Sleep Anxiety: Is the Fear of Insomnia Causing Your Inability to Sleep?

Is the fear of insomnia causing your inability to sleep? In some people, insomnia can begin abruptly after one bad night of sleep. From there, sleep anxiety develops and becomes a nightly pattern. Worry builds as bedtime approaches, and by the time someone gets into bed, they are so worked up, they can’t fall asleep. The fear of not being able to sleep ends up driving insomnia.



After this lousy night of sleep, a negative association develops, and sleep begins to be linked with insomnia. I like this definition of negative association:

 

A negative association between two variables means that when one increases, the other one usually decreases.

 

In other words, the more that sleep gets associated with lying in bed stressed and unable to turn the brain off, the less it’s associated with rest, comfort, relaxation, and drifting off to sleep.

Marjorie’s experience with fear of insomnia*:

The fear of not being able to sleep can create a sleep anxiety that results in an inablity to sleep. Fear of insomnia can drive sleeplessness.

Marjorie is a 36-year-old working in advertising at a busy agency. Her job is fast-paced, cutthroat, and demands top-notch performance. Three years ago, soon after she started with the company, Marjorie was anxious about a presentation she had the next day. Usually, a good sleeper, she couldn’t shut her mind off and was unable to fall asleep. She kept watching the hours tick away and calculating how much sleep she could still get. The fear of doing terribly on her presentation continued to build. She finally got a few hours of sleep, but she felt awful in the morning. 

 

Since this night, Marjorie has been anxious about whether she will fall asleep. She needs to be at the top of her game every day, and sleep deprivation isn’t going to get her there. Marjorie has started to think about these bedtime worries throughout the day. By the time she gets in bed, she is tense and unable to settle her brain or body. Her sleep is getting worse and worse. 



*This patient example is fictionalized but demonstrative of what happens with many patients I work with.

Inability to sleep: A common cycle of insomnia

The fear of not being able to sleep can create a sleep anxiety that results in an inablity to sleep. Fear of insomnia can drive sleeplessness.

Once sleep anxiety develops, people often begin to procrastinate getting in bed. It seems easier to stay up until collapsing from exhaustion instead of facing the possibility of not falling asleep. This sleep-delaying behavior contributes to continued sleep deprivation.

 

To compensate for daytime exhaustion, people then drink coffee or take naps. Both of these actions can result in an inability to sleep later.

 

As bedtime approaches, worries about insomnia increase, and people may drink alcohol to try to relax and help them drift off easier. Unfortunately, alcohol further interferes with the ability to get quality, restorative sleep.

 

The insomnia cycle goes on and on until the fear itself is dealt with.



Treatment of sleep anxiety:

It’s essential to understand the source of insomnia to decide management. Obviously, if someone is drinking caffeine late in the day, or alcohol nightly, the treatment will be focused on changing the behavior.

 

But if the source of insomnia is fear, sleep anxiety is what needs to be targeted. If it isn’t dealt with, people often end up on long-term sleep medication. The fear of not being able to sleep is so great that people don’t want to risk ever going off it.

Treat the fear of not being able to sleep with cognitive-behavioral therapy for insomnia:

The fear of not being able to sleep can create a sleep anxiety that results in an inablity to sleep. Fear of insomnia can drive sleeplessness.

Cognitive-behavioral therapy for insomnia (CBTi) is an effective treatment for sleep anxiety. CBTi works by challenging a person’s misconceptions about sleep and dysfunctional beliefs about their insomnia that often drive the fear. It identifies behaviors sabotaging sleep (watching the time tick away) and changes negative assumptions and “catastrophic” predictions regarding the consequences of poor sleep (i.e., “if I don’t get 8 hours of sleep I will do terribly on my presentation, humiliate myself, and my job will be at risk”).



CBTi therapy will also incorporate:

 

 

Insomnia does not need to be a chronic condition, so don’t settle for a lifetime of sleep medications. Get assistance and interrupt the cycle of insomnia and sleep anxiety that leads to an inability to sleep.

 

Have you experienced sleep anxiety? What have you done that has been helpful to overcome this?

Don’t miss the next post to get recommendations regarding safe and successful discontinuation of sleep medication

When sleep medications are incorrectly discontinued, people may be unable to sleep and draw an erroneous assumption that it means they cannot sleep without a sleep aid. Some medicines can have dangerous withdrawal if not appropriately tapered. This article will go over some general guidelines to consider when making a plan to discontinue sleep aids.

 

Related posts and book recommendations:

If you are using melatonin make sure you read this: Recommended melatonin dosage for adults: You may be surprised!

 

Fall Prevention in the Elderly: Improve Sleep and Reduce Anxiety Without an Increased Risk of Falling

Preventing falls in the elderly can significantly improve quality of life. Unfortunately, falling and injury happen too frequently. Fall prevention in the elderly is the result of common sense safety planning and education regarding contributing factors that set people up to fall. Many frequently used medications increase these risks, especially sleep aids and certain anxiety medications. But insomnia and anxiety also impair quality of life and need to be treated. Learn more about the risks and safer alternatives that can help.



Why is fall prevention in the elderly so important?

Preventing falls in the elderly can significantly improve quality of life. Fall prevention in the elderly needs to include education about increased risks from sleep aids and certain anxiety medications.

Here is a quote from the National Council on Aging that sums up why it is essential to do everything we can to minimize the risk of falling. These are some scary facts!:

 

“According to the U.S. Centers for Disease Control and Prevention:

  • One in four Americans aged 65+ falls each year.
  • Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.
  • Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.
  • Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.
  • In 2015, the total cost of fall injuries was $50 billion. Medicare and Medicaid shouldered 75% of these costs.
  • The financial toll for older adult falls is expected to increase as the population ages and may reach $67.7 billion by 2020.”

Why are so many older adults prescribed medication that can increase the risk of falls?

Preventing falls in the elderly can significantly improve quality of life. Fall prevention in the elderly needs to include education about increased risks from sleep aids and certain anxiety medications.

Many medications increase the risk of falling in the elderly but oftentimes psychotropic medications are the culprit. It would be easy to say “just don’t prescribe them!” but, of course, it isn’t that simple.

Here are 3 examples of why a medication that increases fall risk gets prescribed:



1. Decreased quality of sleep: An unfortunate reality of aging is decreased quality sleep. (This article tells you why. Hint: It’s related to melatonin). Lack of sleep can feel torturous and sleep deprivation also sets people up to make clumsy or careless mistakes that they may not have made if they were more rested.

 

Naturally, people want to sleep so

they ask their physician for a sleep aid.

