Cedars Sinai Medical Center

07/11/2024 | News release | Archived content

How to Get Better Sleep

How to Get Better Sleep

Jul 11, 2024 Amy Paturel

High-quality sleep is critical to health and wellbeing, but one in three U.S. adults doesn't get enough shuteye-and an estimated 50 to 70 million have chronic sleep problems, including insomnia.

Insomnia and anxiety are linked-and can contribute to each other. The most effective strategy to resolve chronic insomnia is a form of therapy called cognitive behavioral therapy for insomnia, or CBT-I, said Waguih IsHak, MD, a psychiatrist at Cedars-Sinai. Studies show that CBT-I is often more effective than medication.

By identifying thoughts, feelings and behaviors that interfere with quality sleep, you can shift thought patterns contributing to insomnia, IsHak said.

Here, he outlines CBT-I-based tips for more restful slumber.

"To get a jumpstart on the process, write out negative thoughts and worries about insomnia on paper before getting in bed. Then, while you're trying to fall asleep, focus on happy memories to neutralize negative thoughts."

Reframe Negative Thoughts

Often, worries and negative thoughts about sleep can keep you from falling asleep. Carve out time during the day to identify, challenge and reframe unhelpful thoughts related to sleep.

"To get a jumpstart on the process, write out negative thoughts and worries about insomnia on paper before getting in bed," IsHak said. "Then, while you're trying to fall asleep, focus on happy memories to neutralize negative thoughts."

Only Use the Bed for Sleep and Sex

When your bed is reserved exclusively for sleep and sex, your brain begins to associate the bed with sleep, rather than frustrations over insomnia.

"People often watch TV, scroll social media and even work in bed, which can make sleep more difficult," IsHak said.

If you're unable to fall asleep within 10 minutes, get out of bed and do something calming. Read a book, meditate or listen to soothing music. Then return to bed only when you feel sleepy again.

Limit the Amount of Time You Spend in Bed

If you struggle with insomnia, you may spend a lot of time lying awake in bed. A CBT-I tactic called "sleep consolidation" limits time in bed to encourage a sense of sleepiness. So, if you're in bed for eight hours, but you're only sleeping for six, try getting in bed later, so you're spending only six hours and 30 minutes in bed. Once you adjust and sleep much of that time, you can gradually increase your time in bed. The caveat: Sleep consolidation is not appropriate for people who have health conditions made worse by lack of sleep.

Practice Relaxation Exercises

If you're mentally cataloguing your to-do list at bedtime, sleep can be hard to come by. The good news: You can minimize the racing thoughts that often accompany insomnia by inducing your body's natural relaxation response.

Try breathing exercises, progressive muscle relaxation (tensing and relaxing your muscles one body part at a time) and guided imagery (visualizing positive images and scenarios) to help you drift off to sleep.

Try an App

Digital CBT-I applications can also help-work with your physician to choose one, IsHak said.

"There are plenty of online resources available, but since the app industry is unregulated, it's important to work with a professional to select the best product for your needs," he said.

What About Sleep Medication?

Certain prescription sleep medicines can be effective for short-term use, but according to IsHak, medications for sleep can worsen insomnia, and certain over-the-counter medications have been linked to worsening memory.

"Melatonin is not a sedative, so you shouldn't take it right before bed," IsHak said. "Instead, take 2 to 3 milligrams two to four hours before bedtime."

The Health Impact of Insomnia

Insomnia or chronic lack of sleep can be linked to medical conditions such as heart disease, chronic obstructive lung disease, asthma and restless legs syndrome. Anxiety, depression and post-traumatic stress disorder can also interfere with sleep.

If you think your sleep is insufficient or compromised in some way, talk to your doctor to identify underlying causes and form a plan to improve your sleep.