Sleep is one of the most important things we need for optimal physical and mental health, as this is when the body rests and repairs itself and the brain consolidates memories and removes toxic waste.

Regular restful sleep helps with cognitive functioning, mood, the immune system, muscle recovery, tissue repair, appetite control, alertness and reduces risk for developing chronic diseases. Sleep deprivation or disorders are extremely common both in adults and teens with roughly one in three adults saying they don’t get enough sleep. Taking action to improve your sleep is vital, and you can do it without medication.

Cognitive behavioral therapy for insomnia is a drug-free program lasting four to eight sessions that helps patients identify and change thoughts or behaviors causing sleep problems. CBT-I works if done consistently. Patients learn to associate the bed with sleep by eliminating non-sleep activities like watching TV or working in bed and changing dysfunctional, anxious thoughts about their inability to sleep. It can be effective within three to four weeks with lasting benefits. Many of the following issues are addressed in cognitive behavioral therapy.

Consume all caffeine before 11 a.m. Despite what you may think, caffeine can take 10 to 12 hours to fully clear your system. Caffeine increases the time it takes to fall asleep, decreases deep, restorative sleep and causes frequent awakenings. When we don’t sleep well, we may drink more caffeine the next day to wake up, creating a vicious cycle.

Alcohol is initially sedating so we think it helps with sleep, but it actually suppresses REM sleep, increases nighttime awakenings and worsens snoring or sleep apnea. It raises the heart rate and increases sympathetic nervous system activity, keeping you from resting fully. Limit alcohol consumption overall and stop drinking three to four hours before bedtime. Marijuana affects sleep in much the same way, initially acting as a sedative but decreasing REM sleep and disrupting sleep cycles, particularly with long-term use.

Eating within two to three hours of bedtime disrupts sleep because the body is working to digest food when it should be at rest. It raises body temperature and may cause acid reflux, all leading to fragmented sleep and shorter REM cycles. Late night eating can also lead to high blood pressure, high blood sugar and weight gain.

Our bodies are meant to be warm during the day but cool down at night in order to sleep. Get rid of heavy blankets, comforters, flannel sheets, pajamas, etc., that trap heat and make you overly hot. Keep the thermostat set to the mid 60s. A warm bath not only relaxes you but raises your core temperature and then the subsequent rapid cooling after you get out stimulates the body’s thermoregulatory system to release melatonin, inducing sleepiness. If you suffer with poor circulation and cold hands and feet, you may have more trouble sleeping so try sleeping in socks and mittens.

Avoid sleep supplements like melatonin. Supplements are not regulated as to what they contain so the label may be inaccurate, and anything over 1 milligram of melatonin is too much. Taking too much or at the wrong time can disrupt normal sleep cycles or cause daytime grogginess, headaches or nightmares.  

Don’t nap unless you are sick. Naps can reduce your circadian rhythm and sleep drive if they are too long or late in the day. Go to bed if you are falling asleep watching TV at night; don’t try to force staying up.

Stress, anxiety or racing thoughts may be the reason you wake up and can’t get back to sleep. We can’t escape our problems, so deal with your stress during the day by scheduling worry time, an hour a day for seven days, nonnegotiable. Doing this can free your mind, leaving it uncluttered the rest of the day because you know you have time to think about your worries.

We sleep better in a dark room, so make the room dark as possible by covering all sources of light, such as clocks, phones and windows. You can sense light when your eyes are closed, so use an eye mask if necessary. We did not evolve for the neurological experience of social media. Interacting with devices too close to bedtime, whether checking emails, social media or working leads to too much stimulation and blue light exposure. Watching TV does not seem to be as stimulating but is a more passive activity.

One of the most beneficial things you can do is to set and keep a regular bedtime and wake time, with the wake time being the most important. Calculate your bedtime by counting backwards from the time you need to wake up using the average number of hours you sleep. Resist the temptation to sleep later on the weekends and keep the same bedtime and wake time. Restrict your time spent in bed; in other words, don’t lie in bed awake, go read or do another quiet, non-stimulating activity.

Some sleep medications like Ambien, Lunesta, Sonata, Xanax, Valium or Ativan are designed to help you fall asleep fast, but in actuality are sedating and can interfere with normal sleep cycles and deep REM sleep that is necessary for restorative rest. Talk with your doctor about non-sedating alternatives. Other medicines can also affect sleep. Find out if your medications need to be taken at a certain time in order to not interfere with sleep, then be consistent in taking them.