Enter Sandman: Finding Sleep When You Need it Most
The definition of insanity, Albert Einstein once quipped, is doing the same thing over and over again and expecting a different result. But for the millions of Americans who head to bed each night, only to spend most of it lying awake in the darkness, the hope for deep, restorative sleep isn't a laughing matter. According to the National Sleep Foundation in Washington, D.C., 75 percent of us experience at least one indicator of a sleeping problem a few nights a week, a number that's increased significantly in the last four years. And while most of us know that we need eight hours of sleep a night to be at our best, only about a quarter of Americans regularly get that much rest.
Quantity of sleep, however, is only half of the issue. As anyone who's been jolted awake by a neighbor's barking dog or their partner's reverberating snores can attest, the quality of those hours spent between twilight and dawn can have a tremendous impact on our waking lives. "Getting shortchanged on sleep can negatively affect your mood, immune heath, attention span, and your ability to deal with stressful situations," says Russell Rosenberg, Ph.D, spokesperson for the National Sleep Foundation, and director of the Northside Hospital Sleep Disorders Center in Atlanta, Georgia.
In addition, a study from Columbia University and St. Luke's-Roosevelt Hospital in New York City concluded that regularly cutting into your sleep time could also put you at greater risk for gaining weight. Researchers discovered that people who average less than 4 hours of sleep a night are 73 percent more likely to become obese than those who got the recommended 7 to 9 hours of rest. It may seem counterintuitive that slumber, an activity that burns so few calories, could help to keep the pounds off, but "sleep deprivation may lower levels of leptin, a blood protein that suppresses hunger," says lead researcher James Gangwisch. Stay up late a few nights in row, and you'll probably notice that your appetite has spiked.
Daytime drowsiness can also increase your chances of making mistakes, whether you're at work or behind the wheel. But since most of us can't put our lives on hold, even in the face of extreme fatigue, we carry on business as usual, mainlining caffeine to help us stay awake during the day while stressing out about the rest we're not getting.
"There are those nights when I lie awake, staring at the clock and calculating how much sleep I can still get before the alarm goes off," says Allison Elliott, 26, a graduate student in Lexington, Kentucky. "It's pretty self defeating."
It's that very pressure to make sleep happen on demand, coupled with a load that we can't lay down once the working day is done, that makes the elusive state of sleep so valuable, and hard to come by.
"If all the stars were aligned, we'd drift off to sleep around twenty minutes after our heads hit the pillow," says Dr. Helene Emsellem, director of the Center for Sleep & Wake Disorders in Chevy Chase, Maryland. "But with social, career, and family obligations looming, sleep is one of the first things to get compromised."
With a never-ending list of daily to-dos and lives that are scheduled down to the quarter-hour, it seems the most difficult task we have to accomplish is giving ourselves the permission to relax and fall asleep. "Sometimes I'll wake up in the middle of the night because I know there's something I'm forgetting to do," admits Elliot. "Now, I keep my laptop near my bed, just in case I need to write it down."
A Prescription for Sleep
With so many obstacles standing in the way of a good night's rest, and the limited time span we've allotted to the task, it's not too surprising that many of us are finding our sleep salvation at the local pharmacy.
"If I'm having trouble falling asleep, I'll try practicing meditation or deep breathing," says Diane Ako, 34, a television anchor in Oahu, Hawaii. "If that doesn't work, there's always Ambien."
Ako isn't alone in her thinking. The total number of people taking prescription sleeping aids such as Ambien, Lunesta, and Sonata has doubled in the past four years, a recent industry study reveals. The newfound popularity of sleeping pills can be attributed to a glut of late-night advertising, heightened awareness for the products, and the recent introduction of several new symptom-specific pills. When their patients aren't getting the sleep they need, doctors are often quick to scribble a prescription.
"Insomnia, even if it's temporary, can deteriorate the patient's overall health and quality of life," says Rosenberg. "The latest sleeping medications are far safer and less addictive than they used to be, and the benefits of prescribing them usually outweigh the potential risks." He suggests that cognitive behavioral therapy can also help patients to get some rest, but "doctors don't always have the time to teach effective sleep techniques."
In the short term, popping a pill may be a quick fix, but "most insomnia drugs are only tested for safety by their manufacturer for a period of ten to twelve weeks," says naturopathic physician, Suzanne Lawton, "Beyond that timeframe, no one is really sure what effect these pills may have on the body."
Lifestyle and Environment
When a patient shares with her physician or naturopath that she’s having trouble getting shut-eye, they’ll ask about her “sleep hygiene,” or lifestyle factors, which may cause sleeplessness.
“Caffeinated beverages, chocolate, alcohol, and even dinner consumed too close to bedtime can all inhibit the body’s ability to wind down,” notes Evan Fleischmann, a naturopath based in West Milford, New Jersey. Regular exercise, which can help promote healthy sleep patterns, can actually hinder it if that treadmill romp takes place too late in the evening.
The patient’s home environment can also set the stage for sleep, with variables such as light, sound, and temperature playing a key role in getting rest.
