I can’t sleep! Help! How do I fix this? As The Sleep Doctor™, you can imagine how often I hear this question—from patients, from friends and colleagues, from people passing me on the street!
Millions of us have
trouble sleeping at night. And finding the right remedy for your difficulty sleeping depends on answering another, fundamental question:
WHY can’t I sleep?
Sleep touches every aspect of our lives. I like to call it the domino of health, because once you fix it so many other areas fall into line—our mental and physical health, our daily functioning, our relationships and lifestyle habits, our diet and exercise routines. And every one of these factors, in turn, can affect our sleep. Sleep problems can arise from:
- Underlying mental and physical health conditions, environment and medications used to treat those conditions
- Sleep disorders, such as insomnia and obstructive sleep apnea
- Stress—both chronic stress from the challenges of daily life, and acute stress caused by specific events and circumstances
- Our daily lifestyle routines, including the timing of our light exposure and eating
- Our sleep environments
- Our pre-sleep routines and our daily sleep-wake schedules
- How often we go out partying and how often we stay in
For many people, it is multiple factors that come together to interfere with sleep—a poor sleep environment and lots of daily stress, or a chronic health condition and an inconsistent sleep routine, for example.
As a first step, I always recommend checking in with your doctor about any concerns or problems you’re having with your sleep, especially if your sleep issues occur regularly, have lasted for several weeks or longer, or are interfering with your daily performance, productivity, mood, or quality of life. You and your physician can review your symptoms, and your doctor will work to identify any underlying medical issues and may refer you to a sleep specialist for an evaluation as part of diagnosing a sleep disorder.
Here, I’ll talk about the strategies, habits, and routines you can implement into your daily life, to sleep more soundly, and reduce your difficulty in falling asleep and staying asleep throughout the night.
What to do when you’re in bed and can’t fall asleep
There are simple, fundamental changes you can make to your daily life that will go a long way toward improving the quality and quantity of your sleep, and reduce the nights you spend awake struggling to drift off into a restful slumber. But we’re all going to have nights when sleep we just can’t fall asleep at bedtime. Here’s how to respond when you go to bed and sleep doesn’t come:
Get out of bed.
Don’t spend more than 20 minutes in bed struggling to fall asleep. You’ll only make yourself anxious and frustrated, which will only make sleep harder to achieve. Get out of bed, move to another room or a comfortable chair in your bedroom, and take a little time to relax before returning to bed.
Keep your mind quiet.
Engaging a quiet, relaxing activity will help keep your mind occupied without stimulating you mentally or physically. Listen to soothing music, read a book (under low light), or use one of the deep breathing exercises below to unwind and bring about feelings of drowsiness that are your signal to return to bed.
Stay away from your phone and the TV.
Cell phones and other technology are stimulating and emit
blue light that can keep you awake. Storing your phones and tablets out of the bedroom can help you avoid the temptation to start scrolling when you’re struggling to fall asleep.
Leave the lights low.
Give yourself just enough light to get around, or read, if you choose. Exposure to bright, a
mbient light at night will suppress the melatonin production you need to facilitate sleep. Use red-light nightlights in the hallway and bathroom.
Cover up your clock.
Staring at the clock and focusing on the sleep time you’re losing will only prolong your wakefulness, and amp up your anxiety about your sleeplessness. Cover up your clock or turn it around, and gently focus on mental and physical relaxation in the moment.
Now let’s talk about the daily habits that can make the process of falling asleep and staying asleep easier and more pleasurable.
Establish a sleep schedule—and stick to it every day
Our bodies crave routine—and inconsistent sleep schedules are often a prime contributor to trouble falling asleep and sleeping well throughout the night. Consistency in your sleep routine—going to bed and, in particular, waking up at the same time every day—is the single most important factor in maintaining a healthy routine of high-quality sleep.
Your sleep-wake cycle is a
circadian rhythm that follows cues from your body’s internal clock. And the specific timing of your internal clock is set by your chronotype. Your chronotype determines your optimal bed and wake times.
The first and most critical step in creating an ideal sleep schedule is to identify your chronotype. You can take this
short quiz to find out whether you're a Lion, a Bear, a Wolf or a Dolphin chronotype.
- Lions’ optimal bedtime is 10 p.m. and wake time is 6 a.m.