 

2. Anxiety: Anxiety is a common and uncomfortable condition and people understandably want to feel better as quickly as possible. Medications that work quickly to minimize anxiety increase the risk of falls in the elderly. Safer alternatives don’t work as quickly as a benzodiazepine so this makes these quick-acting medications tempting (and sometimes necessary) to use.

 

3. A person is already on the medication or was treated with it successfully in the past so they want it back: Maybe the person has tried multiple different medications and has found certain medications are the only ones that work well for their particular condition. They took the medication in the past and want it restarted or perhaps they are currently taking the medication. If the medication helps them feel better and they have no noticeable side effects they may have no motivation to come off the medication based upon theoretical risks.

Preventing falls in the elderly: Sleep aids and risk

Preventing falls in the elderly can significantly improve quality of life. Fall prevention in the elderly needs to include education about increased risks from sleep aids and certain anxiety medications.

There is a clear, established, association between certain sleep aids and increased risk for falls (and an increased risk of dementia! This risk is becoming clearer with recent data).



Here is a quote from a research article published in Sleep:

 

Compared with older adults who did not use sleep medications, those who used physician-recommended sleep medications at baseline were approximately 34% more likely to report a fall at follow-up.

These hypnotic (sleep-inducing) medications like the benzodiazepines and “Z-drugs” can all increase fall risk:

  • Xanax/ alprazolam,
  • Ativan/ lorazepam,
  • Klonopin/ clonazepam,
  • Ambien/ zolpidem,
  • Sonata/ zaleplon,
  • Lunesta/ eszopiclone.

RULE:

If a medication causes sedation (it’s hard to help people fall asleep without some sedation!) it can increase fall risk. Reaction time and postural control (the ability to know where your body is in space and correct balance when it gets off center) decrease when someone is sedated.

 

For example: Think about how often falls happen when people get out of bed at night and try to walk to the bathroom. They are not only sedated but the risk is elevated in dim lights when the eyes can’t compensate for the bodies’ lack of spatial awareness.

What are the alternatives to improve sleep and anxiety?

Behavioral treatments for sleep are effective. These include maximizing sleep hygiene (for a review of what this is and how to improve sleep hygiene read this article) and dealing with sleep-related worries through cognitive behavioral therapy for insomnia (referred to as CBTi. Read more about this here). Mindfulness and relaxation exercises can help and don’t have any side effects.



If medication is necessary, there are options that have less risk than classic sleep aids.

2 medications that have less risk of falls:

1. Melatonin:

Melatonin, an over-the-counter sleep aid (Read my recommendations for dosing melatonin). This medication may have less risk however that doesn’t mean NO risk. It is still sedating and can cause morning drowsiness for some people.

2. Trazodone:

Trazodone (a really old antidepressant medication that is SO sedating people cannot tolerate it in the doses necessary to treat depression) is used pretty much exclusively for sleep now. This medication can have side effects too and also can interact with some other medications. There is more information on these facts in this article,

Alternatives for the treatment of anxiety:

For anxiety, there are treatments like psychotherapy (how therapy works is explained here), and antidepressants. Both of these options can treat anxiety without the same risk that happens with a benzodiazepine (listed above).



Fall prevention in the elderly

Insomnia and anxiety impair quality of life and need to be taken seriously. Weighing the risks and benefits of each treatment option is essential to come up with the best (safest and most effective) choice for each person. The crux of fall prevention in the elderly is to balance treating the symptoms while taking the risks seriously and minimizing them with safer alternatives whenever possible.

For more discussion on sleep and aging read this article:

Sleep and aging: What happens to our sleep and how to make it better

 

Recommended melatonin dosage for adults: You may be surprised!

Melatonin is widely used to treat difficulties with sleep and is readily available given the lack of need for a prescription. Because it is classified as a dietary supplement (not a drug) it isn’t regulated by the FDA and there aren’t any dosing parameters set. This has led to a lack of clarity about the recommended melatonin dosage for adults. The dose people take often varies by their best guess and the pill strength sold in the store they are in. What is melatonin and should you take 3mg? 10mg? The recommendations are vague so no wonder people are confused about how to use melatonin!



By the time people come to see me for a consultation, most who struggle with sleep are either already taking melatonin or have tried it. They take a wide range of doses (generally between 3-30mg but most often 5-10mg). It seems the general theory is “more is better!”

These high doses may not be needed and may actually be less effective!

What is Melatonin?

Melatonin is widely used but the recommended melatonin dosage for adults is unclear. What is melatonin? Learn the dose of melatonin recommended (you may be surprised!) and details about how to use melatonin to help you get better sleep.

Melatonin is a naturally occurring hormone derived from serotonin and is produced in the brain’s pineal gland. It plays several roles in the body but today we will focus on its effects as a sleep hormone regulating our circadian rhythm. Melatonin helps us know when to sleep and wake.

 

Melatonin is controlled by light and darkness. It increases when it is dark outside (usually starting to increase 2 hours prior to bedtime) signaling the body that it is time to go to sleep. When the sun is out we don’t produce melatonin.

What does Melatonin do for sleep?

Our circadian rhythm is like a built-in clock, influencing our sleep habits. Melatonin helps set this circadian rhythm and can normalize it when we get off track due to things like jet lag or night shift work.



Meta-analysis shows melatonin:

 

  • Decreases the time it takes to fall asleep
  • Increases total sleep time
  • Improves sleep quality
  • The effects don’t appear to fade with continued use
  • It has minimal side effects and is generally accepted as safe.
  • It is used in both children and adults.
  • Little dependence potential
  • Many studies have supported it is effective within 1 hour.
  • Melatonin does not suppress REM sleep (the part of sleep when we dream) or change sleep stages unlike what happens with other sleep aids (benzodiazepines or Ambien/Lunesta/Sonata) that target different brain receptors (GABA).

The recommended dosage of melatonin for adults:

Melatonin is widely used but the recommended melatonin dosage for adults is unclear. What is melatonin? Learn the dose of melatonin recommended (you may be surprised!) and details about how to use melatonin to help you get better sleep.

 

The physiological dose (the dose our body naturally produces) of melatonin is 0.3mg when we are young adults. Melatonin levels in young adults are 10x higher during the night than during the day. The higher levels help us fall asleep initially and also help us quickly fall back to sleep when we wake during the night.

 

However, taking more melatonin does not necessarily translate to additional sleep. Several studies report that low dose melatonin works better than higher doses.

 

MORE MELATONIN DOES NOT MEAN MORE SLEEP

 

Dosing recommendations vary but low-dose is generally considered between 0.2-1mg. Several articles recommend 0.2-0.5mg after the 1mg dose was not shown to be more effective than 0.5mg.

