“The logic behind that is trying to anchor those sleep hours as close to nighttime when you normally sleep,” said Dr. Marco, an attending physician in emergency medicine at St. Vincent Mercy Medical Center in Toledo, Ohio. “By waiting and sleeping the next day, you've completely reversed your sleep schedule.”
If you're unable to fall asleep within 20 minutes or so, get out of bed and engage in a quiet activity like reading, Dr. Sateia advised. “Do something relaxing until you feel drowsy again, and ready to give [sleep] another try. Repeat as necessary.”
▸ The darker the room, the better. Consider sleep masks or hotel-quality window shades, especially if you do shift work, Dr. Dilling said.
▸ Limit caffeine and alcohol intake. Caffeine can carry effects for 4–6 hours. “The one time [that] alcohol may be beneficial to sleep is if you're really tense and anxious about something and you just can't get to sleep,” Dr. Smith-Coggins said.
“Some people find that one beer or one glass of wine can be helpful to relax you and let you fall asleep without the negative effects. Generally, though, alcohol is well known to shorten total sleep time and fragment one's sleep,” she said.
▸ Be a noise abater. Wear ear plugs. Post “no delivery” signs on your door. Turn your phone ringer off. Run a fan or air conditioner in your bedroom for white noise.
▸ Sleep in a cool room. This is key during the summer months, Dr. Smith-Coggins said, “because you sleep less efficiently when your body temperature is elevated. That's why we get our most efficient sleep at about 3 a.m.–4 a.m., because our body temperature is lowest then.”
▸ Avoid pets in bed. Your furry friends may not seem like they're disturbing your sleep, “but they really can,” Dr. Dilling said. “Not only from their movement, but if they cause any kind of nasal congestion, they can impact your ability to stay asleep.”
▸ Be wary of sleeping pills. Stay away if you can, “because some of them are physiologically addicting and some are more psychologically addicting,” Dr. Smith-Coggins said. “But they can help physicians if they take the smallest amount possible as infrequently as possible.” Often people get used to them and take higher and higher doses. “That's when they get into trouble.”
▸ Work in some nap time. For example, if you're on night coverage but are still required to work days, so-called “power naps” that last 15–20 minutes “can be helpful in restoring our cognitive function when we're in a sleep-deprived situation,” Dr. Sateia said. “It's certainly not a substitute for a full night of sleep, but it can be helpful. The one caveat about napping is that if you are having an insomnia problem, you need to be very careful because that may reduce your sleep drive and make it even more difficult for you.”
▸ Watch what you eat. Data on diet's effect on sleep “is all over the place,” Dr. Smith-Coggins said. “The one thing most sleep researchers would agree on is that if you're going to eat before bed, a small amount is better than a large amount.” Try to leave some time between when you eat and when you go to bed.
▸ Age matters. As people age, sleep tends to become lighter and more fragmented. Such changes “are not necessarily an inevitable consequence of aging but may be more a function of many of the things that go with aging,” such as additional health problems, psychological stresses, medication usage, and more frequent sleep disorders, Dr. Sateia said.
“In order to try to minimize the impact of those things, do everything you can to remain physically and psychologically healthy; use medication judiciously and only as indicated; maintain regular exercise; and try to maintain as active a life as possible,” he said.
▸ Get a check-up. If the tips listed here don't work, a bona fide sleep disorder or other medical condition could be the root cause of your insomnia or fragmented sleep pattern. For example, if you're sleeping partner tells you that you're a loud snorer or notices that you periodically stop breathing when you sleep, that may indicate obstructive sleep apnea.
When working nights, Dr. Catherine A. Marco tries to sleep 3 hours before and after her shift. Courtesy Dr. Catherine A. Marco
Don't Drive Drowsy: Nap, Coffee Help
When Dr. Smith-Coggins is asked to lecture groups of physicians about sleep, she often poses the following question to her peers: “How many of you have dozed off sometime in the last year while driving?”