30 Days to Better Sleep: Day 10 — Avoid Alcohol Near Bedtime

With few sleeping pill options historically, difficulty falling asleep has been helped with home remedies, including a shot of alcohol. These "nightcaps" seem to make it easier to fall asleep, but with a better understanding of the effects, they are now discouraged. It seems to be a contradiction: alcohol makes you feel sleepy, but it worsens your sleep. Why should you avoid alcohol near bedtime?

Alcohol comes in myriad forms: beer, wine, and spirits or hard liquors such as rum, vodka, whiskey, tequila, brandy, and so forth. No matter its form, it all works the same. Alcohol acts as a depressant of the central nervous system, specifically the brain. It can affect behavior, concentration, and attention. At higher blood alcohol levels, increasing sleepiness and even depressed levels of consciousness can occur. Someone who is highly intoxicated may "pass out," becoming unresponsive to the environment and appearing to be asleep.

In light of these experiences, it would seem to be logical to use alcohol to increase sleepiness and aid the transition to sleep. For people who suffer from insomnia, often characterized by difficulty falling or staying asleep, it is a readily available fix. However, it is unfortunately one to avoid. Why is this so?

The effects of alcohol are short-lived. Though it may make you feel sleepy, it is rapidly cleared out of the body by the liver. As the blood alcohol levels drop, its depressant effects on the brain quickly abate. Your brain acutely rebounds from its depressed state, and this will lead to awakenings or arousals from sleep. Therefore, your sleep becomes more fragmented as the alcohol wears off. This can lead to worsened insomnia during the night.

Moreover, alcohol can have specific effects on the muscles of the airway. It is a muscle relaxant and when the muscles lining the nose, mouth, and throat relax, the airway collapses. This can lead to signs and symptoms of obstructive sleep apnea. As the airway collapses, the brain recognizes this and wakes the affected person to restore breathing, furthering the fragmentation of sleep.

When should you stop drinking alcohol to reduce its effects on sleep? It is recommended that alcohol not be consumed in the 4-6 hours preceding sleep. This may seem rather strict as it basically eliminates the consumption of alcohol in the evening, when most people drink. As an alternative rule of thumb, you should allow 1 hour of time to pass before going to bed for every alcoholic beverage you consume, starting from your last drink. If you have one drink at 9 PM, you can go to bed at 10 PM. For people with sleep apnea, especially if it is untreated, it may be advisable to avoid alcohol entirely as it may worsen the degree of sleep apnea.

So, contrary to custom, you should avoid alcohol before going to bed. Though it may cause transient sleepiness, it ultimately fragments your sleep and could contribute to sleep-disordered breathing such as sleep apnea. If you are serious about sleeping better, avoiding alcohol before bedtime is one small change you can make that might make a big difference.

30 Days to Better Sleep: Day 9 — Create a Relaxing Buffer Zone with Sleep Rituals

Okay, so you don't need a bed made out of pillows to get to sleep. Nevertheless, you can sleep better by creating a relaxing buffer zone prior to trying to sleep. As part of this, you can incorporate sleep rituals that will put your mind to ease and help you fall asleep.

One of the first tasks is to draw a line in the sand. Let's face it, your day will never end. You will always have more work to do, another chore to complete, just one more thing to take care of. Even if you are not working, you might not be ready to go to bed. If your evening is your "me time", there are endless TV programs or movies to watch, sports to play, books to read, and hobbies to indulge. If you let these pastimes creep into your devoted sleep time, there will be no end to the sacrifice. Once you have elected to make sleep a priority, you must start by concluding your day and transitioning towards sleep.

Many people find it helpful to create an artificial closure to the day. This is accomplished by selecting a time that you pronounce to be the end of your day. If you want to go to bed at 10 PM, you might select 8 PM as the time that works best for you. You want to allow yourself several hours to relax. As part of this, you must put aside your work. Those e-mail responses can wait until tomorrow. It's the time to turn off your phone. You have permission to ignore those unfinished tasks. You are only human, and your day has come to its close.

