You’ve had a busy day and you’re tired but sleep just won’t come. Instead, you lie in bed, your mind busily recounting the events of the day and wondering how tomorrow will go. You know you should be trying to relax, but sleep continues to elude you while the clock ticks on relentlessly. Or perhaps you drift off to sleep with no problems but awaken in the small hours and count sheep until your alarm goes off.
Forget about counting sheep. Instead, try a number of insomnia tips to get the overnight rest you need
What Is Insomnia?
Whether the aforementioned scenario plays out when you first go to bed or in the middle of the night, it likely points to insomnia. It’s a term you hear often, but what is insomnia?
Put simply, it’s difficulty initiating or maintaining sleep. About 30% of Americans are thought to suffer from occasional insomnia, and the problem is especially common in older adults, with about 40% of people ages 65 and older affected at some point.
The good news is that insomnia is treatable, and Mount Sinai neurologist and sleep specialist Masrai Williams, MD, says it is important to find solutions that work for you, since poor sleep has been linked to a greater risk of falls, automobile accidents, cardiovascular issues, stroke, depression, and cognitive impairment in older age.
Insomnia Tips to Consider
Given the potential complications associated with sleep disorders, do your part to improve your sleep. Try these 10 insomnia tips to sleep better at night.
1. Tell Your Doctor
Many people suffer sleep deprivation and other problems in silence, but it is important to let your primary care provider know if you frequently experience disturbed sleep. Your doctor may want to review any medications you take, since antidepressants, decongestants, steroids, and drugs for hypertension, cholesterol, and asthma can contribute to or cause insomnia. Sleeping better may be as simple as adjusting the dose or substituting a different medication.
Your doctor also can suggest ways to better manage health issues that cause chronic pain. For example, arthritis can disturb your sleep if it is painful to change position overnight, while anxiety may cause you to lie awake worrying when you should be sleeping. Dr. Williams says that managing these underlying issues may restore natural sleep continuity. “When pain or mood symptoms go untreated, they can keep the body’s stress response active at night,” he explains. “Addressing the source of that discomfort, whether physical or emotional, is often the first step toward better rest.”
Your doctor may want to investigate whether a sleep disorder, such as obstructive sleep apnea (OSA), is a contributing factor. OSA may cause people to awaken many times overnight, and although most people are unaware that they have been disturbed, it is possible for the problem to fully awaken you. If your doctor suspects you have OSA, he or she probably will refer you to a sleep specialist. According to Dr. Williams, identifying sleep apnea early is key.
“Even mild cases can fragment sleep architecture and worsen blood pressure or mood,” he notes. “Diagnosis and treatment, often with continuous positive airway pressure (CPAP) or other targeted therapies, can substantially improve energy, alertness, and overall health.” Dr. Williams adds that insomnia and sleep apnea often occur together, a condition known as COMISA. “Treating both conditions can lead to better outcomes and restore refreshing sleep,” he observes.
Your doctor also may diagnose nocturia, or awakening frequently overnight due to a need to urinate. Nocturia may be caused by something as simple as consuming too many fluids during the evening, or by medications and conditions like prostate enlargement. The latter affects most older men and can make it difficult to fully empty the bladder when urinating. Any remaining urine may trigger the urge to visit the bathroom more than once overnight. “Frequent trips to the bathroom can fragment sleep and have effects on daytime sleepiness,” says Dr. Williams. “Adjusting hydration, medication timing, or treating underlying conditions can often restore much deeper, more continuous sleep.”
2. Get Physical
There is evidence that regular aerobic exercise, such as brisk walking, can help people with chronic insomnia sleep better. Experts believe that physical activity stimulates the body to release endorphins, which relieve anxiety and depression, both of which can impede restful sleep. Exercise also is thought to boost levels of serotonin, which promotes deeper, more restorative sleep. Don’t exercise too close to bedtime, though, as this may cause disturbed sleep.
“People who maintain a consistent exercise schedule often see improvements in sleep depth and quality within a few weeks,” notes Dr. Williams. “Just be mindful to finish vigorous workouts several hours before bedtime so your body has time to cool down and transition into rest.”
3. Look to Your Sleep Environment
Keep your bedroom dark and quiet. If you are disturbed by outside lights, install blackout blinds or curtains, or wear a sleep mask. If noise from traffic or other sources disturbs you, consider wearing earplugs or using a white noise machine to mask the sounds.