 

Despite these studies supporting low-dose melatonin, strengths generally available in stores are between 3-10mg. It takes effort to find a 1mg dose and I have only seen lower doses offered online in liquid form.

 

Here is what we use in my house:

A higher dose of melatonin may actually make sleep worse!

Melatonin is widely used but the recommended melatonin dosage for adults is unclear. What is melatonin? Learn the dose of melatonin recommended (you may be surprised!) and details about how to use melatonin to help you get better sleep.

Higher doses can cause some users to become insensitive to the effects of melatonin because the melatonin receptors essentially turn off when exposed to high amounts.

 

Per a Touch Neurology article:

 

Very high doses may also desensitize melatonin’s receptors in the brain, subsequently diminishing melatonin’s efficacy in promoting sleep. 

Although side effects are generally mild, much larger doses can cause morning grogginess, lower body temperature, and increased prolactin.



Melatonin and Aging

Melatonin is widely used but the recommended melatonin dosage for adults is unclear. What is melatonin? Learn the dose of melatonin recommended (you may be surprised!) and details about how to use melatonin to help you get better sleep.

Production of melatonin decreases with age as our pineal gland gets calcified and less able to produce melatonin. Because of this melatonin has been studied in older adults to see if replacement can improve total sleep time and sleep efficiency (both of these are reduced in aging).

 

In a study of adults over 50, a dose of 0.3mg was shown to be effective. Doses of 0.2-0.5  were shown to restore nightly levels to those of young people for several hours.

 

Because the effect may not be maintained through the night, some people take another dose when they wake in the middle of the night to help maintain sleep for the rest of the night.

Using electronics at night changes melatonin release!

Melatonin is widely used but the recommended melatonin dosage for adults is unclear. What is melatonin? Learn the dose of melatonin recommended (you may be surprised!) and details about how to use melatonin to help you get better sleep.

You may have heard the recommendations to avoid using any electronics starting 2 hours before bed as part of sleep hygiene recommendations. The reason for this is because the blue light emitted by screens (tv, computer, phone, etc) suppresses the rise in melatonin levels making it more difficult to fall asleep.

 

2 options for people who don’t want to avoid using electronics at night:

 

 

There isn’t a ton of good science on the use of blue light glasses (there are many unfounded claims on social media regarding the benefits of daytime usage to prevent eye strain, migraines, etc) but the idea behind blocking it in evening (blue light is a wavelength of light that blocks melatonin) makes sense with minimal cost to try.

3 Pointers for how to use melatonin and recommended melatonin dosage for adults:

Melatonin is widely used but the recommended melatonin dosage for adults is unclear. What is melatonin? Learn the dose of melatonin recommended (you may be surprised!) and details about how to use melatonin to help you get better sleep.

****Important: These recommendations do not constitute medical advice or a treatment relationship. They are here to provide you with education so you can discuss if melatonin usage if right for you with your own doctor.****



  1. Before buying a 10mg pill of melatonin consider trying a low-dose first (0.2-0.5). Several studies have shown low dose to be more effective and it mimics the natural levels that are released in our bodies. With low dose, there is less chance to feel groggy the next day. Get liquid melatonin for easier titration of the dose.
  2. If you have been taking a higher dose and find it is not effective, give your body time to allow the melatonin receptors to function properly again (remember they can shut themselves down when faced with extra melatonin). Then retry melatonin at low-dose.
  3. If you struggle with waking and having difficulty falling back to sleep in the middle of the night consider trying a 2nd low-dose of melatonin to see if you are able to stay asleep more effectively (as long as you don’t get daytime sedation).
  4. Consider using blue light blocking glasses in the evening when using electronics. Given the current culture of constant connectedness, the recommendations to eliminate electronics for 2 hours prior to bed are generally not popular or followed.

What are your experiences using melatonin? Have you tried low-dose and found it to be effective?

My most popular sleep articles for you to enjoy (if you don’t like them maybe they will at least put you to sleep?):

 

8 Great Options to Treat Insomnia (Without Medication)

Can’t sleep? Back to basics!

The Truth About Alcohol and Sleep

Coffee before bedtime? How does caffeine affect sleep?

Sleep and aging: What happens to our sleep and how to make it better

 

 

 

 

 

ADHD and Sleep: 6 Things People With ADHD Can Do to Get More Sleep

Sleep is an essential ingredient for a fully functioning, well-performing brain. In particular, it can assist in boosting moods, increasing focus, improving concentration, and helping with general health and well-being. For people with ADHD, lack of sleep can contribute to an increase in the symptoms of ADHD.  Sleep and ADHD often don’t go well together-  difficulties with sleeping are common with ADHD. Get more sleep by using these 6 simple tips. ADHD and sleep problems don’t have to go hand in hand!

Are you concerned that ADHD may impact you or your loved one?  Take this free online test now: Click here



For a person on an effective ADHD stimulant medication, at times the medicine will seem to not work for a day. When we investigate, we discover that the medicine doesn’t feel like it is working when their sleep cycles are off. They are not getting restorative sleep. The “energy” of the medication goes to helping them wake up without enough left over effect to help them focus and concentrate.

ADHD and sleep problems: Is it a side effect?

Another important point about sleep and ADHD relates to side effects of stimulant medication. One of the side effects of stimulants is lack of sleep. Make sure you are not taking this medicine too late in the day. For most people, as long as it is taken in time, the levels will be low enough by bedtime not to interfere.

 

Here are six tips that can help people with ADHD get a sound night’s sleep. Which ones can you can adopt to improve your sleep?

 

1. Get more sleep by creating a habitual bedtime and wake-up routineFrequently ADHD and sleep problems go together. Try these 6 tips for sleep and ADHD to get more sleep. Small changes can help people with ADHD improve sleep

 

For better quality sleep, go to bed and wake up at a consistent time. This will help get your body and mind into a regular routine. Your body’s internal clock helps to regulate the sleep/wake cycles. Per the Sleep Advisor website, humans are natural cravers for consistency and this goes for your sleep schedule also. 

 

Routines can be even more important for those with ADHD. It is easy to get off task. Having a set pattern that is followed nightly can contribute to more consistent rest.



2. Exercise is great to improve sleep in people with ADHDFrequently ADHD and sleep problems go together. Try these 6 tips for sleep and ADHD to get more sleep. Small changes can help people with ADHD improve sleep

 

Exercise isn’t only used to stay in shape, have good health, and overall well-being; it also lends itself to high-quality sleep. For people with ADHD, exercise improves the ability to focus and concentrate during the day. There is no shortage of benefits for exercise!

