Sleep Routine Makeovers

By Barbara Brody
Tired? You're not alone. About 20 percent of Americans get fewer than six hours of shut-eye nightly, and a growing number have to rely on sleep aids to fall asleep or stay that way, according to the National Sleep Foundation. Is getting more (and better) sleep possible without the help of drugs? To find out, we asked three Woman's Day staffers to share their nighttime troubles with the experts. Here's what they learned.

Problem #1: "I wake up in the middle of the night and can't fall back to sleep." -Marilu Lopez, group creative director

Marilu wakes up almost every night between 3:30 and 4 a.m. and is unable to fall back to sleep. To pass the time and try to make herself sleepy again, she reads The New York Times on her BlackBerry. She eventually falls back to sleep but then wakes up early in the morning and feels exhausted all day.

Advice: Step one is to break the BlackBerry habit, says Joyce Walsleben, RN, PhD, diplomate of the American Board of Sleep Medicine and coauthor of A Woman's Guide to Sleep. The problem is twofold: Not only is reading news articles too stimulating, but the light from the BlackBerry itself can get in the way of the production of hormones that are essential for sleep.

Dr. Walsleben's top tips:

1. Ban the BlackBerry from the bedroom. Also cover (or remove) clocks so that you're not disturbed by the light from them or tempted to stare at the numbers.
2. Stay in bed. If you wake up, keep your eyes closed and practice relaxation exercises that will hopefully lull you back to sleep. One to try: Picture yourself outdoors on a beautiful day with a jar of soap and a wand. Imagine that you're slowly blowing bubbles, and follow each one until it's out of sight. Keep blowing bubbles until there's no more soap in the jar.
3. Relax during the day, too. Take at least three minutes to practice the bubble exercise (or another relaxation technique, such as deep breathing) so that you're not overwhelmed by the worries of the day as soon as your head hits the pillow.

Did it work? "The bubble imagery didn't work for me--I found the concept more annoying than relaxing," says Marilu. "But I have fallen back to sleep a few times by just staying in bed and telling myself, ‘Do not open your eyes. Do not turn on the BlackBerry.'"

Problem #2: "I only get four to five hours of sleep a night." -Abigail L. Cuffey, assistant health editor

Abby's friends call her a vampire because she's such a night owl. She tends to get a second wind around 11:30 p.m. and ends up staying awake until at least 2 a.m. But she also wakes up early in the morning, so the bottom line is she's not getting very much rest. She relies on lots of caffeine to keep her going through the day. On the weekends Abby stays up even later but sleeps in later as well.

Advice: Too much caffeine and inconsistencies between Abby's workweek and weekend sleep schedules are preventing her from getting enough rest, says Michael J. Breus, PhD, a clinical psychologist and board-certified sleep specialist. If she's serious about improving her sleep habits, she needs to ease off the caffeine and stick to a regular schedule.

Dr. Breus' top tips:

1. Start "caffeine fading." There's no need to abandon coffee entirely--plus, going cold turkey can cause bad headaches. A better idea is to drink most of your caffeinated beverages early in the morning and taper off as the day goes on. If you're currently used to five or six cups of coffee a day, try having one or two cups of drip coffee in the morning, a latte (which has a higher milk-to-coffee ratio) or half-caf coffee midday, and a tea or cola in the afternoon if you're still craving caffeine. But after 4 p.m., no more caffeine!
2. Set your alarm clock or cell phone to go off 30 minutes before bedtime as a reminder to stop what you're doing and get ready for bed.
3. Take a hot bath or shower right before bed. This should make you sleepy because your temperature will rise and then dip--and body temperature naturally drops when you get sleepy.
4. Go to bed and wake up at approximately the same time on weekdays and weekends. (A shift of about an hour is OK.)

Did it work? "The advice was good but hard to stick to because life--the holidays, my birthday, etc.--got in the way," says Abby. "But when I did follow it, it worked really well, especially the hot shower at night. Whenever I took one I felt almost tranquilized once I crawled into bed."

Problem #3: "I have night sweats--but I'm only in my 20s!" -Ayn-Monique Klahre, associate home design editor

During the workweek, Ayn-Monique usually goes to bed around 10:30 p.m., but her husband often reads in the bedroom, so the light disturbs her about 30 minutes later. Once she's awakened, she tosses and turns but eventually falls back to sleep--only to be awakened around 3:30 a.m. feeling cold but scrunched into a little ball and sweating. She's exhausted when her alarm goes off in the morning and often hits the snooze button repeatedly. On the weekends she tends to stay out much later and sleeps soundly once she's finally in bed.

Advice: A medical issue could be responsible for Ayn-Monique's sleep troubles, but Dr. Walsleben suspects that her sleep cycle is simply out of whack because she goes to bed so much later on the weekends than she does during the week and because she's going to bed during the week while her husband is still reading.

Dr. Walsleben's top tips:

1. Normalize your weekday and weekend sleep routines as much as possible. That might mean going to bed slightly later during the week than you are now, as well as turning in a bit earlier on Friday and Saturday. The goal is to bridge the gap.
2. Embrace the darkness. Even if you fall asleep with the light on, it probably won't be quality sleep--and it's all too easy to be woken up. If your husband insists on reading in the bedroom after your bedtime, ask him to use a book light or wear an eye mask yourself.
3. Talk to your doctor. If you practice these lifestyle changes for a few weeks and you're not sleeping any better--and still waking up sweating--see your primary care doctor to make sure an unknown medical problem isn't to blame.

Did it work? "Staying up a little later during the week helped me sleep more soundly, and I've used an eye mask when my husband is reading in bed," says Ayn-Monique. "But I still woke up sweaty on occasion, so I'm not sure this issue has been fully addressed. I'll mention it to my doctor at my next physical just to make sure nothing else is going on."