Keep milk and cookies within reach. Milk contains sleep-inducing tryptophan, but you need carbs to get it into your brain. Dr. Esther likes cookies (low-fat, of course) as the carb, but you could substitute crackers if you’d prefer. There are tryptophan supplements on the market, but neither she nor the FDA recommends them; their safety is still in question.
Nix nightcaps. “Sometimes sleepless individuals will have a drink or two to help fall asleep,” says Dr. Esther. “While it will shorten time falling asleep, alcohol actually causes more arousal as your body metabolizes it. The result is it shortens sleep.
“A glass of wine with dinner is okay,” she adds. “But a glass afterward may have an impact on your sleep.”
Treat yourself like a child. Create a nurturing postbath, prebed routine that’s intended to help you wind down, says Dr. Esther. A little reading, a little soft music — whatever makes you feel nurtured and relaxed.
“We tend to take care of everyone else before we take care of ourselves,” says Dr. Esther. “That has to change.”
Stop those thoughts. Once you hit the sheets, worry time is over — especially about sleeping. There’s a therapy trick called “thought-stopping” that works like a charm, says Dr. Esther. “If you find yourself thinking about tomorrow and saying, ‘It’s going to be a bad day because I’m never going to sleep,’ immediately think: ‘STOP. Don’t go there. I know I’ve done this before. If I don’t fall asleep, I’ll get out of bed, flip through a magazine, but I am NOT going to focus on this stuff!’” Sounds simple, but once you try it, you’ll find it works!
Restrict time bed to sleep time. If you’re going to bed at 10:00 P.M., sleeping from 11:30 P.M. until 2:00 A.M., tossing and turning until 4 A.M., then sleeping until 6, you’ve gotten 8 hours in bed but only 4 1/2 hours of sleep. That’s a huge mismatch, which can actually inhibit your sleep drive and cause insomnia all by itself. To prevent it, when you wake at 2, go read a book in the living room. Being up increases your sleep drive — which could make you sleepy enough to fall asleep when you return to bed.
Schedule your sleep time. “Stick with it seven days a week,” says Dr. Esther. Opening your eyes at the same time every morning triggers a series of biochemicals that, as the day winds down, tell your body when it’s time to sleep.
Work with a cognitive behavioral therapist. In a study at the Université Laval in Quebec, researchers measured the effects of cognitive behavioral therapy for GAD on insomnia and found that insomnia practically disappeared among study participants.
What’s more, in 21 other studies involving 470 patients with insomnia from a variety of causes, cognitive behavioral therapy worked just as well as sleeping pills at increasing sleep and improving sleep quality — and it was actually better than sleeping pills at helping study participants get to sleep faster.
Despite its intimidating name, cognitive behavioral therapy — or CBT — is simply learning new information about what keeps you from sleeping (the “cognitive” part) and learning how to manipulate your behavior (the “behavioral” part) so that it doesn’t. It generally takes only four or five 30-minute sessions to effect change.
Unfortunately, certified cognitive behavioral therapists are scarce. To find one, visit http://www.academyofct.org and click on “Find a Certified Cognitive Therapist.” Fill in your Zip code on the pop-up, and a list of therapists in your area will appear. If none do, you can visit http://www.cbtforinsomnia.com. The Harvard researcher who demonstrated the effectiveness of CBT vs. sleeping pills has taken his study and packaged it into an online program.
Seek a sleep specialist. “If you’ve been struggling with a sleep problem for almost a month, talk to a sleep specialist,” suggests Dr. Esther. “You already know what your issues are, but a sleep specialist might be helpful by prescribing an anti-anxiety medication to use for a few weeks as you get control of your worries and establish better sleep habits.”
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