The Importance of Sleep
Another extremely important part of well-being is getting the sleep you need. Insomnia can lead to depression and irritability, as well as poor concentration and other mental and physical problems. The average adult needs at least eight hours of good quality sleep a night, but gets far less. (“Good quality” sleep is not disrupted frequently or marked by restlessness, upsetting dreams, and so on.)
Causes of Insomnia
If your insomnia is temporary — that is, caused by a stressful life event or anticipation of a situation like a major exam or a job interview — it is probably nothing to worry about. However, for chronic insomnia, you might want to work on sleep techniques. (“Chronic insomnia” means you often find yourself unable to fall asleep easily, or you wake up during the night, then lie awake for hours, and this lasts longer than, say, two weeks.)
Sometimes, pain or other physical problems such as heartburn, reflux (GERD), or restless leg syndrome, can interfere with getting a full night's sleep. Medications can be effective against arthritis, post-surgical and other kinds of pain, as well as restless leg syndrome. They can also be used to treat acid reflux, as can various lifestyle changes (also mentioned elsewhere in this book). Depression, bipolar disorder, and other conditions can cause sleep disturbances, as well.
What to Do about It
Even though there can be many causes of insomnia, let's assume for the moment that you are being kept awake by anxious thoughts. In addition to other sleep techniques listed in this book, you might try some of the following. (There are also now several very good books on getting a better night's sleep. You'll find some of these listed in Appendix A.)
Among the tried-and-true are:
Taking a warm bath or shower before bed.
Drinking a little warm milk or herbal (non-caffeinated) tea before bed, or eating half of a turkey sandwich (but beware of heartburn, which can keep you awake). Cashews are also said to cause drowsiness.
Getting a massage.
Making sure your bed is comfortable to sleep in. (The mattress should not be too hard, soft, lumpy, or saggy.)
Making sure the temperature in your room is neither too high nor too low (although keeping your room cool and sleeping under blankets may help, as well).
Listening to relaxing music to help you fall asleep.
If you can't sleep after lying in bed for fifteen minutes or so, get up, but don't stay up for too long or get involved in activities likely to keep you awake. After half an hour of watching TV, reading, or doing something boringly repetitive, or useful but not mentally taxing (such as light housecleaning), get back into bed and try again.
Many experts recommend setting the same bedtime every night and avoiding the temptation to nap during the day. Some suggest getting up an hour or so earlier than usual in the morning to help you fall asleep more quickly at night. Others advise maintaining the same wake-up time, even on weekends, to help your body establish a predictable routine. Try this for a while, and you may find that you are able to fall asleep more easily.
While exercise is beneficial for sleep and overall health, do not exercise less than three hours before bedtime. Doing so can prevent you from falling asleep easily. (Avoid exercise around mealtime, as well, as this can aggravate heartburn and similar conditions.)
Your bedroom should be as dark as possible (assuming you can tolerate the dark). That means no illuminated bedside clocks or nightlights. Sex generally relaxes the body, so that, too, may be a helpful sleep inducer. (And, if not, it probably won't be a complete waste of time.) Oddly perhaps, some patients find that just thinking about sex, but not doing anything about it, creates enough of a feeling of relaxation to send them to sleep.
You may have heard the suggestion that reading or watching TV may be too stimulating, however dull the subject matter. While this seems to be the case for some people, for others just the opposite is true. The best thing you can do is try some of these suggestions and see what works for you.
Don't Sleep In
Although it may be tempting to catch up on lost weekday sleep during the weekend, some experts advise against this, suggesting instead that you develop a regular pattern, starting with the same bedtime every night. (However, some say it's okay to go to bed an hour later on weekends, as long as you don't sleep later.) Many knowledgeable advisers suggest a bedtime routine, as humans are “creatures of habit.” Combining a few of these pieces of advice — for instance, a light snack, followed by a warm bath and a pleasant book — can create a comforting routine, quite conducive to restful slumber.
If All Else Fails
You might want to talk with your doctor about a short-term medication to help you fall asleep and remain asleep through the night. (Most sleep aids are not recommended for extended periods.) There are also over-the-counter products such as melatonin and others. Keep in mind, however, that such products, while they may have many devotees, are not regulated by the FDA.
If you are currently on medication, it might pay to look into a change. Some of the medicines used to treat OCD can cause drowsiness. Taken before bedtime, they might just pull “double duty,” improving your OCD symptoms, while, at the same time, helping you to get a better sleep.