I am a board-certified clinical sleep psychologist with expertise in sleep, here to answer all your questions about insomnia. Ask Me Anything!

I wake up almost every night at 3am. It usually takes me at least 2hrs to fall asleep again. When my partner isn't with me I'll sometimes put on a TV show that I've seen before. It seems to give me something to occupy my mind without actually being interested in it (to stop the obsessive thoughts about what needs to be done tomorrow or that person who was mean to me in 5th grade). It works about 75% of the time but it isn't really an option when my partner is home.

Are there other strategies that might work when I can't use my TV trick?

There is no exact science to this, but if you are struggling with sleep, it’s time to get out of bed. For most people, we suggest getting out of bed after about 30 minutes, but you don’t have to wait that long if you are really alert and know you aren’t going to fall asleep. You can try getting out of bed and doing a simple activity like folding laundry or reading a book. When you feel sleepy again, return to bed. The most important thing to do when you get out of bed is to get your mind off sleep. Then it will naturally come to the surface. Your strategy of watching some TV works this way too! It takes your mind off of trying to sleep, and then it happens! The secret is to find a way not to try. Exactly what that is varies from person to person, but it could be reading, listening to music or an audiobook (with headphones so you don’t disturb your partner), knitting, or whatever takes your mind off of sleep.

For many people, reaching out to a sleep specialist and working with someone who can do cognitive-behavioral therapy for insomnia is an important step to getting past the struggle. Each person is a little different, and you might benefit from some help figuring out exactly what will work for you. You can find a specialist at sleepeducation.org.

I keep waking up at 6AM and can’t fall back asleep no matter what, I miss sleeping in on weekends, help me?

Thank you for this question. For some people, this can represent a form of chronic insomnia, where they wake up too early in the morning and can’t get back to sleep. In general, if you find yourself waking up earlier than you want to, you could try to shift your bedtime later (go slowly- maybe 15 minutes at a time) Keep in mind how much sleep you need. For example, if you generally need about 7.5 hours of sleep, and you go to bed at 10:30pm, your brain SHOULD wake you up at 6am. Another option is to find a morning routine you enjoy and start your day early!

Is running or working out between 1-3 hours before bed ok? I’ve found mixed messages about it.

It depends on the person, many people find that working out within an hour of bedtime can make it harder for them to fall asleep. If you don’t personally find it to keep you from getting to bed then don’t worry about it!

My partner is a light sleeper and rarely sleeps through the night. 1) Might a foam mattress help? 2) Do nightcaps help or hurt?

Thank you!

Sometimes the differences from person to person in how “deeply” they might sleep is just part of normal variations; however, waking up frequently throughout the night could be a symptom of a sleep disorder. Having a mattress that is comfortable is what’s important, and the type of mattress is a matter of personal preference. Alcohol, on the other hand, can most definitely lead to light and fragmented sleep. Alcohol makes people feel sleepy at first, but it disturbs sleep later in the night. It might be worth a try to give up the nightcap for a week or two and see if it helps your partner to sleep more soundly. If not, it’s best to reach out to a sleep specialist for help. They can consider all of the possible causes of this sleeping problem. You can find a sleep specialist at https://sleepeducation.org/.

Thank you for all of the great questions about insomnia! I’m sorry I ran out of time before getting to all of them. I will do my best to reply over the next few days. Hopefully some of this information has been helpful, and I encourage any of you who are struggling with sleep to get help from a sleep specialist. You can find one near you here: www.sleepeducation.org.

Sweet dreams!

I take melatonin every night before bed, is that bad?

Melatonin is a hormone naturally produced by the body at night. It is also sold as a dietary supplement. In general, melatonin supplements appear to be safe; however, it does not appear to have more benefit than “placebo” pills. If you might have insomnia, there are other non-prescription treatments, the most effective of which is cognitive-behavioral therapy for insomnia (CBT-I). It’s best to reach out to your doctor or look for a clinical sleep psychologist who knows how to deliver CBT-I.

https://sleepeducation.org/patients/cognitive-behavioral-therapy/

Any hope for restoring my ability to stay asleep? Sleep maintenance is a problem. Doxepin and Trazadone leave me significantly depressed the following day. I'd rather sleep 3 hours a night than feel like hating everything about living by using those meds.

Unfortunately, a lot of people experience feelings of sleepiness the next day when they take sleeping pills. The good news is that non-medication treatments are actually more effective, and don’t have the same negative side effects. The recommended first-line treatment for insomnia (including sleep maintenance insomnia as you describe) is cognitive-behavioral therapy for insomnia (CBT-I). You can read more about that treatment at https://sleepeducation.org/patients/cognitive-behavioral-therapy/ and find a sleep specialist who can help.

