Sweet Dreams: How to Sleep Better, Lose Weight, and Live Longer

by

YOU CAN LOSE WEIGHT without changing what you eat or doing one minute of exercise! It’s a bold claim. And don’t get me wrong: Nutrition and exercise are important! But there’s another key to weight loss – and most people don’t even know about it. It’s sleep.

In fact, besides eating whole foods and moving your body, getting enough sleep is the most important thing you can do for your health. On the flip side, sleep deprivation makes you fat – AND leads to depression, pain, heart disease, diabetes, and much more.

That’s why in today’s blog I want to talk about the impact sleep has on your health and give you 19 tips you can use to get a good night’s rest and enjoy all the health benefits sleep has to offer. Let’s start by talking about a rather serious sleep condition called sleep apnea.

The Dangers of Sleep Apnea

Sleep apnea is a condition where your sleep is interrupted all night because your airway closes and your body startles you awake so you don’t suffocate. This is a very common and extremely under-diagnosed problem. It affects 18 million Americans and most are NOT treated for it.

Let me tell you about one of my patients who was in that same predicament. He was so tired that he had to stand up at his computer to work during the day so he wouldn’t fall asleep! His wife reported hearing his horrible snoring and gasping episodes at night. He would fall right asleep as soon as he sat down to watch TV at night.

Most frightening, he had fallen asleep at the wheel when driving. Then he came to see me. When we got his sleep apnea diagnosed (with a sleep study in a sleep lab) and got him treated with a device to keep his airway open at night, he lost 50 pounds, his blood pressure turned to normal – and he got his life back.

But people with sleep apnea are not the only ones in trouble. It is estimated that 70 percent of Americans are sleep deprived. The era of Starbucks has been surpassed by an era of prescription stimulants to keep people awake and functioning, like dexadrine and Ritalin – otherwise known as “speed” or amphetamines.

Surprisingly, I see an increasing number of patients prescribed these “uppers” by their psychiatrist because coffee is not enough to keep them energetic. It seems we believe that if you can’t do ten things at once, something must be wrong with you. But this is preposterous.

Your biological rhythms keep you healthy and produce cyclic pulses of healing and repair hormones, including melatonin and growth hormone. When those rhythms are disturbed by inadequate or insufficient sleep, disease and breakdown get the upper hand.

It is estimated that 70 percent of Americans are sleep deprived.

We evolved along with the rhythms of day and night. They signal a whole cascade of hormonal and neurochemical reactions that keep us healthy by repairing our DNA, building tissues and muscle, and regulating weight and mood chemicals. The advent of the light bulb changed all that.

When you are sleep deprived, your cortisol rises – and so do all its harmful effects, including brain damage and dementia, weight gain, diabetes, heart attacks, high blood pressure, depression, osteoporosis, depressed immunity, and more.

The reality is that most of us need at least eight hours of restful sleep a night. But meeting this goal has become more and more difficult. Partially because good sleep is not something that just happens (unless you are a baby or teenager). There are clearly defined things that interfere with or support healthy sleep. Here is what you need to do:

19 Tips to Improve Sleep

First, you have to prioritize sleep! I used to think that “MD” stood for “medical deity” and meant I didn’t have to follow the same sleep rules as every other human being. I stayed up late working long shifts in the emergency room, ignoring the demands of my body to rest. It wasn’t until I learned that shift work (like I did in when I worked in the emergency room) leads to a shortened life expectancy that I quit.

Unfortunately, our lives are infiltrated with stimuli – and we keep stimulated until the moment we get into bed. This is not the way to get restful sleep. Frankly, it’s no wonder we can’t sleep well when we eat late dinners, answer emails, surf the Internet, or do work, and then get right into bed and watch the evening news about all the disaster, pain, and suffering in the world.

Instead we must take a little “holiday” in the two hours before bed. Creating a sleep ritual – a special set of little things you do before bed to help ready your system physically and psychologically for sleep – can guide your body into a deep, healing sleep.

