What’s Keeping You Awake?

Being complex creatures living in a complex world, many factors can have an impact on our sleep. Here you will find some short tips to help you make some important lifestyle changes that will lead to better sleep:

Alcohol

Because it is a depressant, alcohol will make you feel drowsy, and you may fall asleep faster, but after the effects of the alcohol wear off 4-5 hours later you will be awake and alert. A sleep influenced by alcohol is not a full or restful one. Alcohol has also been identified as a contributing factor in sleep apnea and snoring.

What you can do:

• Enjoy your glass of wine, beer or cocktail with dinner or earlier in the evening, well before bedtime.
• If you regularly have difficulty staying asleep, take a look at your alcohol consumption overall. Persistent use of alcohol can disrupt the sleep-wake cycle, creating regular sleep problems.
• Reduce your alcohol use and evaluate changes in the duration and quality of your sleep.

Anxiety/Depression

Sleep disturbance is a core symptom of both depression and anxiety, both of which are treatable and common mental illnesses. In addition, too much concern about not sleeping well actually produces insomnia. The concern produces a physiological reaction that elevates blood pressure, heart rate and brain waves, resulting in a state of hyperarousal.

What you can do:

• Find ways to settle your mind and relax before bed.
• If you think you may have depression or anxiety, seek professional help.

Business Travel

Business travel is sure to disrupt sleep in more ways than one. Travel schedules may require you to rise earlier than usual or be up later than your typical bedtime. Travel across time zones may disrupt your circadian rhythm, making staying awake and falling asleep more difficult.

What you can do:

Onboard aircraft                

• Drink plenty of water – not tea, soda, coffee or alcohol. Your body will need the hydration of water.
• Fall asleep as soon as you can.
• Set your watch to the time of your destination.

To minimize jet lag:

• When traveling east for longer than 6 hours, take a nap upon arrival, then sty up for the rest of the day until early evening.
• When travelling west for longer than 6 hours, keep to your same sleep and wake routine. You might wake early, but adjustment will come soon.

At your hotel:

• Ask the hotel staff whether they have designated quiet floors. If not, request a quiet room away from the elevator, vending machines and stairwells.
• Ear plugs and eye covers; relaxing music; and bath amenities such as lavender aromatherapy, potpourri, soaps and oils can make a difference. Pack these items or request them form the front desk.
• Set a number of wake-up alarms – beside clock, a wake-up call placed by hotel staff and maybe a cell phone alarm. Having multiple backups will cut down on any anxiety that the wake-up alarm will be missed.

Stick to your healthy eating and exercise plan throughout your trip!

Busy Schedules

Many people say they don’t get enough sleep because there is too much to do in a single day. Because there are only 24 hours in a day, seriously consider how you can use them to your greatest benefit. Too few hours available for sleep might mean you are overcommitting yourself, making poor time-management decisions or needing to rethink some priorities.

Take a cold and critical look at where all of the hours in your day are going. For example, your schedule might look something like this:

What you can do:

• Modify your schedule.

To modify your schedule, first identify what you have to do every day:

1. Sleep 7-9 hours
2. Work
3. Perform moderate aerobic activity for 30 minutes
4. Take 1 hour of pre-bed low-stimulation relaxation time.

Now, make some adjustments to include what you absolutely have to do first. How many hours do you have left in the day? How can you use those hours to your greatest benefit?

• What can you do to make the best use of your time? Can you use your time more efficiently?
• Is your work schedule flexible? It might b worth talking with your manager about modifying start and end times to ease a commute or give you more time where you need it.
• How can you delegate and share responsibility for housework and transporting family members to extracurricular events?
• Is it really necessary to stay up to watch the newest episode of a certain TV show?

Caffeine

If by mid-afternoon you cannot go on without another cup of energy, it might be time to look at how much caffeine you are consuming. Having too much caffeine can leave you feeling tired all day and awake all night. The National Sleep Foundation suggests that adults consume no more than 240 mg of caffeine a day. Calculate how much caffeine you are consuming.

What you can do:

• Identify where you can begin to cut back on caffeinated beverages or reduce the types of caffeinated beverages you choose.

Children

Fatigue is the No. 1 complaint among new parent. They long for that magical age – 3 months? 5 months? 12 months? – when their baby will sleep through the night (or at least 5 or 6 hours!). And while most get their wish by the time 6 months of sleep deprivation have passed, many are surprised to learn that their children’s sleep issues continue to change and evolve as their children develop. But with the right information and strategies – and some perseverance – parents of children at every age and developmental level should be able to understand and cope with sleep challenges.