How do I stop waking up in the middle of the night every night?

There are several different things that can cause night wakings. The most important thing is to figure out why. For some people, this can be caused by a sleep disorder like sleep apnea or periodic limb movement disorder. For some people, it might simply be caused by your environment. One of the common reasons people wake up in the middle of the night is chronic insomnia disorder. This occurs when a person struggles with sleep at least 3x/week for at least 3 months, and their sleep problem is sufficiently severe to impact how the person feels or functions during the day. Your best bet is to reach out to a sleep specialist who can help you figure out the cause of your awakenings and recommend the best treatment. You can find a specialist at sleepeducation.org.

Two questions: 1) how long before bed should we turn off our phones? 2) how long after we wake up should we look at our phones?

Thanks!

Engaging with technology near bedtime can be a problem for some people. If you find it hard to fall asleep, it can be helpful to set aside your devices about an hour before you get to bed. For some people, it’s less of a problem and a few minutes is enough for them to mentally disconnect. There really isn’t a reason to avoid your phone in the morning. If it helps you get up and start your day by engaging with your phone, it is unlikely to have an impact on your sleep at night.

Are those blue light filtering glasses a gimmick?

Thanks in advance!

Blue light can be one cause of trouble falling asleep if you are exposed to it at the wrong time. Some blue light blocking lenses can reduce the impact of blue light on your internal clock, and may prevent difficulties falling asleep. Another strategy to reduce blue light exposure is to disconnect from your electronics an hour or so prior to bed. This isn’t always possible but it is the best strategy!

Any suggestions for how to stop hitting the snooze button? I find myself oversleeping and continually hitting snooze.

If you’re hitting your snooze alarm repeatedly, you probably aren’t getting enough sleep. The best thing to do is actually to set your alarm later. If you’re hitting the snooze button, set your alarm later, like as late as you can, so that you jump out of bed in a panic! That will get you going in the morning! If you are getting enough sleep at night and STILL can’t get yourself out of bed, you might want to reach out to a sleep specialist for an evaluation. There are some conditions where people are overly sleepy even when they get enough sleep. The basic recommendation for an adult is to get AT LEAST 7 hours of sleep on a nightly basis. Start there, set your alarm a bit later and see how it goes...

How can I stop getting up to eat in the middle of the night?

Sleep-related eating disorder (SRED) is a sleep disorder characterized by unusual eating behaviors during sleep. If you have this disorder, you sleepwalk and sleep eat without remembering the event afterward. (https://sleepeducation.org/sleep-disorders/sleep-eating-disorder/) This can also be a side effect of some sleeping pills, so it might be best to talk with your doctor if you are using medications to help with sleep.

May not be a good place for this, but don't want to give up a chance. A question that has knocked around my head for some time is: Why do we sleep? I know a standard response is that we sleep to cure tiredness, but I wonder why it was ever considered beneficial for a living creature to essentially be prone and vulnerable about 1/3 of its life.

Other organisms developed a completely different cycle and/or different safe guards, especially when compared to humans. Is there much known as to why this was an evolutionary advantage at some point?

The answer to this question will win a Nobel Prize! In fact, there are probably many reasons why we sleep. First, you are correct that sleep is the only “cure” for sleepiness, but sleep is also associated with learning, memory, muscle repair and maintaining a healthy brain. In terms of evolution - you are correct that we are vulnerable, but we are also using less energy and allowing for active recovery of the brain and body, so it might have an evolutionary advantage as well. Thank you for this great question!

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This experience is probably more common than you think. A lot of people have insomnia struggles that come and go. What happens after a few nights is that your internal sleep drive just takes over and “makes” you sleep. One strategy to try is evening out the pattern. Figure out how many hours you sleep ON AVERAGE (so 8 hours for 3 nights and 5 hours for 4 nights would be an average of about 6 hours and 20 minutes) and set up a schedule that will lead to more consistency - for example - keep your time in bed around 7 hours, and you might just break the cycle. If that doesn’t work, you may benefit from direct treatment of insomnia. The best treatment is called cognitive-behavioral therapy for insomnia. You can read more about that treatment at https://sleepeducation.org/sleep-disorders/insomnia/#treatments-for-insomnia.