We all live with a little bit of post-traumatic stress syndrome (or, I should say, traumatic stress syndrome, because for many of us there is nothing “post” about it). Much research has been done on the effects of stress and traumatic experiences and images on sleep. If you follow my guidelines for restoring normal sleep below, your post-traumatic stress may become a thing of the past.

Here’s how restore your natural sleep rhythm. It may take weeks or months, but using these tools in a coordinated way will eventually reset your biological rhythms:

  • Practice the regular rhythms of sleep – go to bed and wake up at the same time each day
  • Use your bed for sleep and romance only – not reading or television
  • Create an aesthetic environment that encourages sleep – use serene and restful colors and eliminate clutter and distraction
  • Create total darkness and quiet – consider using eyeshades and earplugs
  • Avoid caffeine – it may seem to help you stay awake but actually makes your sleep worse
  • Avoid alcohol – it helps you get to sleep but causes interruptions in sleep and poor-quality sleep
  • Get regular exposure to daylight for at least 20 minutes daily – the light from the sun enters your eyes and triggers your brain to release specific chemicals and hormones like melatonin that are vital to healthy sleep, mood, and aging
  • Eat no later than three hours before bed – eating a heavy meal prior to bed will lead to a bad night’s sleep
  • Don’t exercise vigorously after dinner – it excites the body and makes it more difficult to get to sleep
  • Write your worries down – one hour before bed, write down the things that are causing you anxiety and make plans for what you might have to do the next day to reduce your worry. It will free up your mind and energy to move into deep and restful sleep
  • Take a hot salt/soda aromatherapy bath – raising your body temperature before bed helps to induce sleep. A hot bath also relaxes your muscles and reduces tension physically and psychically. By adding one-and-a-half to one cup of Epsom salt (magnesium sulfate) and one-and-a-half to one cup of baking soda (sodium bicarbonate) to your bath, you will gain the benefits of magnesium absorbed through your skin and the alkaline-balancing effects of the baking soda, both of which help with sleep
  • Get a massage or stretch before bed – this helps relax the body making it easier to fall asleep
  • Warm your middle – this raises your core temperature and helps trigger the proper chemistry for sleep. Either a hot water bottle, heating pad, or warm body can do the trick
  • Avoid medications that interfere with sleep – these include sedatives (these are used to treat insomnia, but ultimately lead to dependence and disruption of normal sleep rhythms and architecture), antihistamines, stimulants, cold medication, steroids, and headache medication that contains caffeine (such as Fioricet)
  • Use herbal therapies – try passionflower, or 320 mg to 480 mg of valerian (valeriana officinalis) root extract standardized to 0.2 percent valerenic acid one hour before bed
  • Take 200 to 400 mg of magnesium citrate or glycinate before bed – this relaxes the nervous system and muscles.
  • Other supplements and herbs can be helpful in getting some shuteye – try calcium, theanine (an amino acid from green tea), GABA, 5-HTP, melatonin, and magnolia.
  • Try one to three mg of melatonin at night – melatonin helps stabilize your sleep rhythms.
  • Get a relaxation, meditation or guided imagery CD – any of these may help you get to sleep.

If you are still having trouble sleeping, you should be evaluated by your doctor for other problems that can interfere with sleep, including food sensitivities, thyroid problems, menopause, fibromyalgia, chronic fatigue syndrome, heavy metal toxicity, and, of course, stress and depression. Also, consider getting tested for a sleep disorder.

Sleep Testing: What You Need to Know

There are many medical sleep disorders, the most common (and most under-diagnosed) is sleep apnea. If you experience excessive daytime sleepiness, fatigue, snoring, and have been seen to stop breathing in the middle of the night by your spouse or partner, then you could be one of the many people with undiagnosed sleep apnea.

People with sleep apnea have a higher risk of high blood pressure, heart disease, and sudden death, so diagnosing and treating it is imperative. High blood pressure is a clue, because half of all people with high blood pressure have undiagnosed sleep apnea.

