Ashwin Lewis
Sleep is a critical function for maintaining health, yet millions of people struggle to fall and stay asleep. While sleeping pills may be effective in the short term, they can have troublesome side effects and cause dependency. To sleep without pills, it is recommended to improve your sleep hygiene, which includes lifestyle and bedtime habits that promote restful sleep. This involves creating a relaxing sleep environment, establishing a bedtime routine, optimizing your bedroom environment, limiting stimulants such as caffeine and alcohol, and making healthy lifestyle changes. Additionally, cognitive behavioral therapy for insomnia (CBT-I) and addressing underlying medical conditions can also help improve sleep without medication.
| Characteristics | Values |
|---|---|
| Avoid | Caffeine, nicotine, alcohol, heavy meals, and liquids before bed |
| Exercise | Everyday, but restrict vigorous exercise to mornings and afternoons |
| Limit naps | To 30 minutes and never after 3 pm |
| Exposure to sunlight or bright light | During the day |
| Bedroom | Cool, dark, quiet, comfortable, and free of distractions (e.g., TV, phone) |
| Bed association | Sleep and sex only |
| Bedtime routine | Relaxing activities like reading, listening to music, or taking a warm bath |
| Pillow and mattress | Comfortable and changed every 5-8 years |
| Clock | Turned away from view |
| Journaling | Writing down worries to address the next day |
| Screen usage | Use screen-dimming software |
| Natural remedies | Warm milk, chamomile tea, tart cherry juice |
| Therapy | Cognitive Behavioral Therapy for Insomnia (CBT-I) |
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What You'll Learn
Create a relaxing bedtime routine
A relaxing bedtime routine can help you wind down and prepare for a good night's sleep. Start by setting a reminder alarm 30 minutes to 2 hours before bed. During this time, you can do some light or moderate-intensity exercise, but wrap up at least an hour before bedtime. You can also do some gentle yoga or stretching to release physical tension and relax your body.
Next, turn off all screens and electronic devices, including your TV, smartphone, tablet, and computer. The blue light from these devices can confuse your brain, making it think it's daytime and suppressing melatonin production. Instead, dim the lights and create a soothing atmosphere with scented candles or an aromatherapy diffuser.
Now it's time to relax your mind. You can try meditation, deep breathing exercises, or progressive muscle relaxation. Mindfulness meditation, in particular, can help you accept your thoughts and manage your emotions. If you prefer, you can also listen to calming music or read a book.
Finally, get into bed, making sure your bedroom is cool, dark, and quiet. Your bed should be a place specifically for rest and sex. Avoid working, eating, or watching TV in bed, and keep your cell phone out of the bedroom.
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Make your bedroom conducive to sleep
Make sure your bed is comfortable and that your pillow is in good condition. Pillows can collect dust mites, fungi, dirt, and oils over time, which can exacerbate allergies. Consider changing your mattress and pillow if they're more than 5–8 years old.
Move your bed a comfortable distance from the bedroom door. This placement provides the body with relief from the activity of the door, calming the amygdala, which is the fight-or-flight mechanism of the brain.
Keep your cell phone out of the bedroom. Turn off alerts for texts and emails on your phone, and download screen-dimming software if necessary.
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Avoid stimulants and alcohol
While a cocktail may seem like a good idea at the end of a long day, alcohol should be avoided when trying to sleep without pills. Although it may help you fall asleep, alcohol disrupts your sleep during the night. It can interfere with your sleep cycle, causing less restorative sleep.
Caffeine is another stimulant that should be avoided. It prevents your body from initiating sleep. Try to have your last cup of coffee at least six hours before bedtime. It's important to remember that soda, chocolate, and certain teas also contain caffeine, so these should be avoided close to bedtime too.
Decongestants, often found in cold remedies, have a potent stimulating effect, so they should be avoided for up to 12 hours before bed.
If you are struggling to sleep, it is important to improve your sleep hygiene. This includes making your sleep environment pleasant and relaxing. Your room shouldn't be too hot, too cold, or too bright. Use earplugs, a fan, or noise machine, and blackout curtains or an eye mask to create a comfortable environment.
