DEAR DOCTOR K:
For the past few months I’ve been having a lot of trouble falling asleep, basically every night. I’m groggy and can’t concentrate on anything all day. I’d give anything for a good night’s rest.
Trouble falling asleep often occurs because a person is overstimulated. There may be unusual stresses in your life that cause a lot of anxiety. With most of my patients, however, there’s no one thing they can put their finger on that explains why they are lying there having trouble falling asleep. Here are some of the things I tell my patients to do, and not to do, to fall asleep more easily:
- Go to bed and wake up at the same time every day, and avoid naps. Get your body used to a regular sleep pattern.
- Cut down on caffeinated beverages during the day. Believe it or not, having caffeine after noon can make you sleep less soundly 10 hours later.
- Avoid heavy meals before bedtime.
- Eliminate alcohol before bedtime. A little “nightcap” may make you feel sleepy right after you take it, but it has a stimulating effect two to four hours later that can interrupt your sleep.
- Exercise daily, preferably early in the day. Regular exercise improves your sleep, although vigorous exercise in the hours just before bedtime can be stimulating and make it hard to fall asleep.
- Eliminate noise or bright lights that might be disrupting your sleep, even if you are not aware of it.
- Use a fan, white noise machine or a recording of nature sounds to lull you to sleep. (By the way, I do this myself, and I’m convinced it helps me sleep more soundly.)
- Maintain a comfortable temperature in your bedroom, slightly on the cool side.
- Try not reading or watching TV in bed. They may be stimulating you even if you think they are relaxing you. (But if you don’t have trouble falling asleep and love to read or watch TV in bed, there’s no reason not to.)
If these changes don’t do the trick, give behavioral therapies a try:
Relaxation therapy: Special techniques help quiet your mind and relax your muscles since stress and anxiety often contribute to insomnia.
Sleep restriction program: This program initially permits only a few hours of sleep per night, then gradually increases your nightly sleeping time.
Reconditioning programs: These programs condition you to associate your bed only with sleeping and sex.
What about sleeping pills? Your doctor may prescribe them. Some sleeping pills go to work rapidly and therefore help people fall asleep. However, most sleeping pills are for short-term or occasional use. Most of my patients don’t need to try pills after they make the adjustments in their lifestyle that I suggest above. I hope the same is true with you.