Get an overnight sleep study done in a sleep lab. It may the best thing you ever do for yourself. It might just save your life!

And remember – don’t skimp on sleep! It is one of the most powerful healing treatments available if you want to achieve lifelong vibrant health.

For more on sleep, I recommend The Promise of Sleep by William C. Dement MD, PhD (Random House, 1999).

Now I’d like to hear from you…

How much sleep do you typically get each night? Do you think it’s enough?

If you are not getting enough sleep, what do you think is the cause?

What healthy sleep habits to you plan to start?

Have you noticed a connection between your weight or health and how much sleep you get?

Please leave your thoughts by adding a comment below – but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!

To your good health,

Mark Hyman, MD

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36 Responses to Sweet Dreams: How to Sleep Better, Lose Weight, and Live Longer

  1. Calvin Thomas February 2, 2013 at 6:30 am #

    Thank you. Indeed, poor sleep leads me to sugar and carb cravings next day to attack lethargy – and afternoon naps – and perpetuates an unhealthy cycle, that melatonin (properly timed and dosed) helps regulate. I had a ‘sleep apnea operation’ and turbonase 25+ years ago. It helped until I gained 20# and now, years later I can see a threshold of weight (for me approx 187# ) where apnea tends to return, and is essentially gone below that threshold. Insomnia tends to happen partly as a result of peeing too often in the night (esp during the 10-day detox) where it went on 24/7. thank you for all you have done and are trying to do for all. I have benefitted, and continue to benefit from your educating initiatives and am acting as a deciple (sp?) of sorts. Nay you maintain your energy and spirit.

  2. Caterina P February 2, 2013 at 12:12 pm #

    Not enough, though I try. Probably 6-6.5. But the herbs aren’t working. Some advice I can’t follow. I must take an antihistamine every night. Even with an air purifier and my daily neti pot, there’s just too much in the air for me to go without, and I have tried. I can’t take it in the morning, because it tends to make me really sleepy. Driving to work after taking it would be irresponsible.
    I have the time to sleep, but wake up too early, and sometimes have trouble falling asleep. I don’t have a problem with sleep apnea, though. I did a study a few yrs ago.

  3. Cheril mosher February 2, 2013 at 9:18 pm #

    I have had sleep problems since my husband passed away. It’s been 18 years, so I don’t think that is the problem, now. I have cut out caffinated drinks quite a long time ago. I have GERD, so avoid eating before going to bed. I have tried reading until I can no longer concentrate on what I’m reading. I have tried Camimile Tea. I found that I am anxious when I go to bed and cannot relax, so I take Ambian to relax me. Sometimes that is not enough. I also found that I can eat a small piece of Havarti Cheese before going to bed and it doesn’t bother my stomach. If I have a Reflux episode, I take 1/2 tsp Baking soda in a cup of warm water. I also put a small amount of Vicks in my nostrils to sleep with the vapor. I sometimes use a Lavender Spray on the Bedspread to relax me. If I talk to anyone, it breaks my ability to get to sleep. I do not have sleep apnea. I am 77 now. I think about things I need to do and things I want to do, and it keeps me from sleeping. I get sleepy some days and fall asleep while watching TV. It seems like there is no simple solution. Yes, I am overweight, but try to eat right.

  4. I’m no longer positive where you are getting your info, but good topic. I needs to spend some time finding out much more or figuring out more. Thank you for fantastic information I was looking for this info for my mission.

  5. Bonnie Pickhardt May 20, 2013 at 6:14 am #

    Your suggestions for developing good habits – following routines to ready the brain and body for sleep provided a few I hadn’t heard about and will try. I find my main problem to be the “just one more thing” syndrome, or the ‘too few hours in the day’ syndrome. Reading the comments above, I see good people struggling to DO and BE their best, and am confident they will eventually find balance. Stay well and keep smiling!

