PRE - SLEEP AND WHEN YOU WAKE

The following suggestions are in general and can help you have a good night’s sleep.

 •            Keep a regular schedule. Try to go to bed and wake up at the same time everyday, even on the weekends. Keeping a regular schedule will help your body expect sleep at the same time each day. Don’t oversleep to make up for a poor night’s sleep – doing that for even a couple of days can reset your body clock and make it hard for you to get to sleep at night.

 

 •            Incorporate bedtime rituals. Listening to soft music, sipping a cup of herbal tea, etc., cues your body that it ' s time to slow down and begin to prepare for sleep.

 

 •            Relax for a while before going to bed. Spending quiet time can make falling asleep easier. This may include meditation, relaxation and / or breathing exercises, or taking a warm bath. Try listening to recorded relaxation or guided imagery programs.

 

 •            Don’t eat a large, heavy meal before bed. This can cause indigestion and interfere with your normal sleep cycle. Drinking too much fluid before bed can cause you to get up to urinate. Try to eat your dinner at least two hours before bedtime.

 

 •            Bedtime snacks can help. An amino acid called tryptophan, found in milk, turkey, and peanuts, helps the brain produce serotonin, a chemical that helps you relax. Try drinking warm milk or eat a slice of toast with peanut butter or a bowl of cereal before bedtime. Plus, the warmth may temporarily increase your body temperature and the subsequent drop may hasten sleep.

 

 •            Jot down all of your concerns and worries. Anxiety excites the nervous system, so your brain sends messages to the adrenal glands, making you more alert. Write down your worries and possible solutions before you go to bed, so you don ' t need to ruminate in the middle of the night. A journal or " to do " list may be very helpful in letting you put away these concerns until the next day when you are fresh.

 

 •            Go to sleep when you are sleepy. When you feel tired, go to bed.

 

 •            Consider avoiding " over - the - counter " sleep aids, and make sure that your prescribed medications do not cause insomnia. There is little evidence that supplements and other over - the - counter " sleep aids " are effective. In some cases, there are safety concerns. Antihistamine sleep aids, in particular, have a long duration of action and can cause daytime drowsiness. Always talk to your doctor or healthcare practitioner about your concerns!

 

 •            Get into a calming bedtime routine that you start 30 - 60 minutes before your desired bedtime. Avoid watching tense or scary movies, or other highly stimulating activities.

 

 Find some activities that you find calming, and that take your mind off of things that are bothering you. This could include using a relaxation CD, reading, taking a hot bath, having a warm drink ( such as decaf tea or milk ), or listening to music. Avoid using alcohol to feel drowsy — it tends to contribute to waking up in the middle of the night.

 

 •            Earlier in the evening, before you go to bed, make a list of things you will need to do tomorrow or in the near future. Once you have made the list, put it away and focus on relaxing. You can start working on your list again tomorrow, and you will have more energy to tackle your list if you get some sleep.

 When you wake in the middle of the night, you CAN get back to sleep.

 •            Do visualization. Focus all your attention on your toes or visualize walking down an endless stairwell. Thinking about repetitive or mindless things will help your brain to shut down and adjust to sleep.

 

 •            Get out of bed if unable to sleep. Don’t lie in bed awake. Go into another room and do something relaxing until you feel sleepy. Worrying about falling asleep actually keeps many people awake.

 

 •            Don ' t do anything stimulating. Don ' t read anything job related or watch a stimulating TV program ( commercials and news shows tend to be alerting ). Don ' t expose yourself to bright light. The light gives cues to your brain that it is time to wake up.

 

 •            Get up and eat some turkey. Turkey contains tryptophan, a major building block for making serotonin, a neurotransmitter, which sends messages between nerve cells and causes feelings of sleepiness. Note that L - tryptophan doesn ' t act on the brain unless you eat it on an empty stomach with no protein present, so keep some turkey in the refrigerator for 3am.

