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10 Solutions for Better Sleep

Don Rosenberg

10 Solutions for Better Sleep©

Don Rosenberg

January, 2025

We traveled from Chicago to Amsterdam on the red eye flight, arriving in the morning there, with hardly any sleep in 24 hours. We expected to get through some hours of sightseeing. That afternoon, I was standing in front of a Van Gogh painting when I literally fell asleep standing up! We can go only so long before we need to sleep. We don’t want to override our biological clock.  Doing so frequently may undermine our habits needed for good sleep.

Rick’s depressed mood affected his sleep.  Worrying about work the next day, many nights he took an hour or two to fall asleep. Most days he woke up an hour or more earlier than planned.  But his bigger source of insomnia was anxiety and worry that he would not get enough sleep.  He was grouchy about it and that prevented him from sleeping.  Thinking is a beta wave brain activity on the order of 32 hertz (cycles per second). But the first entry towards sleep is alpha, 8-13 Hz.  You see how all that worry is incompatible with sleep.

I asked Kathryn this question that I use in an interview to evaluate clients for post-traumatic stress.  One of my questions is “When you lie down to sleep, does this memory tend to intrude more then?”  Traumatic memories and other upsetting memories tend to flood the mind when we remove our attention from all our daily efforts to do tasks, chores, reading, etc.   Kathryn said “Whenever my mind is not busy, it’s there and I can feel adrenalin pumping. It’s almost like putting my head on the pillow signals my body to go into fight or flight mode.  That means no sleep tonight.”

In these examples, we see themes of this article. We need sleep. But often, the very minds that need it most are also interfering with it. To sleep long and well, the mind needs to be more still and sleep-focused. Although sleep is natural, sleep habits are learned.  So, let’s go over tips for mastering great sleep habits.

Sleep is a fundamental to human health and well-being.  Sleep is restorative. The brain is active consolidating memories from that day. The brain is 2% of our mass and uses 1/3 of our energy.  It needs sleep to clear waste.  Your body in essence needs 1/3 of its time to clear out the waste we spend 2/3 of our time awake and accumulating.

Anyone who struggles to get the enough restful sleep knows what it’s like to drag through the day, to be anxious about whether he or she will get good sleep this or that night, and which drugs work or don’t work for sleep. 

Let’s look at normal sleep patterns, the stages of sleep, common sleep problems, and practical strategies to improve sleep quality and to overcome sleep challenges.

I. Normal Sleep

Normal sleep has a regular cycle of rest when the body and mind recharge. Most adults require between 7-9 hours of sleep per night. Individual needs can vary based on age, genetics, and lifestyle factors.  Older folks can tell you they don’t sleep as long as they used to or they wake a couple of times in the night. Teens seem able to get longer sleep – when those early AM high school schedules and late night texting with friends don’t interfere.  Some people brag about needing less sleep. Depressed people may get too little sleep or they may wake up still feeling fatigued as if their minds had spent the night in worry and struggle.  But 7-9 hours is the norm for most people. Significant drowsiness during the night is not normal.

Keys of normal sleep:

1. Aiming for a consistent bedtime and wake-up time.

2. Falling asleep within 10-20 minutes of lying down.

3. Experiencing minimal awakenings during the night.

4. Waking up feeling refreshed and alert.

A comment about naps.  A power nap up to 30 minutes is refreshing. After that, we go into deep sleep and after 30-90 minutes may have sleep inertia, grogginess upon waking.

II. Sleep Stages

We sleep in cycles, each lasting about 90 minutes. During a normal night, these cycles repeat 4-6 times. Each cycle consists of distinct stages:

Stage 1 (Light Sleep)

This is the transition between wakefulness and sleep. Muscle activity decreases. The body relaxes. Brain waves slow markedly from beta to alpha waves.

Stage 2 (Deeper Light Sleep)

Brain waves, heart rate, blood pressure, and breathing slow further. Body temperature lowers. The circulatory system needs its rest. It’s the stage in which you spend the most time during the night.

Stage 3 (Deep Sleep)

Also known as slow-wave sleep (in the brain) with very slow delta and theta waves, the most restorative stage. The body repairs tissues, builds bone and muscle, and strengthens the immune system. It’s about 20% of sleep. 

REM Sleep (Rapid Eye Movement)

REM sleep is when most dreaming occurs. The brain becomes more active, and memory consolidation takes place. This stage is crucial for emotional regulation and learning. It’s about 20% of the night.  Most of it takes place in the second half of the sleep period.  Hence, longer sleep is crucial.

