By Corrie Pikul
These sleep experts have done the research, they’ve heard the up-all-week horror stories (as well as the surprise successes) -- so, we asked, what works for them?
The expert: W. Christopher Winter, medical director of the Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Virginia.
The sleep secret: "I like to take a lunchtime nap to make up for those unavoidable late nights. As a sleep consultant for a number of sports teams, I often travel on weekends, but I need to see patients early Monday morning. So I'll block out 1-1:30pm, always the same time. Naps work best if they're on a schedule because your body learns to anticipate the rest. I follow the same routine: dim the lights, turn on a sound machine, and recline in my chair 180 degrees. It's very important not to sleep longer than 30 minutes to avoid the post-nap funk. I set a wake-up alarm and also ask my assistant to check on me. I have a Zeo sleep management device--a Jawbone UP does this, too -- that shows me how much time I spent in light and deep stages of sleep. If I fall quickly into deep sleep during a nap, I know I'm really sleep deprived and should plan another nap tomorrow."
Sleep disappointment: "Although I counsel those who struggle with sleep to exercise in the morning, that doesn't work for me. I do better with squeezing in a workout later, sometimes at 10 or 11pm."
Do Boring Yet Challenging Math
The expert: Michael Breus, PhD, clinical psychologist and author of The Sleep Doctor's Diet Plan: Lose Weight through Better Sleep
The sleep secret: "The number-one complaint I get from patients is, 'I can't seem to turn off my mind at night.' I've had the same problem, especially when I'm on the road. I used to keep a worry journal in which I would jot down all the things on my mind along with a solution, even if it was just, 'Think about this tomorrow.' That can be effective, but I needed another trick. Counting backwards from 300 by threes is my take on counting sheep, which research has shown is too easy to be effective. It forces me to focus enough to blocks out stressors, but at the same time, it's really boring and puts me right to sleep. I guarantee that even if you do it every night for a month, you still won't make it to the single digits."
Sleep disappointment: "I'm not crazy about memory-foam mattresses. They're great for support, but you can get stuck in one position, and trying to turn to your other side takes five minutes."
Let In The Light
The expert: Clete A. Kushida, MD, PhD, medical director of Stanford Sleep Medicine Center
The sleep secret: "I like to use light to help synchronize my internal clock. I avoid bright light two to three hours before bedtime, so if I'm reading, I use just enough light to see the words on the page. Then, within 30 minutes of waking up, I open the curtains to let in natural light. We know from the literature that light activates the suprachiasmatic nucleus, which is a group of nerve cells in the brain that controls the timing of the sleep-wake cycle and coordinates with our circadian rhythms. For patients who have a hard time waking up and who don't have access to sunshine every morning, we recommend a light box that has more than 10,000 lux, and tell them to keep it about 18 inches from their eyes. This morning light puts a kind of time stamp on the brain and shifts your internal clock for sleep earlier -- that will help you feel sleepy at the other end of the day, too."
Sleep disappointment: "I've heard other physicians recommend valerian-root tea as a natural sleep aid, and there some small studies that show it makes some patients drowsy. I was curious, but it didn't affect me."
Turn On A Fan
The expert: David N. Neubauer, MD, associate professor at Johns Hopkins University School of Medicine
The sleep secret: "I sleep with a bedside fan every night, no matter what the temperature. If the fan's not on, I will definitely have difficulty falling asleep. There's plenty of anecdotal evidence that white noise can be soothing because it blocks out sudden variations in sound—like a barking dog, or a car alarm—that can lighten our sleep or wake us. It also creates ventilation, and we know that people tend to sleep best in cooler temperatures -- try keeping the room at a temp that you would describe as a little chilly when you're not covered up. When I'm traveling, I often buy a small fan for the hotel room. It's worth it to help block out unfamiliar noise and let me get the sleep I need."
Sleep disappointment: "I think the 'no reading in bed' rule makes sense for chronic insomniacs, but I find reading relaxing. I feel like I can put the book down when I get tired."
Claim Your Own Blankets
The expert: John Dittami, an Austria-based sleep researcher and co-author of Sleeping Better Together
The sleep secret: "In Europe, where I live, it's not at all strange for couples to have their own blankets in bed. This solves a lot of problems. We know from talking to couples for our book that using one blanket for two people is not conducive to good sleep. Not only does it make you more aware of your partner's movements, but it can also amplify the heat—and it can cause arguments when the blanket isn't evenly spread over both people. In my case, my partner and I will spend time together talking or cuddling before sleep, but after about 10 or 15 minutes, she turns over, and I turn over, and we each draw up our own separate covers. I know that I snore, so this helps a little bit. The separate covers are like our version of a peace treaty."
Sleep disappointment: "I've tried melatonin for jet lag, and while it did make me drowsy and cause me to sleep later, it wasn't a restful sleep, and I didn't feel refreshed in the morning. To paraphrase Shakespeare, 'it provoked the desire but took away the performance.'"
Get Out Of Bed
The expert: Michael A. Grandner, PhD, research associate at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania
The sleep secret: "I used to have a really hard time falling asleep, but I've since learned that spending time awake trains us that the bed is a place for worry and rumination. The bed needs to be a cue for sleep, period. So now whenever I hear that voice that says, 'This sleep thing is not happening'—which could take 10 minutes or 40 -- I go read or write in a darkened room for at least 30 to 60 minutes. When I try to sleep again, I usually drop right off. In the clinic, this is called stimulus-control therapy, and 20 years of data shows that it can be more effective at treating insomnia than sleeping pills. The problem is that it's much slower to take effect than a pill, and it also has a side effect: you'll probably be tired for the first couple of days. This is why so many people give up and take naps, or sleep in, or refuse to get out of bed at night, and then they're back at square one. For those two sleepy weeks, I suggest patients drink extra coffee, avoid long night drives, and take other stay-awake precautions -- but they also need to hang in there."
Sleep disappointment: "I've tried exercise, but it didn't work nearly as well as the stimulus control."
Establish A Nighttime Routine
The expert: Sam J. Sugar, MD, FACP, director of sleep services at the Pritikin Longevity Center & Spa in Doral, Florida
The sleep secret: "I used to go to sleep whenever I started feeling drowsy, which could be as late as 2 a.m. I would usually disrupt my wife, who was already in bed. About two years ago, she suggested trying the thing that experts -- including myself -- had been recommending to patients for years: that we both go to bed at the same time every night (we didn't have to worry about setting an alarm, because our dog wakes us up every day at 6:29). The idea is that you're creating a habit that the body then wants to stick to, so it tells you that it's tired at the chosen time. Many studies have shown that this kind of repetition is self-reinforcing, including one from last year of over 650 retirees that found that going to bed and waking at the same time helped people fall asleep faster and wake up feeling more refreshed. That's what happened to me, too. I'm lucky that I have my wife to keep us on schedule, but other people might find it helpful to set a go-to-sleep-now alarm, or create a bedtime routine (turn the computer off at 9:50, or wash your face at 10:45)."
Sleep disappointment: "I have trouble sleeping on planes. On one long transatlantic flight, my colleagues insisted that I take a sleeping pill 'to take the edge off.' For 18 hours, I sat wide awake, watching everyone snooze. It was a reminder that we all react differently -- and unpredictably -- to medication."
As a reminder, always consult your doctor for medical advice and treatment before starting any program.