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School of Medicine
Seven Ways to Get a Healthier Night's Sleep
An estimated 18 million Americans still fail to get a good night’s sleep. If you or someone you love is among them, these research findings and expert insights could help you figure out what’s holding you back and what can help.
If you’re longing to wake up energized after a night of deep, refreshing sleep, you’re in good company. One in three adults gets by on six hours or less of nightly slumber, when most of us really need seven to nine hours.
“Humans are essentially the only mammals that willingly deprive themselves of sleep,” says Johns Hopkins sleep expert Rachel Salas, M.D.
And plenty more people wake up feeling tired, thanks to insomnia or more subtle sleep disturbances caused by problems like nighttime reflux and sleep apnea.
“But our need for sleep is still there,” Salas says. In fact, missing out on your fair share of high-quality sleep can boost your risk for depression, becoming overweight or obese, type 2 diabetes, high blood pressure, heart disease, and memory and concentration problems—and can even make you look older.
Yet research suggests that many of us are still taking wrong turns that keep us from getting the sleep we need and deserve. Here are proven solutions that can put you on the right path to better sleep.
Know when to watch the clock.
It’s normal to take 10 to 20 minutes to fall asleep after lights-out. If you’re dropping off within five minutes or find yourself falling asleep during the day, you’re likely not getting enough sleep. But if you’re still tossing and turning after 20 to 30 minutes, get up. Go read a book or listen to relaxing music until you feel sleepy, then return to your bed. It’s one way to train your mind to associate your bed with sleeping instead of struggling, research has shown.
Don’t underestimate caffeine.
It takes nearly six hours for half of the caffeine from your favorite coffee, tea or cola to exit the body. Caffeine too late in the day can cause lighter, more disturbed sleep—or keep you from sleeping at all, researchers have found. In a 2013 study, researchers learned that consuming 400 mg of caffeine (the amount in two to three cups of coffee or one 20-ounce coffee drink) six hours before bed cut total sleeping time by more than an hour.
Skip the nightcap.
An estimated 10 percent of older adults use alcohol to overcome insomnia. It seems to help ... but is actually harmful. A recent review confirms that an alcoholic drink before bed can help you fall asleep faster. But it reduces the amount of time you spend in deeper sleep stages that affect memory, concentration and even physical coordination.
Trade sleep aids for sleep hygiene.
One in five older adults turn to drugstore sleep remedies, which often contain antihistamines that can cause dangerous daytime drowsiness (and can mask a fixable sleep problem). Instead, try upgrading your sleep habits. Salas suggests these steps for natural, high-quality sleep:
- A bedtime ritual: Put on your pajamas. Relax. Avoid stressful activities, like working or having tense discussions.
- A peaceful bedroom: “Some people have a desk in their bedroom with bills on it and constant reminders of all the things they need to do,” Salas says. Instead, keep this room free of distracting clutter.
- No electronics at least 30 minutes before bed: Darkness in the evening helps our brains prepare for sleep. Staring at the light from your phone, computer or television throws off your brain’s internal clock.
Rule out health problems.
Conditions like gastroesophageal reflux disease and obstructive sleep apnea can rob you of quality sleep. If you have heartburn, talk with your doctor about reflux treatments that can ease nighttime reflux. You may have sleep apnea if you snore loudly and gasp or seem to choke at night as tissue in your throat blocks your airways, causing you to momentarily stop breathing. If you share a bedroom, ask, “Do I snore loudly or gasp for breath at night?” Treatments, including weight loss and wearing a pressurized mask for better breathing, can reverse apnea.
Still tossing and turning?
Cognitive behavioral therapy (CBT) for insomnia retrains your body and mind for deep sleep. In one study, CBT was more effective than prescription sleeping pills at helping people with insomnia fall asleep faster and stay asleep with fewer interruptions. A year later, they were still sleeping well—without drugs. Ask your health care provider how to give it a try.
Consult with a sleep expert.
If you’re struggling with lack of sleep, talk to your health care provider. However, Salas’s research as a Johns Hopkins sleep expert has found that doctors often get little training on sleep problems during medical school. If you can’t resolve your problems with your health care provider’s help, consider visiting a sleep specialist. This expert can help figure out if such problems as restless legs syndrome or chronic pain are keeping you from sleeping well.
Sleep apnea (ap-ne-ah): A disorder in which your breathing repeatedly stops or becomes very shallow as you sleep. Your breathing may pause anywhere from a few seconds to a few minutes. This ongoing condition disrupts your sleep, making you tired during the day and increasing your risk for heart problems, diabetes, obesity and driving or work-related accidents.
Restless legs syndrome (RLS): A disorder that creates a strong urge to move your legs often because you notice strange or unpleasant sensations: creeping, crawling, pulling, itching, tingling, burning, aching and even electric shocks. When you move your legs, it relieves the strange sensations. The unpleasant feelings are strongest when you are resting or inactive, and they can make it difficult to fall or stay asleep.
Gastroesophageal (gas-tro-e-soph-a-ge-al) reflux disease (GERD): A condition in which some of the contents from your stomach flow backward, up into your esophagus, causing heartburn. (Usually, food and beverages travel in one direction: down the esophagus and into the stomach.) Because some of the stomach’s digestive juices contain acid, this condition is also sometimes called acid reflux or acid indigestion.
Cognitive behavioral therapy (CBT): Two different psychotherapies—cognitive therapy and behavioral therapy— in one. Cognitive therapy can help you improve your mood by changing unhelpful thinking patterns. Behavioral therapy helps you identify and solve unhealthy habits. When used in conjunction with each another, these therapies have been shown to improve problems such as depression, anxiety, bipolar disorder, insomnia and eating disorders.