6 Ways to Improve Your Sleep (without Medication)

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Tossing and turning into the wee hours of the night? Willing yourself to go to sleep while lying wide awake? This can happen to any of us on a particularly bad night - perhaps before a big presentation at work or after an argument with a family member. But folks who spend night after night struggling to sleep (despite having plenty of opportunity) may have a more chronic sleep condition. If you have difficulty falling or staying asleep as frequently as three nights a week over a period of three months or more, an assessment for insomnia disorder by a physician or licensed mental health professional may be in order. For all of us, learning more about the factors that impact sleep can help us understand how to improve our sleep quality and quantity.

The Role of Sleep Drive, Circadian Rhythm, and Emotional Arousal

Sleep is impacted by a range of factors, several of which can be behaviorally harnessed to improve your sleep. Sleep drive is our biological urge to sleep, and typically increases the longer we are awake. Napping can weaken the sleep drive throughout the day, making it hard to fall asleep at night (or stay asleep for more than a few hours). Circadian rhythm refers to the fact that our bodies experience shifts in factors such as core body temperature and hormone production throughout a 24-hour cycle, which impact our levels of alertness and sleepiness. Generally, we sleep better when we keep a regular daily schedule that is aligned with our circadian rhythm. Emotional arousal can impede sleep–anyone who has ever woken up from a terrifying nightmare knows this well. Feeling calm and relaxed before getting into bed typically makes for the most restful, refreshing sleep.

Science-Based Tips for Better Sleep

Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective intervention for insomnia disorder that is relatively brief (typically 4-8 sessions) and does not require medications. A physician or a licensed mental health clinician can provide advice about whether CBT-I might be the best fit to address your specific sleep concerns. Here are six general tips and behavioral principles from CBT-I that may be helpful to improve sleep.

1. Wake up at the same time every day. One of the best ways to build a high sleep drive and regulate circadian rhythm is to wake up at the same time every morning. Although it requires discipline, many folks with insomnia benefit from keeping to this regular wake time on weekends (yes, weekends) and setting their alarm for the same time regardless of how they slept the night before.
2. Don’t try to sleep until you are actually sleepy. There is a difference between tiredness and sleepiness. We can be tired after a long day of work but still wired–exhausted, but nevertheless wide awake. Signs of sleepiness include yawning, starting to nod off, or having the urge to put your head down. Wait for these signs before getting in bed, because sleepiness is an effective way to counteract emotional arousal.
3. Avoid naps. Naps weaken the sleep drive, just like snacking weakens hunger. Taking a long afternoon nap is the equivalent of scarfing down a burger an hour before you know dinner will be served. Generally speaking, naps are not recommended when trying to recover from insomnia. However, if you need to drive or operate heavy machinery and are in danger of falling asleep, safety is always the first priority. For most, a 30-minute power nap will weaken the sleep drive temporarily without substantially harming overnight sleep.
4. Spend an hour before your typical bedtime doing calming activities. As your typical bed time approaches, engage in calming activities that encourage sleep and cue your body for rest. That could involve a mindless chore such as folding laundry, a pleasant pastime like reading or sudoku, or a relaxing activity such as taking a warm bath.
5. Don’t do anything in bed other than sleep (or sexual activity). At its core, insomnia involves a mental association of the bed with wakefulness. Any time you do anything other than sleep in bed, you are at risk of entrenching this association. For best results, don’t eat, watch TV, or scroll on your phone in bed. Especially avoid any tasks related to work in bed (no shooting off an email or pulling out the laptop for a report).
6. If you can’t sleep, get out of bed. If you find yourself lying in bed for more than 20 minutes without feeling sleepy, get out of bed, go into a different room, and do a calming activity until you become sleepy again. If you struggle with insomnia, designate an area of your home that you will use for night time wakefulness - preferably somewhere cozy with an activity ready. This could be a spot on the couch with a blanket, a book, and lamplight.

Improving Sleep Requires Time and Persistence

It can be easy to get discouraged if you don’t notice substantially improved sleep after a day or two of making a recommended change. However, it takes time to regulate your circadian rhythm and to shift your psychological associations with sleep. Most folks need to stick to behavioral changes for a few weeks before seeing full benefit. Improvement in sleep quality and quantity is possible, but requires persistence.