By MARGARITA TARTAKOVSKY, M.S.
Does getting to bed feel like anightmare? For many of us, as soon as it’s time for bed, the brain begins buzzing. We might experience racing thoughts or a thought or two that keeps gnawing at us. Then those thoughts can turn into worry thoughts about not being able to function the next day because we slept poorly. It can become a vicious cycle.
While there’s “no button to push” to deactivate our thoughts, of course, we can “create the right associations” to help us sleep well, says Lawrence Epstein, M.D., chief medical officer ofSleep HealthCenters and instructor in medicine at Harvard University.
Below, Dr. Epstein and sleep specialist Stephanie Silberman, Ph.D, share their insight on quieting your worries and sleeping well.
1. Realize sleep is essential.
For many of us, sleep is the last thing on our minds when it comes to living healthfully. And sleep is the first thing to get sacrificed if we’re pressed for time.
But not getting enough sleep can cause a variety of issues, includinganxiety. It also prevents people from performing fully and at their best, Dr. Epstein says. Plus, sleep deprivation can increase your risk for health problems such as hypertension, stroke and diabetes, he says.
Once you realize that sleep is vital to your life, he says, you can work on sleeping well.
2. Have a regular sleep schedule.
Getting up and going to bed at the same time is key to good sleep. In fact, Dr. Epstein says that “the greatest promoter of being able to sleep is being in sync with your internal clock” or your circadian rhythms.
3. Create a pre-sleep routine.
Along with a consistent sleep/wake schedule, winding down before bed is one of the best ways to get your sleep back on track. As Silberman says, it’s “very hard to shut down your brain or quiet anxious or worrying thoughts when you’re on the go before bedtime.” You want to separate your day from the nighttime, she says.
Also, “Our body craves routine and likes to know what’s coming,” says Dr. Epstein, also co-author of The Harvard Medical School Guide to a Good Night’s Sleep. By creating a pre-sleep ritual, you’re establishing a clear association between certain activities and sleep.
For instance, if you read before heading to bed, your body knows that reading at night signals sleep time. If you take a warm bath before bed every night, your body recognizes that it’s time to slow down and relax.
Silberman suggests listening to calming music, stretching or doing relaxation exercises. If you’re watching TV before bed, make sure it’s at least a relaxing program, and not something like the news, she adds.
The goal of this pre-sleep routine is to relax your body and prime it for sleep, Dr. Epstein says. So if you’re going to bed at 10 or 11 p.m., “set aside 30 minutes or an hour for pre-sleep time,” he says.
4. Write down your worries — earlier in the day.
For about 10 to 15 minutes a day, “Write down what’s on your mind at an earlier time and what you’re doing about it,” says Silberman, who’s also author of The Insomnia Workbook: A Comprehensive Guide to Getting the Sleep You Need. To kick-start your worry session, she suggests simply asking yourself, “What are the things that come to my mind when I’m lying in bed at night?”
If a worrying thought comes up right before bed, you “can mentally check it off,” and either say to yourself “I’ve dealt with that,” or “I’m dealing with it,” she says. This usually helps to create a “sense of relief.”
Avoid writing up your list before bedtime, Silberman says, because you want to have enough separation from your thoughts at night.
5. Use your bed for sleep and intimacy.
Create a clear association between your bed and sleep, Dr. Epstein advises. In fact, if you’re having trouble sleeping, he even advises against reading in your bed. He says it’s OK to read in your bedroom but avoid the bed.
Similarly, both experts suggest not watching TV in bed, using your computer, doing paperwork or texting on your phone. These activities stimulate your brain, instead of relaxing you.
6. Create an optimal environment.
Creating the right environment for sleep includes keeping your room dark, quiet and at a moderate temperature, Dr. Epstein says. Again, this helps people to relax.
7. Busy your brain with mental exercises.
Being able to distract yourself from your worries can be enough to help you fall asleep, Silberman says. A mental exercise helps your brain focus away from your worries, she says. It can be as simple as “thinking of fruits and vegetables with a certain letter.”
Another idea Silberman suggests is to focus on the details of a particular object, such as its color, shape, size and what it’s used for. Or you can recite lyrics from a favorite song.
8. Focus on the positive.
When you’re lying in bed worrying, it helps to turn to more positive thoughts, Silberman says. You can “focus on good memories and happy events.”
9. Practice relaxation exercises.
Relaxation exercises are very helpful in reducing anxiety and racing thoughts, Silberman says. Exercises to try include progressive muscle relaxation (going through each muscle group and tensing and relaxing it) and deep breathing.
10. Participate in physical activities.
Exercising regularly helps with sleep, Dr. Epstein says. It’s also a major anxiety-reducer. But make sure you exercise a few hours before bedtime, he notes, since physical activity can be stimulating.
11. Think about what’s stealing your sleep and boosting your anxiety.
Ask yourself if your habits are interfering with your sleep or fueling your anxiety. According to Dr. Epstein, the biggest sleep saboteurs are caffeine and alcohol, both of which also boost anxiety.
He says that people just don’t realize that caffeine’s effects can last four to seven hours. Also, remember that tea and chocolate contain caffeine, too.
“Alcohol can help you fall asleep faster, but it fragments your sleep and makes it less restful,” he says. Also, certain medications can disturb sleep. If that’s the case for you, talk to your doctor about taking your medication at a different time or taking a different medicine altogether, he says.
12. See a sleep specialist.
If you feel like you’ve tried everything to no avail, find a sleep specialist in your area who does cognitive-behavioral therapy (CBT), the number one recommended treatment, Silberman says. You may be surprised to learn that sleep disorders such as insomnia can be treated in as little as several sessions and don’t require medication, Silberman says.
There are very specific treatments for sleep, so it’s important to see someone who’s a qualified sleep specialist.
In general, remember that sleep is a priority in your life. It helps you perform at your best and be healthy, Dr. Epstein says. Consider what habits may be increasing your anxiety and try the techniques above to help you relax and get ready for bed.
Photo by Lisa Yarost, available under a Creative Commons attribution license.