What happens when you follow all the lifestyle recommendations for sound sleep, like turning off the TV and cutting out the coffee, but you still can’t get a good night’s sleep? This was among the hundreds of questions about insomnia readers recently posed to the Consults blog.
Q. Some new evidence indicates that good sleep hygiene like not napping and relaxing before bed work for the average person having a bout of sleeplessness but don’t work for many chronic insomniacs (who may be people with unusually high levels of stress hormones). What suggestions can you offer for these people?
Gigi, Ithaca, N.Y.
A. Dr. Michael Thorpy and Shelby Freedman Harris of the Sleep-Wake Disorders Center at Montefiore Medical Center in the Bronx respond:
Sleep hygiene should be considered the foundation of a good night’s sleep for everyone. Good sleep hygiene habits include controlling the bedroom environment (dark, quiet and cool is best), exercising earlier in the day, avoiding caffeine and nicotine, restricting alcohol before bedtime, winding down an hour before bed, keeping a consistent bed and wake time, and avoiding liquids before bed. These simple lifestyle changes can help prevent a few nights of poor sleep from turning into a longstanding problem.