Sleep Problems

Sleep problems can occur at any age and have a variety of causes.  Sleep problems may occur because we neglect to allow enough sleep time.  For example, we may stay up to watch the late night talk show and then get up at 6 a.m. for work the next morning.  Sleep quality may suffer because we ate or drank too much the night before and are awakened by acid reflux or indigestion.  We may have had a stressful day at work or have problems in our relationships that keep our thoughts running and create muscle tension and bodily stress that interferes with sleep.  There may be a physical condition, such as chronic pain or obstructive sleep apnea, which interrupts sleep multiple times nightly.  Sometimes, we become conditioned to bad habits around bedtime, such as routinely staying up too late or falling into persistent worry when we go to bed.  The fear of not sleeping can even interfere with falling asleep!


What is considered normal sleep  may vary with age, but optimal sleep for most people is between 7-9 hours nightly, and includes episodes of deep sleep and REM sleep. REM refers to Rapid Eye Movement, or dream sleep, when the eyes typically move but other parts of the body remain still.  Deep sleep occurs when brain waves slow and take the pattern of delta waves.  Good sleep quality and the feeling of restfulness come with sufficient deep sleep,  though the amount of deep sleep decreases naturally with age.  Many of the body's restorative functions and the brain's consolidation of new learning occur during the deep sleep phase. 

Insomnia refers to a persistent sleep problem.  There are several types of insomnia, but they are typically grouped into three main types.  Onset insomnia is a chronic delay in falling asleep when you first go to bed for the night.  Interval insomnia is awakening at various times throughout the night and difficulty returning to sleep.  Early morning awakening is awakening much earlier than you normally would awake or need to awake, say, at 3 or 4 a.m., and not being able to return to sleep.  Sleep problems and insomnia may be a feature of many mental and physical health disorders.   People with depression and anxiety disorders often report insomnia or intermittent sleep problems.  Alcohol use disorder and other drug use habits may affect the quality and duration of sleep.  On the other hand, sleep problems and insomnia may trigger a depression or use of alcohol or other drugs as a way of "treating" the sleep problem. 

In any case, there are many ways of dealing with sleep problems.  A few of the most effective ways to manage sleep problems and insomnia are described below, but for a more thorough description of the many cognitive and behavioral approaches used to treat sleep problems, see the links under Sleep Problems in the Links & Resources tab.

Ten Ways You Can Improve Your Sleep

          1)  Go to bed and get up on a regular schedule, preferably within an hour's range each night.  For example, go to bed consistently between 10 p.m. and 11 p.m. and get up
                between  6 a.m. and 7 a.m.   Even if you have not slept more than a couple of hours all  night, still get up by 7 a.m.

          2)  Avoid creating backward sleep and wake patterns.  For example, don't go back to sleep through the late morning and don't take long naps during the day.  Don't work on
                your pet project for hours when you wake up at 2 a.m.

          3)  Make the bed a place only for sleep (or sex). Don't get in the habit of doing other work, especially financial activities or other  worrisome matters, when you are in bed.

          4)  If you are a worrier, designate a time well before bedtime when you can worry.  Write out a list of your "worries" and things you need to attend to the next day so that you
                are less prone to dwell on them after you turn the lights out.   Just remind yourself that you have written them down!

          5)  If you can't fall asleep within about 15-20 minutes, get out of bed and do something passive, such as reading a book under low light, listening to music or a boring podcast,
               perusing  your tablet or cellphone with low background lighting, etc.  Return to bed when you start to nod off or feel sleepy.  If you still can't fall asleep, go through the
               same process.

          6)  Avoid any foods or drinks with much caffeine for at least 7 hours before you go to bed.  Avoid drinking alcohol excessively.

          7)  Eat moderately in the evening and allow a couple of hours for food to digest before you go to bed.

          8)  Don't exercise vigorously for at least 4 hours before your bedtime.  Follow a relaxing bedtime ritual that does not take a lot of thought or energy, such as reading
                something light or listening to some calming music.

          9)  Do a simple relaxation technique to help yourself fall asleep.  For example, count your breaths or focus on your body relaxing more with each outbreath.

          10)  Don't watch the clock or look at the time when you wake up in the middle of the night.  That will only tend to inspire more concerns about losing sleep.


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