Insomnia & Sleep Hygiene: ‘You definitely don't want to do anything that's going to mess up your chances of falling asleep and staying asleep.’

Ashley Curtis is the lab director and principal investigator at the Cognition, Aging, Sleep, and Health Lab, or CASH Lab, at the University of Missouri. She studies the relationship between sleep conditions and cognition.

She spoke about the misconceptions about insomnia and about some of the ways that sleep hygiene practices could improve everyone’s sleep health.

Ashley Curtis: A long time ago, one of my first jobs out of undergrad was in a sleep lab. So, I was actually one of the techs that would attach the electrodes on people's heads, and then basically watch them sleep through a camera at night.

So, that was my first kind of foray into the sleep world.

When people first started talking about treating insomnia, it was typically through medication, and I was actually, you know, part of that in one of my first positions.

But what we found out was that a lot of these sleep medications are not really beneficial long term for people with insomnia.

And the other aspect is that they can cause a lot of unwanted side effects, you know, and for aging adults that's particularly important, because, you know, typically, you're on more than one medication.

So, there was this push to develop behavioral interventions.

So, you know, you definitely don't want to basically do anything that's going to mess up your chances of falling asleep and staying asleep, right?

So, no big meals two hours before bed. Don't go on a huge run or do big exercise within a couple hours before bed, because you should really be setting up your environment and your body for the ideal circumstances to fall asleep, right?

So, you don't want to basically trick your body into thinking that “oh, it's wake time now,” right?

So, you don't, you don't want to do that.

Same thing with coffee, you know, have your coffee in the morning. In the afternoon – maybe skip that coffee.

The other thing that people may not know is that napping in the afternoon is not conducive to sleep, right?

So, you want to kind of throughout the day, build up that your urge to sleep. Kind of follow your circadian rhythms so that you're going to be sleepy, and you'll fall asleep quickly, and hopefully stay asleep throughout the night as well.

So, avoid napping in the afternoon.

Some other things that people do with insomnia – like lying in bed forever, ruminating about it –instead of getting up doing something else and going back to bed when you're sleepy.

You know, that's kind of the stimulus association techniques. You definitely want – your body can learn that the bed is associated with sleep. So, things that you can do to make that happen.

I think there's definitely a misconception on, you know, people think that if they just follow sleep hygiene – which is for some people that might help you sleep – but for the majority of people with insomnia, this is a chronic condition. So, they've had this, you know, for 10 years or longer, and that's typically what you see.

So, it's more about not necessarily changing just these little sleep hygiene behaviors. It's more about actually going in and changing the mechanisms that are sustaining your insomnia, right?

There's certain things that you can do to actually that will lead to sleep consolidation.

So, some people with insomnia will be up at night and lay in bed, even when they're not sleepy. So, one thing that you can do is get up out of bed, do something non-stimulating – like read a book or something in another room, go back to that when you're sleepy.

And by doing that, you’re kind of creating that association between the “bed” and “sleep.”