How to Fall Asleep theNatural WayChanging your sleep habits is a powerful fix, free ofside effects

By Consumer Reports

January 05, 2016

The first step you should take to sleep better is to make an appointment withyour doctor. She should review all of the prescription and over-the-countermedications you take, a number of which—including blood pressure meds anda variety of antidepressants—can impair sleep.

Next, she should assess whether you have any medical conditions such asarthritis, heartburn, menopause, and prostate enlargement, all of which arenotorious for interrupting sleep. But they’re often overlooked as contributingcauses, says Marvin M. Lipman, M.D., Consumer Reports’ chief medicaladviser.

Your doctor may also want to establish whether you suffer from sleep apnea(periodic pauses in breathing while you sleep, lasting from a few seconds to afew minutes) or restless legs syndrome (involuntary urges to move your legs).To do so, she will probably refer you to a sleep specialist who might track yourpatterns overnight, either at an inpatient sleep clinic or at home with a portablesleep monitor.

If your doctor rules out medical problems as a cause of your poor sleep,consider cognitive behavioral therapy for insomnia (CBT-I), a form ofbehavioral treatment that focuses on changing habits that disrupt sleep. The

American Academy of Sleep Medicine now recommends CBT-I over sleepdrugs as the treatment of first resort for chronic insomnia.

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A 2015 review in the journal Annals of Internal Medicine concluded that CBT-Ihelped people sleep about 26 more minutes per night. Those improvementslasted even after the therapy stopped—and didn’t pose any of the risks thatdrugs do.

If you’re already taking sleeping pills, CBT-I has also been shown to help weanyou from these drugs, says Lisa Medalie, Psy.D., an insomnia specialist at theUniversity of Chicago. The treatment, which requires roughly two months ofweekly sessions, is usually covered by insurance.

Here’s how it works: You’ll be asked to keep a sleep diary to record when youfall asleep and wake up, how long it takes to fall asleep (and if you wake up,how long it takes to fall back asleep), and how you feel the next day. Then thetherapist will suggest strategies to help change your nagging thoughts and badhabits. At each session, you’ll get “homework,” such as stashing your

smartphone under your bed at night so that you don’t obsessively check thetime or your emails.

Personalized CBT-I is the most effective way to go, but you can start now bytrying out some of the techniques a therapist might recommend.

Practice Makes PerfectHealthy sleep habits should happen all day long, experts say.

A top goal is to keep your body’s wake-sleep cycle predictable. Sleeping insome days feels good in the short term but creates long-term havoc.

Get your body into daylight early in the day if you can. That helps set a proper24-hour clock.

Regular exercise encourages sleep, possibly because it tires you out and easesstress. Avoid working out within an hour or two of bedtime because that mayincrease alertness and make it more difficult to fall asleep.

A cup of coffee at breakfast or midmorning is okay, but if you have chronictrouble sleeping, avoid caffeine for at least 6 hours before bed.

Midday exposure to natural light helps strengthen your body’s 24-hour sleep-wake cycle.

Fight the urge for an afternoon snooze even if you didn’t sleep much the nightbefore, for the same reason that you shouldn’t sleep in: When bedtime comes,you’re ready for sleep.

Big meals close to bedtime are a no-no, especially if you suffer from heartburn,which tends to worsen when you lie down. Alcohol is okay, as long as you willbe up for several more hours. A drink before bed might help you conk out, butit can increase the likelihood of waking up in the middle of the night.

The blue light from laptops and smartphones can slow production of the sleephormone melatonin. So shut them down 2 hours before you intend to go tosleep. Can’t unplug? At least dim the device and hold it a foot or so from youreyes. Or consider special glasses designed to block out blue light.

An hour or so before bed, dim the lights in your bedroom and do somethingrelaxing: Read a physical book (not a lit screen), listen to quiet music, meditate,or have a glass of a warm, noncaffeinated drink. (Note that there might not beanything magical about milk, but any soothing drink before bed may help youunwind.)

Close your curtains, try eyeshades, use earplugs, or turn on a fan or a white-noise machine.

Watching the minutes tick by can become a self-defeating obsession. So putyour alarm clock or smartphone someplace where you can’t easily see or reachit, such as under your bed.

. . . and can’t get back to sleep within 20 minutes, go to another room and do

something relaxing. When you start feeling sleepy, head back to bed.

Editor's Note: This article also appeared in the February 2016 issueof Consumer Reports magazine.

These materials were made possible by a grant from the state Attorney GeneralConsumer and Prescriber Education Grant Program, which is funded by amultistate settlement of consumer fraud claims regarding the marketing of theprescription drug Neurontin (gabapentin).

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