III. Common Sleep Problems

Sleeping should not lead to tiredness! Many people experience sleep disturbances that impact their health and daily functioning. Common sleep issues include:

Insomnia: Difficulty falling or staying asleep. Some people get so anxious worrying about their insomnia, they develop a secondary insomnia, namely, anxiousness that compounds their sleep disturbance.

Sleep Apnea: Interrupted breathing during sleep.

Restless Leg Syndrome (RLS): Uncomfortable sensations in the legs that cause a strong urge to move them.  It’s treated with medications, sometimes with iron supplements.

Narcolepsy: Excessive daytime sleepiness and sudden sleep attacks.

Circadian Rhythm Disorders: Disruption in the body’s internal clock, leading to misaligned sleep patterns.

Hypersomnia: Extreme daytime sleepiness.

Parasomnia: Unusual behavior around sleep, such as sleep walking, nightmares, and sleep paralysis.

Sleep Bruxism: Grinding your teeth, leading to headaches, jaw discomfort, and tooth wear.

Shift Work Disorder: Due to working 2nd or 3rd shift, excessive sleepiness during the day, insomnia, mood problems, can lead to accidents.

IV. Sleep deprivation Is Linked to Problems

Long Term Deprivation

• Obesity – shorter sleep means more ghrelin, the hormone telling us to eat, especially carbs
• Hypertension
• Heart problems
• Stroke
• Diabetes II from more glucose circulating
• May contribute to brain deterioration disorders, such as dementia, due to not clearing amyloid proteins during the night
• May contribute to a state of alarm (anxiety), depressed mood
• May contribute to disruption of our natural body clock, leading to weaker immune response

Short Term Deprivation

• Reduced attention
• Irritability and emotional volatility
• Ineffective working memory
• Interference with memory consolidation – ability to store what you learn – as interfering with sleep reduces recall
• Interference with working effectively on complex tasks and decision-making  – more sleep leads to much better working on difficult tasks
• Needing to artificially stay awake with stimulants, activity, more food for energy
• Car accidents

Longer sleep helps with physical and mental performance and mental well-being.  

V. 10 Tips for Improving Sleep Quality

Some of these are good practical ideas and some come from research on a Cognitive Behavioral Therapy insomnia treatment protocol.

1. Stimulus Control:

• Use the bed only for sleep and intimacy, avoiding activities like reading, watching TV, or using electronic devices.
• Go to bed only when sleepy, and get out of bed if unable to sleep within 20 minutes.  Let’s not associate the bed with being anxious or frustrated.
• Maintain a consistent wake-up time, even on weekends, even if you wanted to sleep longer.
• Reduce noise since noise, even though you sleep through it, makes sleep shallower with less REM and slow-wave sleep.
• Make the room dark --  light produces hormones associated with waking rather than sleep
• Keep track of hours of sleep, time going to bed, time waking, and from 0-10 how rested you feel.  Look for patterns.

2. Sleep Restriction:

• Limit time in bed to the actual amount of time spent sleeping.
• Gradually increase time in bed as sleep efficiency improves.

3. Cognitive Restructuring:

• Identify and challenge negative thoughts about sleep (e.g., "I’ll never fall asleep" or "I’ll be exhausted tomorrow" or “I have to catch up and make up for yesterday.”).
• Replace them with more positive, realistic thoughts. “I accept whatever sleep I get and I’ll be okay” or “I’ve gotten through many days quite well regardless of how much sleep I’ve gotten.” “I can get absorbed in a mindfulness sleep meditation and be comfortable.”

4. Settling Down & Relaxation Techniques:

• Practice mindfulness exercises, deep breathing, or progressive muscle relaxation to reduce pre-sleep anxiety. Autogenic Training or self-hypnosis also help. We’ll help you with these methods in another article.

5. Practice Good Sleep Hygiene:

• Reinforce Positive Sleep Habits: Maintain habits that promote sleep, such as limiting caffeine, alcohol, and heavy meals before bedtime, and all the other suggestions here. Don’t over-ride your biological clock and push through night time tiredness; go to sleep.  
• Stick to a Schedule: Go to bed and wake up at the same time every day, even on weekends.
• Limit Screen Time: Avoid screens at least an hour before bedtime to reduce exposure to the blue light emitted by screens.
• Avoid Stimulants: Reduce caffeine and nicotine intake, especially in the afternoon and evening. Caffeine shortens deep sleep stages.  Alcohol helps you fall asleep, but interrupts REM and causes waking to go to the toilet; the depressant effect wears off in a few hours and the irritant and diuretic effects take over.
• Exercise Regularly: Physical activity can improve sleep, but avoid vigorous exercise close to bedtime. Yoga is particularly beneficial.