- Bears’ ideal bedtime is 11 p.m. and wake time is 7 a.m.
- Wolves do best when they bed down for the night at 12:30 a.m., and wake at 8 a.m. (That wake time isn’t possible for all Wolves—get as close as you can, given the demands of real life.)
- Dolphins’ optimal bedtime is midnight, with a wake time of 7 a.m.
Maintain your sleep-wake schedule daily—that means weekdays
and weekends. I recommend sticking to within 30 minutes of your optimal bedtime and wake time every day.
Set up a relaxing routine for the hour before bedtime
Our nightly pre-bedtime habits go hand-in-hand with a consistent sleep-wake routine in priming our bodies and minds for sleep. I recommend a PowerDown Hour™ as part of everyone’s nightly routine. Your PowerDown Hour™ can be customized to suit your individual preferences, but there’s one practice that everyone is wise to follow:
schedule all your streaming, internet surfing, emailing, and social media scrolling to end before this hour begins. Use this template to create a relaxing, enjoyable, sleep-promoting pre-bed routine:
Set aside 20 minutes for hygiene and grooming and taking any medications that you are supposed to take at bedtime.
Next, devote 10 minutes to each of the following:
Something for your mind. Meditation is excellent addition to a PowerDown Hour™. Or spend 10 minutes reading for pleasure (no bright reading lights, please—and
wear blue light blocking glasses if you’re using an e-reader). Listen to a funny, relaxing, or inspiring podcast, or some music that relaxes you.
Something for your body. A light yoga practice, tai chi, light stretching, a walk around the block with the dog before lights out are all effective ways to clear your mind of the day’s thoughts. The relaxation exercises I discuss below will help you let go, mentally and physically, of the tension and residue of your day. Carve out some time to pay attention to relaxing your body and releasing the tension you’ve built up through the day—your mind will follow suit.
To enhance mental and physical relaxation, schedule a bath or shower for 90 minutes before lights out in order to maximize the sleep-inducing benefits of your nightly soak.
Something for your stomach. My recommendations for a pre-bed snack are to keep it at about 250 calories, a balance of protein and complex carbohydrate, and to steer clear of the
sugar-loaded snacks so many of us crave at night.
Something for your senses. Too often, we forget about touch and smell as influencers of sleep.
Essential oils can be potent sleep promoters by relaxing both body and mind. Research shows sleep-promoting essential oils can help
relieve mild sleep disturbances and
improve sleep quality. Try spending a few minutes of your PowerDown Hour in the company of sleep-promoting scents, such as lavender, jasmine, or vanilla. (Adding essential oils to a nighttime bath is a great way to take advantage of sleep-promoting scents and the relaxation of a soothing, evening soak in the tub.)
Try employing the power of touch to relax, de-stress, and elevate your mood before bed. Partners can take turns giving each other simple massages. You can also use self-massage practices, or the touch therapy practice of reflexology, which
reduces brain wave activity and increases sleepiness.
Create a sleep-friendly bedroom
Your
sleep environment—both your bedroom and the microclimate of your bed, will have a major impact on how well, or poorly, you rest. Small, low-effort changes to your sleep environment can have a major impact on the quality and quantity of your sleep.
Keep the temperature moderate.
The right temperature for sleeping is the one that’s right for you—a temperature that allows you to sleep comfortably throughout the duration of the night, without sweating or feeling chilled. For most people, that’s a room temperature between 67-72 degrees Fahrenheit. Use easily adjustable layers of bedding so you can adapt easily to keep yourself comfortable—and consider sleeping in the nude so you don’t overheat!
Make your bedroom as dark as possible.
Light exposure in the evenings is a major obstacle for sleep. Eliminating light in the bedroom, except for a dim night light, will signal to your body that it’s time to rest, and stimulate the sleep-promoting hormone melatonin. Remove electronic devices from your bedroom, and use blackout curtains to block environmental light.
Block noise.
Noise can disrupt our ability to fall asleep and stay asleep. White noise machines are a terrific tool for shielding your bedroom from disruptive noises that startle you awake or keep you from falling asleep in the first place.
Make your bed a comfortable haven for sleep.
Investing in the highest quality sleep equipment you can afford will pay tremendous dividends for your sleep. Finding the right
pillow and
mattress to meet your individual needs and preferences will increase your comfort, reduce pain and tension, and help you sleep more deeply and soundly throughout the night.
