What research shows is that sleep is actually a learned habit.  Our body develops sleep patterns that are easily disrupted with changes in schedules and stimulation.  Repeated nights spent worrying or tossing and turning in bed teaches the body to associate the bed with arousal and alertness.  To address the problem, we need to help our body “relearn” to associate the bed with relaxation and drowsiness.  Sleep experts refer to three types of “learning” that can help re-establish sleep patterns:  sleep hygiene, stimulus control, and sleep restriction.

Sleep hygiene involves creating a routine that will best enhance sleep.  Physically, we need to avoid caffeine 6 to 8 hours before our bedtime and avoid nicotine, which is also a stimulant.  Also avoid alcohol after dinner.  While alcohol can promote the onset of sleep, it often disrupts your natural sleep patterns, so you should avoid it up to 4 hours before you go to bed.  Regular exercise is really important to getting good sleep, but if done within two hours of bedtime, it can elevate your nervous system instead of relax it.   Your bedroom environment should be very dark, using dark out shades or eye masks can help, cool in temperature, and quiet.  White noise or earplugs are good for this problem.  Give yourself time to wind down before going to bed, and do the same routine each evening so that it becomes associated with sleep.  Avoid sleep medication.  Sleeping pills work only very temporarily and create sleep problems when used over time.  

Stimulus control involves the goal of reconnecting your bed with sleeping through learned association.  The bed should only be used for sleep and sexual activity:  no television, phone, computer use, or reading in the bedroom or in bed.  These activities, especially ones that involve a screen or stimulating material (yes, you Scandal fans) get in the way of associating relaxation with your bed.  Also, you should delay going to bed until you are sleepy.  If you don’t fall asleep relatively soon, get out of bed and return when you are drowsy.

Sleep restriction is also about training your body into patterns of healthy sleep.  It involves restricting the amount of time you spend in bed to the amount of time you currently spend actually asleep.  Research shows sleep restriction to be extremely effective for improving sleep, even though initially you may experience mild sleep deprivation as a result of the technique.  Sleep restriction involves calculating and keeping track of your sleep efficiency, which is the percentage of time you are actually asleep during the period of time you are trying to sleep.  For example, if you usually go to bed at 10 pm and wake up at 6 am, you are in bed for 8 hours.  Of this time, it takes you an hour to fall asleep, you wake for 30 minutes in the middle of the night and are up 30 minutes before you get up.  So, your actual sleep time is 6 hours of the actual 8 hours you are in bed, so the sleep efficiency is 75%.  Sleep restriction would mean reducing your time in bed by 2 hours.  You could either go to bed late, or get up earlier.  After sleep efficiency reaches 85% or greater, the time in bed can be increased in 15 to 20 minute blocks.  Time in bed is increased each week if you achieve 85% or greater.  The pattern is continued until efficiency starts to fall below 80% at which time you decrease sleep by 15 to 20 minute blocks.  You continue the process of increasing or decreasing sleep time by 15 to 20 minute blocks until sleep efficiency falls between 80 to 85% on a regular basis.  This is usually achieved in just a few weeks.

When people have sleep problems, the mere anxiety about sleep can be stimulating and make it difficult to get to sleep.  When you go to bed afraid of what the night will bring, you reinforce the wakefulness and alertness.  Before going to bed, try listening to a relaxing visualization that you can download from a meditation app, or just listen to soothing music.  You can listen to a classical music piece and pay attention to one instrument at a time.  This is mediation without having to even focus on meditation.  And if all else fails, try listening to a book on tape about a subject that doesn’t interest you. Personally, listening to tax advice tends to do the trick for me!