Good Night Sleep

Charles recently told me of his sleeping disorder. Hopefully this will help.

7 Steps To a Better Night's Sleep

In the movies, if you awake in the middle of the night it's probably because a chainsaw-wielding madman is lurking in the shadows. In real life, where most of us live, interrupted sleep can also be a horror show.Finding yourself wide awake after a few hours of sleep or waking often during the night is called parasomnia or sleep maintenance insomnia, and it's much more common (though less gory) than chainsaw-wielding madmen. A 2005 National Sleep Foundation poll found that 75 percent of adults frequently have symptoms of a sleep problem, including parasomnia.

Just as the victims in slasher flicks make fatal errors (why are you running up the stairs?), we are often our own worst enemies when it comes to a solid night of sleep. "People think that because they're able to fall asleep, they'll stay asleep, even if they've had too much caffeine," says Rubin Naiman, Ph.D., a sleep and dream specialist at Andrew Weil's Program in Integrative Medicine at the University of Arizona. But for most of us, the culprit's not that ill-conceived espresso at 5 p.m.

"The root of most sleep problems is stress," says Jeffrey Thompson, director of the Center for Neuroacoustic Research in Encinitas, California, and creator of an audio sleeping aid called the Delta Sleep System. "Our nervous system is built for a sprint, but we're living in a stress marathon," he says. Dr. Naiman adds: "If you go to bed worried, you're probably going to wake up in the middle of the night." When that happens, as you probably know, the next day is pretty much shot.
Ready to give up your role in this scary movie? A new generation of sleep scientists, some of them yoga experts, say: You can do it. With a few simple changes in your routine—and perhaps an attitude adjustment—a peaceful night of slumber can be yours.

Throw out your definition of a good night's sleep
Just as three square meals a day has given way to all-day grazing and smaller portions, "what's good for you" has changed here, too. "Thinking it's necessary to stay asleep for 8 hours straight may be unrealistic," says David Neubauer, M.D., associate director of the Johns Hopkins Sleep Disorders Center and author of Understanding Sleeplessness: Perspectives on Insomnia. "Just as we experience a dip in alertness midafternoon, the inverse is a dip in sleepiness in the middle of the night. There's strong evidence that there's a kind of awakening that's totally normal." History supports this take, Dr. Naiman says. "Before the industrial revolution, people had their first sleep for 3 to 4 hours, awoke for an hour or two, then slept for another 3 or 4 hours."

Even waking every 60 to 90 minutes can be part of a healthy sleep pattern. The deeper stages of sleep, or REM (rapid eye movement) sleep, occur about every 90 minutes and get longer as the night goes on, so your brain might become more alert between those cycles. Since we're conditioned to think that waking during the night is a problem, when it happens, we panic, causing our brains to awaken even further. If you find yourself awake in predawn hours, check your physical state. Do you have an ache, a cramp, or need to go to the bathroom? If so, take care of it. If you don't have a physical complaint, chances are you're experiencing a normal stage of the sleep cycle. Knowing this "helps replace worries that you'll be useless without 8 solid hours of sleep with more neutral thoughts," says Sat-Bir Khalsa, Ph.D., instructor in medicine at Brigham and Women's Hospital at Harvard Medical School. "The useful thought is: 'I can handle the disruption and still feel rested.'"

Get bed-ready
After an action-packed day, your brain needs some time to make order of things and slow its frenetic firing before you're ready to sleep. Pure bodily exhaustion can probably conk you out for an hour or so, but then worries will surface and cause you to stir. How can you get your mind to chill?

Establishing any ritual that you do before bed—taking a bath, sipping a cup of (decaf) tea, anything but checking your e-mail—will do more than relax you right then and there. The repetition also conditions your brain and body for sleep, Thompson says. When you transition to Z-mode the same way night after night, you're creating a Pavlovian response to your ritual. So simply sitting in the spot where you do your breathing or turning on the bath water signals your mind that it will be sleeping soon.
Another way to condition yourself is by playing off the body's internal clock. Dr. Naiman suggests simulating dusk about an hour before you plan to go to bed and dimming the lights significantly. This triggers natural circadian rhythms that help us prepare for sleep.

Quit sleeping with the enemy

Guess who has stress under the covers with them most often? That would be women. "Women tend to take stress to bed and mull over it," says Joyce Walsleben, Ph.D., associate professor at New York University Medical Center and author of A Woman's Guide to Sleep.

To prevent stress from waking you up, Dr. Walsleben suggests keeping a worry book—a journal in which a couple of hours before bed, you write down the thoughts you might stew over. Then, she says, when those thoughts creep into your head later, tell yourself, "I can't improve upon it today, so I'm not thinking about it." Other experts recommend literally kicking those worries out of the bedroom. Physically take the journal to another room and leave it until morning. (Make it sleep on the couch, as it were.)

Make the breath-brain connection
Dr. Khalsa recently supervised a small Harvard study using yoga breathing techniques to treat insomnia, and all subjects reported an improvement in the quality and quantity of sleep. "There is evidence that long, slow abdominal breathing will reduce anxiety and arousal," Dr. Khalsa explains. Dr. Naiman recommends one breathing technique (similar to those Dr. Khalsa used) called the 4-7-8 breath exercise. With your tongue resting on the roof of your mouth, just behind your upper teeth, exhale completely. Close your mouth and inhale through your nose for four counts. Hold your breath for seven counts. Then exhale while mentally counting to eight. Repeat the cycle three more times. Such breathing is essential for restful sleep.

Take a pose to the doze
Yoga asanas were originally designed to calm the body and quiet the mind, preparing the yogi for meditation. Today's researchers see the same process at work. "There's a feedback loop between the muscles and the brain," Dr. Naiman says. "When you stretch and release tension, the brain relaxes, too." The deepest meditative state, or yoga nidra, is known as "sleepless sleep."

To get to a sleepful state, Dr. Khalsa finds Bridge pose especially useful. Lie on your back with knees bent at a 90-degree angle and your heels parallel, close to your butt. Lift your hips up off the floor, pushing your pelvis toward the ceiling. Arch up onto your shoulders, then lace your palms together underneath your body and press your arms into the floor or mat. Hold the posture while taking 10 to 15 long, slow breaths.

When you wake up anyway
Despite all of your best efforts, here you are, awake at an hour even Katie Couric would call ungodly. What do you do now? First, here's a big don't: "If they open their eyes and see the clock, that's it for many stressed people," Dr. Walsleben says. "Seeing the time can trigger them to become fully awake." Keep your eyes closed, or move the clock out of sight.
Tired as you are, you're not about to do more yoga. But if you're still far from dreamland, try a mantra. Silently repeat any word that's soothing or pleasant to you, or simply think "inhale" as you inhale, and "exhale" as you release your breath. Thinking the words over and over focuses and relaxes you, but requires less attention than counting sheep, which can actually be too engaging to work the way it's supposed to.

"Get out, get out!''
After 15 minutes of lying awake in bed, you need a change of venue. "When someone can't sleep, the bedroom can become a torture chamber," Dr. Khalsa says. "Staying there is counterproductive." And you risk associating the bed with your trouble sleeping, which will exacerbate the problem in nights to come.

Go to another room. Make sure you have a night light in your hallway and won't need to turn on brighter lights. Occupy yourself with something calming like knitting, listening to music, or even performing your presleep ritual again. Only when you feel drowsy, Dr. Khalsa says, should you go back to bed. In a very short while, you should be the picture of blissful sleep.