Simple Rules (and Brand New Ideas) for Getting Better Sleep
Illustration: Script & Seal
A restful night starts with a relaxing room. These tips from Cathy Goldstein, MD, sleep expert and clinical assistant professor of neurology at the University of Michigan, will set you up for sleep success.
Thermostat
The optimal room temperature is between 60 and 68 degrees—any hotter, and your body may compensate by cooling you down via sweating, a major sleep disturber. On the flip side, a too-chilly room will cause your body to start shivering in an attempt to warm you up.
Window Shades
If light comes in through your window, hang blackout curtains or shades. Even minor light pollution from, say, a neighbor’s porch is enough to affect your sleep.
Alarm Clock
Red or amber displays are better than blue or green since warmer hues are less disruptive. If your wake-up call comes from your phone, set it to Do Not Disturb so you’re not prematurely woken by lights or sounds.
Fan
White noise is the kind of consistent sound that lulls you to sleep. Try a white noise machine or Goldstein’s favorite form of steady sound: a fan. Not only is the whir relaxing, but you’ll also stay cool, another key factor for a restful night.
Pillows
Dust mite allergies are common and can prevent you from breathing and sleeping well; pillow and mattress protectors from brands like AllerEase may help sufferers sleep more soundly.
Mattress
If you have back problems, you may favor a firmer mattress. If you sleep hot, you may prefer conventional coils—they typically don’t trap heat the way many foam ones do. Still, there’s no strong science proving one type of mattress is ideal for sleep, so stick with whatever feels best.
Pets
Some people claim their furry friend helps them sleep, but for others, dogs and cats should stay out of the bedroom (or at least the bed)— they may wake you up with their movements or noises.
Lightbulbs
Energy-saving LED and CFL bulbs tend to emit significant amounts of blue light, so turn them off two hours before tucking in, and use bedside lamps with traditional incandescent bulbs (no more than 60 watts). Bulbs that give off “warm spectrum” light may be even less rousing to your brain.
TV
Televisions emit blue light, and they can be psychologically stimulating to watch right before bed (and tempting to turn to in the middle of the night). If you can’t give yours up, try not to fall asleep with it on, and keep the remote out of reach.
Phone
Intermittent sounds tend to be especially disruptive to sleep, and research also suggests that if you’re emotionally connected to a sound (say, the email ping that reminds you of work stress), it may wake you more easily. Again, the Do Not Disturb setting (or airplane mode) is the way to go.
Chargers
Even the glow from chargers and indicators can negatively impact your sleep, so unplug and cover up any little lights you can.
The A-B-Zzz's of Sleep
A refresher course in the rules of sound slumber.
No miracle mantra or ingenious gadget will give you a better night’s rest if you’re not following the basic principles of sleep hygiene. The good news: They’re simple. The bad news: They’re not necessarily easy, especially if you like to reward yourself at the end of a long day with an extended session of screen time and Chardonnay. But keep your eyes on the prize! Better rest makes you feel more vital, alert, and present in your life, which is the greatest reward of all. Here's the drill:
Wake up and go to bed at the same time every day. Yes, even on weekends. “Your brain does nothing accidentally,” says W. Chris Winter, MD, a neurologist in Charlottesville, Virginia, and author of The Sleep Solution. “It likes everything scheduled so it knows what’s coming and can prepare.”
Seek natural light. Throw open the shades as soon as you awake, and eat lunch outside (or sit by the window). These habits send a strong reminder to your brain that the sun is up, says Winter: “It sets your sleep-wake clock, so your body keeps you alert during the day and gets you to sleep at night.”
Exercise. The National Sleep Foundation recommends aerobic activities such as running, brisk walking, or cycling (aim for at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity each week), plus strength training and yoga. In a 2004 Harvard study, insomniacs who did daily yoga sessions for eight weeks dozed off faster and spent more time asleep.
Avoid caffeine. If you must indulge, have your last latte by early afternoon. On average, caffeine has a half-life of five hours, so if you drink an after-dinner coffee at 7 p.m., you could still have more than 40 milligrams of caffeine zinging through your system at midnight.
