This article first appeared on Start Sleeping.
According to the National Sleep Foundation, 35% to 40% of adults in the U.S. have problems falling asleep or with daytime sleepiness.
According to researchers at the University of Michigan, globally only a handful of nations get the recommended average of 8 hours per night.
Dr. Matthew Walker, director of the Center for Human Sleep Science at the University of California, says “The silent sleep loss epidemic is one of the greatest public health challenges we face in the 21st century.” He claims that chronic sleep deprivation leads to higher rates of cancer (bowel, prostate, and breast), diabetes, obesity, depression, anxiety, Alzheimer’s, and many other grave health consequences.
In the foreword to the book “Sleep Smarter” by Shawn Stevenson, Dr. Sara Gottfried explains that improving your sleep can result in the following benefits:
- Better skin health and more healthful appearance
- Emotional regeneration and better relationships
- Decreased risk of stroke and cardiovascular disease
- Fewer accidents
- Lower levels of inflammation
- Enhanced immune function
- Hormonal balance
- Faster rate of weight loss
- Decreased pain
- Stronger bones
- Lower risk or Alzheimer’s disease and cognitive decline; better memory
If you’re looking to improve the quality of your sleep, we’ve taken the advice from the top experts in the field of sleep medicine and organized their guidelines into 5 main categories for a good sleep foundation. We also included strategies for napping, traveling, as well as what you need to know about sleeping pills. The 5 major categories are:
- Circadian rhythms & light exposure
- Food & drink
- Stress and bedtime ritual
- Your bed and bedroom
If you don’t sleep enough or the quality of your sleep needs to be improved, the first thing you need to figure out is if you have a sleep disorder. To find out if you have a sleep disorder such as restless legs syndrome, narcolepsy, sleep apnea, or insomnia, get a referral to a sleep doctor. Click here for a full list of sleep disorders.
1. Circadian Rhythms
Your circadian rhythms are physical, mental, and behavioral changes that follow a daily cycle, mainly influenced by light and darkness. Circadian rhythms are found in most living things, including animals, plants, and many tiny microbes.
The main thing you can do to get in sync with your circadian rhythm is to fall asleep and wake up at the same times each morning and night. The hardest part of following this guideline is to not sleep in on the weekends. If you’re sleep deprived and you want to catch up, the best way is with naps. You have to be careful with napping though, as they should be limited to 20 minutes in the afternoon. Taking naps longer than 20 minutes and or taking a nap too late in the day can negatively affect your sleep at night. Sleep experts tell us that if you’re an early riser, your afternoon siesta will probably be around 1 pm, and if you wake up a little later, it may be around 1:30 or 2 pm. If you thought that you got tired in the afternoon because of lunch, the data shows us that people often naturally get tired in the afternoon, even if they haven’t eaten (hence the Spanish or Latin American “siesta.”
Your brain sets its circadian rhythm by it’s exposure to light. This is where a lot of people are making mistakes. Looking at TVs, tablets, and phones late at night expose your brain to blue light that tells your brain that it’s light out and it needs to be awake.
You should be exposed to sunlight in the morning and throughout the afternoon, and a great habit is to expose yourself to sunlight after you wake up, and exercise outside if possible. The other factor that influences your circadian rhythm is temperature, so regularly exercising in the morning will raise your temperature, signaling your brain to wake up, and reducing the temperature of your room at night will signal your brain to sleep (the optimum temperature is 60-68 degrees, you’ll have to experiment to find your optimal sleep temperature).
You should have no exposure to blue light within 1-2 hours of going to sleep. As TVs don’t have blue light blockers, you can wear blue light blocking glasses, or watch programs on your computer, tablet or phone. Many phones have a blue light blocker that you can turn on at night, or you can install an app on your computer, tablet or phone that blocks blue light, such as f.lux.
Put a nightlight in your bathroom and don’t use your normal bathroom lights when getting ready to go to bed. When you get up during the night to go to the bathroom, you should only be exposed to the minimum amount of light. Make sure your bedroom is dark. You can use light-blocking or room-darkening shades, or you can use a sleep mask.
Make sure that you don’t have a bright clock next to your bed. If you do, use the dimmest setting. And if there are any other lights in your room (such as on the tv), cover them.
Calculating Your Optimum Bedtime
We go through a full cycle of sleep in approximately 90 minutes:
- Stage 1 (N1): light, non-rapid eye movement (NREM) sleep where the eyes move slowly and muscle activity slows, and you can be awakened easily.
