Six Tips for Overcoming Sleep Onset Insomnia

Poor sleeping conditions such as those found on planes can interfere with anyone’s sleep. But sleep onset insomniacs may find them particularly challenging, accustomed as we are to not falling asleep very quickly and being bothered by things that other sleepers readily tune out.

Why is it so hard for some insomniacs to fall asleep and what can help? Following are six ways to hold sleep onset insomnia at bay.

Poor sleep conditions compound the problem of sleep onset insomniaIt’s been 10 years since I experienced persistent sleep onset insomnia, but I was reminded of what my nights used to feel like when recently I took a red-eye flight on Spirit Airlines.

Conditions on that plane were not conducive to sleep: seats locked in the upright position; flight attendants whose nattering could be heard over the noise of the engines; dim lighting rather than darkness; kicks to my seat as the 6-footer behind me shifted around in his coach class cubicle; turbulence. I didn’t sleep a wink.

Conditions like these can interfere with anyone’s sleep. But sleep onset insomniacs may find them particularly challenging, accustomed as we are to not falling asleep very quickly and being bothered by things that other sleepers readily tune out.

Why is it so hard for some insomniacs to fall asleep and what can help? Following are six ways to hold sleep onset insomnia at bay.

What Brain Waves Reveal About Insomnia

Research has shown that people with insomnia have a different pattern of cortical activity as we’re drifting off to sleep. Compared with good sleepers, insomniacs are more prone to high-frequency brain waves in the sleep onset period. Once sleep onset has occurred, delta, or slow, waves take longer to appear. This is often taken as evidence of hyperarousal. At night, and possibly during the daytime as well, people with insomnia have higher levels of cortical arousal.

Results of recent study argue otherwise. Here, in the sleep onset period, sleep onset insomniacs were found to experience less high-frequency brain activity than sleep maintenance insomniacs (those who tend to wake up in the middle of the night). But the high-frequency activity in the sleep onset insomniacs took longer to decline. Authors of this study suggest that sleep onset insomnia may be the result of “some form of fast wakefulness inhibition” rather than an expression of cortical hyperarousal.

Relief for Sleep Onset Insomnia

Whatever may be the case, habits I’ve developed over the past 10 years enable me to fall asleep quickly now (barring nights when I’m trying to sleep on a plane). They may help you, too:

  1. Adopt a regular sleep schedule. Be especially regular about getting up at the same time every day—even on weekends. This can be a challenge if you have an erratic daytime schedule or an active social life. If you find you’re really sleepy, catch up on sleep by allowing yourself to go to bed somewhat earlier than normal rather than sleeping in late. The problem with sleeping much later than usual to catch up on sleep is that it sets you up for trouble falling asleep the next night.
  2. Break the association between your bed and wakefulness by reserving your bed (and the bedroom) for sleep and sex. Reading, TV and movie watching, surfing the net, playing video games—all this should happen outside the bedroom. Only go to bed when you’re sleepy enough to fall asleep.
  3. Exercise late in the afternoon or early in the evening. Exercise warms your body up. This triggers an internal cooling mechanism, and when your body is cooling down it’s easier to fall asleep. Aerobic exercise is best but rigorous strength training may work as well.
  4. Observe a wind-down routine in the hour leading up to bedtime. Have the same routine—shower, put on pajamas, brush teeth, read or look at picture books—every night. Your brain will learn to expect that this sequence of activities ends in sleep.
  5. If clock watching at night makes you anxious, turn your clocks to the wall starting at about 9 or 10 p.m. Use a backlit alarm clock on your bedside table—the kind that stays dark at night except when you press the button on top.
  6. If you have to fly at night, arm yourself beforehand with all the accoutrements I forgot to pack in my carry-on: neck pillow, eye mask, earplugs. As for Spirit Airlines, they may say they’re the company with the newest fleet of planes, but seats that keep you locked in an upright position do not lend themselves to a good night’s sleep!

If you often fly at night, what measures do you take to get a decent night’s sleep?