“Our innate need to wind down is prompted by darkness, so passing headlights or the flickering of a television set can disrupt the sleep-wake cycle,” says Fleischmann. And while certain rhythmic or repetitive sounds (like the kind emitted by a white noise machine) might help you nod off, harsh noises like sirens and car horns can jolt you right out of restful REM.
Since moving to a less active neighborhood probably isn’t an option, “Keep the shades tightly drawn, wear an eye mask and use earplugs to help filter out sound,” suggests Fleischman.
Setting your thermostat a few degrees cooler at night can also help to prompt sleep, as well as switching out scratchy sheets for comfortable bed linens. While its not necessary to invest in a very expensive mattress set, make sure the one you have is smooth and free of lumps and that that your comforter isn’t so heavy that it restricts your natural movements.
“If you’re getting better rest in a hotel room then your own, it may be time to consider upgrading your bedding,” says Rosenburg.
Even if your bedroom is a quiet, comfortable haven, the quality of your shut-eye could be diminished if you’re snuggling up to someone who snores, commandeers the covers, or gets up frequently during the night.
“It’s very common for one sleeping partner to be a night owl while the other is more of a lark or early bird,” indicates Rosenberg, “But there’s no rule that says you have to go to bed at exactly the same time.”
Jenny Stamos, a writer from Ontario, Canada, says that she eventually learned this lesson after moving in with her long-term boyfriend. “I tend to fade around 10:00 p.m., but he can stay up until long past midnight,” she explains. “My boyfriend will hang out with me until I fall asleep, then he’ll head back to the living room, plug in his earphones, and watch TV.”
Natural Sleep Techniques
While lifestyle and environmental factors play a major part in the rest that we get, our minds often get the last word on how well we’ll sleep.
“Many of my patients will tell me they just want to shut off the switch in their brain that’s causing them to worry and think too much,” says Lawton, “Unfortunately, it’s not that easy.”
To help patients get some rest (without the use of prescription medications), sleep specialists and naturopaths will often suggest a series of activities or exercises designed to relax the mind and take the focus off the day’s stressful events. Here are some of their most reliable sleep techniques.
Create a pre-sleep routine “You need transitional downtime—you can’t just switch from ‘worry, worry, worry’ straight into soothing sleep,” says Joanne Getsy, medical director at the Drexel Sleep Center in Philadelphia. Make a cup of decaf tea, climb into cozy pajamas, and read an article in your favorite magazine. By creating a short wind down ritual, you’ll signal to your body that its time to enter rest mode.
Turn on the steam heat Taking a hot bath or shower can depress the nervous system and encourage the muscles to relax. “At first this can be stimulating and wake you up, but after about twenty minutes, you’ll feel yourself start to get very drowsy,” say Lawton. The scent of lavender can also be relaxing, so try to find a bath product, which features it as a key ingredient.
Offer yourself hypnotic suggestions Your brain can either work against you—or for you—in bed. Clear away stressful daytime thoughts by replacing them with those more conducive to sleep. “Tell yourself that you’re feeling incredibly tired, that your eyelids and body are getting heavy,” says Lawton. “Once you’ve given your brain the suggestion, the body quickly follows.”
Engage in deep breathing Allow yourself to expel the stress you’ve been holding onto by exhaling it out. To begin, get settled on your back and rest your hands lightly on your belly. “Inhale slowly, feeling your hands lift on your stomach as you draw air in. Hold it for a moment; then slowly let it out. The act of deep breathing can be surprisingly emotional, so take as few or as many breaths as you feel comfortable with,” suggests Fleishmann.
Think of calming visuals “Creating an image in your mind can help lead you away from stressful thoughts and into a dream-like state,” says Getsy. “Some people like to imagine walking along a path near the ocean, while others might think of making snow angels in winter.” She suggests choosing a visual that’s soothing and relaxing, and if you’re inclined, building a simple story around it.
Get Moving Engaging in stretches, poses, and guided relaxation just before bedtime can help release the day’s tension, preparing you for a restorative night’s sleep. If you’re not already a practiced yogi, follow along with movement expert Ann Dyer in zYoga: The Yoga Sleep Ritual (Sleep Garden; $25) for a combination that will take you from type A to Zzz in fifty minutes or less.
Taking sleeping pills isn’t the only way to tackle symptoms of insomnia. These natural remedies can help speed you towards dreamland, without a prescription.
Chamomile If you’re feeling agitated, brew a pot of tea made from the leaves of this fragrant herb. A strong cup can soothe aching muscles and relieve stress, enabling you to fall asleep.
Kava Root This member of the pepper family is a natural relaxant, which can have a therapeutic effect on your body. Take care to consume products made from the root only, as those made with the leaves and stem could have adverse side effects.
Valerian A non-addictive sedative with anti-anxiety benefits, valerian can keep you from feeling wired and worried, reducing the amount of time it takes you to drift off at bedtime.
Melissa Extract Also called Lemon Balm (thanks to its citrus-like scent), this member of the mint family works to relax agitated nerves and encourage proper digestion.