How should you fill the several hours before going to sleep? Try to indulge in an activity that you find relaxing. This activity should not be stimulating; nothing that gets your heart racing or your blood boiling. Pick something that, in the buffet of life, is oatmeal. Many people enjoy reading, taking a bath, stretching, or listening to music. You should probably avoid exposure to light, especially from screens such as your tablet or laptop computers. If possible, it is best to have some time completely free of electronics. This is time that will help you unwind and transition towards sleep.

Once you have identified activities that you find relaxing, make this a habit. Just as children benefit from a nightly bedtime routine, your body will appreciate a consistent transition to sleep. These "sleep rituals" will mentally, emotionally, and physically prepare you for the transition to sleep. Ultimately, it will make it easier for you to crawl into bed and fall asleep quickly. This can be especially helpful if you have insomnia.

Another useful tip is to make this buffer zone free from anxiety and stress. As part of this, it can be helpful to schedule a "worry time" earlier in the day. By focusing your energy on relaxation and rest in the hours before bedtime, you will sleep better and wake feeling refreshed.

30 Days to Better Sleep: Day 8 — Go to Bed Only When Sleepy

After carefully considering the difference between sleepiness and fatigue, you can now make an important choice: go to bed only when sleepy. Among people who suffer from difficulty falling asleep, a common occurrence as part of insomnia, this can be a life-changing decision. It also may defy common practice.

In early life, there is no decision made about when to go to sleep. A sleepy child is soon asleep. When the desire for sleep comes, no matter the timing, it is quickly indulged. As we get older, sleep becomes complicated by our behaviors. We may choose to stay awake, even fight sleepiness, to pursue pastimes. Alternatively, if we have trouble sleeping and feel like we need more sleep, we may go to bed early. We may stop listening to our body's natural cues.

Sleepiness or drowsiness is a cue to get ready to sleep. We should naturally prepare ourselves by settling down into bed. We make ourselves comfortable and, if everything goes to plan, we are soon asleep. In contrast, other descriptions of how we feel - fatigue, tiredness, and exhaustion - may not reflect a desire for sleep if they do not promptly proceed into sleep. Therefore, if we crawl into bed feeling fatigued, this may not result in sleep. Instead, we may be setting ourselves up for insomnia.

People with insomnia often complain of feeling fatigued or tired, but if given the opportunity to sleep, they will struggle mightily. Insomniacs cannot routinely take naps, for instance. If they lie down to rest in the afternoon, they will lie there awake. Insomnia is often described as feeling "tired but wired". Sleep is desperately wanted, but opportunities to sleep are corrupted by wakefulness.

Let's imagine a common scenario that occurs with insomnia and how someone might end up going to bed when he or she doesn't feel sleepy. Insomnia may be provoked by a stressful situation, but it is perpetuated by the resulting changes that are made around sleep. Insomnia is defined as difficulty falling asleep, difficulty staying asleep, or sleep that is not refreshing (in the absence of another sleep disorder). Sleep may become fragmented due to anxiety, with normal awakenings stretching into prolonged wakefulness during the night. By spending several hours awake in the night, it may seem natural to extend the time in bed. Rather than going to bed at 11 PM and getting up at 7 AM, a person with insomnia may go to bed at 10 PM or even 9 PM. In an effort to get more sleep, the time spent in bed is lengthened. However, something inadvertent has happened: this person may now be going to bed when they are less sleepy.

There are two major contributors to the ability to sleep: homeostatic sleep drive and circadian rhythm. The sleep drive is the desire for sleep that builds throughout the day; the longer a person stays awake, the sleepier they become. The circadian timing relates to when we should naturally be awake and asleep, and for humans sleep should occur overnight. (Nocturnal creatures like rats, on the other hand, should be sleeping in the day and awake at night.) By going to bed 1 or 2 hours early, there is less drive to sleep and the timing may be off. As a result, this insomniac may go to bed feeling less sleepy.

As a result, there is a diminished ability to sleep. It would not be unexpected for this person to now have a problem lying awake at the start of the night. By going to bed before sleepiness or drowsiness has developed, the ability to sleep is likewise lost. Similarly, lying awake for prolonged periods in the morning can be detrimental. Even short periods of sleep will diminish the sleep drive and could affect the circadian rhythm.