 

Don’t work out right before you get in bed as this will stimulate the brain and body, making it harder to sleep. Instead, exercise earlier in the day. This will help you drift off more easily at bedtime and will also assist you to stay asleep once you get to sleep.

 

3. ADHD and sleep: Leave hyperfocus activities for the daytimeFrequently ADHD and sleep problems go together. Try these 6 tips for sleep and ADHD to get more sleep. Small changes can help people with ADHD improve sleep

 

To enjoy a sound sleep, any hyperfocus activities should be kept away from the evening’s activities. Hyperfocusing, as many with ADHD will be aware, can be especially tough to disengage from, leaving a smooth transition into bed unlikely.

 

It’s worth bearing in mind that it isn’t just people with ADHD who can find themselves getting sucked into hyperfocusing instead of going to sleep. This is easy to do with the use of smart devices such as phones, computers, and tablets.

 

Remedy the temptations by eliminating them from your bedroom. That means no television, no scrolling through social media on your mobile phone, or watching Netflix on your tablet while you’re in bed.



Even books can be a “problem”

If you are someone who hyperfocuses while reading books you may have to stop reading in bed. Reading is a calming activity that helps many people ease into sleep relaxation. However, if you are someone that can’t stop reading once you start than reading does not serve that purpose for you. Try setting a timer to help you remember you need to stop and go to bed. But you have to be able to listen to the alarm and stop. If you are someone that will keep reading rather than get to bed you may have to keep books out of your bedroom too!

 

4. Solve ADHD and sleep problems by slipping into a warm bathFrequently ADHD and sleep problems go together. Try these 6 tips for sleep and ADHD to get more sleep. Small changes can help people with ADHD improve sleep

 

ADHD and sleep problems go hand and hand when there is a lot on one’s mind. There’s no doubt that overanalyzing when trying to get to sleep can ruin your chances of actually achieving healthy amounts of time asleep. Practicing calming activities before bed can shift the mind from overdrive to rest. 

 

Run a warm, relaxing bath (or shower, if you don’t have a bath). Soaking in the tub can be beneficial in facilitating relaxation and self-soothing. For added relaxation, do a mindfulness or grounding exercise while taking the bath. See the list on my resources page for lots of great apps to help you practice mindfulness. 



5. Sleep and ADHD: Take the worry away by jotting it downFrequently ADHD and sleep problems go together. Try these 6 tips for sleep and ADHD to get more sleep. Small changes can help people with ADHD improve sleep

 

Once your head lays on your pillow, try to clear from your thoughts any issues, problems, and worries that have come along in the day. These thoughts can be a sleep-induction killer- meaning it’s really hard to fall asleep while actively worrying. 

 

Some people with ADHD find it beneficial to write things that are bothering them down. Keep paper and pen on your bedside table so you can jot down whatever it is that’s in your head. Don’t use your phone to take notes as it’s too tempting to start to scroll!

 

6. Remain positive to get more sleepFrequently ADHD and sleep problems go together. Try these 6 tips for sleep and ADHD to get more sleep. Small changes can help people with ADHD improve sleep

 

A nice way to kick off sleep is to imagine the favorite locations you’ve been to, and then re-enact the sounds that you heard while you were there. Let your mind drift to that happy place and the good feelings will help ease you into enjoyable sleep.

 

Allow your mind to readjust and refocus away from worries or your never-ending to-do list. Use this technique to hone in on happy, calm thoughts.



Final thoughts on sleep and ADHD:

 

These are just six of the things that you can add into your life in order to help enjoy better, more restorative sleep. Use trial and error to see what works best and simply go from there. Remember that it takes practice to develop a new habit. Don’t expect the ability to fully relax your mind the first time you try!

 

For more tips on improving your sleep read these posts on insomnia and how to get the best sleep. Once you get more sleep your rested self will thank you!

 

3 New Year’s Resolutions to Improve Your Mental Health

The new year is a time to refocus priorities and set goals for the upcoming year. This year make a New Year’s resolution that will improve your mental well-being. Read ahead for 3 suggestions on how to improve your mental health!

Don’t set a goal by listing the end result you want! Break it down into smaller steps.

The more general or vague goals are, the less likely they will be achieved. Saying “I want to lose weight” is much less effective than saying “I am going to cut out soda”.




Or instead of thinking “I’m going to get in shape” plan out the necessary steps to do it such as “I’m going to go walking with my friend during our lunch break 3 times per week”.

 

Breaking goals into manageable steps makes them less intimidating to tackle.New Years Resolution to benefit your mental health

New Year Resolutions: Sleep better in 2018!

Sleep is one of the basic foundations for how we feel yet it is frequently put low on the to-do-list. Refresh yourself by getting quality sleep. Sometimes there are simple things you can change to make sleep better. (Read more for ideas how to make sleep better).

Ideas for sleep resolutions:

What wakes you up at night? Make changes that specifically target what is getting in the way of your sleep.

 



New Year Resolutions: Volunteer in 2018!volunteer

Find a volunteer opportunity this year. Multiple studies have documented the beneficial effects of volunteering on mental and physical health. Volunteering improves life satisfaction, self-esteem, and happiness. It can lower depressive symptoms and psychological distress (read more here).

 

Volunteering can help you feel more connected to others and result in decreased loneliness and social isolation. Social interaction improves mental and physical health and decreases the risk of depression and anxiety. Volunteering can help you feel less bothered by the stress of daily life and experience a greater sense of purpose and fulfillment. Volunteering can increase self-confidence, self-esteem, and feelings of self-worth.

 

What volunteer work could you do this year? There are endless different types of volunteer organizations and opportunities. What interests you? This could be a perfect way to improve your mental and physical health in 2018 — and help others while you are at it!improve your mental health

New Year Resolutions: Exercise to beat depression in 2018!

Set yourself up for success with exercise this year by defining your goals thoughtfully. Make specific and achievable plans.

exercise goal

Don’t decide your goal is to start running and complete a marathon all in 1 year. Even if you start to run (success!) you may feel discouraged if you don’t progress to marathon distance and give up running completely. This negative cycle gets internalized: “I hate running”, “Running is too hard and I’ll never be good at it”, “I’m not strong enough to run a marathon”.

 

Exercise isn’t just about physical fitness–it also benefits your mental health.

 

Start with a plan that helps you feel successful. Can you commit to walking up and down your stairs for 5 minutes a day? Walking outside for 10 minutes 3 times each week? Joining a relaxing restorative yoga class once a week? Can you exercise with a coworker at lunch for 15 minutes twice a week?

