Sleep and circadian rhythm problems linked with poor mental health – new research

From theconversation.com

By Sarah Chellappa

Every cell in the body has a circadian rhythm. This rhythm follows a near 24-hour cycle that is synchronised to day and night. These circadian rhythms are critical for health and wellbeing.

But our circadian rhythm can become disrupted when our lifestyle does not correspond with this natural day-and-night cycle – for example, if we work night shifts or experience jet lag. Factors such as ageing, genetics and certain medical conditions (such as autoimmune diseases and Alzheimer’s disease) are also linked with long-term circadian rhythm disruptions.

Sleep and circadian rhythm disturbances can also predict the onset and relapse of certain mental health disorders – including depression, anxiety, bipolar disorder and schizophrenia. The more severe the sleep and circadian disruptions are, the worse a person’s mood, risk of relapse and mental health treatment outcomes are.

But despite evidence showing this link, why it exists remains largely unknown. This is what research conducted by myself and my colleagues sought to understand.

We found that sleep and circadian rhythm disruptions appear to trigger or worsen a range of mental disorders – including bipolar disorder and depression. We also uncovered some of the specific biological mechanisms which may underpin this link.

Our review assessed all research published in the past ten years on different mental disorders – including depression, anxiety and psychosis. We mainly focused on adolescents and young adults.

We found that the majority of young people diagnosed with a mental health condition also had sleep problems – such as insomnia (trouble falling asleep and staying asleep), delayed sleep timing and worsened daytime alertness. We also found that one-third of people with bipolar disorder (and other mental disorders) had a disrupted circadian rhythm, where they go to sleep and wake up later than usual.

Our study also pinpointed some of the mechanisms that may explain the link between sleep problems and mental health disorders. Among these mechanisms are an increased vulnerability at the genetic or molecular level to circadian rhythm disruption.

We also found that some participants experienced changes in their brain activity caused by chemical signalling problems that can affect sleep and mood levels. Inappropriate light exposure (such as getting too little natural daylight or too much artificial light at night) and eating too late in the evening or at night may also trigger sleep and circadian rhythm problems.

                                Getting too much artificial light at night may be one of the mechanisms behind circadian rhythm disruption. 

                                                                                                      junpinzon/ Shutterstock

Importantly, we showed that most studies to date have only looked at the effect of sleep on mood or the effects of circadian disruption on mood separately. Both were rarely studied in conjunction, as assessing sleep is far more common (and easier) than assessing circadian rhythms. This is one of the current key research limitations that needs to be addressed in future studies.

Circadian misalignment

One in seven ten to 19-year-olds experience a mental disorder worldwide. Depression and anxiety are among the leading causes of illness and disability among adolescents, with suicide being the fourth leading cause of death among 15 to 29-year-olds. Moreover, not addressing adolescent mental disorders can cause these problems to extend into adulthood.

Adolescence is not only a particularly vulnerable time for developing mental disorders – it’s also a time when sleep and circadian rhythms change. Adolescents often sleep later, due to a delay in their circadian rhythm caused by their development, but have to wake up early due to school. As a consequence, they often experience shorter sleep than needed, which can further worsen their mental health.  

Our review highlights how important it is to pay attention to circadian rhythm disruptions in young people – especially when it comes to risk of certain mental health problems. Our review also highlights the need to consider sleep and circadian problems when someone experiences mental health problems. By addressing such problems, it may be possible to improve one’s mental health and quality of life.

Sleep and circadian interventions

At the moment, treatments for sleep problems (such as insomnia) involve cognitive behavioural therapy and sleep restriction. These focus on improving sleep – while mental health problems due to circadian rhythm disruption are not directly addressed.

Our review highlighted treatments that may help improve mood and sleep quality and align circadian rhythms. This included timing medication intake, exposure to natural daylight (and reducing night time light) as well as eating and being physically active during the day. More research will be needed, however, to better understand the benefits of these treatments in real-world settings.

https://theconversation.com/sleep-and-circadian-rhythm-problems-linked-with-poor-mental-health-new-research-223895

What happens to our mental health when we don’t get enough sleep

From amp.theage.com.au

It started with mild anxiety. Emily, who asked to be identified only by her first name because she was discussing her mental health, had just moved to New York City after graduate school to start a marketing job at a big law firm.

