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Daniel E.
How to get the sleep you need: An argument with the experts
Psychology Today blog: Insomniac
by Gayle Greene, PhD

November 5, 2009

Tired of hearing the same old advice?

Those of us who have trouble sleeping get tired of hearing the same old advice, the same half dozen rules. We read them everywhere. Avoid caffeine, alcohol, and big meals late at night. Don't exercise or engage in stimulating activities near bedtime, such as reading or watching TV in bed. Try taking a hot bath or writing a "worry list." When you can't sleep, get out of bed and do something else. Get up at the same time every day, no matter how little sleep you've had-and don't nap. Oh, yes, and don't worry -you're probably getting all the sleep you need.

As someone who's lived with insomnia for half a century, who spent six years interviewing sleep researchers and fellow insomniacs, writing Insomniac, I found that some of this advice may help some people some of the time, but there is no one-size- fits-all-solution.

About caffeine, alcohol, and big meals close to sleep, the experts got that right. Caffeine sets the stress hormones flowing, speeds the heart, and raises blood pressure. The half life of caffeine, the time it takes for half of it to be broken down, is between 3 and 7 hours-so if your last cup was at 1 PM, you still have a quarter of it left in your system at 3 AM. If you drink it daily and are on the slow side of metabolizing it, it never leaves your system-and we do get slower as we age: if you could tolerate coffee when you were 35, that doesn't mean you can at 50. A woman between ovulation and menstruation takes about 25 percent longer to eliminate it. A woman on birth control pills takes twice as long, according to a 1993 study by M.J. Arnaud. But if life without caffeine is just too bleak, consider tea, which has about half the caffeine of coffee and has, besides, a substance that damps down the stress system. And if black tea is still too strong, green tea has about a third the caffeine content of that.

Alcohol is confusing. It's a complex, "messy" drug that works on several systems, acting as a depressant but also stimulating the stress system. But even when it seems to help you sleep, it breaks down into by-products that come back to bite you, which is why you may wake up a few hours later with a bad buzz. And even if you don't wake up, the EEG shows shallower sleep. So you might want to rethink that nightcap.

Avoid big meals close to bedtime-so say the experts, and so say I. Digestion is an active, intense, heat-generating process, not something you want to initiate close to sleep. The consumption of calories raises body temperature, and as a general rule, anything that raises your temperature-like an electric blanket, a warm room-may wreck sleep, since core body temperature needs to decline for sleep to be initiated and maintained.

Exercise, of course, raises temperature in a big way, which is why we're told to avoid it in the evening. But I've found that if I leave a few hours between exercise and bedtime, evening exercise may actually help. When I swim within a few hours of bedtime, I get a lovely wave of sleepiness an hour or two later-maybe for the same reason that a hot bath helps, because it raises the body temperature so that the rapid decline that occurs afterward signals the body that it's time for sleep. My swimming tends to be relatively relaxed, however, and a strenuous aerobic workout that close to bedtime might have bad effects. You have to find what works for you.

But in the hours just preceding sleep, you need to find ways of chilling out-I mean, literally, cooling down. This means no more trips to the kitchen, no late night emails or anxiety-provoking conversations or projects, physical or mental, nothing that speeds the heart and raises body temperature. Find some way of making a barrier between the day and sleep. Leave the day at the bedroom door.

The experts tell us we should practice nightly sleep rituals, but the unwinding activities people find are actually more various than expert advice allows. Many people find reading bed or watching TV a necessary part of relaxing. Insomniacs tell me that reading computer manuals, or Emmnual Kant, works beautifully. Not for me-my mind has to be at least somewhat engaged. The New York Times works well, sometimes a novel, though no page-turners or cliff-hangers. And nothing work-related.

My preferred way of unwinding is a DVD. Nothing action-packed or adrenalin-pumping, though. Chick flicks work best, things like The Holiday, The Devil Wears Prada, The Jane Austen Book Club- pretty to look at and they have happy endings. A friend swears she can't sleep without watching a half hour of Sex and the City every night. Travel documentaries work well, too, sending me to sleep with visions of other places, other lives, dancing through my head.

Many people have success with worry lists or journal writing as a way of decompressing. Not me: I don't want anything to do with words, and nothing to do with the computer. I work with words all day long, I have words enough buzzing through my head. Besides, when I write, I conjure, bring to life-the last thing I want to do with a worry. No, give me a chick flick.
More later...

Gayle Greene, PhD is a professor at Scripps College, the author of the book Insomniac, and a member of the American Academy of Sleep Medicine
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