Doctors Answers (3)
A regular sleep routine is helpful. Go to bed and wake up at regular times even on weekends. Have a sleep time ritual such as reading a book or taking a nice, warm bath. In water-limited California and Southwestern states, a hot shower may have to be substituted. A bedroom that is very dark is conducive to sleep. Even night lights or light seeping through slats of blinds can be disruptive. Adding curtains or some truly light-occlusive window covering may be helpful. For the budget-conscious student, a dark, inexpensive poster board or towel clipped strategically over the window may help. Make sure to have a good, loud alarm though. The bed and bedroom should be comfortable and at a pleasant temperature for you. White noise can be soothing and can mask disruptive noises. Some possibilities are white noise machines, white noise CDs, or, in the summer, a fan. Vigorous exercise can get you appropriately tired for sleep. For some folks, exercise needs to be 3-4 hours before sleep because, if it's too close to bedtime, it may be stimulatory for them. Wearing kids out can work particularly well. Avoid caffeine 6-8 hours before bedtime. For some, avoidance of coffee may need to be as much as 12 hours before bedtime. Avoid alcohol and smoking before bedtime. Avoid television, smart phones, or computers before bedtime- the bright, rapidly changing images are highly stimulatory. Having difficulty with finding a comfortable position for sleep may be an indication that there is a sleep disorder. Being sleep tested will allow one to see if there is a problem with air flow during sleep.
You bring up a very good question! How do patient differentiate having a sleep disorder vs. not getting enough sleep. Usually we figure that out by getting a good detailed history. One question that I ask my patients that gives me a better idea is this. "If you were able to sleep all through the night and wake up in the morning, do you feel rested or do you feel like you need more sleep?" If the answer is that they feel good or great, then they probably are just not getting enough sleep and we start figuring out ways to improve that. If, however, they state that "I can sleep all night and still not feel good in the morning or I need more sleep" then it is more likely that they might have a sleep disorder. If one is waking up because they are not comfortable, they really should look into different pillows and maybe even a different type of mattress.
Many factors can contribute to a poor nights sleep including stress, chronic medical conditions, chronic pain or allergies, obesity, a primary sleep disorder, use of certain medications, poor sleep hygiene and disruptive environment (i.e. bed partner) just to name a few. To start to address the problem you may need to first see your primary doctor to get a check up including physical exam. They may decide you need to see a sleep specialist or order a diagnostic sleep study themselves. Some simple things you may do on your own include optimizing your own sleep environment with the adequate lighting and temperature, get mentally prepare to sleep 45-60 minutes prior to going to bed, minimize caffeine, alcohol intake or tobacco use especially later in the day, and engage in exercise early in the day. A sleep log of how much time you spend in bed each night including an estimate of the actual time spent sleeping will also help your doctors pinpoint where the problem may lie.