 

Feel proud of what you accomplish because this will help you continue to feel motivated. And literally, I mean this. Make a big deal to yourself when you accomplish your goal. Pat yourself on the back and tell yourself “I did a great job today! I achieved my goal of walking for 10 minutes! Great job, me!”.

 

It is helpful to plan out your exercise ahead of time. Is your goal to run 1 mile 3 times each week? Then schedule it on your calendar and check it off when you are done. Don’t schedule all the other things you need to do but leave exercise off the calendar or it becomes an afterthought and life gets busy.

 

Are you thinking, “Well, what are 10 minutes 3 times per week going to do? Why bother?” If you feel good about what you are doing it will be easier to keep building on your success.

 

There are studies to back up exercise as an antidepressant with even 1 hour total each week! You can achieve this as long as you get started!

 

Here are quotes from the study that talks about exercise to treat depression:Exercise to beat depression

 

“Most of the protective effect of exercise is realized with relatively low levels of exercise, with no indication of any additional benefit beyond 1 hour of exercise each week,” the investigators note.

 

“The protective effect was seen equally across all groups, regardless of the intensity of exercise that was undertaken or the gender or age of the participants,” they add.

“The results of this study indicate that relatively modest increases in the overall amount of time spent exercising per week may be able to prevent a substantial number of new cases of depression,” they conclude.

Are you looking for more ideas about how to improve your mental health in 2018?

Visit the mental health bookstore for a list of excellent mental health books recommended by physicians, mental health providers, and patients that have found them useful.

 

Does your insurance deductible start over in 2018? Read my blog on how to save money on your medication. Don’t throw your money away this year!save money on medication

Improve your mental health! 8 books to get you started:

Sleep and aging: What happens to our sleep and how to make it better

Oh, the joys of aging and sleep!

Insomnia in the elderly is a frequent struggle. The amount of sleep people need (and the quality of sleep) changes over a lifetime.  Sleep may be affected by genetics, mental health, physical health, and medications. These changes can be part of the normal aging process and can happen independently of medical or psychiatric illness.

Sleep and Aging: What frequently happens with insomnia in the elderly?



  • Reduce total sleep time,
  • Cause daytime sleepiness,
  • Increase the number of times you wake up after you fall asleep (reduce sleep efficiency),
  • Reduce dream (REM) sleep,
  • Cause a lighter sleep,
  • Reduce the amount of slow wave sleep so there is less restorative sleep,
  • Shift your circadian rhythm so you are sleepy earlier in the evening and wake early in the morning.

 

Read here for an in-depth article of everything you ever wanted to know about aging and sleep.

Treatment of insomnia in elderly individuals:

There are many treatment options for sleep problems.

Aging and Sleep Hygiene

Before medication is considered it is important to optimize sleep hygiene. Older adults can be more sensitive to environmental disruptions (ie noises and light) so try to set up your sleep space as interruption-free as possible.

 

Learn more about sleep hygiene by reading my post full of tips to help you sleep better: Can’t sleep? Back to basics!

Cognitive Behavioral Therapy for insomnia:

If changes in sleep hygiene don’t solve the sleep issues try cognitive behavioral therapy for insomnia (CBTi).



 

Worries about sleep, racing thoughts, and negative emotions may cause and perpetuate issues with sleep. CBTi can teach people how to fall asleep faster, stay asleep and feel better during the day even if you don’t have the “perfect” night sleep. The goal is to establish healthy sleep patterns so falling asleep and staying asleep become automatic and natural.

 

Unlike sleeping pills, CBTi helps you overcome the underlying cause of your sleep problems and can help you reduce or eliminate the need for medication. Benefits from CBTi can be sustained whereas effects of a sleeping pill are often short-term.

 

It is important to work with a therapist who specializes in sleep therapy. If you are having trouble finding someone in your local area or if it is more convenient to find treatment online there are several online programs that can be very helpful. See my post on CBT for insomnia for a list of online options.

Insomnia in the elderly: Are Sleep Medications Safe?What changes can happen to sleep as we age? Insomnia in the elderly is a frequent struggle. Treatment of insomnia in elderly individuals must be done carefully in order to minimize risks while improving sleep. Sleep and aging no longer need to be mutually exclusive!

If medication is necessary to treat the sleep issues a careful risk/benefit analysis with your doctor should be done first. Unfortunately, as you age you may be more at risk of side effects.

 

It may seem quick and easy to take a medicine for sleep, and sometimes it is necessary, but be aware of the risks. Not to sound too dramatic…… but it would be terrible if you got up in the middle of the night to go to the bathroom, fell, and broke a hip because your balance was impaired from a sleep aid!

 

There are several medications used for sleep known to potentially affect balance. Here are a few culprits (not a complete list): Ambien (zolpidem) and benzodiazepines like Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam),  and Klonopin (clonazepam).

 

Sometimes people are able to get away with using a tiny dose of Benadryl or melatonin or taking a small amount of a prescription medication. However, just because medications are over the counter doesn’t mean they don’t have potential risks!

 

Make sure you do not drink alcohol if you take a sleep aid as the extra sedation can be even more dangerous for you. To learn more about alcohol’s effects on sleep read my blog on this topic.

 

Use care if you do take a sleep aid and put precautions in place that can minimize fall risks.

Insomnia in the Elderly: Take precautions when you get up during the night!

Fall precautions are a good idea regardless of whether you are taking a sleep aid or not.

  • Get up slowly from bed.
  • Create a clear path to the bathroom.
  • Remove throw rugs.
  • Get a nightlight to illuminate your path.
  • Use a cane at night to help you be more steady.

 

Changes in sleep quality and quantity frequently happen with aging. Make sure to take common-sense preventative steps and precautions when trying to improve your sleep.  Eliminate behaviors that could be making it worse such as drinking coffee, soda, or caffeinated tea during the day. Improve sleep hygiene and try to treat insomnia with cognitive behavioral therapy. If your sleep is still a problem discuss the risk and benefits of sleep aids with your doctor to see if a medication trial is right for you.

 

I recommend these products and books to help improve your sleep:

 This post contains affiliate links to Amazon. Dr. Melissa Welby is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. Amazon offers a small commission on products sold through their affiliate links. The prices you pay through these links are the same as you would pay going to Amazon directly. Your purchases via the Amazon affiliation links help support the upkeep and maintenance of this blog.

8 Great Options to Treat Insomnia (Without Medication)

Do your worries keep you awake at night? Restorative sleep is so important for our health yet is often sabotaged by anxiety.  If you are a “sleep worrier” you may benefit from Cognitive Behavioral Therapy for insomnia (abbreviated CBTi). CBT for insomnia is a targeted insomnia treatment that can have long-term benefit and doesn’t require taking medication.