  6. Profile photo of
    Marilyn Aspen November 18, 2013 at 2:01 pm #

    I’ve eaten well, stayed active, and slept well for most of my life. However, in my late 30’s when, over the course of about two years, I developed a fairly severe fear/anxiety/depression issue which resulted in a significant sleep problem that lasted for about 6-8 months, I sought professional help. My internist offered me antidepressants (which, ironically, made me more depressed to think about taking), and a stress-management professional offered a profound, one-time therapy session that was the turning point for me. One of the most important concepts he taught me was that I DIDN’T HAVE TO DO ALL AND BE ALL TO EVERYONE AND EVERYTHING. So effective was his work that I left his office that day motivated, inspired and determined to learn to say “no” and take back my time and life … and live at a pace that supported health of body, mind and spirit. It took persistence and time (a few years) to “rewire” my brain and develop new perspectives and habits, but I was determined. Every day, the process was gratifying … as I regained my health and more … and other than on rare occasions, a good night’s sleep became, once again, the norm for me.

  7. Tunney McFadyen December 31, 2013 at 5:59 pm #

    What are some of the sleep devices you recommend? I have put on weight recently – about 12lbs and so was interested to read of the connection between lack of sleep and gaining weight. I am tired most of each day unless I am doing work that is mentally stimulating and interesting. I use a device called “daddy’s dummy” to help me sleep better and am definitely worse for wear when I don’t use it – but it can fall out of my mouth when I sleep on my side which is my preferred position ….and so the drama continues

  8. Rosie Howell January 1, 2014 at 6:52 am #

    I don’t agree with the statement sleep apnea is not diagnosed enough. I think it is over diagnosed and is the latest “fad” in the world of medicine. The test is costly, (mine was $4000), the initial set up with equipment is expensive and the continued barrage of supplies you need is expensive. I fell for this and can tell you it has made no difference in my life. I use the CPAP as prescribed. I have gained weight, my blood pressure did not get better and I am still sleepy during the day. I wake up several times a night still. I think the real problem is my job. It’s a desk job, all I do is look at a computer all day, and I am mentally exhausted at the end of the day to the point of immobilization. Just total boredom. And how many of us have jobs like this now?

    • Corinne January 26, 2015 at 6:54 am #

      Rosie: do you exercise at all? I too have a computer desk job and have found that if I stand up to work (have an adjustable desk) and exercise in the morning for at least 20 min it makes a huge difference in my sleep and energy levels. Even when you feel sluggish after working all day it’s important to force yourself to workout at whatever time you can. I also walk with a friend (or without) at noon. Start with a walk (wear cleats in winter); try Pilates or whatever interests you. If you don’t have a preferred exercise start experimenting but don’t workout right before bed. Allow at least 2-3 hours beforehand. Good luck!

  9. http://google.com/ January 1, 2014 at 9:24 am #

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  10. Ingrid Bloom April 13, 2014 at 2:00 pm #

    Thank you for all your sensible suggestions to get good sleep. I do all of them and have for a long time. I am not overweight. What exactly should I do to sleep better. Also I do meditation before I go to bed, because I believe, that my insomnia comes from worrying about not sleeping. Do you get any kind of benefit from tossing and turning for sleep. We are told that we need the sleep, but what do you do if you just cannot do it. Sometimes I get 7 hours with some interruptions, but so often I fear to go to bed.

  11. Leslie April 19, 2014 at 6:43 am #

    The days of writing bills, balancing a checkbook, responding to emails just before bedtime are over. Just like I now need to stretch and warm up before I run, I find a sleep routine helps me sleep. I take a bath with magnesium flakes and lavender oil- but will try adding the baking soda. Instead of overhead lighting, an electric candle lights the bathroom. After the relaxing bath, I spray magnesium oil on the bottom of my feet and magnesium lotion on my face and lower back. This new routine has been helping me fall asleep quickly.

