Recognize sleep as the ‘apex predator of healthy habits’ because poor sleep negatively impacts health, focus, productivity, happiness, success, and relationships. Make prioritizing sleep a conscious effort.
Undertake a ‘personal investigation’ to identify what specifically is keeping you awake, as different issues (e.g., circadian rhythm, anxiety, physical disorders) require different solutions.
Focus on how you feel during the day rather than just the number of hours you sleep. If you feel fine and energetic, you’re likely getting enough sleep; if you constantly need naps or doze off, something is wrong, regardless of hours.
Understand that primary care physicians often lack sufficient sleep education (average four-year med school spends two hours on sleep). For complex or persistent sleep problems, seek a sleep specialist rather than relying solely on your PCP.
Before focusing solely on sleep disorders, consult your doctor to rule out any other underlying conditions like chronic pain or severe acid reflux that might be causing or exacerbating your sleep issues. Push harder if your doctor isn’t providing solutions.
View sleeping pills as ‘crutches’ rather than a ‘solution’ for sleep problems. They may offer temporary sedation but often don’t provide quality sleep or address the underlying issue, can be habit-forming, and may even worsen some sleep problems.
If taking any substance regularly to aid sleep, seek guidance from a sleep specialist. Sleeping pills should be used thoughtfully and strategically, ideally as a bridge to a long-term solution, not the solution itself.
Dispense with the myth that everyone needs exactly eight hours of sleep. The appropriate amount varies (7-9 hours for most adults, but 5-11 hours may be appropriate for some); forcing more sleep than your body needs can lead to insomnia.
If you snore loudly, constantly feel like you need a nap, or doze off during moments of stillness (e.g., in a waiting room or watching TV), get screened for sleep apnea, as it can affect anyone regardless of age, weight, or gender.
If you suspect sleep apnea and meet risk factors, ask a sleep specialist for an at-home sleep study. These tests are simple, involve wearing a device on your finger or with a nose cannula, and send data directly to the specialist.
If diagnosed with sleep apnea but unwilling or unable to use a CPAP machine, discuss alternative FDA-approved treatments with your doctor, such as a specialized mouth guard, or try different CPAP mask fits, as adherence is key.
If you experience a discomfort or fidgety sensation in your legs (or other limbs) that compels you to move, especially at night or during periods of rest, ask your doctor about Restless Leg Syndrome. Treatment can include lowering arousal, magnesium, or iron.
For insomnia or other non-apnea sleep disorders, seek a behavioral sleep specialist, ideally one trained in Cognitive Behavioral Therapy for Insomnia (CBTI). Resources like behavioralsleep.org can help locate accredited specialists.
If direct access to a CBTI specialist is limited, explore self-help methods such as specialized apps or books (like ‘The Sleep Fix’) that detail CBTI techniques. These can be effective if you are disciplined in their application.
Recognize and address ‘conditioned arousal,’ where your brain associates your bed with wakefulness and frustration due to prolonged periods of being awake and anxious in bed. This is a key element to solving insomnia.
To power up your sleep drive and break conditioned arousal, set a ‘reverse curfew’ by not going to bed before a specific, slightly later time. Maintain a consistent wake-up time daily, even after a bad night, and avoid naps to build sleep pressure.
Utilize CBTI techniques like sleep restriction (initially limiting time in bed to actual sleep duration, then gradually expanding) or sleep compression (starting with a comfortable window, then gradually cutting back until efficient sleep is achieved) to reduce time spent awake in bed.
If you are in bed for long enough to feel frustrated and awake, get out of bed. Engage in an enjoyable, relaxing activity elsewhere and return to bed only when you feel sleepy to reinforce the association of bed with sleep.
Before bed, perform a ‘constructive worry’ exercise: divide a notebook page, list worries on one side, and the very next actionable step to resolve each on the other. This helps process thoughts outside of bed and reduces racing thoughts at night.
To effectively use meditation for sleep, practice it during the day when you are naturally calm. This builds the skill of noticing distractions without judgment and helps your brain associate meditation with relaxation, making it a more effective tool for occasional stressful nights.
If you have circadian rhythm issues (e.g., shift worker, night owl), use a therapy light that mimics sunlight in the morning while getting ready. This signals to your brain that it’s morning, helping to set your body clock for appropriate wake and sleep times.
Consider food timing to aid sleep and circadian rhythm. If you wake up hungry, opt for light, comforting, easy-to-digest snacks like plain oatmeal. If you struggle to sleep on an empty stomach, eat a sleep-friendly snack (e.g., toast, oatmeal with complex carbs) 1-2 hours before bed.
If you have trouble sleeping, consider eating protein earlier in the day to store tryptophan, and then consume complex carbohydrates at the end of the day. Carbohydrates trigger insulin, which helps tryptophan reach the brain to produce serotonin for sleep.
If reading in bed helps you relax and unwind without making you anxious or losing track of time, it can be beneficial. Avoid activities that are overly stimulating or cause you to ignore sleepy cues, as these can disrupt sleep.