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Monday, February 28, 2011

Your Guide to Better Sleep

We all know that sleep is crucial to having the energy and ability to perform whatever it is we want to do. All it takes is one or two sleepless nights to drive home that point—and we all have a sleepless night or two sometimes. It's the cost of being human and having the capacity to worry about the future and chew over the past.

Yet, it's what we do in response to a bout of insomnia that determines whether we will end up with long-term sleep problems. The fact is that the sleep system tends to right itself after a few nights of insomnia—provided you make no adjustments to your sleep-wake cycle.

Unfortunately, most people take special measures to get some rest. They nap in the afternoon or evening. Or they go to bed early the next night, or sleep late the following morning. Or they take a drink or two to fall asleep.

Every one of these "corrective" measures interferes with your body's sleep "homeostat," a mechanism that builds up pressure for sleep and helps assure a good night's rest. The homeostatic pressure for sleep depends on how long you have been awake—and how active you are while awake.

I spoke to Dr. Michael Perlis, head of behavioral sleep medicine at the University of Rochester. An expert on insomnia, he has plenty of advice to offer on how to get the rest you need while steering clear of sleep problems.

  • Get more exercise—physical and mental. It primes the sleep homeostat. It's a myth that exercise at bedtime is bad. Sex is, among other things, a great exercise.
  • Set a regular bedtime—and keep it. Your body needs reliability.
  • Set up conditions so that you catch the wave of sleep. Sleep has to be permitted. Take obstacles out of the way, and give up the notion that you can control sleep.
  • Learn simple meditation and practice it before bedtime; it cuts down nervous system arousal.
  • Put sleep in the background of your life. Don't monitor it, don't evaluate it.
  • Jack up your body temperature with a warm bath before bed. Exaggerating the normal drop in body temperature that accompanies lying down abets sleep.
  • Keep your bedroom dark, especially as you get older. Even small amounts of light and noise can disturb sleep as you age.
  • Don't overheat your environment. Sleep loves cold. Keep your bedroom cold but load up on blankets.
  • Less is more. The less you do in response to a bout of sleeplessness, the faster your sleep patterns will return to normal.
  • Keeping your wake-up time constant but going to bed one hour later will help 25 percent of insomniacs in one to two weeks. Prepare to feel sleepy at times and avoid driving then. After two weeks, add back the time in half-hour increments.
  • Look on two or three nights of insomnia as a gift—the gift of time you wanted to get done all that you have to get done. Insomnia may be functional, a signal that you need to attend to what got you up.
  • Don't fight the insomnia. The homeostat makes sleep a self-reparative system—if you stay out of its way.
  • Don't worry about the consequences of not sleeping. Worrying about insomnia can create insomnia.
  • Don't sleep with your pets! Animal dander can create allergies that manifest only at night, and the movement of any pet on your bed can wake you up.
  • Do not sleep later to make up for lost sleep. It de-primes the sleep homeostat and reduces pressure for sleep the next night, turning a night of sleeplessness into insomnia.
  • Don't make up for a night of sleeplessness by napping. That undermines the sleep homeostat and makes it less likely you will sleep through the next night.
  • Don't make up for an acute bout of insomnia by going to bed early.
  • Do not try to induce sleepiness by drinking alcohol. Yes, it's a great relaxant—but it is metabolized so quickly it creates rebound insomnia within the night; it's so fast-acting you'll be up in four short hours.
  • Limit caffeine to one cup of coffee in the morning. At age 18, caffeine has a half-life of 4.5 hours, which increases with age. Gradually eliminate caffeine altogether if you have trouble sleeping.

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