  12. Amanda's Pink Power May 17, 2014 at 6:46 am #

    Great and nice blog. It’s also very interesting. We also have a website about Lose weight.

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    • Profile photo of Team Hyman
      Team Hyman June 29, 2014 at 4:54 pm #

      Thank you for your support and for sharing your website!

  13. Vivamagonline September 16, 2014 at 9:36 am #

    WE’RE A SLEEP DEPRIVED NATION. THE AVERAGE CANADIAN GETS CLOSE
    TO 90 MINUTES LESS SLEEP THAN 50 YEARS AGO. HERE’S WHY IT’S IMPACTING OUR HEALTH AND HOW TO GET MORE ZZZZ’S.

    BY NANCY RIPTON
    In today’s busy society, it’s almost a badge of honour to claim that you get too little sleep. In fact, the average person sleeps 60 to 90 minutes less than they did 50 years ago. Thirty-five to 40 percent of the North American adult population has problems with falling asleep or with daytime sleepiness. “It’s a big problem,” says Lawrence Epstein, MD, regional director for the Harvard-affiliated Sleep Health Centers and author of The Harvard Medical School Guide to a Good Night’s Sleep. “People don’t think sleep is important because we can get by with less, but we’re putting our health at risk.”

    – See more at: http://www.vivamagonline.com/sleepless-in-canada/#sthash.i9fhr2DF.dpuf

  14. Evan Brand September 16, 2014 at 12:05 pm #

    Good tips. I’m glad you recommend nothing over 3mg of melatonin as people think it’s an innocent and benign supplement to take.. it’s a hormone people!

    I also created REM Rehab a sleep program that has been popular and includes dietary aspects as well as personalized supplement protocols at http://remrehab.com

    On the recommendation for taking 5-HTP to help increase serotonin and therefore melatonin as long as the cofactors are present is a good idea, but have to be careful with long-term use and one should use L-Tyrosine in combination with. The potential stimulating effects of Tyrosine are nothing to worry about in low doses.

  15. Lisa Streett September 28, 2014 at 8:12 pm #

    I have never been able to sleep, even as a child. I have always stayed up late and woke up early. I do take 30-45 minute naps after work on most days. I am 30 pounds overweight and I have suffered from chronic idiopathic hives and angioedema for 18 years. No diagnosis as to why. I am thinking about participating in a sleep study as soon as I get health insurance. Maybe that will help with the hives and the weight.

    • Lance January 26, 2015 at 8:01 am #

      My son had hives, and we discovered it was a food sensitivity related.to the consumption of gluten. Try eliminating gluten from your diet for a few weeks. He feels ALOT better!

  16. Debbie H. September 28, 2014 at 8:15 pm #

    I had a sleep study done this past March and was diagnosed with Upper Airway Resistance Syndrome. I’ve been fitted with a sleep appliance that helps a bit but not nearly enough. I also have elevated cortisol at night. No idea which came first. Also hypothyroid. I continue to struggle to get a good night’s sleep despite using melatonin, L-theanine, rhodiola, and phosphatidylserine, eat a whole foods diet and aim for 8 hours in bed each night.I have just started trying meditation. Saw an acupuncturist and I think that might work but my insurance will not cover it and at $85 per treatment I can’t afford this out of pocket. I am 59 years old and 6 years post-menopause, gaining weight and desperate!!

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff October 4, 2014 at 10:58 am #

      Hi Debbie,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org/practitioner_search.aspx?id=117 and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
      Wishing you the best of health,
      Dr. Hyman Staff

    • D.D. February 28, 2015 at 8:02 pm #

      I don’t know if you will see this so long after your posting.
      The gold standard for treatment of chronic insomnia (per the National Institutes of Health and the American Academy of Sleep Medicine) is Cognitive Behavioral Therapy for Insomnia (CTBi, or often seen as “CBT-I”).

