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Q. Ever since I returned from deployment two years ago, I’ve had a hard time sleeping. It’s so bad that most nights it takes me two or three hours to fall asleep. My doctor gave me medication to help, but I don’t want to take it every night.
A. A common practice among doctors is to give a pill to a service member suffering from insomnia.
In some cases, medication is very appropriate; for the severely sleep deprived, the occasional “chemical cure” can be a godsend. But using medication to sleep over the long term can make things worse if the person becomes dependent on the drug.
The most effective way to get your sleep back on track is through simple behavioral changes that have been shown to work. The top 10:
1. Avoid caffeine and alcohol. Caffeine is a stimulant. Set a 2 p.m. cutoff for cola, coffee, tea, and energy drinks. Alcohol is a depressant — and while it may seem logical that something that makes you drowsy will help you sleep, in the long run booze disrupts your sleep patterns, causing restless sleep.
2. Structure your environment. The body and mind need quiet, darkness, and a comfortable temperature to sleep. Turn off the TV, close the blinds, and adjust the thermostat before turning in.
3. Stop watching the clock. Watching the minutes tick by leads to frustration, which leads to insomnia. Turn the clock so you can’t see the time.
4. Set a specific sleep/wake schedule. The more your wake-and-rise schedule is fixed, the better your body and mind will respond when you want to fall asleep and when you want to get up. This includes weekends as well.
5. Don’t nap too late. If you have to nap, do it early in the day. Catching late-day winks reduces your need to sleep at night.
6. Rely on the sun. Light is great for regulating your sleep/wake cycle. So let the natural rays shine through in the morning and get a few beams in the afternoon.
7. Eat smart. It’s always a good idea to eat healthy, but that’s not what I’m talking about here. Avoid eating large, salty, or spicy meals right before bed. Your digestive system will thank you.
8. Exercise early. Vigorous exercise releases cortisol, a stress hormone that will not let you sleep. If possible, exercise in the morning or early afternoon.
9. Stop thinking in bed. Very few problems get solved between the time you get into bed and fall asleep. All you’re doing is keeping yourself up. Worry about things earlier in the evening.
10. Use the bed only for sleep. Watching TV, playing video games, or cramming on homework in bed are the worst things you can do if you’re trying to sleep better. In essence, you’re associating the bed with everything but sleep. One exception to this rule: sex.
Bret A. Moore is a clinical psychologist who served in Iraq and author of the newly published “Taking Control of Anxiety: Small Steps for Getting the Best of Worry, Stress, and Fear.” Email firstname.lastname@example.org. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.