Cut back on the cocktails. Alcohol causes the body to increase the chemical adenosine, which is linked to sleep. However, once the alcohol leaves your system, you’ll be jolted awake again. It also disrupts your sleep cycle, so you spend less time in restorative REM sleep.
Photo: David Arky
Sleep or Else?!?!
There you are again, staring at the ceiling, and the sandman cometh not. You’re calculating how many hours you’d get if you conked out right now, fearing you’ll be a hideous, baggy-eyed, mumbling, bumbling zombie all day tomorrow. If you’re one of the 15 million to 25 million Americans who have chronic insomnia—meaning you’ve had difficulty falling or staying asleep three or more times per week for at least three months, a condition that disproportionately affects women (blame hormones, depression, anxiety)—you’re familiar with the bitter irony. “The more you can’t sleep, the more you think about the fact that you can’t sleep. It becomes a vicious cycle,” says Reena Mehra, MD, of the Sleep Disorders Center at Cleveland Clinic.
Cognitive-behavioral therapy for insomnia (CBT-I) is as effective as prescription drugs (if not more so), has no demonstrated side effects, and treats sleep woes long-term, says Mehra. In 2016, the American College of Physicians recommended CBT-I as the first-line remedy for adults with chronic insomnia—after a systematic review of over a decade’s worth of randomized controlled trials. The program employs three main components: healthy sleep habits, relaxation techniques, and changing the way you think about sleep.
Like any kind of cognitive-behavioral therapy, CBT for sleep involves reframing harmful thoughts. Instead of regarding your hours in bed as time that must be spent unconscious, consider it an opportunity for rest, advises neurologist W. Chris Winter, MD. “If you can find it in yourself to accept sleepless moments as peaceful downtime, this can help you get off the anxiety cycle,” Winter says. In fact, while we all know how ultraimportant sleep is, some studies show that quiet rest can also be beneficial to your brain. Let that information console you, and remind yourself you’re enjoying being in your comfy, cozy bed (aren’t you glad you sprang for high-thread-count sheets?). This is your time— no one is asking you for anything, and there’s nowhere you have to be. It’s a rare chance to relax.
Need some extra coaching? Your local hospital may have behavioral sleep medicine specialists or psychologists on staff who offer CBT-I. You can also look for group sessions through your healthcare provider. If you can’t find a specialist in your area, try Go! To Sleep, a six-week Cleveland Clinic–developed online program ($40; Shop.ClevelandClinicWellness.com), to help you reset your thoughts and behaviors to make sleep happen. Research on the therapy published in the journal Telemedicine and e-Health in 2017 showed it helped people significantly improve their insomnia, results that continued over four months. Help is out there. And that’s a reason to rest a little easier.
A Bitter Pill
For chronic insomniacs, sleep medication is not a magic bullet.
About 4 percent of adults in the U.S. take a prescription sleeping pill in any given month, according to a 2013 report from the CDC. While pills can help regulate your sleep for short periods—say, while you’re in Europe for a week—they can impair your functioning the next day, sometimes in ways you don’t even recognize. “Sleeping pills can basically make you lose consciousness, which will have side effects for the brain,” says Michael Grandner, PhD, director of the Sleep and Health Research Program at the University of Arizona College of Medicine. Many sleep meds slow brain activity by binding to the same neural receptors targeted by Valium, Xanax, and some types of anesthesia. Since the drugs suppress motor movement, they may leave you uncoordinated and accident-prone the next morning. Plus, studies indicate that long-term use may have lasting consequences for your memory and increase your risk of cognitive decline, which is why they’re intended as a short-term solution only.
Moreover, as Grandner points out, “over time the effects weaken, and people become terrified of what will happen when the pills stop working altogether—which can make the sleeplessness even worse.” Chronic insomniacs, he says, would be better served by a program like cognitive-behavioral therapy for insomnia, which gets to the root of the problem by attempting to reframe the thoughts, beliefs, and behaviors that keep someone awake. Another side-effect-free strategy is spraying your pillow with lavender oil, says neurologist W. Chris Winter, MD; studies have shown that the scent can encourage sleep. This really pays off when you’re traveling, Winter says. Use the oil every night at home, then bring it on the road to mist your hotel pillow. You’ll help trick your brain, which associates scents with memory, into thinking you’re snuggled in your own bed.