      CBT-I works as well as sleep medication in the short term, and better in the long term. It takes 8-10 weeks of weekly one-hour sessions where the goal isn’t just to help the patient improve their sleep, but to teach the patient to be their own sleep therapist for the future, as well. Sleep may continue to improve for up to 6 months after therapy is ended.

      You might be able to for to the American Academy of Sleep Medicine an do a search for a CBT-I trained specialist in your area. If there are none listed, try calling large sleep centers nearby, especially if associated with a university, as those university sleep medicine departments are often the only place in town offering CBTi. Another possibility is one of the online programs that include weekly emails or chats with the specialist – any program that you select should be run by board certified health care professionals, not a person who used to have insomnia and had CBTi or another non-licensed person.

      Good luck!

  17. Shawn Van Meter Blount September 28, 2014 at 8:37 pm #

    Omega 3’s and grass-fed animal products. Proper fatty-acid balance leads to hormone balance which equals sleep.

  18. I am a health coach and nutrition consultant, and one of the most common health challenges I see with clients is difficulty sleeping. I also sometimes feel challenged by insomnia, so I found your article helpful both professionally and personally.

    My go-to tips for sleep support include taking magnesium at night before bed, using a calming aromatherapy spray on my pillow and feet at night, avoiding caffeine, getting sunlight every day, and sometimes taking herbal support with passion flower, etc.

    One question though: I though Dr. Sara Gottfried suggested a much lower dosage of melatonin if trying that route, like .5-1 mg. What are your thoughts?

    Thank you for your helpful and informative article!

  19. Marco September 29, 2014 at 4:26 am #

    Thanks a bunch for the tips!!! Warming the middle for proper chemistry by raising core temperature did i not know of. I thought the feet regulated the most and should be cold before bed, to simmer down the temperature so the body don’t make thermogetic energi and keeps you awake.

    I like cold feet to get me to sleep but i will definietly try to warm my middle / abdominen to relax the body. Thanks again Mark and the Staff :) :)

  20. Chiva Tafazzoli September 29, 2014 at 6:01 am #

    How did you therapy the sleep apnea? What kind of device was that? How long did the patient have to use it and in which form until he got his life back and lost 50 pounds?

  21. Stephanie September 29, 2014 at 10:16 am #

    I have been taking Unisom and it is the only thing helping me sleep at this moment. I have a huge exam in a couple of weeks and this, I believe is why I am waking up at 3:15 every morning. Some nights I fall back asleep and some nights I don’t. Passion flower and all the other “sleep herbs” are not helping me.

  22. Rj Hallstrom September 29, 2014 at 11:12 am #

    I love my cpap machine. It literally changed my life! Maybe even saved my life! Was so tired during the day, I would almost cry because I couldn’t lay down at work and take a nap. My blood pressure had sky rocketed and I had to start taking meds for it. My gerd was awful, and my weight was rising. I do not sleep one night now without my machine. If you even think you have apnea, get tested. I know of several people who have died in their sleep from it. It’s real and it kills.

  23. Mark Burhenne DDS September 29, 2014 at 4:02 pm #

    Kudos to you, Mark, for recommending a sleep study in a lab. Too often people wait until they have heart disease or other conditions that sleep apnea puts you at risk for — but why wait for those indicators? It’s not normal to feel fatigue or sleepiness during the day, so don’t fight through it — get a sleep study!

    A sleep medicine MD recommended this iPhone app to me, which I recommend to all my patients and readers to measure how many interruptions are in their sleep: http://askthedentist.com/how-to-find-out-sleeping-well/

    Another indicator of sleep apnea is grinding the teeth — a sign that you are struggling to keep your airway open at night. If you’re a teeth grinder, get into the lab for a sleep study ASAP!

    – Dr. B

  24. Dodie Jacobi September 29, 2014 at 11:19 pm #

    Big difference in sleep for the nights I jacuzzi with Epsom salts, and don’t. I sleep solidly and deeply when I soak.). Will try adding baking soda. Also just started the three hour sacred time for not eating before bed and love it. Thanks for a great post worth sharing.

