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Can't Sleep?

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Tips for Better Sleep
  • Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day, even on the weekends. Sticking to a schedule helps reinforce your body's sleep-wake cycle and can help you fall asleep better at night.

  • Avoid caffeine for at least eight hours before your desired bedtime. Your body takes many hours to eliminate the stimulant and its effects. Some people are more sensitive than others to caffeine and need to stop drinking it as early as noon. Be aware that even decafeinnated coffee has a small amount of caffeine.

  • Avoid alcohol in the four to six hours before bedtime. Alcohol may help you get to sleep, but there is a rebound, wakefulness effect once it wears off in the middle of the night.

  • Avoid nicotine in the four to six hours before bedtime. Nicotine is a stimulant and can keep you awake.

  • Review any medications or herbal supplements you might be taking with your primary care provider or local pharmacist and be sure you're taking them at the right time of the day. Many preparations can be sedating or energizing and thus have a significant effect on sleep.

  • Regular physical activity, especially aerobic exercise, can help you fall asleep faster and help your sleep more restfully. Avoid exercising within two hours of bedtime.

  • Avoid large meals and drinks within two hours of bedtime.

  • Don't nap later than 3 p.m. and limit daytime naps to less than 1 hour.

  • Sleep in a dark, quiet room with a comfortable temperature. Sunlight has a natural waking effect on the body and significantly influences the body's internal clock. Keep all light out of the bedroom at night and open the curtains in the morning to wake up. Avoid turning on bright lights during any trips to the bathroom.

  • If you can't fall asleep within 20 minutes, do a quiet activity somewhere else and return to bed when you're sleepy.

  • Wind down in the 30 minutes before bedtime with a relaxing pre-sleep ritual such as a warm bath, soft music, or reading.
What about melatonin?
A recent Harvard study found that melatonin, taken during the daytime, can relieve daytime insomnia for night-shift workers or jet-lagged travelers, but it didn't appear to do much for other causes of insomnia. In this study, oral melatonin helped participants fall asleep during the day, when their bodies weren't normally producing melatonin, but the oral supplement was not helpful at night, when their bodies were already producing the hormone themselves. Sleep, April 2006

The hormone melatonin, normally produced by the brain's pineal gland, helps regulate sleep cycles and the circadian rhythm. In the evening the level of the hormone in the bloodstream rises sharply, reducing alertness and inviting sleep, and in the morning it falls back, encouraging waking. Melatonin has long been proposed as a way to help people sleep, but exactly who might benefit and when has been debated. Millions of Americans take the hormone to improve sleep, however an extensive review two years ago by the federal Agency for Healthcare Research and Quality said there was little or no evidence of melatonin's efficacy. It appeared to be safe when used over a period of days or weeks, "at relatively high doses and in various formulations. However, the safety of melatonin supplements used over months or even years was unclear". Agency for Healthcare Research and Quality
In the News

Sleep loss adds up to weight gain in women July 7, 2006
In a large-scale study over 16 years, women who slept only five hours per night gained significantly more weight, and gained weight at a more rapid pace during the study's 16-year time period, than women who slept seven or more hours per night. This occurred despite the fact that women who slept less had lower total caloric intake than women who slept more.

There have been several theories about why sleep loss may predispose to weight gain. In this study, researchers theorized that less sleep may have affected the womens' basal metabolism rate, so that those women who got less rest, had a lower basal metabolic rate. MedPage Today

Paying off sleep debt on the weekends may be counter productive June 22, 2006
A recent study reinforces advice from sleep experts: Sleeping late on Saturday and Sunday mornings may make you more tired and cranky on Monday and Tuesday. Fatigue and sleepiness on Monday and Tuesday contributes to a sleep debt that isn't paid off until the weekend. The typical weekend snooze helps people get back on an even keel, but the vicious cycle then repeats on Monday. Sleep specialists contend that altering bedtimes and wake-up times can change a person's body clock. Wake time has a much bigger effect on circadian rhythm than bedtime. If you stay up three hours later, you get a half-hour delay in the (circadian) phase, but if you wake up three hours later, you can get a two and a half hour delay." MedPage Today

Written by N Thompson, ARNP Last updated July 2006

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