Sleep Problems

Do you have trouble falling or staying asleep? Does your mind race, your body twitch, and/or your dreams waken you? Sleep problems are one of the primary reasons that people seek medical attention. They can interfere with both mental and physical health, leading to problems at work, in school, and in relationships. In this article I will first identify several kinds of sleep problems, and will then give some suggestions for how to get a better night's sleep (so you can wake up feeling rested).

There are multiple varieties of sleep problems. The most common categories of sleep difficulty include having trouble falling asleep, and having trouble staying asleep. People have trouble falling asleep for a multitude of reasons including anxiety/stress, obsessive thinking, caffeine or sugar ingestion, restless leg syndrome, side effects of some medications (most commonly ADD medications, decongestants, etc. ), and many others. Difficulty staying asleep (waking frequently) and/or early wakening can be caused by such things as depression, anxiety, nightmares, hormonal imbalances, etc. Below I will review some behavioral strategies for improving both of these sleep conditions, but certainly if you have had long-standing sleep problems it makes sense for you to see your doctor first to rule out any potential physical causes.

Some general strategies for improving sleep habits might include:

1) Making sure that your bedroom is conducive to sleep. This basically just means setting up your bedroom environment to maximize the possibility of sleep: making sure your bed is clean and comfortable, your room is quiet and dark, and the temperature in your room is comfortable. This might sound basic, but for a lot of college students problems in the physical environment can be one of the primary causes of sleep disturbance. Maybe your hall is noisy, your roommate is up late studying with the lights on, or your room is too hot. Doing the best you can to negotiate these environmental conditions with your roommate, RA, or anyone else who can assist you in altering your physical environment will most likely help you to get a better night's sleep.

Another practical issue that can contribute to sleep problems for students is using your bed for multiple functions. Ideally, your bed should be used for sleep and sex ONLY. If you frequently study in bed your body can become conditioned to remaining alert while in bed. This can lead to sleep problems down the road. Try studying at your desk, in a common area, or in the library to reduce these problems.

2) Getting into a sleep routine. Having a bedtime routine that you do the same way (and preferably, at the same time) each night helps prepare your mind and your body for the fact that it's time to relax and sleep. Bedtime routines might include taking a hot shower/bath, listening to relaxing music, reading (something light--not schoolwork!), deep breathing, etc. Anything that allows your body to physically relax and does not require much mental concentration can work in a sleep routine.

Although many people include TV-watching as part of their routines, there is some research suggesting that this might not be helpful. TV can actually stimulate brain activity rather than quiet it, and many television programs contain some level of disturbing material that can make its way into your dreams, leading to disrupted sleep.

Once you've established a routine, whatever that includes, it is important to do it the same way and at roughly the same time every night. The routine helps condition your body and mind to relax, and also helps to reset your circadian rhythm (that controls your sleep cycles). Once this conditioning is established it will take less and less time for you to reach this state, allowing you to drop into sleep more easily and quickly.

3) Learning some strategies for getting back to sleep if you waken in the night. There are some very specific dos and don'ts here. First of all, if you awaken in the night because of a nightmare, it helps to move your body, mentally remind yourself that it was just a dream, and maybe have a sip of water or a small snack. While you won't want to stay awake for any length of time after a nightmare, falling back to sleep too quickly can lead you right back into your bad dream. Moving your body or ingesting some water or food can help ground you to "real life" rather than your dream life. (As an aside here, foods like turkey, milk, and peanuts contain an amino acid called tryptophan which is a precursor to serotonin, a neurotransmitter in your brain that helps your relax. Eating small amounts of these kinds of foods can chemically promote relaxation. )

If you find yourself waking up for other reasons during the night and have trouble getting back to sleep afterwards, you might try a brief relaxation exercise. Using deep breathing, progressive muscle relaxation, or visualization can be helpful in this regard. (To learn more about these things, feel free to contact someone in the Counseling Center for help. )

One of the big "don'ts" of waking up in the night is simply lying in bed not sleeping. If you wake up and have trouble going back to sleep for 30 minutes or more, get up and do something else. Read, listen to music, meditate, or do something else relaxing until you feel sleepy. Lying in bed worrying about falling back asleep can lead to increased anxiety, which actually wakes you up.

4) Making sure that you do things during the day that will help you sleep at night. There are things that you can do during your waking hours that will help (or hinder) your nighttime sleep patterns. Some of the things that help people get a good night's sleep are: exercising regularly, eating well, and doing relaxing activities just before bed. In terms of exercise, there is some evidence that exercising in the morning and getting morning sunlight help people feel more awake and alert for the rest of the day. It also can tire the body out enough that you really feel ready for sleep by bedtime. Eating well (especially getting enough iron) can also improve sleep patterns.

There are also some specific things that people do that can hinder good sleep at night. These include: napping during the day, ingesting too much caffeine or sugar (especially late in the day), not including enough physical activity in the day, and/or not managing stress effectively. Sometimes these negative patterns are so ingrained that they're difficult to change. For example, if you are in the habit of napping in the afternoon and then drinking Mountain Dew around 4pm to wake you up enough to study for the evening, your body will have trouble sleeping later that night. Sometimes the only way to reset your body's natural sleep rhythm is to stay awake for a full 24-hours, and then go to bed early the following night (no naps!). While this is undesirable to most of us, it can help to change your sleep patterns and get you back on track to go to bed early and get up early enough in the morning to attend to all of your responsibilities without needing a nap or excessive caffeine.

Another daytime or evening activity that negatively impacts sleep is drinking alcohol. Consuming alcohol may help you fall asleep initially, but will almost always lead to frequent waking, dehydration (feeling hot and thirsty), and unrestful sleep. If you are someone who tends to have trouble sleeping well, you may choose to avoid all alcohol consumption for a period of time and see if that makes a difference for you.

Getting a good night's sleep can help you to feel happier, less stressed, and better able to concentrate. Lack of sleep or poor quality sleep can lead to heightened emotional reactivity (which can disrupt relationships dramatically), irritability, poor mental focus, memory problems, and many other distressing symptoms. Incorporating some of these strategies to improve your sleep may make a big difference in your quality of life. Again, it is important to remember that if you have tried these (or other) strategies and continue to struggle with insomnia, you may need to consult your primary care physician to rule out any underlying medical issues.