Some signs you may benefit from CBT for Insomnia:

When you have trouble falling asleep or wake in the middle of the night:

  • Do you check the clock to see how many hours you have left until morning?
  • Are you someone that calculates the hours you need to function well the next day?
  • Do you start to worry about how awful you will feel the next day, how you will not have the energy to take care of what you need to do, or will most certainly fail your exam?

If your worries help you fall back to sleep then stop reading this and keep worrying! If like the rest of us, worries actually keep you awake consider trying cognitive behavioral therapy for insomnia.

CBT for Insomnia:



Do your worries keep you awake at night? Restorative sleep is often sabotaged by anxiety. If you are a "sleep worrier" you may benefit from cognitive behavioral therapy for insomnia. In this post, you will find great online CBT for insomnia programs and apps for sleep including programs to learn meditation for sleep.

CBTi can teach people how to fall asleep faster, stay asleep and feel better during the day even if you don’t have the “perfect” night sleep. The goal is to establish healthy sleep patterns so falling asleep and staying asleep become automatic and natural.

 

The techniques learned in CBTi help address factors associated with insomnia (like racing thoughts, worry, and negative emotions). Unlike sleeping pills, CBTi helps you overcome the underlying causes of your sleep problems and can help you reduce or eliminate the need for medication.

 

Dr. Steph, MD is a sleep specialist who writes a blog all about sleep. Here is a great post she wrote: 5 Steps to Remove Worries from Bedtime

 

CBTi is evidence-based therapy shown to be effective in scientific trials. Some studies show 70% of people who do CBT for insomnia obtain a lasting benefit. They can have sustained improvements whereas effects of a sleeping pill are often short term.

Treatment for Insomnia: Online Resources for Sleep

I have compiled a list of online resources and phone applications helpful in treating insomnia. Online resources are a great option for people who don’t have a local therapist who practices CBTi or who want to try the treatment on their own. These are not the only programs available and resources are continually being developed.



Before starting CBTi make sure to review sleep hygiene and address other sleep-interfering behaviors you may have. For a review of sleep hygiene read my post on Sleep Basics. Dr. Kristen Stuppy, pediatrician, also writes a great post on Sleep Tips that is helpful for all ages.

Treatment for Insomnia: Online CBT for Insomnia:

Sleep Improvement Programs:

http://www.myshuti.com
https://www.sleepio.com/cbt-for-insomnia/
http://www.cbtforinsomnia.com

CBT for Insomnia Phone Applications:

CBT-i coach

The app will guide users through the process of learning about sleep, developing positive sleep routines, and improving their sleep environments. It provides a structured program that teaches strategies proven to improve sleep and help alleviate symptoms of insomnia.
iPhone

Android

 

Beneficial Apps for sleep:

Mindfulness and Meditation for Sleep

Calm App:

For mindfulness and meditation to bring more clarity, joy and peace to your daily life. Experience less anxiety and better sleep with our guided meditations, sleep Stories, breathing programs, and relaxing music. 

iPhone or Android 

 

Headspace App:

Perform at your best through the life-changing skills of meditation and mindfulness. With the free Basics pack, Headspace teaches you the essentials of living a healthier, happier life. If you enjoy the Basics, then it’s time to subscribe. Once you do, you’ll have access to hundreds of meditations on everything from stress and anxiety to sleep and focus.

 iPhone or Android

 

Simply Being:

Enjoy the deep relaxation, stress relief and benefits of meditation without prior experience. You can choose from 5 meditation times and you have the option to listen to the guided meditation alone or with music or nature sounds. You can also listen to the music or nature sounds alone. In addition, you can choose how long to listen to the music or nature sounds after the voice guidance finishes.

iPhone or Android

 

Insight Timer:

Insight Timer is a most popular free meditation app with a lot of free content:
– Stream 8,000 guided meditations
– Stream 1,000 music tracks
– Follow 1,600 meditation teachers and 500 Topics
– 5,000 discussion groups
– Stats and milestones for tracking your progress
– Device syncing
– Integration with Apple Health

iPhone or Android

 

Want more information on how to improve your sleep?

Read these posts:Do your worries keep you awake at night? Restorative sleep is often sabotaged by anxiety. If you are a "sleep worrier" you may benefit from cognitive behavioral therapy for insomnia. In this post, you will find great online CBT for insomnia programs and apps for sleep including programs to learn meditation for sleep.

The truth about alcohol and sleep

Coffee before bedtime?

Sleep and aging: What happens to our sleep and how to make it better

 

Sleep is too important to sacrifice. If you are struggling with insomnia get yourself the help you need. Treatment doesn’t have to mean taking an insomnia medication. There are great online resources that you can take advantage of from the comfort of your own home.

 

In addition to the links above, I recommend the following products and books to help improve your sleep and treat insomnia.

 

 

Do your worries keep you awake at night? Restorative sleep is often sabotaged by anxiety. If you are a "sleep worrier" you may benefit from cognitive behavioral therapy for insomnia. In this post, you will find great online CBT for insomnia programs and apps for sleep including programs to learn meditation for sleep.

This post contains affiliate links to Amazon. Dr. Melissa Welby is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. Amazon offers a small commission on products sold through their affiliate links. The prices you pay through these links are the same as you would pay going to Amazon directly. Your purchases via the Amazon affiliation links help support the upkeep and maintenance of this blog.

Any product I recommend on this site I believe to be a good quality product and are not influenced by being an Amazon affiliate.

 

Can’t sleep? Back to basics!

Is your sleep suffering? Can’t sleep at all? Let’s talk about sleep problems, some basic information about sleep and sleep hygiene, and how to sleep better. We often don’t make the connection between poor sleep and habits we have that interfere with it. Quality sleep is essential to feeling well. We feel lousy when we have a lack of sleep! Chronic lack of sleep can have medical consequences and make it hard to recover from an illness like depression.

How to Sleep Better: Sleep Hygiene




You may be able to improve sleep by practicing better sleep hygiene. Sleep hygiene is really about getting back to basics: minimizing disruptions while sleeping, maximizing comfort, and identifying things interfering with sleep while adding in things to improve sleep. Here is a link to a great review of sleep hygiene that will help you figure out how to improve your sleep problems.

Is your sleep suffering? You can't sleep? Let’s talk about sleep problems, information about sleep and sleep hygiene, and how to sleep better. Many of us have habits that can interfere with sleep. Quality sleep is essential to feeling well. Lack of sleep causes us to feel lousy.

 

How many people do you know who drink coffee later in the day or drink alcohol before bed? Read my previous posts on caffeine and alcohol’s effects on sleep to see what happens to sleep when we drink these.

