Get Better Sleep: 7 Tips for 7 Hours

Do you get fewer than seven hours of sleep per day? If you answer yes, you are not alone. In fact, one-third of American adults “undersleep,” according to the most recent, comprehensive Centers for Disease Control (CDC) report.[1] Since the recommended daily allowance of sleep is between seven and eight and a half hours, that means millions of Americans are walking around (and driving) tired, even if they claim they don’t feel it.

Why is lack of sleep a problem? Because it affects our day-to-day alertness and our long-term health. According to the 2014 CDC report:

Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality…Insufficient sleep impairs cognitive performance, which can increase the likelihood of motor vehicle and other transportation accidents, industrial accidents, medical errors, and loss of work productivity that could affect the wider community.

Adequate sleep depends on certain lifestyle choices, as well as the hormones cortisol, melatonin, estrogen, progesterone, thyroid, and insulin. Given my own focus on the effects of hormones on the body, I’m frequently asked how to sleep better.

A typical request goes like this: Dr. Sara, I can’t sleep. I know sleep is crucial to health, but I’ve tried everything. It got worse in my late forties. Help!

Top 7 Tips for Better Sleep Now

The goal is to sleep seven to eight and a half hours per day. (More than eight and a half hours of sleep per day is associated with a higher rate of mortality.[2]) Note that these hours do not have to be continuous—bathroom interruptions are fine, and power naps are encouraged. Getting enough sleep is the single best thing you can do to stay younger; conversely, getting too little sleep can speed up the aging process.

Here are my top seven suggestions for acquiring more shut-eye. Put these tips into action starting tonight. Those suffering from chronic sleep problems will likely see results by implementing more than one tip. It’s rare that only one approach (monotherapy) would help make your sleep ideal. Instead, improved sleep comes from multiple (in medical terms, pleiotropic) approaches.

1. Be in bed at the right time. Many people need to wake up at 6:00 a.m., which means going to bed, at the very latest, by 11 p.m. in order to get seven to eight and a half hours of sleep per day. But these days, it’s tempting to stay up late Instagramming. In order to achieve optimal sleep, try to relegate most screen-time hours to daytime, freeing up nighttime hours for sleep, especially one hour before your designated bedtime.
2. Dance differently with stress. Or as my sister says, “Chill, Winston!” We have the power to upgrade our nervous systems to interact with stress from a calmer vantage point. How so? Via guided visualization, meditation, autogenic training (a way to self-produce a feeling of warmth and heaviness throughout your body). These practices are especially effective right before going to bed or for returning to sleep after middle-of-the-night wakeups. Popular guided visualizations can be found on Headspace, the Stop, Breathe, and Think app, and, specifically for mothers, with Lisa Beachy meditations. (Here’s a YouTube example of autogenic training.)
3. Don’t count on weekend catch-up sleep. It’s a myth that you can catch up on sleep during the weekend. Even though you might feel as if you counterbalanced your weekday sleep deficit, it doesn’t work. Rather, chronic short sleep episodes (sleep deprivation) override infrequent, longer sleep episodes (making it up on weekends).[3] That is to say, your body still functions according to your five-day-a-week sleep deprivation pattern. Therefore, it’s best to be consistent about a healthy bedtime, seven days a week.
4. Moderate caffeine intake according to your genes. Some people can drink coffee right before bed and still go to sleep the minute their head hits the pillow. Others, such as me, cannot consume any caffeine at all—not even the small amounts in green tea—without triggering insomnia. The reason is that I, along with 51 percent of Americans, possess the slow metabolism gene, called CYP1A2, meaning we process caffeine at a turtle’s pace.[4] Some slow metabolizers have to limit caffeine to a maximum 200mg/day, while others, like me, are completely intolerant. (Note: If you are interested in your genetic makeup, you can join 23andme.com to have your DNA analyzed. To understand your caffeine metabolic rate, browse your raw data for SNP ID rs762551. If you’re AA, you’re a fast caffeine metabolizer. If you’re AC or CC, you’re a slow metabolizer.)
5. Consider hypnosis. As a clinician, I have witnessed the success of hypnosis in alleviating insomnia, and research backs this up. In particular, a 2015 meta-analysis of randomized trials of 502 insomniac patients showed that hypnotherapy can help, although not necessarily for everyone.[5] It’s certainly worth a try for chronic undersleepers.
6. Avoid blue-screen time before sleeping. Laptop in bed with you? Close-up screen time is ubiquitous. While the technology offers countless conveniences, it can wreak havoc on sleep hormones. This is because the screen’s blue light suppresses melatonin, the hormone that needs to rise for optimal sleep. Melatonin elevates with darkness, hence sleep is induced during nighttime hours. Therefore, if you have difficulty sleeping, avoid bright lights and LCD screens (including TV) two hours before bed in order to allow your body’s melatonin levels to naturally rise at night. If two hours is too many, you can try software, such as f.lux, that adjusts your computer screen to match the natural lighting of the time of day.
7. Try supplements for insomnia. Here are several that work:
   1. CBD oil. CBD is the cannabis compound that does not produce the “high.” Research has drawn a connection between CBD oil and easier sleep.[6] Start with a few drops before dinner, and slowly build up to 5-10 mg, twice per day.
   2. Cortisol Manager. Brand: Integrative Therapeutics. Take one at night.
   3. Progesterone. When insomnia occurs during peri-menopause or menopause, talk to your doctor about taking oral, which has been shown to improve sleep.

If insomnia is a challenge for you, use these tips to entrain better sleep patterns. If it seems hard to tweak your routine in order to sleep more, do this: Test out one or more of these changes for one week. Chances are, once you are on a better sleep regimen, you’ll feel the effects so immensely that you’ll prefer to continue on that trajectory. Sleep tight.

If insomnia is a challenge for you, use these tips to entrain better sleep patterns. If it seems hard to tweak your routine in order to sleep more, do this: Test out one or more of these changes for one week. Chances are, once you are on a better sleep regimen, you’ll feel the effects so profoundly that you’ll continue on that trajectory. Sleep tight.

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[1] Liu, Y. “Prevalence of Healthy Sleep Duration among Adults — United States.” CDC Morbidity and Mortality Weekly Report 65, no. 6 (2016):137–141.

[2] Kripke, D. F., et al. “Mortality associated with sleep duration and insomnia.” Archives of General Psychiatry 59, no. 2 (2002):131-136.

[3] Cohen, D. A., et al. “Uncovering Residual Effects of Chronic Sleep Loss on Human Performance.” Science Translational Medicine 2, no. 14 (2010):14ra3.

[4] Thorn, C. F., et al. “PharmGKB summary: very important pharmacogene information for CYP1A2.” Pharmacogenetics and Genomics 22, no. 1 (2012):73-77.

[5] Lam, T.H., et al. “Hypnotherapy for insomnia: a systematic review and meta-analysis of randomized controlled trials.” Complementary Therapies in Medicine 23, no. 5  (2015):719-732.

[6] Zhornitsky, S., et al. “Cannabidiol in humans-the quest for therapeutic targets.” Pharmaceuticals 5, no. 5 (2012):529-552