Illustration: Script & Seal
In the Wee, Small Hours
Why it’s always darkest before the dawn.
In his poem “Four in the Morning,” Wislawa Szymborska calls 4 a.m. “The hollow hour. / Blank, empty. / The very pit of all other hours.” If that part of the night regularly finds you excruciatingly alert, you have sleep-maintenance insomnia (as opposed to sleep-onset insomnia, suffered by those who have difficulty falling asleep). Your eyes are popping open because the sleep pressure that built up and eventually led you to fall asleep is now waning, says sleep researcher Michael Grandner, PhD. This pressure mostly dissipates within a couple of hours, leaving you more vulnerable to waking up for prolonged periods during the second half of the night.
As sleep-maintenance insomniacs know all too well, those predawn hours are prime time for crafting catastrophic scenarios about nuclear winter or your 401(k). That dread isn’t just the loneliness of feeling like the only one in the world who’s awake. It’s also neurobiology: “Our brain doesn’t function in the middle of the night like it does during the day,” says Grandner. “The ‘mature’ parts of your brain that help you maintain perspective aren’t awake in the middle of the night, so you blow things out of proportion. It’s a bad thing to be awake while reason sleeps.”
Middle-of-the-night wakers should pay special attention to their sleeping environment, as well as caffeine and alcohol consumption, says Grandner. If you’re still waking too early, try these tips to find your way back to the land of Nod:
Get out of bed. For some people, “the worst thing they can do is lie there trying to get back to sleep,” says Grandner, as that could train your brain to associate your bed with sleeplessness. Take this opportunity to rearrange your spice rack or open a book—just make sure it’s nothing too disturbing or suspenseful.
If you’re anxious, write down what you’re ruminating about, whether it’s a chore you forgot to do (change the furnace filter) or something more abstract (what will happen to the kids if you die). Getting your concerns out of your head and onto the page helps free your mind so you can settle back down.
When you feel sleepy, return to the bedroom. Stretch out, breathe deeply, and go to your happy place: Imagine yourself in any setting where you feel a sense of peace, whether it’s a beloved vacation spot or under your favorite tree.
Thermostat
The optimal room temperature is between 60 and 68 degrees—any hotter, and your body may compensate by cooling you down via sweating, a major sleep disturber. On the flip side, a too-chilly room will cause your body to start shivering in an attempt to warm you up.
Window Shades
If light comes in through your window, hang blackout curtains or shades. Even minor light pollution from, say, a neighbor’s porch is enough to affect your sleep.
Alarm Clock
Red or amber displays are better than blue or green since warmer hues are less disruptive. If your wake-up call comes from your phone, set it to Do Not Disturb so you’re not prematurely woken by lights or sounds.
Fan
White noise is the kind of consistent sound that lulls you to sleep. Try a white noise machine or Goldstein’s favorite form of steady sound: a fan. Not only is the whir relaxing, but you’ll also stay cool, another key factor for a restful night.
Pillows
Dust mite allergies are common and can prevent you from breathing and sleeping well; pillow and mattress protectors from brands like AllerEase may help sufferers sleep more soundly.
Mattress
If you have back problems, you may favor a firmer mattress. If you sleep hot, you may prefer conventional coils—they typically don’t trap heat the way many foam ones do. Still, there’s no strong science proving one type of mattress is ideal for sleep, so stick with whatever feels best.
Pets
Some people claim their furry friend helps them sleep, but for others, dogs and cats should stay out of the bedroom (or at least the bed)— they may wake you up with their movements or noises.
Lightbulbs
Energy-saving LED and CFL bulbs tend to emit significant amounts of blue light, so turn them off two hours before tucking in, and use bedside lamps with traditional incandescent bulbs (no more than 60 watts). Bulbs that give off “warm spectrum” light may be even less rousing to your brain.
TV
Televisions emit blue light, and they can be psychologically stimulating to watch right before bed (and tempting to turn to in the middle of the night). If you can’t give yours up, try not to fall asleep with it on, and keep the remote out of reach.