- Stage 2 (N2): the first stage of NREM sleep as eye movement stops, the brain slows down, the heart rate slows, and the body temperature begins to drop; this is where the brain prepares for deep sleep. It is more difficult to be awakened in this stage than in stage 1.
- Stage 3 (N3): this is where deep NREM sleep occurs; this is the most restorative stage of sleep. Being awakened in this stage is rare.
- Stage 4: This is the rapid eye movement stage (REM) where the eyes move rapidly from side to side and when dreaming occurs. You can be awakened more easily in this stage.
The National Sleep Foundation recommends a range of 7-9 hours for adults ages 26-64, 7-8 hours for those 65 and older. If you find that 7.5 hours isn’t enough for you, add 15 more minutes of sleep to your routine until you find the number that works for you.
The next step is to adjust your sleep and wake time to slightly earlier or later until you’re waking up 5-10 minutes ahead of your alarm. This is because everyone can have slight variations in their sleep cycles. If you’re waking up much earlier than your alarm, then go to bed a few minutes later. If you’re sleeping through your alarm, then you’ll want to go to bed earlier.
In addition to figuring out how much sleep you need, it’s also helpful to know your chronotype, or when you prefer to sleep. Everyone pretty much knows what their preference for when to sleep is, with the two categories being a morning person, or phase advanced, or a night person, or phase delayed. Dr. Winter explains that our chronotype is genetic, influenced by your clock genes, and can be manipulated to some degree by light exposure, light timing, exercise schedules, social interaction, and sleep schedules. Age is also a factor, with younger people tending towards going to bed late, and older people tending to go to bed earlier. Working with your chronotype will help you get quality sleep.
Circadian Rhythm Sleep Tips:
- Don’t expose yourself to bright lights (specifically blue light) within 1-2 hours of going to bed.
- Go to bed and wake up at the same time every night (including the weekends).
- Expose yourself to sunlight early in the morning and throughout the day, and exercise early in the morning outside if possible.
- Respect your chronotype or tendency to go to bed earlier or later when figuring out the best time for you to go to bed every night.
- Limit your naps to 20 minutes at the most, and don’t nap late in the day. The best time is around 1-1:30 pm if you’re an early riser, or 2:30-3 if you’re a late riser.
People who exercise regularly sleep better at night, and the more vigorously you exercise, the more you benefit. Exercise can tire you out and relieves stress, both of which help many people fall asleep faster and increases sleep duration.
According to Sleep.org, people that work out early in the morning spend 75% more time in the most restorative stages of sleep compared to those who exercise later. It can reset your circadian rhythm by raising your core body temperature, and if you work out outside, being exposed to sunlight will also reset your circadian rhythm. The only issue is that your core body temperature is lower when you wake up, so make sure you warm up gradually as your risk of injury is higher.
Working out in the evening is not a good idea for most people as your core temperature will stay elevated for 4 to 5 hours, as one of the cues to your system to sleep is a drop in body temperature. It also elevates your cortisol levels, which can make it more difficult to get to sleep. Though it has been generally accepted that exercising vigorously within 3 hours of bedtime will prevent you from going to sleep, new research shows that it may not be true for everyone. Dr. Michael Breus says that everyone has a different chronotype, which is a classification of your genetic propensity towards when you’ll sleep, based on the PER3 gene.
The best way to find out what the best time to exercise is to try working out at different times and record the quality and quantity of your sleep in a journal. Make sure that you do the same length and intensity of workouts, and try to keep other factors the same so the only factor that’s different is the time of exercise.
3. Food & Drink
Caffeine and nicotine are common causes of people not sleeping well. Caffeine can cause issues with your sleep up to 12 hours after drinking it, so limit your intake to mornings. The nicotine in cigarettes is a stimulant that can interfere with sleep as well.
The general rule with food and liquids is not too little, and not too much. Drinking too many liquids in the evening will make you get up too often during the night which interrupts our sleep cycles. Interrupted sleep is as bad or worse than not enough sleep.
At night limit the amount of sugar and refined carbohydrates as it can trigger wakefulness at night. Also, don’t eat too large of a meal at night within 3 hours of going to bed. Avoid spicy foods at night as they can be tougher to digest, and though there are a few exceptions below, avoid fatty foods close to bedtime as well.
