By John Swartzberg, M.D.
Are you sleep deprived?
The odds are good that you'll answer yes. In 2013, the Centers for Disease Control and Prevention called insufficient sleep a major public health problem, noting that nearly 30% of adults get less than six hours of sleep a night. And a national survey by the Better Sleep Council found that a solid majority of us (61%) crave sleep more than sex.
Check our chart: How Much Sleep Do You Really Need?
It's conventional wisdom that we sleep less than our ancestors, although that may not be true. One new study of hunter-gatherer societies found they sleep on average 5.7 to 7.1 hours a night, about the same as people in modern societies.
Honestly, the best way to tell if you're getting enough sleep is simple: Are you tired during the day? If you have energy and think clearly, you're probably getting enough sleep. If you feel tired, worn down, or fuzzyheaded, you probably need more sleep.
What can you do about those lost Zs if you do need more sleep? Here are 14 solid, proven, healthy ways to get better sleep.
1. Cut Caffeine. I admit it. I love caffeine. But if you're having trouble sleeping, it's important to reduce, if not eliminate, caffeine in your diet. If you can't give it up entirely, at least try to stay away from caffeine within four to six hours of bedtime; half of the caffeine you take in at 7 pm is still in your body at 11. It's not going to make a marked difference in just 24 hours, but within a few days of getting rid of caffeine, you should notice that you're sleeping better.
2. Limit Alcohol. This one is so falsely seductive. I've had so many patients, particularly elderly people, who rely on a glass of wine or two to help them with going to sleep. And it does that--there's no question about it. But alcohol also alters your sleep patterns and the quality of your sleep. When the alcohol level in your body drops a few hours later, it wakes you up and causes agitation, making it difficult to sleep peacefully for the rest of the night.
3. Butt Out. Nicotine is a stimulant, just like caffeine and can disrupt your sleep. No doubt you already know a thousand reasons you should be giving up smoking--now you have a thousand and one.
4. Eat Lightly. The idea of falling into a tryptophan coma after a big Thanksgiving turkey dinner is a cultural touchstone, but in reality, a heavy meal just before bed isn't good for your sleep--or your health. Tryptophan is a building block of the sleep-related chemical serotonin, but the studies are conflicting as to whether the amount you get in food is enough to have any effect on sleep. What's much more convincing is what we know about when, what, and how much to eat. Eat lightly, if at all, before bed, and avoid foods that might cause stomach trouble--like anything that's spicy, fatty, or fried.
5. Set a Schedule. Your body needs to become habituated to going to bed and getting up at set times, whether it's a weekday or weekend. It sounds like tough love, but if you force yourself to get up, say, at 6:30 am for a few days, regardless of how you slept the night before, and then to go to bed promptly at 10:30 pm, it can help you re-set your sleep pattern. It might be painful for a few days, but it will likely be worth it.
6. Establish a rhythm. Along with establishing regular, consistent bedtimes and wake-up times, set up a soothing bedtime ritual. If you've ever put a baby to sleep, you know how important these routines are in settling a wakeful brain into sleep mode. It works the same way for adults. Plan a relaxing routine for the 30-60 minutes before bed. This won't be the same for everyone, of course. For one person, it might be 15 minutes of meditation followed by a cup of chamomile tea. Someone else might like a warm bubble bath accompanied by calming music.
7. Say no to naps. After a disrupted night's sleep, the idea of a quick afternoon nap can be so seductive. But midday naps can perpetuate the cycle of sleep problems. If you absolutely must lie down for a few minutes, make it a catnap only, and set your phone or watch to wake you after 10 to 20 minutes.
8. Get a workout. Adding exercise to your daily regimen helps with all kinds of things that may interfere with your sleep, like anxiety and depression, but it also provides specific physiological boosts to sleep itself. Exercise strengthens circadian rhythms, and may stimulate longer periods of slow-wave sleep, the deepest and most restorative phase of sleep. Polls have found that people who exercise regularly, even if they don't get any more sleep than non-exercisers, report a better quality of sleep.
9. Put away that tablet. If you want to read before bed, don't use a smartphone, tablet or other light-emitting e-reader. Although all light slows down the production of melatonin, the hormone that helps us sleep, blue light from screens seems to be the most potent at doing this. Studies have found that people who use these devices at bedtime take longer to fall asleep and have disrupted circadian rhythms.
10. Cool it down. You don't want Arctic temperatures, but a cool bedroom--around 66 degrees--is best for sleep, research suggests.
11. Keep it quiet. If you're in a full house, you may be going to bed when other people are still up and rattling around. Or perhaps you live on a street with a lot of traffic. Using a "white noise" machine can help you mask all that ambient sound, along with sudden noises like a door slamming. You can find a variety of devices specifically made for this purpose for around $25. A fan or air purifier can work nicely too.
12. Clear the clutter. Many people relax more easily when their bedrooms aren't cluttered and full of distractions, so try going minimalist in your bedroom. One survey found that people who made their bed in the morning were 19% more likely to get a good night's sleep. Maybe they're just happier about their sleep space?
13. Get up. Wait, what? If you're tossing and turning and getting more and more frustrated with your inability to sack out, staying in bed may just make it worse. Get up and do something relaxing, like reading a book, until you feel drowsy.
14. Try therapy. If insomnia is really plaguing you and you've gotten into a vicious cycle of anxiety over being able to get to sleep, cognitive behavioral therapy has been shown to be an effective way to help people "train" themselves to break that cycle. Investing in a couple of visits with a trained therapist can be well worth it!
I may be shouting into the wind (or the white noise machine), because the Better Sleep Council tells me that less than half of all people who are chronically sleep deprived are taking any specific action to change that. But humor me. Commit to trying at least a few of these options for a week. And sweet dreams!
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John Swartzberg, M.D., is chair of the editorial board of BerkeleyWellness.com and the UC Berkeley Wellness Letter.
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