Phone
Intermittent sounds tend to be especially disruptive to sleep, and research also suggests that if you’re emotionally connected to a sound (say, the email ping that reminds you of work stress), it may wake you more easily. Again, the Do Not Disturb setting (or airplane mode) is the way to go.
Chargers
Even the glow from chargers and indicators can negatively impact your sleep, so unplug and cover up any little lights you can.
The A-B-Zzz's of Sleep
A refresher course in the rules of sound slumber.
No miracle mantra or ingenious gadget will give you a better night’s rest if you’re not following the basic principles of sleep hygiene. The good news: They’re simple. The bad news: They’re not necessarily easy, especially if you like to reward yourself at the end of a long day with an extended session of screen time and Chardonnay. But keep your eyes on the prize! Better rest makes you feel more vital, alert, and present in your life, which is the greatest reward of all. Here's the drill:
Wake up and go to bed at the same time every day. Yes, even on weekends. “Your brain does nothing accidentally,” says W. Chris Winter, MD, a neurologist in Charlottesville, Virginia, and author of The Sleep Solution. “It likes everything scheduled so it knows what’s coming and can prepare.”
Seek natural light. Throw open the shades as soon as you awake, and eat lunch outside (or sit by the window). These habits send a strong reminder to your brain that the sun is up, says Winter: “It sets your sleep-wake clock, so your body keeps you alert during the day and gets you to sleep at night.”
Exercise. The National Sleep Foundation recommends aerobic activities such as running, brisk walking, or cycling (aim for at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity each week), plus strength training and yoga. In a 2004 Harvard study, insomniacs who did daily yoga sessions for eight weeks dozed off faster and spent more time asleep.
Avoid caffeine. If you must indulge, have your last latte by early afternoon. On average, caffeine has a half-life of five hours, so if you drink an after-dinner coffee at 7 p.m., you could still have more than 40 milligrams of caffeine zinging through your system at midnight.
Cut back on the cocktails. Alcohol causes the body to increase the chemical adenosine, which is linked to sleep. However, once the alcohol leaves your system, you’ll be jolted awake again. It also disrupts your sleep cycle, so you spend less time in restorative REM sleep.
Photo: David Arky
Sleep or Else?!?!
There you are again, staring at the ceiling, and the sandman cometh not. You’re calculating how many hours you’d get if you conked out right now, fearing you’ll be a hideous, baggy-eyed, mumbling, bumbling zombie all day tomorrow. If you’re one of the 15 million to 25 million Americans who have chronic insomnia—meaning you’ve had difficulty falling or staying asleep three or more times per week for at least three months, a condition that disproportionately affects women (blame hormones, depression, anxiety)—you’re familiar with the bitter irony. “The more you can’t sleep, the more you think about the fact that you can’t sleep. It becomes a vicious cycle,” says Reena Mehra, MD, of the Sleep Disorders Center at Cleveland Clinic.
Cognitive-behavioral therapy for insomnia (CBT-I) is as effective as prescription drugs (if not more so), has no demonstrated side effects, and treats sleep woes long-term, says Mehra. In 2016, the American College of Physicians recommended CBT-I as the first-line remedy for adults with chronic insomnia—after a systematic review of over a decade’s worth of randomized controlled trials. The program employs three main components: healthy sleep habits, relaxation techniques, and changing the way you think about sleep.
Like any kind of cognitive-behavioral therapy, CBT for sleep involves reframing harmful thoughts. Instead of regarding your hours in bed as time that must be spent unconscious, consider it an opportunity for rest, advises neurologist W. Chris Winter, MD. “If you can find it in yourself to accept sleepless moments as peaceful downtime, this can help you get off the anxiety cycle,” Winter says. In fact, while we all know how ultraimportant sleep is, some studies show that quiet rest can also be beneficial to your brain. Let that information console you, and remind yourself you’re enjoying being in your comfy, cozy bed (aren’t you glad you sprang for high-thread-count sheets?). This is your time— no one is asking you for anything, and there’s nowhere you have to be. It’s a rare chance to relax.