She knew it was normal to feel a little on edge. But she wasn’t prepared for what came next: chronic insomnia.

Operating on only three or four hours of sleep, it didn’t take long for her anxiety to ramp up: at 25, she was “freaking nervous all the time”.

When a lawyer at her firm yelled at her one day, she experienced the first of many panic attacks. At a doctor’s suggestion, she tried taking a sleeping pill, in the hopes that it might “reset” her sleep cycle and improve her mood. It didn’t work.

According to the Australian Institute of Health and Welfare, 48 per cent of Australian adults report at least two sleep-related problems. And it is having a profound effect on mental health.

An analysis of 19 studies found that while sleep deprivation worsened a person’s ability to think clearly or perform certain tasks, it had a greater negative affect on mood. And when the US National Sleep Foundation conducted a survey in 2022, half of those who said they slept less than seven hours each weekday also reported having depressive symptoms. Some research even indicates that addressing insomnia may help prevent postpartum depression and anxiety.

Clearly, sleep is important. But despite the evidence, there continues to be a shortage of psychiatrists or other doctors trained in sleep medicine, leaving many to educate themselves.

So what happens to our mental health if we aren’t getting enough sleep, and what can be done about it?

How does poor sleep affect your mood?

When people have trouble sleeping, it changes how they experience stress and negative emotions, says Aric Prather, a sleep researcher at the University of California, San Francisco, who treats patients with insomnia. “And for some, this can have a feed-forward effect – feeling bad, ruminating, feeling stressed can bleed into our nights,” he says.

Carly Demler, 40, a stay-at-home mother in North Carolina, says she went to bed one night and never fell asleep. From that point onward, she would be up at least once a week until 3 or 4 am. It continued for more than a year.

She became irritable, less patient and far more anxious.

Hormone blood work and a sleep study in a university lab offered her no answers. “It was like my anxiety was a fire that somehow jumped the fence and somehow ended up expanding into my nights,” she says. “I just felt I had no control.”

In the end, it was cognitive behavioural therapy for insomnia that brought Demler the most relief. Studies have found that CBT-I is more effective than sleep medications are over the long term: as many as 80 per cent of the people who try it see improvements in their sleep.

Demler learned not to “lay in bed and freak out”. Instead, she gets up and reads so as not to associate her bedroom with anxiety, then returns to bed when she’s tired.

“The feeling of gratitude that I have every morning, when I wake up and feel well rested, I don’t think will ever go away,” she says. “That’s been an unexpected silver lining.”

Adults need between seven and nine hours of sleep a night, according to the US Centres for Disease Control and Prevention. Teenagers and young children need even more.

It’s not just about quantity. The quality of your sleep is also important. If it takes more than 30 minutes to fall asleep, for example, or if you regularly wake up in the middle of the night, it is harder to feel rested, regardless of the number of hours you spend in bed.

But some people, “have a tendency to think they’re functioning well even if they’re sleepy during the day or having a harder time focusing,” says Lynn Bufka, a clinical psychologist and spokesperson for the American Psychological Association.

Ask yourself how you feel during the day. Do you find that you’re more impatient or quick to anger? Are you having more negative thoughts or do you feel more anxious or depressed? Do you find it harder to cope with stress? Do you find it difficult to do your work efficiently?

If so, it’s time to take action.

How to stop the cycle.

We’ve all heard how important it is to practise good sleep hygiene, employing the daily habits that promote healthy sleep. And it’s important to speak with your doctor, in order to rule out any physical problems that need to be addressed, like a thyroid disorder or restless legs syndrome.

But this is only part of the solution.

Conditions like anxiety, post-traumatic stress disorder and bipolar disorder can make it harder to sleep, which can then exacerbate the symptoms of mental illness, which in turn makes it harder to sleep well.

“It becomes this very difficult to break cycle,” Bufka says.

