General ways to improve sleep Many things can interfere with sleep, ranging from anxiety to an unusual work schedule. People who have difficulty sleeping often discover that their daily routine holds the key to nighttime woes. First-line strategies
Before we examine specific sleep problems, it makes sense to address some common enemies of sleep and tips for dealing with them. Cut down on caffeine
Caffeine drinkers may find it difficult to fall asleep. Once they drift off, their sleep is shorter and lighter. For some people, a single cup of coffee in the morning means a sleepless night. That may be because caffeine blocks the effects of adenosine, a neurotransmitter thought to promote sleep. Caffeine can also interrupt sleep by increasing the need to urinate. Get your copy of Improving Sleep
When you wake up in the morning, are you refreshed and ready to go, or groggy and grumpy? For many people, the second scenario is all too common. This report describes the latest in sleep research, including information about the numerous health conditions and medications that can interfere with normal sleep, as well as prescription and over-the-counter medications used to treat sleep disorders. Most importantly, you’ll learn what you can do to get the sleep you need for optimal health, safety, and well-being.
 | People who suffer from insomnia should avoid caffeine as much as possible, since its effects can endure for many hours. Because caffeine withdrawal can cause headache, irritability, and extreme fatigue, some people find it easier to cut back gradually than to go cold turkey. Those who can’t or don’t want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine-sensitive. Stop smoking or chewing tobacco
Nicotine is a central nervous system stimulant that can cause insomnia. This potent drug makes it harder to fall asleep because it speeds your heart rate, raises blood pressure, and stimulates fast brain-wave activity that indicates wakefulness. In people addicted to nicotine, a few hours without it is enough to induce withdrawal symptoms; the craving can even wake a smoker at night. People who kick the habit fall asleep more quickly and wake less often during the night. Sleep disturbance and daytime fatigue may occur during the initial withdrawal from nicotine, but even during this period, many former users report improvements in sleep. If you continue to use tobacco, avoid smoking or chewing it for at least one to two hours before bedtime. Use alcohol cautiously
Alcohol depresses the nervous system, so a nightcap can help some people fall asleep. However, the quality of this sleep is abnormal. Alcohol suppresses REM sleep, and its soporific effects disappear after a few hours. Drinkers have frequent awakenings and sometimes frightening dreams. Alcohol may be responsible for up to 10% of chronic insomnia cases. Also, because alcohol relaxes throat muscles and interferes with brain control mechanisms, it can worsen snoring and other nocturnal breathing problems, sometimes to a dangerous extent. Drinking during one of the body’s intrinsic sleepy times — midafternoon or night — will induce more sleepiness than imbibing at other times of day. Even one drink can make a sleep-deprived person drowsy. The combination of alcohol and sleepiness also significantly increases a person’s chance of getting into a car accident. Be physically active
Regular aerobic exercise like walking, running, or swimming provides three important sleep benefits: you fall asleep faster, attain a higher percentage of deep sleep, and awaken less often during the night. Exercise seems to be of particular benefit to older people. In one study, physically fit older men fell asleep in less than half the time it took for sedentary men, and they woke up less often during the night. Exercise is the only known way for healthy adults to boost the amount of deep sleep they get. Research shows that older men and women who report sleeping normally can still increase the amount of time they spend in deep sleep if they do some form of aerobic activity. But try to avoid exercising within two hours of bedtime, because exercise is stimulating and can make it harder to fall asleep. Stick to a regular schedule
A regular sleep schedule keeps the circadian sleep/wake cycle synchronized. People with the most regular sleep habits report the fewest problems with insomnia and the least depression. Experts advise getting up at about the same time every day, even after a late-night party or fitful sleep. Napping during the day can also make it harder to get to sleep at night. Keeping a sleep diary may help you uncover some clues about what’s disturbing your sleep. If possible, you should do this for a month, but even a week’s worth of entries can be useful. If your goal is to sleep longer at night, napping during the day is a bad idea. Because your daily sleep requirement remains constant, naps take away from evening sleep. But if your goal is to improve your alertness during the day, a scheduled nap may be just the thing. Insomniacs who are anxious about getting enough sleep may also find that a scheduled nap improves the quality of their nighttime sleep by reducing anxiety. If possible, nap shortly after lunch. People who snooze later in the afternoon tend to fall into a deeper sleep, which causes greater disruption at night. An ideal nap lasts no longer than an hour, and even a 15- to 20-minute nap has significant alertness benefits. Shorten or eliminate naps that produce lingering grogginess. For more on the importance of getting a good night’s sleep and developing strategies to improve your sleep, buy Improving Sleep: A guide to a good night’s rest, a Special Health Report from Harvard Medical School. | 
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