Need some extra coaching? Your local hospital may have behavioral sleep medicine specialists or psychologists on staff who offer CBT-I. You can also look for group sessions through your healthcare provider. If you can’t find a specialist in your area, try Go! To Sleep, a six-week Cleveland Clinic–developed online program ($40; Shop.ClevelandClinicWellness.com), to help you reset your thoughts and behaviors to make sleep happen. Research on the therapy published in the journal Telemedicine and e-Health in 2017 showed it helped people significantly improve their insomnia, results that continued over four months. Help is out there. And that’s a reason to rest a little easier.
A Bitter Pill
For chronic insomniacs, sleep medication is not a magic bullet.
About 4 percent of adults in the U.S. take a prescription sleeping pill in any given month, according to a 2013 report from the CDC. While pills can help regulate your sleep for short periods—say, while you’re in Europe for a week—they can impair your functioning the next day, sometimes in ways you don’t even recognize. “Sleeping pills can basically make you lose consciousness, which will have side effects for the brain,” says Michael Grandner, PhD, director of the Sleep and Health Research Program at the University of Arizona College of Medicine. Many sleep meds slow brain activity by binding to the same neural receptors targeted by Valium, Xanax, and some types of anesthesia. Since the drugs suppress motor movement, they may leave you uncoordinated and accident-prone the next morning. Plus, studies indicate that long-term use may have lasting consequences for your memory and increase your risk of cognitive decline, which is why they’re intended as a short-term solution only.
Moreover, as Grandner points out, “over time the effects weaken, and people become terrified of what will happen when the pills stop working altogether—which can make the sleeplessness even worse.” Chronic insomniacs, he says, would be better served by a program like cognitive-behavioral therapy for insomnia, which gets to the root of the problem by attempting to reframe the thoughts, beliefs, and behaviors that keep someone awake. Another side-effect-free strategy is spraying your pillow with lavender oil, says neurologist W. Chris Winter, MD; studies have shown that the scent can encourage sleep. This really pays off when you’re traveling, Winter says. Use the oil every night at home, then bring it on the road to mist your hotel pillow. You’ll help trick your brain, which associates scents with memory, into thinking you’re snuggled in your own bed.
Illustration: Script & Seal
In the Wee, Small Hours
Why it’s always darkest before the dawn.
In his poem “Four in the Morning,” Wislawa Szymborska calls 4 a.m. “The hollow hour. / Blank, empty. / The very pit of all other hours.” If that part of the night regularly finds you excruciatingly alert, you have sleep-maintenance insomnia (as opposed to sleep-onset insomnia, suffered by those who have difficulty falling asleep). Your eyes are popping open because the sleep pressure that built up and eventually led you to fall asleep is now waning, says sleep researcher Michael Grandner, PhD. This pressure mostly dissipates within a couple of hours, leaving you more vulnerable to waking up for prolonged periods during the second half of the night.
As sleep-maintenance insomniacs know all too well, those predawn hours are prime time for crafting catastrophic scenarios about nuclear winter or your 401(k). That dread isn’t just the loneliness of feeling like the only one in the world who’s awake. It’s also neurobiology: “Our brain doesn’t function in the middle of the night like it does during the day,” says Grandner. “The ‘mature’ parts of your brain that help you maintain perspective aren’t awake in the middle of the night, so you blow things out of proportion. It’s a bad thing to be awake while reason sleeps.”
Middle-of-the-night wakers should pay special attention to their sleeping environment, as well as caffeine and alcohol consumption, says Grandner. If you’re still waking too early, try these tips to find your way back to the land of Nod:
Get out of bed. For some people, “the worst thing they can do is lie there trying to get back to sleep,” says Grandner, as that could train your brain to associate your bed with sleeplessness. Take this opportunity to rearrange your spice rack or open a book—just make sure it’s nothing too disturbing or suspenseful.
If you’re anxious, write down what you’re ruminating about, whether it’s a chore you forgot to do (change the furnace filter) or something more abstract (what will happen to the kids if you die). Getting your concerns out of your head and onto the page helps free your mind so you can settle back down.
When you feel sleepy, return to the bedroom. Stretch out, breathe deeply, and go to your happy place: Imagine yourself in any setting where you feel a sense of peace, whether it’s a beloved vacation spot or under your favorite tree.
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