Therefore, train yourself to go to bed when you are feeling sleepy, not because the clock says it is time to sleep or because you are fatigued. You will find that you fall asleep more easily and sleep better through the night. To help yourself feel more sleepy, you can also work on creating a relaxing buffer zone before bed, a project to commence next.

30 Days to Better Sleep: Day 7 — Learn the Difference Between Sleepiness and Fatigue

It may seem like semantics, arguing over the meanings of similar words, but it really does matter: What is the difference between sleepiness and fatigue? Not only may discriminating between these distinctive feelings identify different causes, but it may also help to treat insomnia.

Some people lose touch with what it feels like to be sleepy. Sleepiness or drowsiness is the extreme desire to fall asleep. Imagine that you are sitting after lunch in your most comfortable chair. You are cozy and relaxed. Your eyelids become heavy, each time they close they stay that way a moment longer. You are ready to doze off. You are sleepy.

Contrast this sleepiness with a different collection of words: fatigue, tiredness, exhaustion, and low energy. These sentiments are felt deep in the bones and muscles, a heaviness to the limbs, as if you just ran a marathon. You can't summon the energy to accomplish what you need to. You are physically and mentally dragging through the day. This may occur in the setting of other illness, such as anemia, hypothyroidism, or even cancer. It may even be labeled as chronic fatigue syndrome.

No matter how extreme the fatigue, it does not result in sleep. People who feel fatigued may lie down to rest or take a nap. They do not, however, fall asleep. People with extreme sleepiness or drowsiness will be able to sleep if given the opportunity. Why does this matter?

Sleepiness often occurs in sleep deprivation among those who get inadequate total sleep time. It may also be a symptom of sleep disorders such as sleep apnea or narcolepsy. In contrast, fatigue is a common complaint among those with insomnia.

Not only does distinguishing between sleepiness and fatigue lead to a different set of possible causes, but recognizing sleepiness can also contribute to improving insomnia. How might this work? This concept will be discussed more in the next article, but it is critically important for people to only go to bed when they feel sleepy. If fatigue is used as a prompt to go to bed, this may result in lying awake for prolonged periods of time at the start of the night, trying to fall asleep. This is a major contributor to insomnia.

Consider carefully whether you are having more difficulty with sleepiness or fatigue. It may point to a distinct underlying cause and correcting it will depend on a different set of treatments. As you work to sleep better, use this exercise to reflect on your own needs.

30 Days to Better Sleep: Day 6 — Pay Off Your Sleep Debt

In these economic times, we are perhaps overly familiar with financial matters, including debts. As we put our collective financial house in order, it similarly may be appropriate to focus on improving our sleep by paying off our sleep debt. What is a sleep debt and what can be done about it?

The concept of sleep debt is meant to highlight that there are consequences to failing to meet your individual sleep needs and that, to a limited extent, you can correct this sleep deficit. As previously discussed, everyone has a specific sleep requirement in order to feel rested. Although it may average close to 8 hours, there is some variability, with some people requiring more or less. When you fail to get enough sleep to meet your requirement, you will begin to accumulate a sleep debt.

The most important consequences of inadequate total sleep time relate to sleep deprivation. There are specific symptoms that occur, from sleepiness to poor concentration to mood changes. There may be physical effects, including weight gain and decreased pain tolerance. Some people will experience hallucinations in extreme sleep deprivation. It may even increase your risk of death.

Many people will attempt to recuperate lost sleep by varying their sleep schedules. If you have to get up early to go to work on weekdays, you may not get an adequate amount of sleep. By the weekend, when you have more control of when you wake up, you may sleep in to catch up on the lost sleep. In a sense, you are running up a sleep debt during the week (which manifests as sleep deprivation) and then paying it off by sleeping more on the weekend.

How might this work? One important occurrence during sleep is the clearance of a neurotransmitter in the brain called adenosine. This chemical contributes to sleepiness and is responsible for the homeostatic sleep drive, in which the longer we stay awake, the more likely we are to fall asleep. When we do not have enough pillow time, we cannot fully clear out the accumulated adenosine. We are left with the residual mental effects described above. By extending the total sleep time on the weekends, we can finish clearing it out.