Certain medications, including psychiatric drugs like antidepressants, can also cause insomnia. If a medication is to blame, talk to your doctor about switching to a different one, taking it earlier in the day or lowering the dose, says Dr Ramaswamy Viswanathan, a professor of psychiatry and behavioural sciences at State University of New York Downstate Health Sciences University and the incoming president of the American Psychiatric Association.

The cycle can afflict those without mental health disorders too, when worries worsen sleep and a lack of sleep worsens mood.

Emily, who worked in the big law firm, would become so concerned about her inability to sleep that she didn’t even want to get into bed.

“You really start to believe ‘I’m never going to sleep’,” she says. “The adrenaline is running so high that you can’t possibly do it.”

Eventually, she came across Say Goodnight to Insomnia by Gregg D Jacobs. The book, which uses CBT-I techniques, helped Emily to reframe the way she thought about sleep. She began writing down her negative thoughts in a journal and then changing them to positive ones. For example: “What if I’m never able to fall asleep again?” would become “Your body is made to sleep. If you don’t get enough rest one night, you will eventually.” These exercises helped her stop catastrophising.

Once she started sleeping again, she felt “way happier”.

Now, at 43, nearly 20 years after she moved to New York, she is still relying on the techniques she learned, and brings the book along whenever she travels. If she doesn’t sleep well away from home, “I catch up on sleep for a few days if necessary,” she says. “I’m way more relaxed about it.“

https://amp.theage.com.au/lifestyle/health-and-wellness/what-happens-to-our-mental-health-when-we-don-t-get-enough-sleep-20240222-p5f73q.html 

How chronic poor sleep adversely affects the body and brain

From veronews.com

Written by: Jackie Holfelder

If you’re having sleep difficulties, you’re not alone. The American Sleep Apnea Association reports that about 50 million to 70 million Americans have sleep disorders, and 1 in 3 adults (about 84 million people) do not regularly get the recommended amount of uninterrupted sleep they need to protect their health.

Sleep is comprised of two Q’s: quantity (duration of sleep) and quality (depth of sleep), according to Dr. Mark J. Pamer, a pulmonologist who treats patients with sleep problems.

He says, “When individuals fail to obtain adequate duration or quality of sleep, daytime alertness and function suffer.

“Chronic sleep insufficiency is very common in our modern society and may result from things like work demands, social and family responsibilities, medical conditions and sleep disorders. As sleep debt accumulates, a person may experience reduced performance, be at increased risk for accidents and death, and experience detrimental effects on both psychological and physical health,” he adds.

Sleep specialists say that one of the tell-tale signs of sleep deprivation is feeling drowsy during the day. In fact, even if a daytime task is boring, you should be able to stay alert during it if you are not sleep-deprived.

Dr. Pamer agrees, stating that there are three levels of sleep deficit, and each brings escalating life-affecting problems:

• Sleep insufficiency exists when sleep is insufficient to support adequate alertness, performance and health, either because of reduced total sleep time (decreased quantity) or fragmentation of sleep by brief arousals (decreased quality).
• Acute and accumulated sleep deprivation results in measurable changes in cognitive performance, alertness and neurobehavioral function. Susceptibility to such changes varies among individuals and is based on circadian factors. Circadian rhythms are 24-hour cycles that are part of the body’s internal clock, running in the background to carry out essential functions and processes. One of the most well-known circadian rhythms is the sleep-wake cycle. When properly aligned, a circadian rhythm can promote consistent and restorative sleep. But when this circadian rhythm is thrown off, it can create significant sleep problems, including insomnia.
• Chronic sleep insufficiency has been associated with a variety of adverse outcomes in observational studies. Potential consequences include reduced performance, increased risk for accidents and death, and detrimental effects on both psychological and physical health.

The Columbia University Department of Psychiatry says that there is a strong link between insufficient sleep and mental health disorders. While insomnia can be a symptom of psychiatric disorders such as anxiety and depression, it is now recognized that sleep problems can also contribute to the onset and worsening of mental health problems, including depression, anxiety and even suicidal ideation. Sleep deprivation studies show that otherwise healthy people can experience increased anxiety and distress levels following poor sleep.

