

“When I woke up this morning my girlfriend asked me, “Did you sleep good? I said “No, I made a few mistakes.” - Steven Wright

First, you are not alone. A shocking 50-70 million Americans have sleep difficulties of some kind. But not to worry, there are some very practical strategies that you can use if you would like to try change your behaviors to improve your sleep. As Steven Wright joked, we all make mistakes in our sleep related behaviors. This post will review some of the tools used in Cognitive Behavioral Therapy for Insomnia (CBT-I) to get started towards a more restful night tonight!

1. Retrain your mind and body for sleep.

If you can’t sleep, then get up and do something instead of there worrying. It’s the worry that gets you, not the lack of sleep. - Dale Carnegie

When we lie sleeplessly in bed our brain begins to associate bed with . Stimulus control works to retrain your brain how to sleep. There are some guidelines you can follow on your own that can really help in this area. First, avoid using your bed for anything (ok almost anything!) except sleep. Secondly, if you are in bed awake for more than 20 minutes, get up and sit in a chair outside of the area and participate in a non-activating activity in low light. For example reading, crafting, or implementing a relaxation exercises. Try not to use anything with a screen.

Sleep Hygiene can also contribute to training your body to sleep. One healthy step towards this is to develop a nighttime ritual. Having a cup of tea (decaffeinated), taking a warm shower, stretching, changing into specific pajamas before bed can all help send messages to your brain that it is time to go to sleep.

2. Manage your and worry.

Man should forget his before he lies down to sleep. - Mahatma Gandhi

Stress and can create substantial barriers to sleep. Some tools that you can use during your day and near bedtime to reduce worry and stress are breathing exercises and muscle relaxation exercises. Both of these tools can help to reduce stress and induce relaxation which will help you prepare your body and mind to rest.

Worry time: Pick a scheduled time to worry and write your worries down. If you think of something during the rest of the day, tell yourself you will worry about that during your “worry time.” If you must, take a minute to write down your worry at that time.

Lastly, don’t look at the clock while sleeping! This can lead to increased pressure and worry about sleeping. I have had clients that go so far as to put the clock in another part of the room or put tape over the screen to avoid temptation.

3. Daily Activities and next steps

A well spent day brings happy sleep - Leonardo da Vinci

What you do during the day does affect the quality of your sleep. There is plenty of evidence that supports the fact that exercising during the day can help you sleep better. Also, napping during the day can negatively affect your nighttime sleep.

One of the main ideas of for Insomnia is the idea of “sleep efficiency” which basically means the proportion of time that you are actually asleep while in bed. In CBT-I you work with a therapist to help you create a “sleep debt” (a need to fall asleep) by allowing yourself less time (opportunity) to be in bed. This results in being tired while in bed and thus, eventually sleeping more.

Hopefully some of these tips will be helpful for you. Certainly a consultation with a clinician who has expertise in CBT-I can help you guide yourself to a night of restful sleep.

Sweet !

Follow Dr. Fader on Twitter @drfader