What To Do If You're Struggling To Sleep

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Symptoms of insomnia are the most common sleep disorder and affect about one third of Americans at some point in their lives. (Pixabay)

Many people have trouble sleeping, at least sometimes. Symptoms of insomnia are the most common sleep disorder and affect about one third of Americans at some point in their lives.

But chronic insomnia — when trouble sleeping persists for more than a month, and alters how you feel and perform during the day — is different, and affects about 8 to 10 percent of Americans.

So what should you do when you’re having trouble sleeping?

Here & Now‘s Peter O’Dowd gets advice from Dr. Lawrence Epstein of Harvard Medical School’s Division of Sleep Medicine. He’s also the former president of the American Academy of Sleep Medicine.

Interview Highlights: Dr. Lawrence Epstein

On tips for getting back to bed

“There are two approaches to treating insomnia. One is with medication, and the other what are called behavioral therapies. And there are a whole group of techniques that are used, including things like relaxation techniques, making sure the environment no longer triggers these responses by changing the environment so that you can again get back into a pattern of relaxing. You can actually learn to relax, and people know the examples of this. It’s what meditation is, and yoga, and other things where you learn to relax. And once you can relax and bring down that arousal, the body’s natural sleepiness will come out and help you get to sleep.”

On what methods he recommends

“My preferred method is to start off with the behavioral methods, things that you can do, behaviors you can do that improve sleep. When you compare the two, medication and behavioral techniques head to head, they’re about equal in terms of their effectiveness, but the changes that come about are longer lasting through the behavioral techniques than through medication. All medications have side effects. Sleeping medication, you can develop tolerance and withdrawal from them if used for long periods of time, and can affect cognitive functioning. So, when I use medication, I try to use at the lowest possible dose for the shortest period of time and couple them with these behavioral changes as a way to get longer lasting effects.”

On changing your environment

“One of the things that’s recommended to, again, change the environment and your response to it, is to avoid making bed a battleground, a place where you feel really bad and anxious. You wanna reserve bed for sleep and intimacy only. So if, indeed, if you’re lying in bed, rather than being annoyed and frustrated and pounding the pillow and disturbing your bed partner, get up, go out of bed, go some place else. So now, the living room where the couch is is the place you don’t want to be and you really want to get back to the bedroom. And during that time you do something that you find relaxing. So, listen to music, reading — something that’s calming. Don’t get on the computer and play war games, and don’t go searching for Pokemon Go. Do something that will allow, again, your inherent sleepiness to come out. When you feel it, then you go back to bed and try to go back to sleep.”


Dr. Lawrence Epstein, with the Division of Sleep Medicine at Harvard Medical School and former president of the American Academy of Sleep Medicine. The medical school tweets @harvardmed.

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