Dr. Pamer adds, “Sleep deprivation may result in a mental status that resembles depression or anxiety, with patients reporting poor mood, irritability, low energy, decreased libido, poor judgment and other signs of psychological dysfunction. These symptoms often disappear when normal sleep is restored.”

The Sleep Foundation states that getting enough hours of high-quality sleep fosters attention and concentration, which are prerequisites for most learning, as well as supporting numerous other aspects of cognition, including memory, problem-solving, creativity, emotional processing and judgment.

Levels of brain activity fluctuate during each stage of sleep – including both rapid eye movement (REM) and non-REM (NREM) sleep – and evidence increasingly suggests that sleep enhances most types of cognitive function. Even people who are sleep deprived for only a few nights will suffer from cognitive impairment.

For people with sleep deprivation, insomnia, sleep apnoea or other conditions that prevent adequate rest, short-term daytime cognitive impairment is common. Improving sleep quality can boost cognitive performance, promote sharper thinking, and may reduce the likelihood of age-related cognitive decline.

Adds Dr. Pamer, “even when sleep-deprived subjects perform at a normal level, they often report the need for greater effort to maintain performance.”

Chronic poor sleep puts us at increased risk of serious medical conditions, such as obesity, heart disease and diabetes. During sleep, the body secretes hormones that help control appetite, metabolism and glucose processing.

Poor sleep can lead to an increase in the body’s production of cortisol, also known as the stress hormone. In addition, skimping on sleep seems to throw other hormones out of whack. Less insulin is released after you eat, and that, along with the increased cortisol, may lead to too much glucose in the bloodstream and thus an increased risk of type 2 diabetes.

How much sleep is enough? The Centres for Disease Control and Prevention recommends that adults should get between seven and nine hours of sleep each night, although so-called “short sleepers” require much less and many individuals find they need up to ten hours to function at their best.

Medical experts say you should see a sleep specialist if problems persist for more than three months and are affecting your daily life. A sleep specialist can diagnose and treat sleep disorders like sleep apnoea, insomnia, narcolepsy, restless leg syndrome and others.

They are most often neurologists, pulmonologists or psychiatrists who have completed additional training in sleep medicine.

Dr. Pamer says that individuals frequently report that their quality of life suffers due to lack of sleep. They often cut back on activities they enjoy, claiming that they do not have enough energy to perform the activity.

Inappropriate drowsiness and unplanned naps may be a source of embarrassment and friction, both at home and at work. Patients who fall asleep at work or whose productivity suffers due to sleepiness may be reprimanded, denied advancement or fired. Falling asleep at home may cause resentment and marital discord.

Dr. Mark J. Pamer is a pulmonologist who treats sleep, pulmonary and allergy issues. He received a D.O. degree from Nova Southeastern University, did a rotating osteopathic internship at Palmetto General Hospital, completed a residency in internal medicine at the University of Florida, and a fellowship in pulmonary/critical care medicine at Rush University Medical Center. He has board certification in internal medicine, pulmonary disease and critical care. His office is located at 573 NW Lake Whitney Place, St. Lucie West. The phone number is 772-785-5864 and his website is MarkPamerDO.com.

https://veronews.com/2024/02/22/how-chronic-poor-sleep-adversely-affects-the-body-and-brain/

How lack of sleep could increase heart disease risk among women

From lifestyle.livemint.com

A new study shows that persistently high insomnia symptoms are linked to a 70% increased risk of cardiovascular disease

It’s well-known that lack of sleep affects mood and overall well-being. Now, a new study shows that sleep patterns during midlife may strongly influence the risk of heart disease later in life, especially among women. 

Cardiovascular disease is the leading cause of death in women and lack of or disturbed sleep is a concerning health issue among women, especially in their midlife. Expanding on the association between the two, the new study, conducted by researchers from the University of Pittsburg, shows that regularly sleeping less than seven hours a night as well as disturbed sleep can increase the risk of stroke, heart attack, and myocardial infarction. 

