Why can't I sleep?

By Dr. Batya Ludman · Published June 14, 2013

Let's face it: with a six day work week and plenty of stress, we are a very exhausted country, suffering from both a collective and individual sleep deficit. No one gets enough sleep these days and often the sleep we do get is of very poor quality. Poor "sleep hygiene" is extremely detrimental to your physical and mental health, impedes social relationships, decreases job performance, increases work absenteeism, impacts on driving, anger, attention, cognitive performance, memory, sexual interest, weight and just about anything important in your day-to-day functioning. Whether your problem is getting into a good sleep routine, falling asleep, staying asleep, waking too early, staying awake during the day, nightmares or sleep apnea, chronic sleep issues can actually be life threatening.

I'm lucky: I've never needed much sleep. I actually enjoy seeing the world wake up. So when I recently shared a hotel room with a colleague, I was amazed. This woman's behavior was a real eye opener! When we arrived early that morning, she immediately ordered extra pillows and a blanket for that night (I was far more concerned about finding the best seat for the conference that morning). When the session ended for lunch, she went back to the room to nap for a few hours, and after dinner that evening when I went off to swim and call my children, she went off to "prepare" for bed. She got ready for bed, turned out her light and slept for 9 hours! Discussing this at breakfast she told me she naps every day and shuts off the phone in her house whenever she sleeps. The bottom line - if you want to sleep well, you have to properly set the stage for sleep.

The amount of sleep we need as adults varies and what is enough for one person is not for another. Many people don't get enough sleep, and what they do get is of poor quality, and doesn't serve to restore or refresh us. We go to bed tired and wake up exhausted. Sleep is not just a "time out" from our daily lives. We each may sleep differently but it must be seen as a priority if we care about ourselves, our family and each other. I say this with no exaggeration as our country must examine ways to enhance our quality of life by providing more leisure time and hopefully reducing our chronic sleep deficit.

Assuming that you would love to wake up feeing well rested, alert and full of energy, here are a few suggestions for getting more and better quality sleep:

Set the stage for sleep. Sleep only in your bedroom. Make sure your bed and pillows are comfortable and your bedroom well ventilated, quiet and dark. Establish pre-sleep rituals such as a warm bath or a few minutes of reading. Use your room only for sleep, illness and intimacy. Keep your television out of your bedroom and don't fall asleep with the television on. If you get tired, go to bed!

Maintain a regular sleep/wake schedule. Go to bed and get up around the same time each day. If you are a clock watcher, hide your clock. Checking it over and over just increases anxiety. Have a daily plan with routine times for meals, chores, and exercise. If you nap, do so early in the afternoon and keep it short, under an hour.

Maintain good sleep hygiene. Maintain a healthy diet. Don't eat heavy or spicy meals before bed and avoid caffeine and alcohol when tired or when on sleep medication. Reduce evening liquid consumption if it interferes with your sleep and don't snack during the night. Exercise regularly, but not close to bedtime, and get outdoors during the day and enjoy plenty of sunlight.

Dumb down all technology. Turn off all electronic devices long before you go to bed and keep your "i" devices out of the bedroom. Texting and tweeting result in hyper- arousal, and intermittent light and noise are thought to have a detrimental impact on your nervous system, preventing the onset and continuation of sleep. Both your body and brain need time to wind down and completely relax.

Avoid stress – especially at bedtime. Examine your day and see where you are overscheduled and how you can reduce stress. Address underlying causes of worry, anxiety and depression which may result in insomnia, hypersomnia, and early morning awakening. Keep a notebook next to your bed, write down thoughts that keep you awake and then "let them go" or designate a specific time to worry. Get out of bed for a short while if you can't sleep.

While everyone suffers from occasional sleep disruption, if your sleep continues to be a problem seek help. Working together with a clinical psychologist specializing in treating sleep issues can be of enormous help in enabling you to make the most of your shut-eye. In completing a thorough sleep history and sleep diary, issues such as chronic pain, hormonal changes, and other physical and emotional symptoms can be rapidly assessed as a first step in understanding the exact nature of your sleep problem. Treatments involving muscle relaxation, breathing techniques, mindfulness exercises, and cognitive behavior therapy (CBT) which helps address maladaptive thoughts and poor sleep habits, all offer excellent non-medicinal alternatives, often equal to, or more, effective than medication and with fewer side effects. Sleep medication should be used sparingly at most and rarely for more than a few weeks.

Making the most out of the sleep you get is critical given that we seem to have so much more to do with so much less time to do it. Wishing you only sweet dreams.