Food

Caffeine: Consuming caffeine can cause you to stay awake. Avoid it 4 to 6 hours before bedtime. Fifty percent of caffeine consumed at 7 p.m. remains in the body at 11 p.m. Coffee, tea, many soft drinks and chocolate are common sources of caffeine.

Heavy/spicy foods: These foods can cause heartburn for indigestion and interfere with sleep patterns.

Liquids: Consuming liquids within the 90-minute-period before sleep can cause frequent awaking to urinate.

What you can do:

For your last meal of the day, select foods rich in sleep-producing amino acid tryptophan, including:

• Dairy products: cottage cheese, cheese, milk
• Soy products: soy milk, tofu, soybean nuts
• Pasta
• Seafood
• Meats
• Poultry
• Whole grains
• Beans
• Rice
• Hummus
• Lentils
• Hazelnuts, peanuts
• Eggs
• Sesame seeds, sunflower seeds

Eating a moderate snack – made up of complex carbohydrates with a small amount of protein – an hour prior to bed can help bring on sleep. Some suggestions include:

• Cereal with milk
• Yogurt
• Toast with jam
• Peanut butter or nuts
• Oatmeal and raisin cookies
• Slice of apple pie
• Scoop of ice cram

Grief/Loss
We all experience grief and loss at various in our lives. The shock and pain resulting from the death of a family member or a pet, loss of a job, and other losses can affect our sleep.

Sleep disturbance is a physical reaction to grief and loss. Although each person’s grief symptoms are totally unique – like a fingerprint – difficulty sleeping is considered a normal grief reaction as long as it does not last too long. Sleep problems related to grief should not be ignored.

What you can do:

• If you are experiencing difficulty sleeping after a major loss, don’t be alarmed, but get help by going to grief support groups or grief counseling before it affects your health.
• Insomnia or sleeping too much can be a sign of depression. Contain your EAP or behavioral health care provider if you are concerned about sleep too much or too little.

Lifestyle

A workday confined to an office doesn’t offer much opportunity for physical activity. Just like children, we also need to run around until we tire ourselves out. Moderate aerobic activity of 30 minutes a day improves sleep. There are additional benefits to your heart and waistline as well!

What you can do:

• Run, walk or ride your bike for 30 minutes at least 5 days a week. This doesn’t mean you have to join a gym or make radical lifestyle changes – just do things a bit differently. Ride your bike in your neighborhood to get to the pharmacy or to pick up a loaf of bread. Make new friends or reconnect with old friends while walking at lunch or after dinner.
• Look for opportunities to multitask – get active and check something off your “to do” list. For example, go up and down the stair with every load of laundry you do. The more times you are up and down the stairs, the greater the benefit!

Medications

Certain medications may be keeping you awake. Many over-the-counter products could be the culprit. Insomnia can be a side effect of some decongestants or cold medicines, diet pills, No-Doz or herbal medications. Some prescription medications can also cause or contribute to insomnia, especially some blood pressure medications, stimulants (often used to treat attention-deficit / hyperactivity disorder (ADHD), such as Ritalin and Concerta), and some asthma medications. Other drugs that may cause insomnia in some patients include medications used to treat heart disease, opioids for chronic pain, and certain antidepressants. Provigil, which may be sued to treat conditions such as ADHD and multiple sclerosis, can cause insomnia.

What you can do:

• Avoid taking cold medicines with ingredients such as pseudophedrine (Sudafed) and phenylephrine (cold tablets and nasal sprays) close to bedtime, or even taking them at all.
• Talk to your doctor about your medications. Could these be causing your insomnia? She may lower the dose or advise you to take them earlier in the day.

Men’s Health Issues

Prostate health

As men grow older, frequent urges to urinate during the night can be an irritating sleep-wrecker. Mayo Clinic researchers confirm bladder function in men worsens with age, and then prostate gland may be responsible.

What you can do:

• Limit the amount you drink in the hour before bedtime.
• If you are urinating multiple times at night, see your doctor to improve your sleep and ward off more serious bladder and prostate problems.

Nicotine

Nicotine affects the brain in the same way that sunlight encourages wakefulness. Smoking an hour or less before bedtime makes it more difficult for your body to relax and enter into sleep.

What you can do:

• If you are ready to quit smoking, contact your health provider for information, tools and resources that are available to support you.
• If you are not ready to quit, avid nicotine in the hour before your bedtime.

Pets

What about the barking dog or cat that jumps onto your bed – have they ever disrupted your zzzs? A study conducted by Mayo Clinic surveyed 300 patients. Fifty-three percent of the pet owners considered their sleep to be disrupted in some way due to their pets! Most of us recognize that the sleep environment can greatly affect how (and whether) we sleep, but are you doing everything you can to make your bedroom a sleep haven? Well-rested pet owners will have more energy and love to give to their pets!