Keep your bedroom clean.
A clean bedroom reduces the impact of everyday allergens on your nightly rest. And keeping your bedroom clean makes your sleep space an inviting place you’ll look forward to retreating to when your day is finally done.
Use relaxation techniques to quiet your mind
Stress is a major contributor to sleep difficulties, making it harder to fall asleep and sleep soundly throughout the night. Often, we arrive at bedtime with a wired, racing mind and a keyed-up nervous system, which make it all but impossible to relax and drift off into a night of rest.
Simple meditation and breathing techniques can help you relax and unwind mentally and physically to prepare you to fall asleep. These are three of my favorite relaxation exercises—try using one or more of them as part of your nightly PowerDown Hour™.
Deep breathing for relaxation
- Lie down on the bed, find a comfortable position, and close your eyes.
- Gently rest one hand on your chest over the heart and the other hand on your stomach.
- Slowly inhale, noticing your stomach rise.
- Hold your breath for a few seconds.
- Slowly exhale, noticing your stomach fall.
Continue this pattern of breathing to help release stress and tension in the body.
Progressive muscle relaxation
- Find a comfortable position lying down with your eyes closed.
- Gently tense the muscles in your face while breathing in for five seconds.
- Release the muscle tension in your face while breathing out, paying attention to how it feels to have your muscles relax.
- Move incrementally through your body, from neck to shoulders to arms and hands, legs and feet. Gently tense your muscles while breathing in for five seconds. Exhale and release the tension, putting your awareness on the experience of relaxing your muscles.
Body scan
- Lay in a comfortable position, preferably on your back. Center your attention on your body and breath. When you get distracted—and you will-- gently return your attention to your body and breath.
- Start at the top of your head. Notice where your head makes contact with your bed or pillow and simply acknowledge any pressure or sensations.
- Work your way down through your face, throat and neck, taking notice of tingling, tightness, or other sensations.
- Continue across your shoulders and down your back, letting yourself become aware of any pressure or tension.
- Move your attention through your torso to your legs and feet. Take notice of the weight of your body and limbs against your mattress. Simply acknowledge how your body feels in the moment, taking a moment to register without judgment any, pain, tension, or other sensations.
Adopt sleep-promoting habits throughout the day
Too often, we only pay attention to sleep at bedtime. The reality is, sleeping well is a 24-hour endeavor. The choices we make throughout the day can have a big impact on how well we sleep at night. Simple adjustments to daily habits can deliver major improvements to sleep, especially when you’re consistent with them over time. Here are the lifestyle changes that can have the biggest impact on your sleep:
Limit sugar, load up on fiber.
Recent research from scientists at Columbia University found that
diets high in sugar and other refined carbohydrates may elevate risks for insomnia. The same study found that high-fiber, vegetable- and fruit-rich diets may lower insomnia risks.
Eat for your chronotype.
The when of eating as important as what you eat, for sleep and health. In my latest book
, Energize!, I cover in detail how to establish eating routines in sync with your chronotype and body type, to boost your energy and sleep better. The big takeaway? Establishing 8-, 10-, or 12-hour daily eating windows gives your body time to rest and digest, to burn calories for energy rather than storing them as fat. A light snack at night typically isn’t disruptive to sleep—but eating heavily close to bedtime will make it harder to fall asleep and make sleep more restless.
Make time for movement.
Physical activity during the day helps us feel tired and ready for sleep at night, and a
strong body of research points to the benefits of regular exercise for consistently high-quality sleep.
Soak up sunlight.
Sunlight exposure supports our body’s sleep-wake cycle and sleep patterns. Try for at least 5 minutes of sunlight first thing in the morning, to wake you up and sync your internal clock for the day and shoot for 30 minutes of sunlight exposure over the rest of the day.
Limit caffeine and alcohol.
Caffeine is a stimulant that takes your body several hours to metabolize. I recommend avoiding caffeine after 2 p.m., to protect your ability to fall asleep at bedtime.
Alcohol functions as both a sedative and a stimulant in the body. Consuming alcohol close to bedtime may help you fall asleep more quickly, but it will reduce your time in deep sleep and can cause you to sleep restlessly and wake more often later in the night. I recommend avoiding alcohol within 3 hours of bedtime.
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