There are limits to this ability, it seems. If we had a period of sleep deprivation in the remote past, we are unable to make up for it by catching up on sleep now. It is unclear what long-lasting consequences result from sleep deprivation, but the health effects of sleep disorders suggest that these may not be insignificant.

If you find yourself running up a sleep debt, it is rather simple to correct the situation. Once you have determined your sleep needs, you should ensure that you allow an adequate amount of time in bed to meet it. Initially, you may need to sleep in several days in a row to make up for the recent sleep that you have lost. By thereafter maintaining an adequate sleep period, you will avoid the undesirable consequences of chronic sleep deprivation.

As you make broader changes to sleep better, it will be key to build a solid foundation and start by paying off your sleep debt.

30 Days to Better Sleep: Day 5 — Sleep at the Right Time for You

It is amazing how many people struggle to sleep due to the simple fact that they are trying to sleep at the wrong time. In order to better understand when you should be sleeping, it might be best to start by considering the two major reasons we sleep at all.

There is admittedly much that we don't know about sleep. Our current understanding nevertheless identifies two processes that contribute to our ability to sleep: homeostatic sleep drive and circadian rhythm. The first concept is rather simple: the desire for sleep builds the longer that we stay awake. No one will argue with this; it's easy to test. The science behind it relates to the gradual accumulation of a chemical within the brain, or neurotransmitter, called adenosine. It makes us feel sleepy. And, incidentally, blocking it is what makes caffeine effective as an alerting stimulant.

The other major player in the timing of sleep is our circadian rhythm. This is the pattern of internal processes that are synchronized to the natural day-night cycles. This directs key functions of our body and associated behaviors, including: body temperature, blood pressure, hormone levels, hunger, and sleep. It strongly dictates when we feel tired and when we are most awake.

As a brief aside, each and every cell of our body has "clock genes" that direct the activity of the cell. Even our fat cells follow a circadian rhythm! This helps the body to coordinate its activities. There is a part of the brain that is responsive to light called the suprachiasmatic nucleus (SCN). The SCN is the central pacemaker of the body, coordinating all the peripheral clocks with carefully timed hormonal changes. Therefore, sunlight (especially morning light) seen through the eyes and relayed to the SCN has a powerful effect on our circadian patterns, especially when we sleep.

With the circadian patterns of sleep, there is also clear variability between people in the timing of the longest sleep period. This sleep phase may be delayed in people who identify as night owls or advanced in morning larks. Night owls often feel most productive into the late evening and may not go to bed until 2 AM or later. This delayed sleep phase syndrome is especially common among teenagers. Conversely, elderly people are more likely to have an advanced sleep phase and go to bed and rise earlier. This has important implications on the appropriate timing of attempted sleep.

If you are a night owl and your body's natural tendency is to go to sleep at 2 AM, what do you think will happen if you try to go to bed at 11 PM? It should be no surprise that you would complain incessantly of difficulty falling asleep (insomnia). It might take 2 or 3 hours before you fall asleep; coincidentally, right about the time that your body is ready for you to be sleeping. Imagine what would happen if you forced someone with a "normal" sleep phase to go to bed early. Instead of hitting the hay at 10 PM, this person is forced to go to bed at 7 PM. No one would be surprised if they complained of trouble falling asleep. When we attempt to sleep is key to our ability to sleep.

Many people are aware of their natural tendency, whether they prefer to go to bed early or stay up late. It may be clear throughout life, but it can also change subtly. For those who find themselves needing to sleep at more standard times, there are ways to harness the power of the SCN to fall asleep easier and wake feeling refreshed, no matter what time it is. If you have trouble falling asleep, take an honest look at your sleep patterns and consider whether you are trying to sleep at the right time for you.

30 Days to Better Sleep: Day 4 — Calculate Your Sleep Needs

You have been told that you need 8 hours of sleep, right? Well, that may not be completely accurate. In fact, there's a lot more to the story. Since you are setting out to sleep better, it's a perfect time to figure out what your goal should be.

Certainly 8 hours is often touted as the "average" amount of sleep an adult needs, but it is just that, an average. Let's expand that a little. The average healthy adult needs 7.5 to 8.5 hours of sleep each night. Even still, it is probably safe to think of this as a bell-shaped curve that extends to the extremes. There are some people who need 4 hours of sleep and others who need 10 hours. In fact, just as many people need more as those who get by with less than 8 hours. This amount also changes dramatically throughout the lifespan.

