DEAR DOCTOR: I've always been a sound sleeper, but in the last few months, I'm tossing and turning way into the night. I really don't want to start take sleeping pills. Is there anything I can do?
DEAR READER: With our busy lives and jam-packed schedules, sleeplessness is becoming a national epidemic. The federal Centers for Disease Control and Prevention say that one in three adults doesn't get enough sleep. In fact, the CDC identifies sleeplessness, also called insomnia, as a public health problem.
The first intervention that we recommend is evaluating for medical reasons for your sudden insomnia. Sleep apnea, depression and restless leg syndrome are a few of the conditions associated with lack of sleep. However, if all is well and you've simply hit a rough patch, here are some steps you can take to give yourself a better shot at a good night's sleep:
Plan ahead: You can help your body to anticipate sleep cycles by following (and abiding by -- that can often be the challenging part) a set bedtime. Decide what time you will get up in the morning and again, follow through.
Get moving: A half-hour or so of exercise during the day can help with sleeplessness. A swim, a brisk walk, getting your heart rate up with hand weights or a game of tennis, whatever is easiest and most enjoyable will work. But don't exercise in the hours before your set bedtime as doing so can actually interfere with sleep.
Here are some more tips:
-- Limit caffeine: If you're a morning coffee drinker, keep it to one cup. After that, skip the caffeine. This includes tea, sodas, energy drinks and (sorry) chocolate.
-- Watch your alcohol and nicotine intake, which are bad for sleep: Both tend to keep you in the lighter stages of sleep, which means waking easily throughout the night. And we wouldn't be doing our jobs if we didn't urge everyone to quit smoking altogether. It's a deadly habit.
-- Make sure to relax: This is easier said than done, which is why we encourage our patients to try mind-body techniques like meditation, mindfulness, breath work, guided imagery, yoga and tai chi. The sustained flow and rhythmic breathing helps to minimize stress.
-- Limit screen time: Many of us are tethered to our phones and computers, but the blue light that screens emit can interfere with sleep. Turn off screens a few hours before bed. And avoid the temptation of sleeping with your phone by your bed.
-- Try a transitional activity: Reading a book, listening to music or doing a crossword can help ease you from daytime alertness to the softer edges of sleep.
-- Create the right environment: Do what you can to minimize light and noise in the bedroom. Earplugs and an eye mask can help. Research shows that we sleep better in cooler temperatures.
-- Try relaxation techniques: Starting at your feet and slowly moving upward, focus your attention on each region of your body. When you feel it relax, move on. If you get to your head and you're still awake, start over.
If insomnia persists, we recommend seeing your physician. He or she can offer new insight and may offer supplements or medications. If needed, your doctor can steer you to a good sleep specialist.
(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)
(Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)