Exercise Improves Sleep, Preserves Mental Fitness

You may have been a couch potato for most of your life, but now, if you’re middle-aged and envisioning a healthy retirement, you’d better change your ways.

Moderate-to-vigorous exercise can mitigate some effects of aging, including poor sleep quality and cognitive decline. Research generally supports this claim, so especially if you’re prone to insomnia, you’ll want to check this out.

Insomnia and mental decline can be alleviated with exercise
Me, returning from my first bike ride this year

You may have been a couch potato for most of your life, but now, if you’re middle-aged and envisioning a healthy retirement, you’d better change your ways.

Moderate-to-vigorous exercise can mitigate some effects of aging, including poor sleep quality and cognitive decline. Research generally supports this claim, so especially if you’re prone to insomnia, you’ll want to check this out.

Age-Related Sleep Problems and Exercise

Sleep tends to be less robust as we age. Middle-aged and older adults get less deep sleep (the restorative stuff) than younger people. Our sleep is less efficient, too, peppered with wake-ups during the night. In the morning, we wake up feeling less rested, with fewer resources to meet the demands of the day.

Investigators are now looking at lifestyle factors that might alleviate aged-related sleep problems. A majority of studies suggest that both male and female exercisers tend to experience better sleep quality and fall asleep more quickly than people who don’t exercise.

Newer Data From Objective Tests

The majority of such studies are based on reports from participants rather than objective tests. In two more recent studies, investigators used objective measures to assess the relationship between participants’ level of physical activity and their sleep.

The SWAN Sleep Study was an observational study involving 339 middle-aged women. Over 6 years, investigators collected data on their activity level in three domains: (1) Active Living (activities like watching TV and walking to work), (2) Household/Caregiving (housework and childcare), and (3) Sports/Exercise (recreational activities and sports).

Toward the end of the 6-year period, the women underwent in-home polysomnography (a sleep study) every night during one entire menstrual cycle or 35 days, whichever was shorter. They also kept sleep diaries and filled out sleep-related questionnaires.

Altogether this made for a lot of data on a lot of women. The findings reported here are both significant and clinically important:

  • Activities in the Active Living and Household/Caregiving categories had little impact on women’s sleep. Women typically spend a lot of time doing these activities, yet they may not be vigorous enough to affect our sleep.
  • Women with high Sports/Exercise activity over the 6-year period experienced better sleep, especially on measures of sleep quality and sleep continuity.
  • Greater recent Sports/Exercise activity was associated with better sleep quality and better sleep continuity—and more deep sleep (insomnia sufferers, take note!).

What About Men?

Routine exercise has similar benefits for men, a small exercise intervention study showed. Via polysomnography, the sleep of 13 men aged 60 to 67 was assessed 3 nights before and 3 nights after they participated in a 16-week exercise program. The program consisted of regular 60-minute workouts on the treadmill. The workouts were fairly rigorous and the results, impressive. Compared with their sleep before starting the exercise program, by the end of the program the men’s sleep

  • had significantly greater continuity. Acute exercise reduced their nighttime wakefulness by 30%.
  • was significantly deeper. On nights following exercise, they experienced a 71% increase in slow-wave (deep) sleep. (That 71% is not a typo, by the way!)

Exercise Protects Mental Fitness

If the sleep benefits of exercise don’t move you to action, maybe the high cost of inactivity to your brain will. Regular exercise helps improve cognitive function and protects against cognitive decline. How it does so has yet to be worked out, but one theory holds that exercise has a beneficial effect on the brain due to its positive effect on cerebral blood flow. For optimal functioning the brain has to have adequate blood flow. Moderate-intensity exercise increases blood flow to the brain in healthy adults.

But blood vessels may lose their ability to respond normally in the brain and elsewhere, a situation called vascular dysfunction, which is associated with cardiovascular disease. Systemic vascular dysfunction will likely reduce blood flow to the brain and manifest as cognitive impairment.