The scientists analysed data collected from 2,517 women whose sleep was assessed up to 16 times over 22 years during midlife. In a press statement, researchers elaborated that consistently high insomnia symptoms—which were reported by almost a quarter of the participants—were associated with a 70% increased risk of a cardiovascular disease event.

The study found that an average sleep duration of less than five hours every night was associated with a 72% increased risk of strokes, heart attacks, heart failure and coronary artery disease among women, Earth.com explained. The findings were published in the journal Circulation.

Furthermore, women who had persistently high insomnia which was also accompanied by short sleep had an even greater increased risk (75%) of cardiovascular disease events, the statement explained. The impact on the heart could also be due to insufficient sleep which can raise blood pressure and disrupt the body’s rhythm.

Women who had persistently high insomnia which was also accompanied by short sleep had an increased risk (75%) of cardiovascular disease events. (Pexels)

“These findings underscore both the prevalence of insufficient sleep at midlife in women as well as the importance of insomnia to women’s cardiovascular health over midlife. These data further suggest the potential value of treating insomnia to support women’s heart health,” said co-author Rebecca Thurston said in the statement.

Previous studies have also shown strong links between sleep and cardiovascular disease. For instance, a study published in the journal Sleep Medicine in December 2023, showed that artery calcification—refers to a condition wherein fatty deposits accumulate on the inside of the arteries—is almost twice as common in night owls compared to early birds.

https://lifestyle.livemint.com/health/wellness/sleep-issues-heart-disease-risk-women-111708513559883.html

How Patients With Diabetes Should Manage Their Sleep

From codeblue.galencentre.org

Getting enough quality sleep is important for good health and wellbeing, but sleep problems plague many people with diabetes 

KUALA LUMPUR, Feb 19 – Imagine sleep as the body’s nightly orchestra, conducting vital processes that repair tissues, build muscles, and optimise metabolic functions.

For those navigating the complexities of diabetes, the significance of these nocturnal processes becomes even more critical, especially in regulating blood sugar levels.

During sleep, the body releases growth hormone, which helps regulate glucose metabolism. As such, having adequate sleep is important as it helps improve insulin sensitivity, making it easier for the body to use insulin effectively.

Poor sleep patterns, such as insufficient sleep or disrupted sleep, can lead to insulin resistance, a key factor in the development and management of type 2 diabetes.

In 2021, an estimated 529 million people were living with diabetes and it is predicted to increase to 1.3 billion by 2050.

Not getting enough rest and sleep can have a negative impact on people with diabetes. One outcome of sleep deprivation is an increase in the hormones ghrelin and reduced leptin levels that regulate appetite and hunger.

This imbalance caused by sleep deprivation may lead to higher calorie intake during the day. 

This coupled with a poor sleep pattern can lead to fatigue and reduced energy levels. This can discourage physical activity and exercise, which are essential for managing diabetes.

It is therefore important to keep a consistent sleep pattern and maintain a regular sleep schedule. 

                                          Poor sleep throws off appetite hormones, making it harder to manage. (Shane/Unsplash)

Various interventions are being explored to improve sleep quality in people with diabetes. These may include behavioural interventions like cognitive behavioural therapy for insomnia (CBT-i), lifestyle modifications, and in some cases, drugs. 

In CBT-i, a trained provider helps to identify thoughts, feelings and behaviours that make their sleep problems worse and replace them with habits that can support sound sleep. The goal is to address both the quantity and quality of sleep to positively impact metabolic health and diabetes management.

While most of us are aware that having insufficient sleep is bad as it can lead to sluggishness and irritability, having too much sleep can be detrimental in many ways.

Studies have shown that there is a “J-shaped” relationship, which refers to the observed association between extremes of sleep duration (too much or too little) and an increased risk of developing diabetes, with an optimal sleep duration appearing to be in the range of seven to nine hours per night. 

This is because too little or too much sleep may disrupt metabolic processes, potentially contributing to insulin resistance and an elevated risk of diabetes. As such, achieving a balanced and regular sleep pattern is essential for overall health and diabetes prevention.