What you can do:

• Provide your dog with a bed in your bedroom, instead of sharing your bed.
• Limit your pet’s water intake in the few hours before bedtime (so your pet doesn’t wake you up to go outside).
• Special considerations for cat lovers: Because cats are nocturnal, they prefer to be up at night. Keep your cat up during the day, play with your cat in the evening before bedtime, and don’t feed your cat first thing in the morning.

Shift Work

If you work nights or shift work, making sleep a priority is the key to getting healthy sleep. Try to minimize exposure to the sun on the way home from the night shift by wearing wrap-around sunglasses. This avoids activation of your internal daytime clock. Stay on a consistent sleep schedule and go to bed as soon as you can after work.

To stay happy and safe in your shift work, be aware of changes in your energy level. Work carefully and take breaks when feeling tired or less alert. Be patient with yourself and your family, especially when staring a new shift. Keep the lines of communication open, put plans in place to help everyone adjust, and maintain healthy habits so that working non-traditional hours can work for you.

What you can do:

• Keep a consistent routine on a particular shift. When you change shifts, adjust your routine to accommodate new work hours.
• Balance shift work and family time. Be sure to eat at least 1 meal per day with your family and make special plans for alone time with your significant other.

Sleep disorders

While there are more than 100 types of sleep disorder, the most common are:

Insomnia: Insomnia is characterized by difficulty falling asleep, awakening frequently during the night, lying awake in the middle of the night or awakening too early in the morning despite not feeling refreshed.

Sleep apnea can be a more serious disorder, even life-threatening. In sleep apnea, breathing stops or gets very shallow while sleeping, causing frequent awakenings, often with symptoms of choking or gasping for air. There is some evidence linking sleep apnea with obesity.

Restless leg syndrome (RLS) is a sensory disorder that causes an almost irresistible urge to move the legs. Symptoms most often occur when relaxed or lying down and are not necessarily confined to sleep time.

Narcolepsy is a disorder that causes a person to have difficulty staying awake. Narcolepsy can cuase a person to fall asleep suddenly during the day. These “sleep attacks” occur even after getting enough sleep at night.

What you can do:

• To help determine whether you have a sleep disorder, first pay attention to your sleep habits and daily routine. Whether you are planning to try self-help techniques or to visit a doctor, a record of your sleep habits will prove valuable. Keep a sleep diary. A daily sleep diary should record all sleep-related information including:
• Time you went to bed and work up (total sleep hours)
• Quality of your sleep – times that you were awake during the night and what you did (for example, stayed in bed with eyes closed or got up, had a glass of milk, and meditated)
• Types and amount of food, liquids, caffeine or alcohol you consumed before bed, and times of consumption
• Feelings and moods before bed – happiness, sadness, stress or anxiety
• Drugs or medications taken, amounts taken, and times of consumption
• You can address most common sleep problems through lifestyle changes and improve sleep habits, but it is important to see your doctor or a sleep specialist for a diagnosis if your sleep does not improve.

Sleep environment

Temperature

Temperature plays an important role in sleep. Our bodies need to be warm enough to fall asleep, and the room temperature needs to be cool enough to keep us asleep.

What you can do:

• Take a warm bath and put on a pair of the softest socks you own before climbing into bed.
• Set your bedroom temperature around 68 degrees Fahrenheit (20 degrees Celsius), which is the ideal room temperature for sleep.

Turn out the lights

The flashing glow of those neon signs in films has been replaced by the LCD glow of the computer screen, the white scramble of network sign-off or the red haze of the alarm clock punctuated by flashing dots. All of this stimulation keeps our minds active and eyes open.

What you can do:

• Power down the computer, turn off the television and turn your alarm clock around. There is nothing there to see until morning.
• Turn out all the lights and block all light coming into your bedroom – even if that means hanging black-out shades.

Nurture your relationship – with your bed

If you have difficulty sleeping, you may begin to view your bed as anything but a place of rest. Commit to giving your bed 7 to 9 hours of your time each night.

What you can do:

• Set a bedtime and stick to it. Read a book, meditate or count sheep s you become sleepy. If you spend more than 30 minutes in bed without falling asleep, get up and try again in 30 minutes. Keep to your bedtime ritual, though. Ultimately your body will expect to sleep when it hits the bed.
• Set a wake-up time and stick to it. If you wake in the middle of the night, don’t look at the clock (it’s turned around anyway). Remind yourself it is still time to sleep. Keep to your wake-up ritual. Ultimately your body will anticipate when it is time to wake up.

