Doc’s Corner

Dos and Don’ts After a Bad Night’s Sleep

Insomnia is different than just a bad night of sleep. Insomnia is defined as difficulty falling asleep, difficulty staying asleep, or waking up early in the morning and not being able to return to sleep. In general, people with insomnia sleep less or sleep poorly despite having an adequate chance to sleep. The poor sleep causes difficulty functioning during the daytime. Insomnia is not defined by the number of hours slept because the amount of sleep needed varies from one person to another.
In many cases, insomnia occurs when there is another problem, such as stress, pain, or a medical condition. In these cases, treatment of the underlying problem may help to improve sleep. In other cases, either the cause of insomnia is not clear or the insomnia does not get better when the co-existing problem is treated; therefore, the insomnia itself needs to be specifically addressed.

What to do after a Bad Night?
Ok, you’re dragging after a night of tossing and turning. It’s probably going to be a tough day at work. What can you do to make things a little easier and make sure you sleep better tonight?

Don’t: Hit The Snooze Button
Is there anything sweeter? It’s not like you’re really “sleeping in,” and that extra 10 minutes is just the thing to give you a bit of extra energy, right? Not really. You need up to an hour of extra ZZZs before it helps. Otherwise, you’re really just creating stress for yourself by shortening your morning prep time.

Don’t: Sleep In
You decide to take the morning off. You can make up that sleep from 9 to noon, right? Tempting, but probably a bad idea. You set your body’s “internal clock” when you go to bed and get up at the same time each day. It’s best to stick to that routine, even if you didn’t sleep well. It’ll help get your cycle back on track.

Do: Get Some Sun
It helps your body set its clock. It can also help counter sleeplessness by helping your mood and brain. So if you want to get more sleep tonight than last night, wake up and greet the light of the day. It helps to get out in the middle of the day, too. If you’re in an office, maybe take a little stroll through the park around lunchtime.

Do: Get Some Caffeine, but Not Too Much
If you skip your regular morning coffee or tea, you may get even groggier. It could also make you irritable and give you a headache. So have some. A little extra might even help you stay alert. Remember, though, that it sticks around in your system for several hours. So don’t overdo it. And don’t have caffeine – coffee, tea, or otherwise — close to bedtime.

Do: Exercise — at The Right Time
It can improve your sleep and help you fall asleep more quickly. But don’t do it too close to bedtime because it stimulates your body to make something called cortisol. That’s a hormone that makes you more alert. That’s good when you’re trying to wake up for work. But it’s not so good when you’re trying to get back to sleep. If you must exercise in the afternoon or evening, try to finish at least 3 hours before you go to bed.

Do: Nap — the Right Amount
A 20-minute nap will sharpen your attention and motor skills. A 90-minute one may improve your creative thinking. But naps between 20 and 90 minutes (or your own personal sweet spot) can leave you more groggy than when you started. Set an alarm. Keep in mind that a nap of any length, especially later in the day, can make it harder to get to sleep in the evening. That can lead to a vicious cycle of sleeplessness and a messed-up sleep routine.

Don’t: Drink Alcohol
It can make you sleepy. But after a few hours, as your body processes the alcohol, it wakes you up. And the quality of the sleep you do get after a few drinks may not be as good.

Maybe: Take Melatonin
Your body makes it naturally and usually makes enough. But you can try a supplement of 1 to 3 milligrams 2 hours before bedtime after a sleepless night. It doesn’t make you sleepy, but can have a calming effect that can lead to sleep. Don’t take it if you’re pregnant or breastfeeding. Also stay away if you have seizures, an autoimmune disease, or depression. If you have diabetes or high blood pressure, talk to your doctor before you take it.

Do: Eat Light and Early
If you don’t want to repeat last night’s lack of sleep, a big greasy burger, fries, and a shake at 11 p.m. probably won’t help. Eat a lighter dinner several hours before bed. If you’re hungry later, snack lightly on foods that don’t disturb your sleep. Toast or yogurt are often easy on the system.

Don’t: Smoke
You probably know that smoking is bad for your health. But if you’re already a smoker and you’re trying for a good night’s sleep, try not to do it too close to bedtime. Like caffeine, tobacco is a stimulant that can keep you from getting to sleep. Talk to your doctor about ways to quit smoking for good.

Don’t: Surf the Internet
Too much of any light after the sun goes down can mess up your sleep, but the “blue light” given off by your smartphone, computer, or tablet is especially bad. Calm yourself before bed. Keep your bedroom dark and quiet, too.

Do: Hydrate
You want to drink enough fluids so that you don’t wake up thirsty in the middle of the night, but not so much that you wake up because you need to pee. And of course, avoid alcohol and caffeine close to bedtime.

Don’t: Make Big Decisions
Without proper sleep, your judgment goes down the tubes. Overworked brain cells can’t put thoughts together or remember basic information. Even your basic understanding of an event as it happens may be different. So keep your head together and wait. Things may be clearer after a good night’s rest.

Do: Chill Out for Bedtime
Start to relax as bedtime approaches: no bright lights or stressful talks or activities. All of that can make it hard to fall asleep. Try to keep your bedroom dark and quiet. And cool, too: 60-67 F is ideal.

When to See Your Doctor
Sometimes sleeplessness is natural. A big event in your life — good or bad — may cause it. If this happens now and then, it may be nothing to worry about. If sleep problems start to change your general mood and work habits, it may be time to talk to your doctor. It’s especially true if problems stick around for a month or more. Together, you can figure out why you’re having trouble sleeping and what to do next.

Paul R. Block, MD, FACP, FCCP


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