While many people may find themselves sleeping more as they get older, this should not change their sleep patterns as most adults usually need the same amount of sleep throughout their adult years. 

As such, if a person still feels tired and sleepy after nine hours of sleep, it might be a sign that they have other health conditions such as diabetes or heart disease. Going for a sleep study or sleep test is recommended to rule out any other possible sleep disorder.

Shaun Lee is a professor at Monash University Malaysia’s school of pharmacy

https://codeblue.galencentre.org/2024/02/19/how-patients-with-diabetes-should-manage-their-sleep/ 

The Impact of COVID-19 on Mental Health: A Focus on Insomnia

From medriva.com

COVID-19 and Insomnia: A Closer Look

A survey conducted among 1,056 people in Vietnam who had contracted a mild form of COVID-19 revealed that a staggering 76.1% experienced insomnia after their recovery. The study further highlighted that 22.8% of the participants reported experiencing severe insomnia. The data indicated that individuals who had been diagnosed with anxiety or depression were more likely to suffer from sleep disturbances. This aligns with previous research that has associated sleep disturbance with symptoms of long COVID. The researchers involved in the study have recommended the implementation of interventions to mitigate the potential long-term negative impacts of the infection.

Connecting Mental Health Disorders and Insomnia

The study revealed a more disturbing trend among those individuals who were dealing with anxiety or depression. It found that people with depression were more than three times as likely to experience insomnia, while people with anxiety were nearly four times more likely to suffer from sleep disturbances. These findings emphasize the need for public health agencies to consider targeted interventions for those who have had milder cases of COVID-19 to mitigate the potential long-term negative impacts of the infection.

Trajectory of Mental Health Changes Post-COVID-19

A longitudinal study conducted to investigate the trajectories of mental health changes in individuals infected with COVID-19 found notable changes in mental health outcomes over time. Depression showed significant improvement, while anxiety and insomnia did not exhibit significant changes. The study identified younger individuals and those who experienced severe COVID-19 infection as high-risk groups with worse mental ill health. The main predictors of these changes in mental health outcomes were fatigue and post-COVID impairments. This emphasizes the need for ongoing assessment, support, and tailored interventions for the evolving mental health needs of individuals following a COVID-19 infection.

Prevalence of Anxiety and Depression Post-COVID-19

Another study reviewed the changes in the prevalence of anxiety and depression among COVID-19 patients during a two-year recovery period. The highest prevalence of anxiety was found at 3-6 months post-recovery, while the highest prevalence of depression was reported within the first month of recovery. The study also noted regional differences in the changes in prevalence of anxiety and depression, with anxiety prevalences in Asian countries being lower than non-Asian countries, and depression prevalences in Asian countries being higher than non-Asian countries.

Insomnia among Healthcare Workers during COVID-19

The impact of the COVID-19 pandemic on the mental health of healthcare workers has also been a subject of concern. A study of 1038 healthcare workers found significant associations between insomnia, resilience, COVID-19 anxiety, and social support. Insomnia was identified as a significant predictor for anxiety and depression, and was associated with various health issues. The study provides a theoretical framework for understanding insomnia among healthcare workers, including predisposing, precipitating, and perpetuating factors.

https://medriva.com/health/mental-health/the-impact-of-covid-19-on-mental-health-a-focus-on-insomnia/ 

12 Strategies for Fighting Insomnia

From orlandohealth.com

By Ziad R. Mattar, MD

It’s hard to know where to begin if you struggle to fall asleep. Roughly a third of all adults battle insomnia at some point in their lives, and the answer to a better night’s rest may be as simple as changing a few everyday habits.

Before you seek the help of a sleep medicine specialist, here are some strategies you can try to return to restorative sleep.

Start a Sleep Log

Before you make any changes, begin a sleep log to track what is and isn’t working. Record what time you go to bed and awaken, as well as what time you wake up at night, if that’s an issue. The more information you track, the better. You may find it helpful to also track what time you finished dinner as well as if you exercised during the day.

A sleep log is typically the first step recommended by sleep doctors. They will suggest that you go to bed and wake up at the same time consistently. Routine is key, and helping the body fall asleep is easier if it’s at the same time nightly.