Turn down the noise

Barking dogs, sirens, noisy neighbors or a snoring partner are just a few of the sounds that can inhibit a good night’s sleep. The intensity, regularity, intrusiveness and familiarity of noises all have an effect on sleep.

What you can do:

• Insert earplugs
• Listen to soft, soothing music
• Run a fan or air conditioner
• Turn on a white noise machine
• Decorate your room with rugs, carpet or heavy curtains to absorb sounds
• Install double-pane windows in your bedroom

Stress

There is no way to avoid stress. Life is – and will always be – stressful. What you can do is manage sress by minimizing its unhealthy effects.

In order to set the stage for your best sleep, you need to be able to minimize the stressful events or increase what restores you.

What you can do:

• Look at the totals. If your restoring total is higher than your stress total, congratulations! You are managing your stress and working well to maintain balance!
• If your stress total is higher than your restoring total, it’s time to take action. Take a closer look at the stressors you identified. Is there a pattern or a theme? Take a look at what you are not doing to restore yourself. Begin to pull from the list of what you are not doing and try some of these strategies.

Women’s Health

Women have unique biological conditions that can affect the quality and quantity of their sleep over their life span.

Premenstrual syndrome. Premenstrual syndrome (PMS) is a group of symptoms linked to changing hormones during the menstrual cycle. Some women may be affected more than others. If you have PMS symptoms, they typically occur in the week or 2 weeks before your period (menstruation or monthly bleeding). The symptoms usually go away after your period starts. Stress and emotional problems do not seem to cause PMS, but they may make it worse. Trouble sleeping is one common symptom.

What you can do:

• Take a multivitamin every day that includes 400 micrograms so folic acid. A calcium supplement with vitamin D can help keep bones strong and may help ease some PMS symptoms.
• Exercise regularly
• Eat healthy foods, including fruits, vegetables and whole grains.
• Avoid salt, sugary foods, caffeine and alcohol, especially when you are having PMS symptom
• Find healthy ways to cope with stress. Talk to your friends, exercise or write in a journal
• Don’t smoke

Over-the-counter pain relievers such as ibuprofen, aspirin or naproxen may help ease cramps, headaches, backaches and breast tenderness. In more severe cases of PMS, prescription medicines may be used to ease symptoms.

Pregnancy. Aches, pains, anxiety, baby’s movements, and increase in the body’s metabolism and bathroom runs keep many pregnant women awake at night.

What you can do:

• Avoid eating large meals 3 hours before going to bed
• Do mild exercise, such as walking
• Avoid taking long naps during the day
• Sleep on your left side, and use pillow between your legs and under your belly to help you get comfortable
• Talk with your partner, friends, doctor or midwife to relieve stress.

Menopause. Menopause is a normal change in a woman’s life when her period stops. During menopause, a woman’s body slowly makes less of the hormones estrogen and progesterone. If you are near menopause, you may have symptoms form the hormone changes in your body. You might start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. You might have trouble falling back to sleep if you wake during the night.

What you can do:

• Avoid alcohol or caffeine and spicy or acidic foods, which can trigger hot flashes in some women
• If night sweats wake you, try sleeping in a cool room or with a fan on
• Dress in layers that you can take off if you get too warm
• Use sheets and clothing that let your skin “breathe”
• Talk to your doctor about treatment for symptoms that are keeping you awake

Work

Are you working smarter – or longer? Advances in technology and the rise of the global market have been both a help and a hindrance. Are you working 24/7 in the office and at home? When you short-change yourself on sleep, you will short-change your employer, too. Accidents, cognitive impairments and poor decision making are all linked to insufficient sleep. Is that how you want your work to be judged?

What you can do:

• Accept the idea that you can’t do it all. It is your responsibility to make your best effort to manage your time well and work smart. When you have too much to do it is your responsibility to talk with your manager. Are co-workers, associates or interns available to share the workload? Create a plan and suggest it to your manger.
• If you need to work outside of your scheduled work time, do so with limits. Step back to assess how you spend your time and consider how you can set parameters. Unwind, relax and be involved with your family, friends and leisure activities.

Worry

We all worry at times. But some people are worry experts, locked into daily, uncontrollable worry. While the themes may vary with age and from person to person, the common thread is the same: chronic and exaggerated worry over situations and topics that can’t be turned off at will. These thoughts can interfere with daily life functions such as sleep.

What you can do:

• If you are chronically worried or fearful, you may have an anxiety disorder. Ask yourself some questions: Which situations cause anxious feelings? How long have you had these feelings? Is the worry reasonable?
• Contact your behavioral health provider once diagnosed, anxiety disorder is highly treatable. Treatment methods include medication and cognitive-behavioral therapy.

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