These needs are likely determined, at least in part, by our genetics. Some people are short sleepers and others are long sleepers. It is the luck of the draw. And this tendency persists throughout life. How do you calculate what your personal needs may be?

It is relatively straightforward to figure out your sleep needs. With a few simple steps, you will know how much you need to be sleeping to feel rested. First, you need to have the luxury of getting enough sleep. (This speaks to an important topic that will be discussed later this month: Make sleep a priority.) You cannot allow work schedules, family obligations, hobbies and pastimes, or other activities encroach on your sleep period. This can be tough to arrange. The hope, ultimately, is that you will be able to go to bed and sleep until you naturally wake up. Initially, you will be sleeping off your sleep debt, but (in time) the length of your time spent sleeping will approach an average. This is your sleep need.

What if you fail to meet your sleep need? You will soon develop symptoms of sleep deprivation. Experiments have shown that humans need 8 hours and 10 minutes of sleep to avoid detrimental effects on daytime function (again, an average). Let's say that you calculate that you need 9 hours of sleep. Every night that you get 7 hours of sleep, you will be sleep deprived by 2 hours. It is easy to understand how important it is to determine your own need. The cumulative effect of chronic sleep deprivation may have dramatic consequences, and could even cause your death.

So once you have determined your individual sleep need, you will have established a clear goal in your efforts to sleep better. Now that you know how much you should be sleeping, your efforts can turn to improving the quality of the sleep that you get.

30 Days to Better Sleep: Day 3 — Lock the Pets Out of the Bedroom

In order to continue the advances made to create an ideal sleep environment, there is one additional heart-wrenching task: lock the pets out of the bedroom.

Many people insist that they wouldn't be able to sleep without their faithful cat or dog nestled amid the covers. In fact, some might even suggest that this favored pet would be unable to sleep without their human companions. If this sounds like a dependent relationship, it probably is, but it doesn't have to be.

You have been able to sleep without your pet and, much to your personal chagrin no doubt, your pet can sleep without you. In fact, you will probably sleep better without each other's presence. Why might this be so?

First, you are bound to awaken more in the night with a pet present in your bed. It is natural to have awakenings from sleep. Unfortunately, when there are more people or animals in a small space, these awakenings will become disruptive and the causes can run the gamut. Your dog may start scratching its ear. Your cat may walk across your pillow to get to the other corner of the bed. A noise may provoke barking or meows. There may even be pleas for food or a trip outside. If you have multiple animals, a fight may even break out in the night! Bottom line: it is a disturbance that you don't need.

Animals also inevitably introduce pet dander into the sleep environment. If you are prone to allergies or asthma, this fur may disrupt your breathing. You may have worsened snoring or even breathing problems such as upper airway resistance syndrome (UARS) or sleep apnea as a result. Though you may not be able to sneeze during sleep, it may keep you awake.

Depending on the size of your pets, they may also restrict your movement during sleep. If you feel like you can't change positions without disturbing your companion animal, you may subconsciously be still. If you are sleeping on your back, you may put yourself at risk of sleep apnea as well.

You will have to consider your own needs. If you sleep soundly, it may not ultimately bother you to have your pet in the bedroom. However, if you suffer from difficulty falling or staying asleep (a condition known as insomnia), then you should make your bedroom a space that is best for sleep.

If you are seeking ways to sleep better, put your pets outside the bedroom door and close it tight. They will sleep more soundly - and so will you.

30 Days to Better Sleep: Day 2 — Remove the Electronics from the Bedroom

On the path to better sleep, today's task requires a little manual labor: remove the electronics from the bedroom.

Ideally, your sleep environment should be a space that is maximally conducive to sleep. For most people, this involves having a devoted room in the home with a bed. It should be cool, dark, and quiet. It should be a space reserved for sleep and sex. It should be preserved as an area devoted to sleep. In order to accomplish this, you must remove the electronics.

