• Posted February 7, 2022

Searching for Good Sleep? Here's What You're Doing Right - and Wrong

Many Americans are working hard to get a good night's sleep, and feeling the effects when they miss the mark.

About 32% of people feel more tired these days than they did before the pandemic began, according to the results of a new HealthDay/Harris Poll survey. About 28% says they're getting less sleep than they did before the pandemic.

"During the peak of the pandemic with all these surges, people are at home -- appropriately trying to quarantine, trying to isolate," Dr. Raj Dasgupta, associate professor of clinical medicine at the University of Southern California's Keck School of Medicine, said in a HealthDay Now interview.

"There just wasn't that structure in the day," Dasgupta continued. "The next thing you know, you're staying up at night and you're waking up later in the morning, because there wasn't that motivation to get out there."

These changes have caused Delayed Sleep Phase Syndrome in many, in which their sleeping rhythms have been thrown off by disruptions in routine, Dasgupta explained.

The syndrome causes people to miss out on what Dasgupta calls the "Two Qs" -- quantity and quality of sleep.

"Can you get to those deeper stages? Can you get to REM sleep?" Dasgupta said. "Those deeper sleep stages and REM sleep stages help every single part of our body."

Insomnia is another common sleep disorder that can lead people to miss out on the Two Qs, Dasgupta said.

"It's not hard to diagnose insomnia, but it's really hard to manage," Dasgupta said. "It's hard to live with."

Insomnia is often fueled by anxiety and depression, causing a "vicious cycle" where your inability to fall asleep heightens the feelings that are interfering with your sleep, Dasgupta explained.

Between 15 and 20 million Americans also suffer from obstructive sleep apnea, although Dasgupta believes those estimates are low.

Sleep apnea occurs most often when your tongue, soft palate or throat muscles relax during sleep, blocking your airway. You can't breathe, and wake up choking.

"You'll wake up because of these apnea episodes, and it's almost like you're just stuck in those lighter stages" of sleep, Dasgupta said. "Even if you slept 7 or 8 hours per night, you still don't feel refreshed during the day."

Snoring is a key sign of sleep apnea, Dasgupta said. Other signs include daytime sleepiness or fatigue, night sweats, frequent trips to the bathroom at night, and waking with a choking or gasping feeling.

Dasgupta said he prefers to treat chronic insomnia with cognitive behavioral therapy (CBT), analyzing a person's activities before bed and altering them to give the patient the best chance for a good night's sleep.

Meanwhile, the Harris Poll results indicate that people have been trying on their own to change their routine for better sleep:

• 36% have tried to reduce their stress
• 33% tried to manage their anxiety
• 20% eliminated or reduced caffeine
• 19% meditated before bed
• 18% have altered their sleeping environment by adding blackout curtains or a white noise machine
• 16% avoided screen time.

About 16% of people are currently taking over-the-counter sleeping pills on a regular basis, the survey also found.

But taking sleeping medications can be tricky, Dasgupta said. You have to schedule the dose to ease you to sleep at the right time, and the drug's half life will determine when sleep is initiated and whether sleep is maintained.

About 36% of survey respondents said when they drink alcohol they typically sleep better, but sleep experts warn against this approach.

"It may get you to sleep really fast, but it totally interferes with your sleep cycle. In fact, it disrupts REM sleep, your dream sleep," said HealthDay Medical Correspondent Dr. Robin Miller. "What will happen is, once it wears off halfway through the night, you get a rebound REM and so a lot of people will get nightmares and very vivid dreams if they've been drinking.

"If you're going to drink, keep it at two drinks and do it at least three hours before you sleep," said Miller, a practicing physician with Triune Integrative Medicine in Medford, Ore.

You can watch the full HealthDay Now interview here:

People suffering from sleep apnea can be treated using a continuous positive airflow pressure (CPAP) device, in which the patient wears a mask that provides air pressure that keeps their breathing passages open during sleep, Dasgupta said.

Others also can be fitted with a dental device that helps keep their airway open, or you might try sleeping on your side rather than your back, Dasgupta added.

As far as folks who are just plain having trouble with sleep, there are a number of different tactics to help you get back to bed and sleep deep, Miller said.

For example, if you've been unsuccessfully trying to sleep for 20 to 25 minutes, don't keep beating your head against the Sandman's wall.

"What's best for many people is to get up and do something calming," Miller said. "You can meditate. You can read under a low yellow light -- not a blue light. You can find different ways to relax. The key is to get yourself sleepy."

People dealing with changes in their routine during the pandemic should make sure that they limit their bed to just sleeping or sex only, Miller said.

"Even if you have to work in your bedroom, do not use your bed for work," Miller said.

If you're tempted to use a screen in bed -- and most of us do it -- you might want to make it a bit more challenging for yourself, Miller added.

"Maybe what you should do is do it standing. That way you'll get tired and you'll finally lie down," Miller said.

Exercise can help sleep, but only if you give your body time to wind down afterward. Miller suggests people exercise at least four hours before going to sleep, and no sooner.

You also should avoid caffeine after 2 p.m., Miller said.

More information

Harvard Medical School has tips for good sleep.

SOURCES: Raj Dasgupta, MD, associate professor, clinical medicine, University of Southern California's Keck School of Medicine, Los Angeles; Robin Miller, MD, MHS, physician, Triune Integrative Medicine, Medford, Ore.