Below are listed some suggestions for things you can do to help with simple insomnia. These suggestions are called “sleep hygiene.” Good sleep hygiene can correct many issues with insomnia without the use of medication.
1. If after attempting to sleep you have not fallen asleep within 15-20 minutes, get up out of bed and go to another room in the house. Engage in some quiet activity. This step is very important. It prevents your brain from associating the discomfort of insomnia with your bed. If you struggle with insomnia while remaining in bed your brain will begin to associated cues from your bedroom with the anxiety associated with not sleeping. Then the bedroom itself will begin to cue insomnia.
2. Only return to bed when you feel drowsy.
3. If you do not fall asleep within 15-20 minutes again, repeat steps 1 and 2, and repeat throughout the night as often as necessary. Do NOT try to make yourself sleep. Sleep is a passive process and the harder you try to sleep the more difficult sleep is to achieve. Often insomnia is worsened by worry over not sleeping. You can go for long periods of time without sleep, without harmful effects. Your body will sleep when it is ready.
4. Get up for the day at a consistent wake time. If you usually get up at 7AM when not experiencing insomnia, then get up at 7AM. Get up at this time regardless of how bad the night before was. The biggest mistake to make in coping with insomnia is to try to catch up on sleep lost the night before. Sleeping during the day tends to worsen the problem. Your body’s circadian rhythm or “body clock” works like a timer running backwards. It starts ticking down when you have a solid consistent wake time. It also helps to expose yourself to sunlight as soon as possible after waking. This helps your brain to get a clear signal that the day part of the cycle is starting. This will make you more receptive to sleep as the clock tics down.
5. Remain awake for a full daytime cycle. Avoid any naps unless absolutely unable to stay awake. Avoid caffeine in coffee, tea, sodas, and other foods. Avoid herbal supplements that have a stimulant property. Only indulge in a nap when your sleep cycle is stable.
6. Avoid over the counter sleep aids. Often they will cause a rebound effect when used more than a few nights. If the insomnia is not complicated by depression, and is primarily at the beginning stage of sleep. Use of melatonin may be helpful (start with 3 mg about an hour before bedtime). Effective doses show quite a wide range.
7. If you think a lot about problems before you go to sleep, try writing down your thoughts and feelings in a journal prior to attempting to sleep for the night. Many people experience a decrease in ruminating when journal writing before bedtime. Its as if you mind is satisfied that there is a “hard copy” and stops recycling the thoughts.
8. Begin a nighttime ritual at least one or two hours prior to retiring for the night that is conducive to sleep. Avoid complicated tasks or vigorous exercise in this interval before sleep. Ask yourself if your activities during this interval help with “winding down” from the day. Try taking a warm bath, listening to soft music. Avoid stimulating activities. Make sure the lighting in your home is low. Bright lights suppresses your brain’s production of melatonin, a brain chemical involved in the initiation of sleep.
9. Don’t try too hard. The harder you try, the more awake you’ll become.
10. Get some aerobic exercise. A little aerobic activity in the late afternoon or early evening goes a long way towards relieving physical and mental stress and contributes to being prepared for sleep.
11. Avoid alcohol. It may help sedate us for the first half of the night, but the second half of the night can be fraught with increased awakenings and light sleep. If you struggle with insomnia in the middle of the night, alcohol can often be a factor.
12. If your caffeine intake is high reduce gradually (100mg every few days) until completely off caffeine. Abrupt cessation of caffeine can result in headache and fatigue.
13. Repeat steps 1-12 faithfully for 7-14 days. If the problem persists you may be experiencing a problem more complicated than simple insomnia and may want to consult with a psychologist.