Hi Jennifer, I’m so glad I found this ama! I’ve had trouble sleeping my whole life. I’m a recovering addict (haven’t used in 5 years) because of this I refuse prescription medications. My issue is falling asleep. My question is what steps can I take to help myself fall asleep? It seems most nights my brain just won’t shut off.

First of all, congratulations on your 5 years of sobriety! It’s hard work, and avoiding medications might be the best choice for you. In general, medications don’t work as well as other approaches anyway. The best treatment we have for insomnia is cognitive-behavioral therapy for insomnia (CBT-I). This is a very effective approach for helping people fall asleep more quickly.

Feeling exhausted during the day, but “revved up” at night can be caused by several factors.

First, you might be trying to go to bed and getting up earlier than your natural tendency. Sleeping “out of sync” with your internal clock can cause this to occur. Second, some people with chronic insomnia get more anxious as bedtime approaches. If you struggle with sleep for more than 3 months, this can represent a clinical condition called “chronic insomnia disorder”. That may require help from a sleep specialist.

Chronic insomnia disorder is:

Trouble falling or staying asleep that is severe enough to impact how you feel or function during the day. If this occurs more than 3 times per week for longer than 3 months, you should reach out to a sleep specialist for help. You may have chronic insomnia disorder.

A few strategies that might help you get through this include:

Go to bed when you feel sleepy

Do a calming activity for the last 30 minutes or so before getting in to bed

Practice a mindfulness exercise that you can use if this continues to be a problem.

Is there any way I can stop myself from kicking my leg as I sleep? It wakes me up quite a bit. Also, why the heck do we get the “jimmy-legs”?

Restless legs syndrome is a neurological sleep disorder that causes you to have uncomfortable feelings and the urge to move your legs. Restless legs syndrome makes it difficult to get comfortable enough to fall asleep. The symptoms are usually worse in the evening and at night. The sensation is difficult for some people to describe. It has been described as a crawling or creeping sensation. You may lie down and begin to feel itching inside your legs. If you move your legs or get up and walk around, these symptoms may go away. The discomfort may return when you try again to go to sleep.

Restless legs syndrome is usually manageable through medication and lifestyle changes. Talk to a sleep specialist if you think you have restless legs syndrome. The doctor will ask you about your medical history and if you are on any medications that might be making your symptoms worse. The good news is that there are treatments that can help relieve this condition. You can find a sleep specialist at sleepeducation.org.

How long should you wait before giving up on getting to sleep? What should you do once getting up?

There is no exact science to this, but if you are struggling with sleep, it’s time to get out of bed. For most people, we suggest getting out of bed after about 30 minutes, but you don’t have to wait that long if you are really alert and know you aren’t going to fall asleep. You can try getting out of bed and doing a simple activity like folding laundry or reading a book. When you feel sleepy again, return to bed. The most important thing to do when you get out of bed is to get your mind off sleep. Then it will naturally come to the surface.

Roughly every three months since I was 13 or so I go through a phase of insomnia. I go to bet at regular time (10:30-11:00) and have no problem falling asleep, but I wake up at about 3:00 and I cant get back to sleep. I stay up and function normally (I nap on my lunch break about 20-25 minutes) through these periods.

I guess the question is is this normal or should I talk to my doctor?

If your sleeping problem impacts how you feel during the day, or makes it hard for you to the things you need to do, it’s worth reaching out for help. I suggest you reach out to a sleep specialist specifically who can do a full evaluation of your specific situation. You can find one at sleepeducation.org.

If I’m staying up for ~ 15+ hrs 3-4 times a week but getting my sleep in large chunks without any set sleeping schedule, do you think this will be detrimental to my health in the future?

In general, we know that consistent sleep times are associated with good health. It’s difficult to know if your particular schedule will have detrimental effects on your health, but it might. Insufficient sleep – due to inadequate or mistimed sleep – contributes to the risk for several of today’s public health epidemics, including cardiovascular disease, diabetes and obesity.

The recommended amount of sleep for an adult is to get at least 7 hours each night, so the closer you can get to that regular routine, the better. https://doi.org/10.5664/jcsm.5866

I take sleeping aid every night to help me fall asleep. My pills have 50mg of DCI and I take two. What is concerning too much?

Also, any tips on shutting down my brain so I can go to sleep? My mind races ALL the time.

I am not familiar with that medication, but I recommend you speak with your doctor if you are concerned about the dose. Feeling exhausted during the day, but “revved up” at night can be caused by several factors, and is common in people who have chronic insomnia disorder. I have heard the feeling described as “tired but wired.”

This can represent a clinical condition called “chronic insomnia disorder”. That may require help from a sleep specialist. Some people also experience anxiety that makes their insomnia problem even worse and treating anxiety can help too.