It’s also important to keep your bedroom cool. It may be tempting to turn up the heat during the winter, but a temperature between 60 and 67 degrees Fahrenheit is best for optimal sleep.
4. Make Sleep Hygiene Your Motto
Modify lifestyle habits that can disturb sleep. Avoid caffeine, nicotine, and alcohol close to bedtime, and establish a bedtime routine that helps you wind down—for example, you might want to take a warm bath and read for 15 minutes or so. Avoid your cellphone and tablet, since the bright light emitted by electronic devices can disturb your circadian rhythm, the body’s natural 24-hour clock that governs alertness and sleep-wake cycles.
“The blue light from phones and tablets sends a daytime signal to your brain,” explains Dr. Williams. “Even brief exposure can delay the release of melatonin, a hormone that helps regulate the sleep-wake cycle, making it harder to fall asleep. Aim to disconnect at least 60 minutes before bed, or use a warm, low-light setting if you must use a device.”
5. Use the Bed for Sleep Only
Don’t read, watch television, talk on the phone, or surf the internet in bed. You are aiming to condition your brain to perceive the bed as being for sleep and sex only. If sleep doesn’t come within about 20 minutes of lights out, don’t reach for your book. Get up and go into another room to read until you feel sleepy, and then go back to bed.
6. Avoid Late Mornings
Many people with insomnia stay in bed late the next morning to try to make up their sleep deficit, but this can disturb your natural sleep-wake rhythm even more. Instead, set an alarm for the same time each morning every day of the week, and aim to get up within 10 to 15 minutes of it sounding. If you have gotten into a long-term habit of very late mornings, ease into the earlier wake time gradually by setting your alarm 15 minutes earlier each day across a week or two.
“Your internal clock adjusts best to gradual shifts,” says Dr. Williams. “Keeping a stable wake-up time anchors your circadian rhythm and makes it easier to fall asleep naturally at night.”
7. Relax into Sleep
Relaxation techniques like slow, deep breathing, progressive muscle relaxation, and visual imagery can be helpful if anxiety about not being able to fall asleep is preventing rest.
8. Avoid Catastrophizing
This practice of imagining the worst-case scenario is common in people who sleep badly. You may lie in bed worrying that a bad night’s sleep will keep you from doing a good job the next day, or you may dread how fatigue will affect your schedule. This kind of negative thinking can fuel wakefulness, so you end up in a cycle of being anxious because you can’t sleep and being wakeful because you are anxious.
Instead, try to focus on the times when sleeping badly has not interfered with your ability to function. Another helpful strategy is to write down the things that keep you awake and think through possible solutions.
“It’s common to overestimate how much poor sleep will harm you the next day,” Dr. Williams adds. “Reframing those thoughts reduces pressure and helps the brain relax enough to drift off.”
9. Consider Cognitive Behavioral Therapy
Also known as talk therapy, cognitive behavioral therapy for insomnia (CBT-I) combines behavioral modification with cognitive strategies, including many of the insomnia tips discussed here. Many people find CBT-I to be as effective as medications for the treatment of insomnia, and its benefits can be long lasting. CBT-I typically is conducted by a sleep specialist, psychologist, or other mental health practitioner, usually requires six to eight sessions, and can be done in person or remotely.
“CBT-I retrains both the mind and body to sleep again,” says Dr. Williams. “It is one of the most effective nonmedication treatments we have for chronic insomnia, and results are often lasting once people complete the program.”
10. Understand the Risks of Sleep Medications
Previous surveys suggest that nearly one in three older Americans use some sort of sleep medication but have not told their health-care provider. Even over-the-counter sleep aids can cause side effects such as falls and daytime drowsiness, and they also may interact with other drugs.
If you are considering an over-the-counter remedy, check with your doctor first. If your physician suggests a prescription sleep medication, see it as a short-term solution. Prescription sleep drugs can be addictive and are associated with similar side effects as over-the-counter aids. Plus, they may worsen sleep the longer they are used.
For best results, sleep medications should be used at the lowest possible dose for a limited duration and combined with good sleep hygiene and behavioral approaches such as CBT-I. Dr. Williams emphasizes that medication is only one piece of a larger plan.
“We want people to use these medications strategically while working on the underlying habits and stressors that contribute to insomnia,” he says. “The ultimate goal is to help the body regain its natural ability to sleep independently.”
