Most people have experienced the feeling of tossing and turning in bed or having trouble falling asleep.
For some, it's a rare occurrence. For others, it's every night.
There are countless reasons. biology. time of life. disease.
But for most people, there are ways to improve both the quantity and quality of sleep.
Experts say these strategies require knowledge, discipline, ingenuity, and maybe a good fan, not drugs, equipment, or gadgets. Most people can even continue their caffeine habit. At least in moderation and in the morning.
Rebecca Robbins, a research scientist in the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital in Boston, says, “The best sleep you get is when you practice healthy sleep strategies that set you up for a successful night's sleep.” says.
How to fall asleep quickly: “Don't try too hard”
for About 15% of people For people who struggle to consistently get a good night's sleep, researchers like Dr. Charles Zeisler of Harvard University offer a lot of advice, starting with the simple suggestion: “Don't worry about it too much.” We offer
Many people who think their sleep is terrible have unrealistic expectations of what a good night's sleep looks like, and are far from the old days when they could sleep like a rock for half a day. I guess you remember that. That's just not realistic for middle-aged people, he and others say.
Experts say if you have to get up to go to the bathroom in the middle of the night, or if you wake up repeatedly, that's okay. Cheisler, head of Harvard Medical School's division of sleep medicine, said that in today's society, everyone wants to sleep efficiently, but when they can't, they get frustrated.
Historical research suggests that our ancestors slept in two groups, separated by a few hours, until the Industrial Revolution put a value on each day's work.
Zeisler says some people think they don't sleep well because they don't take into account their bodies' natural needs for this gap.
“They may just not allocate enough time in bed to get as much sleep as they need. They want to be asleep 95% of the time they set aside for sleep, and they want to keep it to a minimum.” “We're trying to keep it to a minimum,” he says.
Zeisler and others instead advocate patience.
Even well-rested people take 15 to 20 minutes to fall asleep, and older people take the same amount of time to fall asleep or fall asleep as younger people. “It's important not to throw in the towel at night just because you wake up,” says Cheisler.
Tracking your sleep with a wearable device may be helpful for some people, but it too often causes stress, according to several experts.
Sleeping is not the time to be a perfectionist.
“We want people to go to bed feeling like they can sleep,” said Jennifer Martin, the David Geffen Professor of Medicine at the University of California, Los Angeles. “Eventually, they have to stop trying so hard.”
sleep hygiene
The term “sleep hygiene” refers to good habits and routines that help people sleep well most nights.
The specifics of when to go to bed and when to wake up vary from person to person based on personal needs and demands of daily life, but the basic principles apply to everyone.
“All of these behavioral changes are the secret to healthy sleep,” Robbins says.
Below are some basics.
◾ Go to bed and wake up at about the same time every night. Bedtimes that vary significantly can confuse your body clock and make it difficult to fall asleep.
◾ Some people may need a bedtime snack to help them fall asleep, but others find eating before bedtime a hindrance. Robbins said “a king's breakfast, a prince's lunch and a pauper's dinner” works best for most people. In other words, eat more in the morning, less in the afternoon, and less in the evening.
◾ Avoid drinking “nightcaps.” Alcohol at night may initially help you fall asleep, but it has been shown to interfere with subsequent sleep and worsen sleep apnea.
◾ If you are sensitive to caffeine, avoid consuming too much caffeine, especially in the afternoon. If you're not sure, try experimenting for a week by reducing your intake or eliminating it completely.
◾ Manage stress. Meditation and breathing exercises can help you decompress.
◾ Keep naps short and not close to bedtime.
◾ Expose yourself to as much natural light as possible in the morning. This aligns your circadian rhythm and makes you more alert in the morning.
◾ Some sleep researchers have special lights in their homes or software on their computers (f.lux The first is to limit your exposure to blue light at night. Blue light is a signal that it's morning! to the brain.
◾ Establish a bedtime routine. This includes turning off devices such as phones, bright lights, and other stimulating activities for a period of time.
◾ Feel the need for noise? Choose a fan over the TV, says Dr. James Lowery, president of the American Academy of Sleep Medicine Board of Directors. There are “no screams, no car crashes” for his fans. Even reading can be too stimulating for some people.
Lowry said mobile phones “should be placed face down next to the bed when charging and should not be placed on top of the body.”
