Three Types of Sleep Problems
Sleep problems generally are divided into three different types:
- Initial Insomnia: refers to difficulty falling asleep.
- Middle Insomnia: refers to difficulty maintaining sleep, such as through frequent waking, restless sleep or other types of interruptions.
- Terminal Insomnia: refers to early waking and not being able to get back to sleep.
Which of these is a problem for you?
Research-Based Sleep Hygiene Strategies
There is quite a bit of research now about how sleep can be promoted. The following strategies are part of good sleep hygiene (based on Hunter, Goodie, Oordt, and Dobmeyer, 2013):
- Caffeine: Caffeine disturbs sleep. Avoid caffeine 6 to 8 hours before bedtime.
- Nicotine: Avoid nicotine before bedtime and during the night, as nicotine can keep you awake.
- Alcohol: Alcohol often promotes the onset of sleep, but is often associated with interrupted and restless sleep as well as early waking. Therefore, avoid alcohol any closer than 4 hours before going to bed.
- Exercise: While regular exercise generally promotes sleep, do not exercise vigorously within 2 hours of bedtime as it may elevate nervous system activity and interfere with your ability to fall asleep
- Bedroom Environment: Your bedroom should have a moderate temperature and be quiet and dark. Sounds can be masked with background white noise (e.g., the noise of a fan) or with earplugs.
- Activities in Bed: Generally, our mind associates certain places with certain activities. If spend a lot of waking time in your bed (e.g., TV, reading, just hanging out), that’s what your mind will associate with being in bed. Therefore, try to preserve your bed only for sleep as much as you can.
- Eating: A light bedtime snack, such a glass of warm milk, cheese, or a bowl of cereal can promote sleep. Avoid snacks in the middle of the night because awakening may become associated with hunger.
- Avoid Naps: The sleep you obtain during the day takes away from the amount of sleep you need that night. If you must nap, schedule it before 3:00 p.m. Don’t sleep more than 15 to 30 minutes.
- Unwinding: Find what works for you to wind down, and perhaps give yourself an hour to do so.
- Regular Sleep Schedule: Keep a regular time each day, 7 days a week, to get out of bed. Keeping a regular waking time helps set your circadian rhythm so that your body learns to sleep at the desired time.
- Screen Time: The flickering of screens tells the brain to be awake, just like daylight promotes wakefulness. Therefore, avoid any time in front of a screen (TV, computer, smartphone) about 1 hour before going to bed. Instead, read a book or use a reading device that does not have a flickering screen. Ideally, read something slightly boring (i.e., don’t read a thriller before bed).
- Sleeping Pills: Sleep medications are typically effective only temporarily and often lose their effectiveness after 2 to 4 weeks when taken regularly. Over time, sleeping pills actually can make sleep problems worse; withdrawal from the medication can lead to an insomnia rebound. Keep use of sleeping pills infrequent, but don’t worry if you need to use one on an occasional basis.
Working with the Mind to Promote Sleep
In addition to developing good sleep hygiene, we can work with our mind to promote falling asleep. Most importantly: sleep cannot be forced. It can only be promoted (through sleep hygiene, see above, or strategies, see below). The following strategies can help promote sleep.
(Not) trying to fall asleep: The more you try to fall asleep, the less likely you’ll fall asleep.
Focusing the mind: Many people cannot fall asleep because they get hooked by thoughts. Therefore, training the mind not to get hooked on thinking is an essential strategy. You can simply train your mind to notice feelings of sleepiness (rather than getting hooked by thinking). Or you can “Watch thoughts like clouds” (see below) or pay attention to body sensations through a “Body scan” (see below).
Watching thoughts like clouds: Watch for getting hooked on to thoughts like: “Now it is too late and I am still awake, I have to fall asleep now…” or “Why can’t I fall asleep, this is terrible!”
When a thought like that comes, simply notice it like a cloud appearing and moving through the sky before disappearing. When you are hooked, just come back to watching thoughts like clouds.
Body Scan: One of the most effective strategies to promote sleep is the body scan. Unlike other relaxation strategies, the focus of the body scan is to just notice body sensations and not to try to change anything (e.g., changing how you feel, trying to make pain go away, trying to fall asleep). The les you can try to fall asleep, the better. Therefore, take as long as you like.
- Breath: Start by noticing your breath. Don’t try to change your breathing, just notice it.
- Scan: Scan your body from toes to head for body sensations (tensions, temperature, sensations from clothes or leaning against furniture or noticing the body on the floor, if you are lying down). Don’t try to change anything, just be aware.
- Whole Body: Then notice your whole body.
Here is a recording of a 10-minute body scan: https://youtu.be/IU41c4prNOk
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