Awakening at the same time every morning helps. Setting an alarm and rising, even if you're in a deep sleep, will help you in the future. This may be unpleasant for a few days but will pay dividends in the long run.

Get Help for Mental Health Disorders

If you battle anxiety, depression or PTSD, you are not alone. These common conditions all affect your sleep. A doctor can prescribe medication, but most will recommend beginning mental health counselling as a first step. Lack of sleep exacerbates mental health disorders, so addressing the issue is key.

If you have experienced major trauma, help from a therapist or psychologist is best. Practices such as cognitive behavioural therapy can regulate your nervous system, helping you to rest and feel safe again, allowing for proper sleep.

 

Take A Look at Your Medications

Many people don’t realise that their medications act as stimulants, keeping them up at night. This can be maddening, especially if you’re more symptomatic and take medication at night. Medications prescribed for the following are worth another look.

• Depression
• Asthma
• Blood pressure
• Allergies

Ask your prescribing doctor if an alternative medication or lower dose may work. With your doctor’s OK, you can experiment by taking the medicine earlier in the day until you find a time that allows for a full night of sleep.

Herbal medications may also play a role. These are not regulated by the FDA and can contain more ingredients than you realise. Talk to your primary doctor if you suspect any herbs or herbal supplements are affecting your sleep.

Move Your Body

Physical and even social activity are two of the best ways to ensure a good night’s sleep. Ideally, you’re getting 30 minutes of physical exercise, five days a week. If your week currently doesn’t contain any exercise, it’s OK to do what you can and build up the amount of time spent moving. Every bit helps, whether it’s taking the stairs at the parking garage or parking in the farthest space at the grocery store to get more steps in.

Limit Naps

Naps can help you recover from missed sleep, but napping for too long each day can prevent you from falling and staying asleep. If you must nap, limit it to no more than 15 to 20 minutes.

Monitor Caffeine Intake

Caffeine is one of the biggest obstacles between you and sleep. Stop consuming caffeine by 5 pm. If this still keeps you awake, try stopping an hour earlier and walk your way back to a time that works. If you’re more sensitive to caffeine, you might have stop drinking it by 11 am or noon.

Stop Eating Late at Night

Avoid meals and snacking late at night. Your body can’t get the full rest it needs if it’s busy digesting food. It’s recommended that you finish eating between 2 and 4 hours before bedtime.

If you can, have your largest meals at breakfast or lunch, and opt for a smaller, easier-to-digest dinner. A lighter dinner, such as salad or soup, will satiate you without keeping you up. Avoid fried foods at dinner as they are hard to digest. Pay attention to foods such as tomatoes and tomato products that can cause acid reflux and affect sleep.

Skip Sweets

Avoid chocolate before bed. Chocolate is a stimulant and also can induce acid reflux.

Limit alcohol

The occasional single glass of wine with dinner is OK, but any more than that, especially right before bed, could compromise your sleep. Alcohol can help you fall asleep, but you will metabolize it in about 3 hours, turning into sugar, which will then wake you up.

Stop Smoking Before Bedtime

Don’t smoke before bedtime as smoking exacerbates insomnia. If you’re a smoker, try to have your last cigarette or vape at least 2 hours before bed.

Create Ideal Sleep Environment

Avoid too much stimulation in the bedroom. Turn off the TV or music, and put away your smartphone, when you’re trying to sleep. Your brain needs to rest at night, and any stimulation can disrupt the sleep cycle. If you must have sounds, choose a noise machine, an audio book or something similarly soothing and relatively monotone.

Light also plays a role in your sleep. You want your sleep space to be pitch black, which may necessitate wearing a sleep mask or hanging blackout curtains.

Create Before-Bed Routine

The hour before bed is ideally devoted to relaxing activities. Take a warm bath, practice a bit of light yoga, read or listen to soft, soothing music.

If you try all these measures and are still having issues, it’s time to see a sleep specialist.

https://www.orlandohealth.com/content-hub/12-strategies-for-fighting-insomnia