 

 •            Consider changing your bedtime. If you are experiencing sleeplessness or insomnia consistently, think about going to bed later so that the time you spend in bed is spent sleeping. If you are only getting five hours of sleep at night, figure out what time you need to get up and subtract five hours ( for example, if you want to get up at 6: 00 am, go to bed at 1: 00 am ).

 

 This may seem counterproductive and, at first, you may be depriving yourself of some sleep, but it can help train your body to sleep consistently while in bed. When you are spending all of your time in bed sleeping, you can gradually sleep more, by adding 15 minutes at a time.

 Our final chapter will deal with a problem that is very common – sleep disorders in children.

LIGHT FOR HEALING

The circadian rhythm is more a function of darkness and light rather than actual time of day. Bright light can discourage drowsiness, and darkness can cause sleepiness, day or night. Light therapy is a treatment used for people who suffer from circadian rhythm sleep disorders. Your body has an internal clock that tells it when it is time to be asleep and when it is time to be awake.

 

 This clock is located in the brain just above an area where the nerves travel to the eyes. This area is called the SCN. Your clock controls the “circadian rhythms” in your body. These rhythms include body temperature, alertness and the daily cycle of many hormones.

 

 The word “circadian” means to occur in a cycle of about 24 hours. Circadian rhythms make you feel sleepy or alert at regular times every day. Some people have a circadian rhythm sleep disorder. This causes their natural sleep time to overlap with regular awake activities such as work or school.

 Among other factors, your clock is “set” by your exposure to bright light such as sunlight. Exposure to bright light or “light therapy” is one method used to treat people with a circadian rhythm sleep disorder.

 

 The goal for treating patients who have circadian rhythm problems is to combine a healthy sleep pattern with an internal clock that is set at the right time. This will allow them to enjoy the benefits of good sleep.

 

 Light therapy can help someone “re - set” a clock that is off. Regular sleep patterns help to keep the clock set at the new time. Light therapy is only part of a treatment plan that should be guided by a doctor who is familiar with sleep disorders.

 The use of a special light box may be helpful.

 

 The procedure is noninvasive and simple. The patient sits a few feet away from a box - like device that emits very bright fluorescent light ( over 4, 000 lux ) for about 30 minutes every day. The following people might benefit from light therapy in specific ways.

 •            Shift workers. Light therapy should be maximized during hours they are at work and minimized when they need to sleep.

 •            Frequent travelers. Light therapy may be useful for adjusting to new time zones and reducing jet lag.

 •            Nursing home patients.

 •            People with delayed sleep - phase syndrome. ( These people have a natural tendency to fall asleep very late at night or in early morning hours, but then sleep normally. )

 Everyone should check with their physician before using light therapy. The following people should avoid it or use it only under a physician ' s direction:

 •            Anyone with eyes or skin that is highly sensitive to light.

 •            Anyone taking medications that increase the risk for photosensitivity.

 •            People with bipolar disorder.

 Timing of the therapy depends on the type of insomnia or sleep schedule of the individual. For example, in people who cannot get to sleep at night, light therapy in the morning and restricting bright light at night may be helpful. People who wake up early in the morning may benefit from light therapy performed in the evening, although a 2002 study reported that it had no effect in this group. Some light boxes have dawn / dusk simulators that help determine the correct brightness.

 Patients typically receive bright light therapy at home, with the use of a light box. The light box emits a standard dosage of 5, 000 to 10, 000 lux ( a measure of illumination ) of white light while you sit in front of the light, at a specified distance, for approximately 30 - 60 minutes after waking in the morning. Light therapy should always be used within the proper limits for light intensity and duration of exposure.

 Bright light therapy has not been known to show any major side effects. Some patients have reported minor side effects including: eye irritation and dryness, headache, nausea, and dryness of skin. To reduce the chance of experiencing these minor side effects, it is recommended that you begin light therapy very slowly and consult your doctor before use.

 Finally, there are some general tips that you can practice that can help with your insomnia.