Tossing and Turning at Bedtime
Many people have trouble getting to sleep quickly, spending well over 30 minutes tossing and turning before being able to nod off. In the wake of a recent study linking sleeping pills with an increased risk of mortality and cancer, some people who once relied on medications to sleep are looking to non-pharmaceutical solutions. Haviva Veler, sleep specialist at the Komansky Center for Children's Health at New York-Presbyterian Hospital/Weill Cornell Medical Center, offers tips on how both adults and adolescents can get on the fast track to restful slumber.
What makes people fall asleep?
When it gets dark outside, the brain secretes the hormone melatonin in response to the decrease in ambient light. This causes the feeling of being drowsy or sleepy.
What do you suggest your patients do to get to sleep faster?
First, keep a constant sleep schedule, especially over the weekend. If you sleep until noon, it completely confuses your internal clock.
Next, sleep in a room that is dark, quiet and a little on the cool side. When the body starts preparing for sleep in the early evening, its temperature starts to drop. So avoid hot showers or hot milk, things that will increase body temperature. If the room temperature is higher than 75 degrees, experiments show prolonged sleep onset.
For the same reason, try not to eat big meals right before sleeping…because the process of breaking down sugars causes our body temperature to increase.
Does exercise make falling asleep easier?
Exercise during the day improves sleep. It makes you more tired so sleep will come faster and be more sustained. Just avoid excessive exercise an hour before bedtime.
Instead, during the hour before going to sleep, try to stick to quiet activity in a dim light. Avoid TV, emails, what I call i-stuff: iPads, iPods. Their bright ambient light blocks the release of melatonin. Read in low light or on a Kindle, which has a softer light.
Reading is tricky, though, because if it's very interesting, you can get too absorbed and continue for hours. A boring book or a report, something that won't excite you too much, is better than something absorbing that may keep you up.
How late in the day can people with sleep troubles have caffeinated drinks?
Caffeine is long-acting, keeps you awake at night and makes you wake up multiple times during the night. Its half-life, or the time it spends in your system, is about eight hours. So you should really stay away from it for eight hours before bedtime.
What about trying to fall asleep when you are jet-lagged?
After changing time zones, try to get as much light exposure as possible during the mornings. This increases the awake phase and helps synchronize your internal clock, which makes for better sleep. Melatonin can be useful as both a sedating agent and to adjust your internal clock to the new time zone.