Chronic insomnia disorder is:

Trouble falling or staying asleep that is severe enough to impact how you feel or function during the day. If this occurs more than 3 times per week for longer than 3 months, you should reach out to a sleep specialist for help. You may have chronic insomnia disorder.

A few strategies that might help you get through this include:

Go to bed when you feel sleepy

Do a calming activity for the last 30 minutes or so before getting in to bed

Practice a mindfulness exercise that you can use if this continues to be a problem.

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Nightmares can occur any time day or night when we sleep. For most people, nightmares happen in the early morning hours because that is when we have the most REM sleep, and most nightmares happen during REM. One reason you might experience vivid nightmares during a nap after staying up all night is that your brain is really craving REM sleep, so you might actually have more of it during your nap than you would if you had slept the night before. You might not have this experience if you get a good night’s sleep!

How effective are weighted blankets really?

My SO has all kinds of anxiety mostly at night and drinks a few beers to help him sleep. I've been wondering if a weighted blanket help at all.

Some people find weighted blankets to be helpful for reducing feelings of anxiety. If he finds the weighted blanket seems to help him settle in to sleep, there isn’t any harm in using one. Most of the actual data we have is about how these blankets can be helpful for kids, but that doesn’t mean they work for adults.

On the other hand, alcohol is a problem when it comes to sleep, and a few beers is enough to cause sleep to be fragmented during the night. It would benefit the quality of his sleep to cut back on the alcohol near bedtime.

I was recently diagnosed with very mild sleep apnea, believe my AHI was around 8. I have also had my testosterone drawn, while in normal ranges on the low end think in the 300’s. I was prescribed a cpap but with my insurance deductible not met has been cost prohibitive. I have not started hormone replacement therapy either. Your thoughts on either or utilizing both treatments/therapies? Thanks!

CPAP is the best available treatment for sleep apnea, and it is unfortunate to hear that your insurance issues are at play. With mild disease, you may also want to explore oral appliance therapy, although the out of pocket costs may be similar. There is some evidence that taking testosterone may make sleep apnea worse in men, so you may need to be retested after you start the medication, and at a minimum, you should talk with your doctor about this possibility.

What may be triggering episodes of sleep paralysis while attempting TO fall asleep, not when waking up? I almost fall asleep but stay conscious but cant move. It may last up to 45 minutes before I can break out of it. Thank you

About one out of four people experience sleep paralysis on occasion; however, if it happens regularly, it can be a sign of a sleep disorder that requires evaluation and treatment such as narcolepsy. Narcolepsy is a disorder in which people feel very sleepy during the day, and this is sometimes accompanied by other symptoms like sleep paralysis. If this happens to you frequently or if it’s causing you to worry, you might benefit from an evaluation by a sleep medicine specialist. You can use this link to find one near you: sleepeducation.org.

I have gastroparesis and I find it really hard to find ways to sleep. I have almost suffocated in my sleep from laying down all the way and stomach acid getting in my lungs. I try to sleep proped up on a wedge pillow or on a large stack of pillows. It tends to hurt my lower back and I can't sleep as well. Do you have any suggestions on other ways I could sleep?

This sounds like a potentially complicated issue that would really benefit from a consultation with a board certified sleep medicine specialist. It’s also possible that an untreated sleep disorder, like sleep apnea, is making your symptoms worse. You can find a sleep specialist near you at this link: sleepeducation.org.

Hello! In the absence of refreshing sleep (chronic and long term illness), how can I help my body rest and restore?

The short answer is to do the best you can to take care of your sleep. A few important strategies, even for people with medical problems are:

Create a calm and comfortable place to sleep.

Keep a routine around your sleep - settle in for the night and get up to start your day at about the same time. If you aren’t feeling well, it’s best to get out of your sleeping bed and spend time somewhere else if you can.

Don’t worry too much about it! Anxiety and worry about not sleeping just makes the problem worse.

My son (18) takes melatonin most nights to fall asleep. Is this a problem?

Melatonin is a hormone naturally produced by the body at night. It is also sold as a dietary supplement. In general, melatonin supplements appear to be safe, and they are recommended for the treatment of specific types of sleep disorders called “circadian rhythm sleep wake phase disorders,” which are common in teenagers and young adults. For people with these sleep disorders, melatonin is considered more effective and safer than sleeping pills. However, it does not appear to be a good treatment for insomnia. If your son is struggling to sleep each night, he should contact a medical provider and discuss his symptoms.