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Exercise daily, but not too late
Exercise is a great way to improve your sleep, but it's important to avoid vigorous physical activity too late in the day. Daily exercise can help tire your body out, making it easier to fall asleep at night. However, it's recommended that you restrict vigorous exercise to the morning or afternoon. Gentle exercises like yoga can be done before bedtime as they can help you relax.
Exercising daily is a form of good sleep hygiene, which refers to the daily behaviours that can help you get better sleep. Good sleep hygiene can help you feel sleepy at bedtime, fall asleep faster, and wake up less often during the night. It can also reduce your reliance on sleeping pills.
If you're struggling with insomnia, it's important to address the root cause of your sleep problems. This may involve improving your sleep hygiene, speaking to a doctor, getting in sync with your body clock, trying cognitive behavioural therapy, or getting treated for any underlying sleep disorders or medical conditions.
In addition to exercise, there are other aspects of sleep hygiene that can improve your sleep quality. This includes creating a pleasant and relaxing sleep environment, maintaining a consistent bedtime routine, and avoiding stimulants like caffeine and nicotine during the day and alcohol in the evening.
By incorporating daily exercise and practising good sleep hygiene, you can improve your sleep quality without relying on sleeping pills.
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Try cognitive behavioural therapy
Cognitive behavioural therapy for insomnia, or CBT-I, is a recommended treatment for chronic insomnia. CBT-I is a short, structured, evidence-based approach that focuses on restructuring the thoughts, feelings, and behaviours that contribute to insomnia.
CBT-I is provided by a doctor, counsellor, therapist, or psychiatrist with specific training in this form of treatment. During CBT-I, a trained provider will help you identify the thoughts, feelings, and behaviours that are contributing to your insomnia.
Cognitive interventions involve cognitive restructuring, which aims to change inaccurate or unhelpful thoughts about sleep. Behavioural interventions include stimulus control before bed, sleep restriction, and incorporating relaxation techniques to establish healthy pre-sleep habits. Psychoeducational interventions provide information about the connection between thoughts, feelings, behaviours, and sleep.
CBT-I guides patients through a series of changes in sleep-related behaviours. This includes identifying and eliminating habits that were developed to improve sleep but have become ineffective, as well as reducing sleep-related worry and other sources of heightened arousal. Therapists help patients overcome obstacles to making necessary changes in sleep-related behaviours and re-evaluate beliefs about sleep that may be causing unnecessary anxiety.
If you think CBT-I might be right for you, you can locate CBT-I providers and verify their credentials through professional organizations, including the American Psychological Association, American Board of Sleep Medicine, Association of Behavioral and Cognitive Therapies, and Society of Behavioral Sleep Medicine. Several digital CBT-I applications have also been developed to reduce the cost of treatment and increase accessibility.
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Frequently asked questions
Sleep hygiene refers to the daily behaviours that can help you get better sleep. This includes things like maintaining a pleasant and relaxing sleep environment, keeping your bedroom cool, dark and quiet, and avoiding stimulants like caffeine and nicotine during the day.
Make sure your bed is comfortable and your room is not too hot, cold or bright. Use earplugs and an eye mask if necessary. Avoid working, eating or watching TV in bed, and only use your bedroom for sleeping and sex.
Some natural remedies that may help you sleep include warm milk, chamomile tea and tart cherry juice. While there is not much scientific proof that these drinks improve sleep, they may be worth trying if you want to avoid side effects and drug interactions.
Sleeping pills can have significant side effects and can be addictive. They may also stop working over time, leading people to take higher doses. Even when they are not working, the risks of harm remain. These risks include negative impacts on memory and concentration, increased risk of falls and fractures, and increased risk of car accidents and hospitalisation.
If you are struggling to sleep, you may want to try cognitive behavioural therapy for insomnia (CBT-i), or speak to a doctor about other treatments for underlying sleep disorders or medical conditions. You can also try creating a relaxing bedtime routine, such as reading, listening to a podcast or taking a warm bath.
