It's National Sleep awareness week, and a report by the U.S. Center for Disease Control and Prevention (CDC) shows that most of us need some help to sleep better. So here are some key sleep strategies from Rodale.com advisor Jeffery Rossman, PhD.
RODALE NEWS, EMMAUS, PA—When I speak to groups of guests at Canyon Ranch about improving their sleep, I usually take a brief survey of those in attendance to learn about the source of their sleep difficulties. A few people report that they’re kept awake by a physical problem, such as chronic pain or nasal allergies. A few by factors in their sleep environment—a snoring spouse, a young child. And over half say it’s by stress and an inability to turn off their minds. Many of the guests report they have used sleeping pills, and a smaller percentage relate they are taking them continuously. Sleep and health are so closely connected that it's well worth taking time to address the factors that keep us from getting the sleep we need. But not all sleep remedies are as helpful as they may seem.
THE DETAILS: I am frequently asked whether it is safe and helpful to take sleeping pills. I tell people that sleeping pills can provide welcome relief from a temporary sleep problem. For instance, if you’re in the hospital recovering from surgery, and pain is making it difficult to sleep, temporary use of a hypnotic sedative can help you get much-needed rest.
However, long-term use of sleeping pills has several drawbacks:
• Sleeping pills sometimes lose their efficacy over time.
• Some sleeping pills can negatively affect sleep architecture, producing more of the lighter Stage 2 sleep, rather than the deeper, more restorative rest characteristic of Stage 3 and Stage 4 sleep.
• Some over-the-counter sleeping pills contain antihistamines that block the action of a specific neurotransmitter, acetylcholine, which can lead to cognitive impairments.
• Some sleeping pills have been associated with potentially dangerous side effects, including getting up and walking, eating, and even driving while asleep.
In order to achieve long-lasting improvements in insomnia, I recommend cognitive-behavioral therapy. This approach includes several components, including establishing a regular sleep-wake rhythm, limiting the amount of time spent in bed awake, learning to identify and change anxiety-producing thoughts that interfere with sleep, and utilizing breathing and relaxation techniques to calm the mind and relax the body.
A study published in the Journal of the American Medical Association found that sleeping pills provided modest short-term benefits, but added no additional long-term benefit beyond what patients achieved with cognitive-behavioral therapy. In fact, among insomniacs who received 6 weeks of treatment with both cognitive behavioral therapy and sleeping pills, those who discontinued the medication and continued to use cognitive-behavioral techniques slept better at 6-month follow-up (and even better at 12 month follow-up), compared to people who kept using sleep medication. The authors concluded that for long-term improvement in sleep quality, there was no added value in adding medication to cognitive-behavioral therapy.