 

There are often a lot of things we can do on our own to help get a better nights sleep.

 

Dr. Steph, MD is a sleep specialist and writes all about sleep.  She has a post related to sleep hygiene with great recommendations on how to sleep better: 6 Ways to Optimize your Sleep Environment.

 

It’s not just us adults that can use some help with our sleep. Dr. Kristen Stuppy, pediatrician, writes about sleep-deprived teens. Teens have habits (excessive cell phone use is a big one) and activities (sports, early school hours, lots of homework) that interfere with any chance of getting enough sleep. There are consequences to this sleep deprivation. “Teens are at the highest risk for falling asleep at the wheel”. She includes good sleep hygiene suggestions specifically geared towards this age group.



Sleep Problems and Sleep Cycle

There are different stages of sleep:

Is your sleep suffering? You can't sleep? Let’s talk about sleep problems, information about sleep and sleep hygiene, and how to sleep better. Many of us have habits that can interfere with sleep. Quality sleep is essential to feeling well. Lack of sleep causes us to feel lousy.
Stages of Sleep

Insomnia can involve difficulty falling asleep, difficulty staying asleep, non-restorative sleep or some combination of all of these. We need to get into a deep sleep to feel restored and rested.

 

There are many medical conditions (think sleep apnea) and substances that can interfere with the sleep cycle. An important part of treating insomnia is figuring out what the source of it is.

Suffering from Lack of Sleep? What are Your Sleep Requirements?

Different people require different amounts of sleep to feel well. I would LOVE it if I felt great with 5 hours of sleep but I just don’t. I know some people who feel their best at 9 hours and lousy at 8. What is your optimum amount? To understand more about your sleep need and the effects of sleep deprivation visit: http://sleepmedicine.com/content.cfm?article=14.

Can’t Sleep? Sleep Debt Happens

Is your sleep suffering? You can't sleep? Let’s talk about sleep problems, information about sleep and sleep hygiene, and how to sleep better. Many of us have habits that can interfere with sleep. Quality sleep is essential to feeling well. Lack of sleep causes us to feel lousy.Unfortunately, when we don’t sleep enough we accumulate a SLEEP DEBT! There are a lot of consequences to chronic sleep debt including obesity, diabetes, heart disease, memory impairment, and stroke.

 

Insulin resistance can be caused by not sleeping enough and is a common reason why people with sleep apnea gain weight. Untreated sleep problems can increase the risk of obesity, insulin resistance, and type 2 diabetes.

 

Luckily research has shown these changes in our body can be reversed by repaying sleep debt. Here is a great summary which includes suggestions on how to repay your debt.

Evaluating Sleep Problems: Epworth Sleepiness Scale

If you find yourself dragging during the day, the Epworth Sleepiness Scale is a rating scale that can determine your level of sleepiness. If you score 10 or above it is recommended you have an evaluation for a possible sleep disorder or an underlying condition affecting your sleep. Here is a link to take the test.

 

For other general sleep information, I recommend the Ohio Sleep Medicine Institute which maintains a fantastic website. It includes information on a plethora of sleep topics pertaining to both children and adults. Go check it out and then get to sleep!

 

Want more information on how to sleep better?

8 Great Options to Treat Insomnia (Without Medication)

Sleep and Aging: What happens to our sleep and how to make it better

 

 

I recommend these products and books to help improve your sleep and treat insomnia:

 

 

 

The Truth About Alcohol and Sleep

Many people believe having a drink will help them sleep better. Insomnia is a common problem and alcohol can help people fall asleep quicker. On the surface this sounds great but what does alcohol REALLY do to one’s sleep? Shall we stop prescribing sleep aids and recommend everyone have a few shots of liquor instead? Read here to learn more about the side effects of alcohol and if alcohol and insomnia are related. Does alcohol cause insomnia? If you are wondering how to sleep better and feel fresh the next day you may need to skip that cocktail with dinner.

Alcohol and Sleep: Different Parts of SleepAlcohol and sleep

In order to understand what alcohol does to sleep it’s important to learn about the different parts of sleep. Sleep is made up of superficial sleep, dream sleep (called REM sleep), and deep sleep (called slow wave sleep). We rejuvenate ourselves during deep sleep. This is what helps us to have a restful night’s sleep. For an adult, normally the majority of our deep sleep happens in the second part of the night and comprises 20% of our total time asleep.

Alcohol and Sleep: Does Alcohol Cause Insomnia?



These are some significant side effects of alcohol!

After falling asleep alcohol causes us to enter deep sleep quicker but then what happens? A frequent complaint is that people wake up between 1-3am and then get poor sleep the rest of the night. Alcohol is rapidly metabolized and as the alcohol leaves the bloodstream it leads to shallow sleep with multiple awakenings.

 

Since dream sleep is inhibited by alcohol in the first part of the night there can be a “rebound” of dream sleep which can lead to nightmares or vivid dreams.

 

Alcohol can disturb our bodies ability to regulate temperature causing sweating.

 

Sleep-disordered breathing is made worse by alcohol. Alcohol causes the throat muscles to relax and masks the effect of low oxygen in the bloodstream in our brain’s breathing center. Alcohol can cause “non-snoring” people to snore and even have their breathing interrupted in sleep (called apnea). Hangover symptoms are partially caused by this breathing-disordered sleep!

Alcohol and Insomnia

Dr. Steph, MD is a sleep specialist who writes all about sleep. In her blog post called Alcohol & Sleep she writes about the side effects of alcohol on sleep:

 

So how soon before bedtime should you cut off alcohol intake to not have these effects? Even afternoon light drinking has been shown to disrupt sleep. A study where subjects drank in the afternoon but their blood alcohol level was 0.00% at bedtime still demonstrated increased awakenings throughout the night, reduced total sleep time, reduced REM sleep, and reported more “superficial” sleep.

Here is a great article if you want to read more about alcohol and sleep.



Chronic Alcohol Use: Side Effects of Alcohol on Sleep

Alcohol and Insomnia

Alcohol’s effects on sleep are different for people who chronically drink as they become tolerant to the sedative effects of alcohol making it even harder to fall asleep. They have an increase in light sleep with multiple awakenings and a further decrease in restorative sleep.

 

Unfortunately for people who are alcohol dependent sleep changes can persist even after long periods of abstinence. Poor sleep has been shown to be a major reason for relapse.

 

Read more about the side effects of alcohol that happen with chronic alcohol consumption and what that does to sleep.