“Vascular dysfunction and altered blood flow regulation may be a key link between cardiovascular disease and cognitive decline,” writes Jill N. Barnes in a paper titled Exercise, Cognitive Function, and Aging.

Protecting vascular health—which typically declines with age—may also protect against cognitive decline. Barnes cites a few studies that suggest that exercise is the key to protecting vascular functioning. A few other human studies show that both aerobic exercise and strength training help maintain cognitive fitness. In addition, animal studies have shown that sustained aerobic exercise promotes the growth of new nerve cells in the hippocampus, a part of the brain associated with memory.

So particularly if you’re middle aged or older and prone to inactivity, check into starting an exercise program now. It will improve your physical and mental health and—perhaps more relevant if you’re looking for help with insomnia—it will likely improve your sleep.

Sleep After Exercise a Boost to the Brain

We tend to have more brain power following exercise and a good night’s sleep. But what aspect of sleep might explain the beneficial effects of physical activity on the brain? Is it sleeping longer that enhances mental prowess?

Authors of a new study think they know—and insomnia sufferers should take note.

Exercise increases sleep efficiency, in turn increasing brain powerWe tend to have more brain power following exercise and a good night’s sleep. But what aspect of sleep might explain the beneficial effects of physical activity on the brain? Is it sleeping longer that enhances mental prowess?

Authors of a new study think they know—and insomnia sufferers should take note.

Effects of Exercise on Sleep and Cognition

Research has shown that exercise—or physical activity in general—is beneficial to sleep. Physical activity helps people fall asleep quickly and sleep more deeply. It also tends to improve sleep efficiency, that is, it increases the amount of time in bed spent sleeping.

Exercise is also known to have positive effects on the brain. Physical activity enhances memory and the “executive control processes” that occur with activity in the frontal region of the brain. This part of the brain is responsible for planning, initiating, and monitoring complex mental and physical tasks.

Researchers at the University of Pittsburgh and the Georgia Institute of Technology were interested in these relationships. They wanted to know which aspect of sleep following exercise was associated with improved executive control, and whether there were differences between younger and older adults.

Study Particulars

A total of 112 community residents participated in the study, 59 young adults (ages 21–30) and 53 older adults (ages 55–80). They went through two rounds of cognitive testing spaced one week apart. The cognitive testing involved several computer-based and pencil-and-paper tasks assessing working memory, task switching, verbal ability and fluency, and delayed recall of information.

Participants also wore an accelerometer armband during the week between the two testing sessions. Similar to sleep and activity trackers on the market today, the accelerometer monitored participants’ physical activity and their sleep.

Sleep Efficiency Rules

As expected, the more physically active participants performed better on the tests. The novel finding was this: what mediated, or facilitated, this relationship was not that the exercisers slept longer than their sedentary counterparts. It was that their sleep was more efficient. This was true for both younger and older study participants.

A Relationship Between Sleep Efficiency and Insomnia

So sleep efficiency seems to be an important aspect of sleep. If you’ve got chronic insomnia—if you experience trouble thinking and concentrating after nights of broken sleep—you’ll want to take note. Insomniacs’ sleep is often inefficient. Your sleep efficiency is low if you

  • lie in bed awake for a long time before falling asleep,
  • wake up several times during the night, or
  • wake up in the middle of the night and take a long time to fall back to sleep.

Sounds familiar, right? In all these situations, you’re spending lots of time in bed lying awake rather than asleep. Your sleep efficiency is high if

  • you fall asleep quickly, and
  • your sleep is deep enough to remain solid and unbroken throughout the night.

When your sleep is efficient, you’re asleep most of the time you’re lying in bed and awake very little. This may not reflect your situation now, but it is something to work toward.

As the study above suggests, one way to improve your sleep efficiency is to get daily exercise. The authors’ “novel finding fits in line with the broad view that uninterrupted sleep may promote brain health and that this process may be facilitated through physical activity.”

There are also insomnia treatments that increase sleep efficiency. One was in the news recently, and I’ll write about it in next week’s blog post.

Does regular exercise have any effect on your sleep? If so, what is it?