  25. Angela September 30, 2014 at 1:33 pm #

    I know I don’t sleep enough but it’s my own fault really. I love to read and as a busy mom of two, as well as running my own home based business, I can’t seem to find the time during the day. I do love Arbonne’s new Sleep Well spray. It delighted me but did not surprise me that all the herbal recommendations made are ingredients in this one product. Our family loves it!! Cheers to more beauty sleep!

  26. Morgan October 7, 2014 at 11:49 am #

    I have been suffering from sleeping problems for the past few years but the past couple of months it has been severe, leading to lack of motivation and a zombie-like state where I can’t function at work. This has even led to anxiety and had begun to cause depression. I started using Natural Calm’s Ionic Magnesium Citrate Powder with the help of THIS article, where other products are also mentioned. It has helped immensely:

    http://www.vivamagonline.com/calm-amidst-the-hollywood-storm/#sthash.etZSTWEL.dpuf

  27. Vivamagonline October 8, 2014 at 1:25 am #

    Hi there, my friend who told me regarding this weblog, this blog is simply awesome. There are lots of blog article like this in web. I was read one article same like this one and i hope below article will help to someone surely: http://www.vivamagonline.com/calm-amidst-the-hollywood-storm/

  28. may October 29, 2014 at 2:03 pm #

    Very good writings, and the most important factor of getting good sleep is to eat enough vegetables ,fruits, and less junk foods, fried foods.

  29. Linda Lewis January 25, 2015 at 9:02 pm #

    I have sleep apnea and sleep with a Cpap 11 lbs pressure… I still do not sleep well at night..but can sleep like a baby during the day , sometimes all day.. Any thoughts????

  30. Wilma J OConnor February 2, 2015 at 10:54 pm #

    Thank You! For these hints, I’m just getting over the flu, & my sleep pattern got turned around I can’t sleep at night I try but only able to sleep 3-5 hours then between 10AM-12 noon I cannot hold my eyes open I fall asleep wake up at between 3:00-4:00 PM I feel like that I’m on A merry-go-round… Please help! I can’t get anything done!!! Thank You!

  31. D.D. February 28, 2015 at 7:51 pm #

    Sleep hygiene is ok for those people who don’t actually have chronic insomnia – but it isn’t too effective for people with chronic insomnia. In fact, for someone with chronic insomnia, trying these things (which they’ve usually already done before seeking treatment) becomes a perpetuating factor. That’s because these changes won’t work to help chronic insomnia, and when they don’t, it often results in increased fear and anxiety: “what’s wrong with me! I must be dying! Nothing works!”

    Chronic insomnia is a self-perpetuating disorder. When the original precipitating factor is no longer causing sleep loss, the insomnia persists because of behavioral and cognitive changes combined with bio-neuro-chemical hyper-arousal and stimulus dysregulation (i.e., neural pathways that stimulate wakefulness in the sleep environment). The gold standard treatment for insomnia is Cognitive Behavioral Therapy for Insomnia (CBTi), which addresses these perpetuating factors and results in decreased sleep latency, wake after sleep onset, and early awakening time.

    None of the supplements, unfortunately, have any evidence supporting efficacy for chronic insomnia — for those supplements for which there have been well designed studies, there are none showing any effect not explained by placebo. For jet lag traveling westward, there is decent evidence that one dose of melatonin can be effective as a preventative; for insomnia, though, bucketloads of it wouldn’t be enough crossing the blood-brain barrier to matter. I wish that we had at least one supplement to use in treating insomnia, because taking a pill is so much easier than going to eight to ten one-hour treatment sessions and doing the work. But that’s where we are right now.

    If someone has chronic insomnia (> 3 months, missing 30+ minutes of sleep due to difficulty falling asleep, staying asleep, or waking too early, 3 or more nights a week, and feeling irritated, fatigued, having poor focus/concentration or noticing problems with memory during the day) – a referral to a behavioral sleep specialist is what is needed.

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