What Sleep Doctors Do When They Can’t Sleep
Did you have trouble sleeping last night?
You're in excellent company.
The Centers for Disease Control and Prevention (CDC) estimates that every night about a third of Americans don’t get the recommended seven or more hours of sleep necessary for good health. And it’s not always for a lack of trying. Even when we get to bed at a decent hour, things can go awry. You know how it goes: Your partner is snoring, the baby wakes up or you’re stressed about work.
Getting to sleep—and staying there—can be tough. Seventy percent of American adults report having insufficient sleep at least one night a month. But everyone has trouble getting to sleep at certain points—even sleep specialists. Yes, those who are most familiar with good sleep practices and the right ways to fall asleep can occasionally find themselves pillow punching and clock watching. We wondered what they, with their insider knowledge, do when sleep eludes them. Do they meditate? Succumb to the lure of the cell phone? Quiet a racing mind by reading the owner’s manual for every kitchen appliance?
Here are their expert tips.
Get out of bed
It sounds counterintuitive, but if you can’t sleep after 15 or 30 minutes, sleep specialists recommend you get up and out of bed.
“If I have a rough night, I don’t lay in bed for a long time,” says Shelby Harris, author of “The Women’s Guide to Overcoming Insomnia” and Clinical Associate Professor of Neurology and Psychiatry at the Albert Einstein College of Medicine. “Once my brain is active and I find myself getting frustrated, I get up and remind myself that I can still get through the day even with a poor night of sleep. Getting out of bed helps to act as a placeholder so I’m not in bed trying to force sleep, and it often quiets my brain.”
Do something mundane
Science now confirms what PowerPoint budget presentations told us long ago: Boredom induces sleep.
A Japanese study conducted on mice and published in the journal Nature Communications has found that the same center of the brain associated with motivation and pleasure can also promote sleep in the absence of stimuli. So it stands to reason that if you want to get sleepy, get bored.
Michael Grandner, Ph.D., director of the Behavioral Sleep Medicine Clinic at the University of Arizona, likes to clean out his spam folder when he can’t sleep. “Sometimes I set a timer and try again [to fall asleep] after the timer goes off,” he says. Another tactic: Read a cookbook or a magazine column. “They’re short, and after each recipe or column I can reassess if I’m sleepy enough to return to bed,” notes Harris.
Do something you enjoy
And then there’s a whole other school of thought that recommends using this time out of bed for something pleasurable, even if that means reluctantly powering on a screen.
Research shows that those who use electronic devices like smartphones before bed take longer to fall asleep, sleep for shorter periods and have poorer sleep quality than those who don’t use a device before bed. These sleep-disrupting effects are, in part, due to the blue light emitted from these devices.
“I know that trying to sleep is the surest way to chase sleep away, so I just get up and enjoy some extra ‘me’ time,” comments Jade Wu, Ph.D., a behavior sleep medicine specialist and Sleep.com sleep advisor. “I don't try to bore myself to sleep with a dull book or monotonous task, but instead, I do something actually enjoyable, like journaling or watching a show.”
According to Wu, you can minimize the sleep-sabotaging effects of a tablet or cell phone’s light by dimming it or putting it on night mode. “Using a screen for [a short time] should be fine,” she adds, “especially if you get bright light exposure during the day. In fact, if you spend 30 to 60 minutes outside during the day, any typical amount of screen use at night is moot.”
Read a book
In one study looking at reading’s impact on sleep, 48% of people who read a book in bed before sleep reported improved slumber compared to just 28% of the control group.
“I read fiction every night before going to sleep,” says Janet Kennedy, Ph.D., a clinical psychologist and founder of NYC Sleep Doctor. “When I’m more wound up or just not sleepy, I read longer and tell myself that my body will let me know when it’s ready to sleep. The effort of engaging in fiction clears my mind so I’m not thinking about the stresses of the day when I go to sleep, which helps me fall asleep faster and improves my sleep quality. I’ve been doing it so long that my body starts to relax as soon as I pick up the book.” Picking up a book also works for when you find yourself awake at night, Kennedy explains. “Reading works in the middle of the night, too, if I wake up and my mind starts racing.”
Practice deep breathing
Dr. Lisa Shives, a board-certified specialist in sleep disorders, practices focused breathing when she finds herself tossing and turning. “I try to take deep, slow breaths,” Shives says. “I focus my attention on how it feels in my body as the air moves in and out. This takes my mind off any worries I may have, especially the worry that I am having trouble sleeping, and it stimulates the parasympathetic nervous system [which controls the body’s ability to relax] via the vagus nerve [the main nerve of the parasympathetic nervous system]. That slows heart rate, blood pressure and in general calms down the body.”
Deep breathing has long been used as a tool to reduce anxiety, and recent research is demonstrating its worth as a sleep aid.
In one study done on post-operative heart patients, those who performed deep breathing exercises had better sleep quality and longer sleep duration than the control group. In another study looking at front-line nurses in China working during the COVID-19 pandemic, sleep quality was improved after the group was instructed in a breathing relaxation technique known as diaphragmatic breathing relaxation training.
Listen to music, an audiobook or a podcast
While one study finds that music (classical music, in particular) beats out audiobooks when it comes to improving sleep quality in listeners, it’s important to do what appeals to you.
“I personally like to listen to an audiobook or podcast,” says Wu. “The audiobook either puts me to sleep with the narrator's soothing voice (I highly recommend ‘The Secret Life of Trees’ for this reason), or I get to listen to something interesting. It's a win-win situation that will, at the very least, distract me from my unproductive busy brain.”
Quit obsessing about the sleep you’re losing and enjoy the downtime
The daytime is full of obligations and responsibilities. But at 3 a.m., time blissfully stands still. Our experts advise embracing it.
“It is physiologically impossible not to sleep, so that simple certainty of nature fills me with optimism on the occasions when I find myself in bed, awake,” says Dr. Chris Winter , a sleep neurologist and Sleep.com sleep advisor. “My plan for this is to simply enjoy the minutes or hours I am awake in bed in much the same way I enjoy the time I'm awake not in bed. I don’t judge success or failure when it comes to my sleep based upon the metric of ‘speed to unconsciousness.’ I think most people who truly understand sleep know that the secret is being equally happy in bed awake as you are asleep.”
Most importantly, don’t sweat a bad night’s sleep as it’s bound to happen. If you can’t sleep, just remember that one night of bad sleep isn’t going to make or break you. Take a deep breath, make a plan and don’t stress.