because of excessive preoccupation with, or apprehension
about, falling sleep.
Here's the drill:
Go to bed only when sleepy.
Get out of bed if you haven't fallen asleep in 20 minutes.
Curtail all nonsleep activities in bed (no watching TV,
eating, planning, or problem solving).
Arise at the same time every morning.
Avoid daytime napping.
Don't get attached to unreal expectations about getting
a perfect sleep every night.
Do not blame insomnia for all daytime problems.
Do not catastrophize (imagine all the bad things that will
happen as a result) after a poor night's sleep.
Finally, if this chapter is making you worry too much about
sleep, put it down and go out for a walk in the sunshine!
Throughout the night, your brainwaves are continually cycling
between slowwave activity of non-rapid eye movement, and
fastwave activity of rapid eye movement. Meditation and relaxation
exercises can significantly help you get back into slowwave
activity if you are awakened in the middle of the night. For getting
to sleep faster or for falling back to sleep in the middle of
the night try meditation or relaxation exercises as a way of hopping
onto the slowwave sleep train that pulls you into the deepest
stages of regenerative rest.
Acupuncture is a helpful adjunct for treating insomnia. Thousands
of research articles attest to the neurochemical effects of acupuncture,
which significantly elevates endorphins to block pain pathways,
promotes the production of chemicals that reduce inflammation,
enhances circulation, and reduces the activity of neuromuscular
spasm. In as much as acupuncture balances the nervous system and
neurotransmitters, there's a logic for its use in promoting relaxation,
which results in a better quality sleep. In China acupuncture
has been used successfully for two thousand years to treat sleep
problems, though this effect has yet to be studied in controlled
trials that are considered the gold standard in Western medicine.
In my own practice I use acupuncture as part of a comprehensive
approach to insomnia in conjunction with other treatments based
on the underlying causes of the sleep problem.
February 10, 2010