Marijuana, Alcohol & Sleep
Though many use alcohol to relax before bed, there’s evidence that it will prevent you from getting quality sleep because it significantly reduces stage 5 sleep or REM (rapid eye movement). A studyout of the University of Melbourne found that students who drank before bed had interrupted sleep patterns. It may reduce the time it takes to get to sleep, but it won’t help you get the benefits of restorative sleep. Stanford Health Care states that alcohol speeds the onset of sleep, but causes wakefulness in the second half of the night, counteracting the benefit.
Marijuana looks to have a similar but more an even worse effect on REM sleep. REM is the stage of sleep where you dream, and when pot smokers stop smoking, they start having dreams again, and usually a lot more, as if the brain is making up for lost time. Though why humans sleep and dream is one of science’s mysteries, when we dream our brain is reviewing images and experiences from the day and coming to terms with them. It also helps form memories. In REM sleep you also restore your brain chemistry to its normal balance.
A study out of the University of Pennsylvania found that people who started smoking pot early in life were more likely to have sleep problems later in life, and that marijuana seems to impair sleep quality.
The University of Pennsylvania study also found that 42% of pot smokers experienced sleep issues when they quit, just as many alcoholics experience insomnia when they quit.
Foods That Help you Sleep
Understand that eating foods that help you sleep can supplement a good sleep hygiene program, but don’t treat it as the most important part and ignore the basics. You don’t want to be making mistakes on the big things (such as going to bed at different times every night) and expect that your night time snack is going to make up the difference.
There’s more scientific research needed, but there are a few foods that are promising to help you get quality sleep likely because they contain some of the following:
- Melatonin: a hormone that plays an important role in regulating the sleep cycle. It’s produced by the pineal gland in the brain, it’s produced only released at night or in the dark. Studies have shown it to be effective in helping people get to sleep and in combating jet lag.
- Magnesium: people with insomnia often are magnesium deficient, and low magnesium levels often lead to sleep restlessly and waking up frequently during the night. Talk to your doctor about this, but people that often get muscle cramps, have muscle tightness, and/or have cold hands and feet often benefit from higher magnesium intake. Supplementing magnesium, or eating magnesium-rich foods can improve sleep quality by increasing muscular relaxation, helping regulate stress levels, and has been shown to help people with restless legs syndrome, which can cause insomnia. Supplementing magnesium has also shown to have a stabilizing effect on mood and effective in relieving symptoms of mild to moderate anxiety and mild to moderate depression.
- Tryptophan: is an essential amino acid (meaning that your body doesn’t produce it so you have to ingest it) that has similar effects to magnesium. It increases the production of serotonin, which gives you a sense of well-being. It’s a natural mood regulator, has a calming effect, promotes sleep, and fights anxiety. It also has been found to reduce food cravings and fight sugar addiction.
- Potassium: According to a study published in 1991 in the journal Sleep, potassium may help keep people asleep. Another study out of the University of Wisconsin School of Medicine and Public Health found that without potassium channels, you don’t get slow-wave sleep, which is important for restful sleep. Bananas are a good source, but not the best. Beans, leafy greens, baked potatoes, and avocados are the best sources.
- Vitamin D: according to a 2012 study in the Journal of Sleep Medicine, lack of vitamin D may lead to daytime sleepiness. According to the National Health and Nutrition Examination Survey (NHANES), 90% of Asians, Blacks, and Hispanics living in the United States and 75% of the while population are vitamin D deficient. The best source is sun exposure, but vitamin D is also found in salmon, swordfish, and tuna.
- Calcium: helps the brain to use tryptophan to manufacture the sleep hormone melatonin.
- Selenium: according to data from the National Health and Nutrition Examination Survey, a selenium deficiency can keep you from falling asleep. High selenium foods include brazil nuts, oysters, tuna, shrimp, salmon, and cremini mushrooms.
- Fiber: according to the Journal of Sleep Medicine, a low fiber high in saturated fat are associated with lighter, less restorative sleep. “It was most surprising that a single day of greater fat intake and lower fiber could influence sleep parameters” said Dr. Marie-Pierre St-Onge, principal investigator in the study.
- Complex carbohydrates: unlike simple carbohydrates, complex carbohydrates break down slowly, preventing blood sugar spikes and keeping serotonin levels consistent. Some examples are beans, whole grains, and vegetables. Simple carbohydrates include candy, soda, and many processed foods that add sugar.