Start by unplugging the television. Many people enjoy falling asleep to TV, but this can be a very disruptive part of the sleep environment. It can delay your bedtime and reduce your total sleep time. As you finally doze off, the noise may cause you to awaken. If it remains on, this can occur throughout the night. Along with the television, clear out your gaming systems, VCR, DVD player, Blu-ray player, and any other entertainment devices.

Next, turn your attention to your computers. Power off the desktop, pack away the laptop, and remove your tablet computers. It may even be advisable to clear out your electronic readers such as your Kindle or Nook. These devices are small, quickly slip into bed, and can easily be a source of distraction and sleep disruption. If you wake in the night and begin using your computer to pass the time, you lose the association between your bedroom and sleep. Instead, it becomes the place where you can lie awake at night and surf the Internet. Moreover, the exposure to low levels of light may disrupt your circadian rhythm and your ability to fall asleep, resulting in insomnia.

Additionally, leave your cell or mobile phone in the other room when you go to bed. These phones are increasingly recognized as a source of sleep disturbance in children and adolescents, with many "sleep texting" inadvertently. If your phone sounds with an alert for a text message or if a call rings through, this will disrupt your sleep. Don't let this disruption intrude into your sleep environment. If possible, you should not have any phones in your bedroom space.

Before reveling in the success of accomplishing today's task, do one final sweep of your bedroom. Is there any other technology that might be a source of distraction or disruption? Are there devices that will prevent you from having a quiet, soothing sleep space? You may clear out radios, alarm clocks, portable music players, and anything else that has a power cord and an on/off switch. Preserve your bedroom as an electronics-free zone.

Your bedroom is for sleeping, and by removing these electronics you will begin to re-establish the healthy relationship between this space and the expected associated behavior. You will reduce your exposure to disruptive low levels of light and intrusive noises at night. Moreover, with this simple task you will begin to initiate changes that are integral to sleeping better.

30 Days to Better Sleep: Day 1 — Wake Up at the Same Time Every Day

If you have resolved to sleep better, you may be overwhelmed with where to even begin. When sleep problems creep into your life, it can be difficult to identify the entangled issues and set things right. Chances are that your trouble sleeping didn't fully develop overnight, so allow yourself the time you need to improve your sleep. Over the next 30 days you will be introduced to specific changes that you can make to sleep better. Depending on your individual needs, you may be able to pass by a recommendation without a second thought. However, for the advice that hits closer to home, take the time that you need to resolve the issue. Together let's set out on the path to better sleep!

The first challenge may seem inconsequential, but it typically yields results quickly: wake up at the same time every day. Ideally, you would be able to sleep as much as you need to and wouldn't wake with an alarm clock, but to begin with you can use one. You should select a wake time that you can observe every day, including weekdays and weekends. For most people, this would mean selecting a time that would allow you to get to work or school during the week and then getting up at the same time on Saturday and Sunday.

Once you have selected your wake time, consider whether it is feasible. This isn't about making yourself an early bird if you are a night owl. Though society may pressure you into believing that waking earlier is somehow better, more moral, reflective of a hard-working nature, what evidence is there for this? Plenty of successful people stay up until 2 A.M. and sleep in until 10 A.M., so don't fall into that trap. Consider your own body and your needs. Pick a wake-up time that you can maintain and don't let it be too early or inconsistent with your typical, natural pattern.

Why does it matter to wake up at the same time every day? Think of your wake time as the anchor to your day. Our bodies follow a circadian rhythm and this relies on consistency. There are many things that you do at about the same time every day, not the least of which is sleep. Anchoring your wake time in place is a cue (or zeitgeber) to your body about when you should be awake and when you should be asleep. Waking at the same time every day will actually help you to sleep better at night. This is especially important for people who have difficult falling or staying asleep, characteristic of insomnia.

It is important that when your alarm goes off at your selected wake time, you get up. You cannot hit the snooze and stay in bed for 9 minutes or even an hour. You want consistency, and this requires ruling yourself with an iron fist. You might put your alarm clock across the room if you are apt to hit the snooze while half asleep. In order to track your success, you can record your bedtime and wake time on a sleep log. This information will be useful as you implement further changes to improve your sleep.

If adhering to a fixed wake time daily proves to be a difficult task for you, allow yourself 1 to 2 weeks of consistency in your wake times before you make further changes to sleep better.