 

Alcohol and Insomnia: Consider skipping that drink!Alcohol and Insomnia

Overall, alcohol reduces the amount of time we spend in deep sleep. It decreases our sleep efficiency (the ratio of total sleep time to time in bed) and our overall time asleep. Alcohol interferes with the restorative functions of sleep leading people to be more tired all day.

 

For your health and well-being, it is important not to put yourself into a sleep deficit day after day. Poor sleep and stress will cause you to get run down and not perform at your peak. Many people believe alcohol improves their sleep but I hope you have learned the truth about its effects. Unfortunately, if you are having trouble sleeping alcohol is just going to make it worse!

 

Want more information on how to improve your sleep? Read these posts:

Coffee before bedtime?

8 Great Options to Treat Insomnia (without medication)

Can’t Sleep? Back to basics.

Sleep and Aging: What happens to our sleep and how to make it better.

 

I recommend these books and products to help improve your sleep and treat insomnia:

 

This post contains affiliate links to Amazon. Dr. Melissa Welby is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. Amazon offers a small commission on products sold through their affiliate links. The prices you pay through these links are the same as you would pay going to Amazon directly. Your purchases via the Amazon affiliation links help support the upkeep and maintenance of this blog.

Any product I recommend on this site I believe to be a good quality product and are not influenced by being an Amazon affiliate.

 

Coffee before bedtime? How does caffeine affect sleep?

How does caffeine affect sleep?

Sleep aids are a necessary part of treatment for many people suffering from insomnia. However, sometimes it may be as simple as altering the time of caffeine consumption to treat sleep issues. Although it tastes great there are side effects of caffeine. How does caffeine affect sleep? Caffeine significantly diminishes sleep quality and quantity. It takes longer to fall asleep and there is less restorative, deep sleep. Read more to learn about the relationship between caffeine and sleep.



How much caffeine is in coffee?How does caffeine affect sleep? How much caffeine is in coffee? Read about the side effects of caffeine and how long coffee lasts in your body. Caffeine and sleep don't always mix well. Altering time of coffee can improve your sleep- read why.

The average daily consumption of caffeine by adults in the US is ~300mg. The approximate amount of caffeine in 8oz of coffee is 100mg but this varies widely by different beans and brewing techniques.

How much caffeine is in coffee? To check the amount of caffeine in your favorite drinks see this link: http://www.caffeineinformer.com/the-caffeine-database.

Different amounts of caffeine per drink:

  • Kcup 120mg
  • Brewed coffee 163mg
  • Instant coffee 57mgHow does caffeine affect sleep? How much caffeine is in coffee? Read about the side effects of caffeine and how long coffee lasts in your body. Caffeine and sleep don't always mix well. Altering time of coffee can improve your sleep- read why.
  • Dunkin Donuts brewed coffee 178mg
  • Starbucks Grande coffee 330mg
  • Coca-Cola classic 34mg
  • Mountain Dew 54mg
  • Monster Energy Drink 160mg
  • Red Bull 80mg
  • Lipton Iced Tea 48mg
  • Black Tea 42mg.

Side note: Possible health benefits of coffee?

Ok, this may be slightly off the topic of caffeine’s effects on sleep but I don’t want to neglect the possible benefits of your morning coffee!

 

In her blog, fellow physician and coffee lover Dr. Michelle Ramirez, writes about whether coffee is a vice or a virtue. She discusses the possible health risks and benefits of coffee and includes lots of interesting coffee facts. She says:

 

“In general, coffee can help lower your cardiovascular risk and improve your lipid profile, decrease your risk of diabetes, help with your mood and depressive symptoms and it can prevent certain types of cancer. I didn’t mention this, but it can also help to increase your exercise output and your attention. Other studies have also suggested a reduction in development of Parkinson’s disease, risk of suicide and risk of death from all causes. Many potential benefits that reinforce drinking coffee for good health.”

 

Caffeine and Sleep: How is caffeine processed in my body?How does caffeine affect sleep? How much caffeine is in coffee? Read about the side effects of caffeine and how long coffee lasts in your body. Caffeine and sleep don't always mix well. Altering time of coffee can improve your sleep- read why.

Caffeine is completely absorbed within 1 hour but its stimulating effects can be evident in 15 minutes. The time it takes your body to eliminate 1/2 of the caffeine (called half-life) is on average 3-5 hours.

 

Some people are considered fast or slow metabolizers dependent on how fast their liver breaks it down. Half-life is affected by many factors including:

 

  • age (older adults process caffeine slower),
  • prescription medication (this article is a good review of many different medications and their effects on sleep),
  • psychiatric conditions,
  • smoking (causes faster metabolism),
  • pregnancy (slows caffeine metabolism significantly).

 

The importance of half-life is that it determines how long caffeine remains in the system. On average, caffeine effects continue for 8-14 hours.



Caffeine and Sleep: Side Effects of CaffeineHow does caffeine affect sleep? How much caffeine is in coffee? Read about the side effects of caffeine and how long coffee lasts in your body. Caffeine and sleep don't always mix well. Altering time of coffee can improve your sleep- read why.

Coffee doesn’t affect my sleep!How does caffeine affect sleep? How much caffeine is in coffee? Read about the side effects of caffeine and how long coffee lasts in your body. Caffeine and sleep don't always mix well. Altering time of coffee can improve your sleep- read why.

If a person says “I can fall asleep right after I drink a cup of coffee” it doesn’t mean they have an accurate perception of what is happening in their sleep. Studies have shown that even though participants denied any effects on sleep quality these detrimental effects were documented by sleep monitors.  In one study, effects were tested with caffeine dosed 0, 3, and 6 hours before bedtime  http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29198.

 

Caffeine was shown to reduce sleep by approximately 1 hour even when it is drank 6 hours before bedtime!

 

We don’t have studies documenting caffeine’s effects on sleep when consumed 9 and 12 hours prior to bed but we know that the caffeine is still in our system for 8-14 hours. Because of this, I recommend stopping drinking coffee 12 hours prior to bedtime. If this idea causes you to shudder, try at least switching to decaf (which by the way is not entirely caffeine free).

Enjoy your coffee but enjoy it in the morning!

 

Want more information on how to improve your sleep?

Read these posts about sleep:

The Truth about Alcohol and Sleep,

Can’t Sleep? Back to Basics 

8 Great Options to Treat Insomnia (Without Medication).

Sleep and Aging: What happens to our sleep and how to make it better

I recommend these products and books to help improve your sleep and treat insomnia:

 

How does caffeine affect sleep? How much caffeine is in coffee? Read about the side effects of caffeine and how long coffee lasts in your body. Caffeine and sleep don't always mix well. Altering time of coffee can improve your sleep- read why.