6 Tips For Getting to Sleep

Sleep deprivation

There are a growing number of people who awaken feeling exhausted without the burst of energy they once felt as children and young adults. While many of us are going to bed too late in the evening to give us an adequate night of sleep, many more people get to sleep at a reasonable hour but experience difficulty falling  asleep and/or staying asleep throughout the night.

Millions of people suffering from sleepless nights, and the pharmaceutical drug industry is quite aware of this problem. Sleep medications are the number 1 most advertised class of medications in the U.S. among all medications! While these medications can be effective in the short term, they also include serious risks including retroactive amnesia, and reduced time in deep sleep (Stage III and IV).

Below is a quick list of activities that I recommend to my patients. They can be done quickly and easily with proven benefit and no risk.

    1. Exercise 15 minutes or more daily
      • Have you ever been unable to sleep and felt the need to move your arms and/or legs while lying in bed? By moving and stretching the muscles, tendons, and ligaments through exercise, you will fidget less when sleeping; thereby allowing your body to more deeply relax.
      • Exercise also reduces anxiety and perceived stress, particularly if you engage in an exercise that captures the mind’s attention so that you are less likely to be making your ‘to do’ list while you are exercising. Examples include: Tai Chi, yoga, dance class, chi running (conscious breathing while running).
    2. Meditation or Prayer
      • Meditation can be in the form of sitting meditation or moving meditation. Moving meditation includes yoga and martial arts.
      • I recommend you do 5 minutes of meditation or prayer in the morning and just before going to bed.
      • These practices have been shown to alter your immune system, nervous system, and stress hormones in beneficial ways. Specifically, these practices downregulate the sympathetic nervous system (i.e. our “fight or flight” systems); upregulate the parasympathetic system (helping us to be calm, relaxed, and slowed down); increase DHEA levels (the “hormone of well-being”); and lower cortisol levels (the “stress hormone”). For breathwork tips, visit Dr Weil’s website.
    3. Use an alarm clock and get to sleep
      • Set your alarm (cellphone, watch, or good old-fashioned bedside alarm) for 90 minutes prior to your desired bedtime. When the alarm goes off, it’s time to tuck technology in for the night (TV, smart phones, computers, bright e-books, etc.) This is an especially effective technique because technology has two implications on sleep:
        • Blue LED light on screens results in 50% reduction of melatonin, which makes falling asleep difficult. You may want to purchase software called f.lux, which is designed to modulate the LED yellow-blue color predominance to reduce the impact on melatonin levels.
        • Electronic content is thought stimulating, disrupting the onset of sleep, and prompting you to awaken in the middle of the night due to cycle disturbance.
    4. Unwind before bed
      • Spend 15 minutes stretching or doing yoga 1 hour prior to bed. It will unwind the body and mind allowing you to fall asleep and stay asleep more easily.
    5. Cognitive Behavioral Therapy or Mindfulness-Based Cognitive Behavioral Therapy
      • Abbreviated as CBT or MBCT, these are forms of therapy that reduce worrying (e.g. ruminating about the past or future events), and increase your ability to engage in constructive thoughts and bringing your mind to the present moment. They also increase your ability to notice earlier in the process that you are thinking about future or past events; thereby alleviating unwanted thinking and behaviors more quickly. These methods are useful for people with anxiety, sleep problems, and even depression. This approach has been shown to be as effective as medications for helping people get to sleep and stay asleep throughout the night.
    6. Consider dietary supplements
      • The scientific evidence is mixed; however, in my clinical experience, these therapies along with medication can be helpful in the short term while you lay the foundation for good behaviors and lifestyle practices.
      • Examples of combination formulas include: Cortisol Manager by Integrative Therapeutics, Benesom by Metagenics, Serenity by Gaia.
      • Examples of individual supplements worth considering include: melatonin, passion flower, wild oats milky seed, hops, valerian, 5-HTP, and chamomile.

If you find yourself waking up and having difficulty falling asleep, I would also recommend that you engage in a breathing practice (counting your breath: 4 counts inhalation, 1 count pause, 6 counts exhalation) for 5-10 minutes. If you don’t fall asleep, then get out of bed and stretch out the body doing yoga practice.  By moving your body into complicated positions and engaging your breath in a conscious manner, you will engage your mind back into the present moment rather than the future or past. You will stretch out the muscles, fascia, tendons, and ligaments to allow you to settle back into bed in a more relaxed manner.

Look forward to hearing your feedback on which of these recommendations you find most helpful!

Wishing you well,

Dr. Brad Jacobs

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