6. Establish a Sleep-Friendly Environment

• Create a Cool, Dark, and Quiet Bedroom: Use thicker curtains or shades, earplugs, or white noise machines.  Background noise you ignore consciously still affects you unconsciously by keeping your brain on alert.
• Invest in a Comfortable Mattress and Pillows: Ensure your bedding supports restful sleep.

7. Relax Before Bedtime

• Develop a Wind-Down Routine: Engage in calming activities like reading, meditating, or taking a warm bath.
• Practice Relaxation Techniques: Try deep breathing, progressive muscle relaxation, or mindfulness exercises.
• Mind Clearing: Bedtime is not the time for thinking about tomorrow’s schedule or going over today’s problems or unpleasant experiences. If those things are on your mind, get out of bed and write them down.  Your thoughts in bed would be better spent on how comfy the pillow feels, how the bed is supporting your comfortable body parts, how you purposefully slow breathing, and other pleasant images.

8. Address Underlying Problems

• Manage Stress: Use strategies like journaling or therapy to address stressors.
• Consult a Professional: Seek help for persistent sleep issues, as they may indicate a more serious condition like sleep apnea or depression.  Treatment of trauma experiences is important for having a clearer mind. 

9. Specifically for Shift Work: Some lifestyle changes that may help relieve symptoms include: 

• Keeping a regular sleep schedule, including on days off
• Taking 48 hours off after a series of shifts
• Wearing sunglasses when leaving work to minimize sun exposure
• Taking naps when possible
• Avoiding caffeine, alcohol, and nicotine

10. Caution About Reduce Sleep Aids

• While some medications help us fall asleep, some of them are habit-forming (e.g., Ambien/zolpidem, lorazepam, alprazolam).  Sleep meds also include Lunesta, trazadone, mirtazpine, and others. Some are more useful when used intermittantly.  Other medications may be used mostly in psychiatry to promote sleep in patients with depression or other problems. The jury is out on melatonin supplements.  Follow doctor’s recommendations.  Getting sleep is the important thing. If you become dependent on a medication, get help to reduce it under medical supervision. I recall a client who ended up in the hospital with very troubling behavior that turned out to be caused by stopping long-term use of one of these drugs.

VI. Final Thoughts

Sleep is a cornerstone of physical and mental health. By understanding normal sleep patterns, the stages of sleep, and common problems, you can take proactive steps to enhance your sleep quality. Implementing the tips above, including evidence-based CBTi strategies, mindfulness, and other strategies, can lead to better rest and, in turn, improved well-being and productivity.

If sleep challenges persist, don’t hesitate to consult a healthcare provider for tailored advice and interventions. Remember, good sleep is not a luxury—it’s a necessity.

VII. For more information, Paste These Links Into Your Brower

National Sleep Foundation

https://www.sleepfoundation.org/

American Academy of Sleep Medicine

https://sleepeducation.org/

Better Sleep Council   https://bettersleep.org/

National Healthy Sleep Awareness Project   https://sleepeducation.org/healthy-sleep/

ISU Sleep Resources Page  https://wellness.illinoisstate.edu/living/sleep/resources/#Sleep-Resources2

TED Talks on Sleep

https://www.ted.com/talks/jeff_iliff_one_more_reason_to_get_a_good_night_s_sleep?subtitle=en

https://www.ted.com/talks/russell_foster_why_do_we_sleep?subtitle=en

Shorehaven Behavioral Health is a major mental health clinic and training center with therapy offices in Brown Deer, Greenfield, and Mt. Pleasant, and also offering telehealth throughout Wisconsin. We specialize in challenging cases and rapid access to services.  In addition to depression, anxiety, behavioral problems, and most other psychological problems, we work extensively with children & families and with substance use problems. Our DBT program has three groups – for younger adolescents, older adolescents, and adults – and has openings. We also accept referrals for substance abuse care from clinicians who are not comfortable with that population.  Call 414-540-2170.

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