Here are some of the top foods to help you sleep:
- Sweet potatoes: a great source of complex carbohydrates and potassium.
- Almonds: containing magnesium, just one ounce (a handful) has 19% of your daily recommended need.
- Bananas: also contains magnesium, potassium, and tryptophan.
- Turkey: contains tryptophan, but there’s evidence that the protein in turkey may help promote sleepiness.
- Fatty fish: the combination of vitamin D and omega-3 fatty acids have been shown to increase the production of serotonin, the sleep-enhancing brain chemical. One studied observed that men who ate 300 grams of Atlantic salmon three times per week for six months fell asleep 10 minutes faster than those who ate chicken, pork, or beef.
- Cherries: you might assume that the sugar in this fruit may keep you up, but there’s evidence that eating cherries or drinking tart cherry juice before bed may improve your sleep quality, and has been studied for its role in relieving insomnia. It has high levels of melatonin. Research from Louisiana State University ran a study where participants (older adults with insomnia) who drank tart cherry juice twice per day for two weeks increased their sleep length by 90 minutes. “Even though the amount of tryptophan in Montmorency tart cherry juice is smaller than a normal dose given to aid sleep, the compounds in Montmorency tart cherries could prevent the tryptophan from breaking down so it’s able to work in the body more effectively. Even though the amount of tryptophan in Montmorency tart cherry juice is smaller than a normal dose given to aid sleep, the compounds in Montmorency tart cherries could prevent the tryptophan from breaking down so it’s able to work in the body more effectively,” Co-author of the study, Dr. Frank Greenway explains, “These compounds may help to improve tryptophan bioavailability for serotonin synthesis, which could have a positive effect on sleep. Increasing serotonin also helps improve mood and decrease inflammation.”
- Kiwi: another fruit that contains serotonin, as well as antioxidants vitamin C and carotenoids, kiwis reduce inflammation, which may improve the quality of sleep. There have been several studies that link kiwis to better sleep. One conducted at Taiwan’s Taipei Medical University tested a group of 22 women and 2 men between the ages of 20 and 55, all of whom had issues sleeping. For 4 weeks the volunteers ate 2 kiwis one hour before bed, and their results were surprising. The amount of time it took to fall asleep dropped by 35%, the amount of waking up throughout the night dropped by 29%, sleep quality increased by 42%, and participants slept an average of 13% more.
- Honey: the glucose in honey reduces levels of orexin, a neurotransmitter in the brain that makes you more alert. It also allows tryptophan to enter the brain more easily.
- Oatmeal: high in carbs and a source of melatonin, oatmeal has been reported to induce drowsiness before bed.
- Passionflower tea: In a study published in the National Institutes of Health, 41 adults drank a cup of passionflower tea before bed and reported higher sleep quality. This is probably due to its apigenin, an antioxidant that reduces anxiety as well as reduces insomnia and promotes sleepiness. The brain also produces more GABA (gamma-aminobutyric acid) when drinking passionflower tea, which is deficient in those with insomnia.
- Chamomile tea: contain apigenin, an antioxidant that binds to receptors in your brain to promote sleepiness and reduce insomnia. A study from the University of Michigan published in the National Institutes of Health found that the 37 participants who drank chamomile extract twice per day for 28 days fell asleep 15 minutes faster and experienced less nighttime waking.
- Walnuts: a great source of many vitamins and minerals, including magnesium, protein, melatonin, as well as omega-3 fatty acids. Walnut’s fatty acid profile has ALA, which is converted to DHA, which may increase the production of serotonin, the “happy hormone” that is also a sleep-enhancing brain chemical.
The Carbohydrate/Protein Snack
Carbohydrates make tryptophan more available to your brain, and with protein being a building block of tryptophan, it can be a good combination an hour or so before bed. It could be cereal with milk, but try to keep it low sugar, and a snack-sized portion, such as almond butter on toast.
There are a lot of supplements that can help you sleep, but as with any other sleep tips, it’s not a replacement to good sleep hygiene. For example, if you’re going to bed at a different time every night (breaking a cardinal rule of sleep hygiene), you may have better sleep by supplementing magnesium, but you would do even better if you were getting at the root cause of poor sleep.
As with foods that can help you sleep, everyone responds to different supplements in different ways. Here are some of the top supplements to consider:
- Magnesium: There are several ways to supplement magnesium. The most common is in tablet form, but many people have found more success with creams and powders that you add to water. Many people are not fans of pills, especially larger ones. My doctor told me that I was magnesium deficient, and even when I took higher doses of magnesium tablets, for whatever reason my sleep didn’t improve. It was only when I started using a powder that you add to warm water that I noticed my sleep improved.
