Tossing, turning, thoughts racing—insomnia has become widespread since the pandemic. In fact, more than 60% of people report an increase in trouble falling and staying asleep, according to Journal of Sleep Research.
If you are among them, you likely have tried all the popular methods for better sleep, including going to bed at the same time every night and/or taking an over-the-counter supplement or even a prescription medication. Some people even try monitoring their sleep patterns with a phone app.
Renowned sleep scientist Aric A. Prather, PhD, says these tips and tricks don’t address the real culprit—you. Your stress and anxiety over sleep—or actually, not sleeping—may be what’s interfering with your ability to get your shut-eye. What’s more, your angst often leads you to do things that make sense in the short term but end up undermining how your sleep naturally works.
Dr. Prather, a practicing clinician who has helped hundreds of sleep-clinic patients, spoke to Bottom Line Personal about the cognitive behavioral therapy techniques he uses, as well as some unconventional strategies that you should be trying…
Sleep isn’t something you do as much as it is something that happens to you. Two powerful biological mechanisms that guide the process of falling and staying asleep are at work in your body…
Homeostatic sleep pressure is a buildup of neurochemicals such as adenosine that are byproducts of the brain’s activity and that increase the longer you are awake.
Circadian rhythms are more nuanced. They are a “master clock” reliant on environmental cues such as natural light. Through the buildup and release of hormones and proteins, circadian rhythms track cellular functions and allow your body to anticipate and respond to physiological needs such as sleep.
These two biological cycles are influenced by all kinds of external factors, including stimulants (think sugar and caffeine), exercise, temperature, social interactions…and rumination. Not surprisingly, ruminating in bed at night—when your mind starts racing with anxious thoughts—can profoundly disrupt your internal cycles and compromise your ability to sleep.
But there are things you can do to influence your homeostatic sleep pressure and circadian rhythms in positive ways and to avoid rumination.
Get up at the same time every day. Most people with insomnia think the key is going to bed at the same time each night, but this scenario involves forcing yourself to fall asleep, which just creates more anxiety. Better: It is much easier to control when you wake up, and it helps regulate and stabilize your ability to grow tired and sleep at the end of the day. You don’t have to suddenly become an early bird—choose a wake-up time that you can consistently maintain both on workdays and weekends. It should realistically suit your life and allow an ideal amount of sleep time for you each night (most adults should plan for seven hours).
Load manage your stress. Many people go full tilt all day and into the evening, then try to unwind just before heading to bed. It’s challenging to work off that pent-up stress, and that is why you are so restless when you turn off the lights. Better: Keep your overall stress levels manageable by taking five five-to-10-minute microbreaks throughout the day. Each break should be screen-free and phone-free. You can use the time to meditate, take a walk, talk to a friend, listen to a podcast and/or garden.
Worry early. Days can be so busy that it’s easy to distract yourself from worrying and save it all up for when you climb into bed. Better: Set aside 15 minutes during the mid- to late afternoon for “emotional worry” time. Set a timer, and give yourself the freedom to fret about whatever is bothering you most. Don’t try to come up with solutions to your problems. The goal is to give your pesky thoughts free rein. Jot them down on a piece of paper. When the timer goes off, discharge your thoughts by crumpling up the paper and throwing it in the trash before you go on with your day. Then if you do start to ruminate in bed, tell yourself, I’ll save this stuff for tomorrow and obsess over it in my next emotional worry session.
Stick your head in the freezer. We often hit a valley of low energy in midafternoon—that is a preprogrammed part of our circadian rhythms. And we commonly turn to coffee or napping, but these fixes can compromise sleep later on that night. Better: Give yourself a mild physical shock. Cold jump-starts the nervous system, raises your heart rate and makes you more alert. If you can’t easily put your head in the freezer, fill a sink with cold water and immerse your face or forearms for 15 seconds.
Set an alarm to go off two hours before you go to sleep. By mid-evening—when the retinal cells in your eyes start to process the dimming of natural light in your environment—your body’s pineal gland starts producing the hormone melatonin. That’s when you should move into wind-down mode. Wrap up your work, e-mail and to-do lists. Keep artificial lights low. Try especially hard to avoid the stimulus-reward loop of social media and phone apps—they seem relaxing but actually are designed to stoke your attention and can cause a rise in the stress hormone cortisol, which provides an energy boost and keeps you up. Instead…
Focus on wind-down activities that are relaxing and tranquil. Suggestions: Reading…knitting…bathing or showering, which promotes sleep by cooling your core body temperature as the water evaporates from your skin afterward…and watching TV, but skip the nail-biter dramas and stick with reruns of TV sitcoms you’ve enjoyed watching before.
Make your bed a haven. Avoid doing wind-down activities there. Don’t climb into bed until your eyelids are heavy and you want to sleep. The idea is to break the association between your bed and your wakefulness and angst. Think about it—you wouldn’t sit at the dinner table for hours waiting to get hungry.
If your mind starts to race, slow it with measured breathing. Focusing on and controlling your breath is a basic way to influence how you feel and think. Resource: Through its app and online content offerings, Headspace.com offers meditation and relaxation instructions that are geared to helping you sleep. Cost: 14-day free trial…then about $12.99 a month.
Stand on the platform, and watch the trains go by. This meditative technique can be used to disengage from rumination. If you experience intrusive, troublesome thoughts, envision them as train cars rumbling by while you observe them from the safety of the platform. Don’t get on the train because it will take you to places you don’t want to go. Instead, watch the cars with curiosity as they move past and down the track out of sight.
If you don’t fall asleep after 20 minutes, get out of bed. Transition back to your wind-down activities until you feel sleepy again. The idea is to let your homeostatic sleep pressure continue to build. Some people worry that getting up will be stimulating, but if you can’t sleep, you are already awake and mentally aroused. Continuing to lie there and struggle just reinforces the wrong associations with your bed.
If you wake up in the middle of the night, the same “rules of bed” apply. If you can’t return to sleep quickly, get up and resume wind-down activities. Caution: If you are older and/or have chronic pain, it may not be easy or safe to move around your home in the middle of the night. In that case, at least sit all the way up in bed to make it clear to your body that you are no longer in sleep mode. Or try what I used to do as a kid—turn yourself around so your head is at the bottom of the bed and your feet near your pillow. I used to read like that until I got sleepy, then I returned to my normal sleep position.
If you have a spouse or partner: Accommodating your partner can make it hard to implement the above strategies. Example: Getting up whenever you can’t sleep might disturb the other person. Suggestion: Sleep apart for a few weeks if you are suffering from insomnia. Do your reconditioning in a guest room if you have one. If that’s too disruptive, try more creative solutions. Example: One patient set up a comfy space in the living room with his wife that became their “before bed” nook. They shared quality time there, then each partner went off to the bedroom to sleep when he/she grew tired.