Medicines are effective, but expensive
Rowley said the drug, which was developed as a sedative, works very well in the short term.
He is more concerned about people using drugs designed for other purposes, such as allergy and cold medicines, which have sedative side effects. “That's where a lot of us get upset,” Lowry said of sleep specialists' feelings.
1 patient, A recent visitor to his office was taking an “all-natural” sleep aid that contains about 15 ingredients, all of which can interact with other medications. “You have to be careful,” he said.
Melatonin has not been shown to be effective for insomnia in any research trials. Additionally, most people aren't using it correctly, using doses too high to be effective or too close to bedtime, Lowry said.
“If melatonin is effective, it's probably 0.5 to 3 (mg),” says Lowery. “It's not good for insomnia, but if you want to try it, a lower dose is probably better than a higher one.”
Additionally, Martin said, “If you have trouble staying asleep and take melatonin at night, it may actually make your problem worse, not better.”
at least one new Drug therapy is currently in late-stage clinical trialsbut the researchers said they are withholding judgment until they see whether the new drug's effects are better than existing drugs or better than behavioral changes.
What has so far been far more effective than drugs, Martin said, is a type of talk therapy called cognitive behavioral therapy for insomnia, or CBT-I.
CBT-I trains people to avoid behaviors and thoughts that make their insomnia worse.
“The way people think and behave is what perpetuates the problem of insomnia,” Martin says. “If we can help people go to bed with a better mindset and create sleep and wake habits and routines that are most conducive to falling asleep when they're in bed, it seems like they can get back to normal.”
When you need medical help: Sleep apnea
Experts say people with real sleep problems need professional help. Sleep problems become more common as we get older.
Many physical and mental illnesses are associated with sleep problems. For example, people with ADHD, autism, and depression often report sleep problems. Getting help with your sleep problems may help control other symptoms.
Sleep problems that last longer than about three months usually need to be treated like sleep apnea. Sleep apnea is often characterized by loud snoring or choking that wakes someone up (and often the person next to them).
One People following researchers A group of people with and without sleep apnea were observed for 18 years starting at the age of 48. In the group with sleep apnea, only 58% were alive at age 66, compared to 94% in the group without sleep apnea. This translates into a six to seven times increased risk of death, primarily from heart attack and stroke, “so it's very important to get treatment,” Zeisler said.
The standard treatment, called CPAP (continuous positive airway pressure), which uses a machine to keep the airways open, can be cumbersome and difficult to maintain, but most patients can adjust to it over time, experts say. said.
One widely used brand was recalled in 2021, stigmatizing the industry and confusing patients. Supply chain issues with the microchips used in the devices have left many people unable to use their CPAP machines for long periods of time. Unfortunately, these barriers remain, limiting treatment for an already complex and difficult-to-treat condition, Robbins said.
Other apnea treatments include implantable devices and surgery that are covered by health insurance.
Busting myths about sleep
in Research published in 2020, Robbins and Zeisler looked at 20 common myths about sleep among other experts. Robbins recently offered interpretations of some of the most enduring.
Falling asleep anytime and anywhere is not a sign of good sleep. It's a sign of a sleep-deprived person.
There is evidence that 7 to 9 hours of sleep provides the most optimal health and well-being. People who think it's okay to sleep less can probably lead to health problems later on.
Older people don't need as much sleep as younger people, but they often sleep less because their sleep is lighter and their sleep is more likely to be interrupted.
when Sleep is important. Closing your eyes for 8 hours during the day won't give you as much rest as 8 hours in the dark, but it's better than less sleep.
Time spent lying in bed does not count as sleep time.
It's not a good idea to stay in bed all the time if you can't sleep. Instead, experts recommend changing your environment and doing less stressful activities for a while before going back to sleep. That might not mean picking up your phone or getting work done, but instead taking a hot shower or stretching until you feel tired.
Finally, experts say that sleep is not a time when the brain is “off.” The brain is not passive during sleep; it is actively firing, removing waste, storing memories, and preparing for the day.
Robbins said people in general are starting to realize that sleep is just as important as diet and exercise in maintaining good health.
“Gone are the days of bragging about not getting enough,” she said.
Contact Karen Weintraub at [email protected].
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