- CBD: Cannabidiol is a chemical compound found in the cannabis plant. It doesn’t make you high (THC does that). There’s a growing body of research that demonstrates CBD’s anti-inflammatory, pain-relieving, and calming effects (though more research is needed). Supplementing CBD for sleep has been found to relieve anxiety, reduce sleep latency (the amount of time it takes to fall asleep once you lay down), and increase the length of sleep as well as the depth.
- Melatonin: Produced naturally in your body, melatonin doesn’t make you sleep. Melatonin levels rise in the evening that helps promote sleep. You can naturally inhibit this process by exposing yourself to bright lights within 2 hours of going to bed, and by not exposing yourself to natural light during the day. But it can be an option if you have a few nights where it takes a long time to get to sleep, or for jet lag, but you would only use it for a short time.
- Valerian: The National Institutes of Health published a study that showed that the use of valerian was found to almost double the chance of sleeping better. Valerian is relatively inexpensive and has no known side effects.
- GABA: Gamma-Aminobutyric acid is an amino acid naturally produced in the brain. Though it doesn’t get as much press as other supplements, Dr. Michael Breus (also known as the “sleep doctor”) refers to GABA as the breaks of the brain as it’s the brain’s most important inhibitory neurotransmitter. So for people that have a hard time shutting their brains down at night, GABA is a good option to supplement. GABA reduces stress, lowers anxiety, and creates a calm mental state. In a 2008 study, GABA was found to be 30% lower in insomnia patients. There are several supplements to affect GABA activity, including magnesium, valerian, hops, L-theanine, kava, passionflower, magnolia bark, skullcap, lemon balm, black seed oil, and ashwagandha. It’s also found in several foods: halibut, shrimp, yogurt, soy, lentils, sunflower seeds, almonds, cocoa, tomatoes, berries, spinach, broccoli, potatoes, and fava beans. According to Dr. Breus, GABA can interact with other medications, such as high blood pressure, anti-depressant, and neurally-active medications; and can react with herbs and supplements that lower blood pressure. Speak with your doctor before you try GABA.
- 5-HTP: 5-hydroxytryptophan is converted by the brain to serotonin, which helps initiate sleep. It usually increases the amount of REM sleep by 25%, and increases deep sleep in stages 3 and 4.
- L-theanine: An amino acid found in tea plants, studies have shown that it improves the quality of sleep, reduces stress, diminishes PMS (premenstrual syndrome) symptoms, and reduces the negative side effects of caffeine. It works well with melatonin and 5-htp.
Most experts recommend using sleep pills for short-term situations, if at all, but not for long term use, such as:
- You’re traveling and crossed a few time zones and have a hard time falling asleep.
- You have an important meeting in the morning and you’re unable to sleep in a new environment, such as a hotel.
- You start doing shift work and you’re trying to acclimate to the new schedule.
- Loss of a loved one, job, divorce, or chronic pain.
Dr. Winter recommends to have a plan for when you will and won’t take a sleeping pill. You could plan on using it for a few days after your work shift changes, for example, but no longer. He’s critical of doctors that don’t discuss a plan with their patients.
There’s a lot of research that tells us about the dangers of sleeping pills. According to the Dr. Daniel Kripke whose research is published by the National Institutes of Health, “Use of hypnotic drugs (sleeping pills) is associated prospectively with a greatly increased risk of all-cause mortality.” He goes on to say, “In addition to respiratory depression, hypnotics appear to be causally related to serious illnesses and premature deaths from cancer, serious infections, mood disorders, accidental injuries, suicides and homicides.”
Dr. Winter explains, “The problem is, the promise of these pills is a bit empty. I have never read a study that has shown these pills to reduce the time it takes to fall asleep by more than a few minutes, nor add more than a few minutes of total sleep to the user’s night.”
Users can become psychologically addicted to sleeping pills. According to recovery.org, the signs of sleeping pill abuse include:
- memory loss
- drowsiness during the day
- dry mouth
- coordination issues
- unusual dreams
- slowed breathing
- itching and/or swelling
A better alternative is to take melatonin (also for temporary situation). The best option is to practice good sleep hygiene and to only use sleeping pills occasionally, if at all.