Clinical psychologist Michael Breus makes his living dispensing sleep advice as a private practitioner in Los Angeles and as a consultant, author, and frequent media source. He has sterling credentials: he’s a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine.
But he admits that he does something that would shock many of his fellow sleep doctors: almost every night, he falls asleep to the sound of TV reruns.
“It’s OK to fall asleep with the TV on,” Breus insists, if it works for you as it does for him (and his wife). The familiar noise can act as a distraction from the thoughts of the day that often keep people awake, Breus says. The trick is just to “listen out of the corner of your ear” and set a timer that turns off the TV after a short while.
That bit of unconventional advice is a favorite among his clients, Breus says, because it’s something a lot of people do. But, he says, too many of us still do not do—and often do not want to do—the key things that would let us get a consistent good night’s sleep.
And we are paying a price for that. More than one-third of U.S. adults habitually get less than the recommended nightly minimum of seven hours of sleep, raising risks for diabetes, heart disease, obesity, depression, vehicle crashes, injury, and mistakes at work, says the Centers for Disease Control and Prevention. A poll for the Sleep Foundation found that 35 percent of adults reported poor or fair quality sleep; 20 percent said they did not wake refreshed even one day per week.
The good news, Breus says, is that most people could emerge from this fog by following just five steps.
Wake up at the same time each day
Our bodies’ daily rhythms are controlled by an internal master clock. That clock is reset each morning when we rise. So your wake-up time matters more than your bedtime, Breus says. “I’m sorry to tell you that if you wake up at 6:30 a.m. on weekdays, you are going to need to wake up at 6:30 a.m. on weekends as well,” he says. The payoff, he says, comes on Monday mornings when your body clock will not, for once, be out of sync with your alarm clock.
Stop caffeine by 2 p.m.
There’s no need to give up your favorite latte or cup of tea, Breus says. But, he says, the boost in alertness lingers longer than most of us realize. Caffeine works largely by blocking adenosine, a chemical that builds up in your brain over the course of each day, increasing sleepiness. Without enough of that buildup, you can’t fall asleep. The half life for the caffeine effect—the time it takes for about half of it to dissipate—is six to eight hours, he says.
Stop drinking alcohol three hours before bedtime
Too many people believe alcohol is a sleep aid, Breus says, “but there’s a difference between passing out and falling asleep.” Alcohol too close to bedtime disrupts sleep rhythms, leading to lighter, more restless sleep, especially in the second half of the night.
Get regular exercise
Studies link physical activity with deeper, longer sleep. The best time of day to exercise? It varies from person to person, but some people find that their sleep is disrupted if they work out in the four hours or so before bedtime, Breus says. Many people find that a morning walk, jog, or other aerobic workout does the most to improve sleep quality, he says.
Get 15 minutes of bright light (preferably sunlight) within 30 minutes of waking
A strong dose of morning light shuts down production of the sleep hormone melatonin and resets your internal clock, helping you to feel alert for the day and sleepier at night, Breus says. If you get up long before sunrise or just hate cold mornings, you might want to try eating your breakfast in front of a light box, a device some people use to treat seasonal affective disorder. You want one that emits 460 nanometers of blue light. At his house, Breus says, he puts sunlight-mimicking “daylight” bulbs in the bathrooms where he, his wife, and two children get ready for school and work.
Once you establish those key habits, you can look at additional life changes, he says. Here are a couple of changes to consider:
Avoid blue light at night
The same kind of light that gets you going in the morning can keep you going too late at night. A lot of blue light comes from our beloved electronic devices—computers, smartphones, and tablets. The best idea is to keep your face away from screens at night. But if you can’t do that, try apps that create warmer light, or wear a pair of blue-blocking glasses. Use warm-colored light bulbs designed for nighttime use in bedrooms.
Give up nighttime snacking
Night eating throws off your body clock and can disrupt sleep. It’s best to avoid heavy evening meals and to finish eating by 8 p.m. or so.
Boost your magnesium levels
This mineral plays an under-recognized role in promoting sleep. And most of us do not get enough from food sources such as dark leafy greens, nuts and seeds, and whole grains. If you want to try a supplement, check with your doctor first.
Pay attention to pillows
If yours is two years old, throw it away. It’s probably worn out and providing lousy support. Buy a new one that’s made for your starting sleeping position—generally a thicker pillow for side sleepers and a thinner one for back sleepers.
Studies show that scents such as lavender and vanilla can help people relax at bedtime. Experiment with scented massage and bath oils, pillow and linen sprays, sachets, and diffusers. But never light a scented candle at bedtime; sleep and fire don’t mix.
Be careful with melatonin
This hormone rises naturally through the evening and past bedtime, helping us stay asleep through the night. Melatonin supplements are popular, but most people take too much, increasing the risk of side effects such as headaches, dizziness, and daytime drowsiness. If you want to try it out, start with just 0.5 to 1 mg doses rather than the widely sold 3 or 5 mg pills.
Change habits to fight insomnia
Breus says sleeping pills have a place as a short-term solution for travelers, for example, and for people with some physical and mental health problems. When it comes to treating chronic insomnia, he says, sleeping pills can be used as a short-term way to break the cycle. But the gold-standard treatment for insomnia, he says, is cognitive behavioral therapy (CBT), an approach in which people learn to change the habits and thought patterns that get in the way of better sleep. He advises seeking out a therapist trained in CBT for insomnia.
Dr. Michael J. Breus, Ph.D., is a clinical psychologist and both a diplomate of the American Board of Sleep Medicine and a fellow of The American Academy of Sleep Medicine. He was one of the youngest people to have passed the board at age 31 and, with a specialty in sleep disorders, is one of only 163 psychologists in the world with his credentials and distinction. Dr. Breus is on the clinical advisory board of The Dr. Oz Show and appears regularly on the show. He has been interviewed on CNN, Oprah, The View, Rachael Ray, The Early Show, and Today, among others. Dr. Breus is the author of three books, including The Power of When, and writes about sleep on his website, www.thesleepdoctor.com.