Can't Sleep? Scientists Weigh In On Bedtime Rituals How do you get a good night's sleep? Many of us have routines we use to try to reach that blissful state of slumber — from meditation to melatonin to putting on a pair of socks. Sleep scientists weigh in on which sleep rituals actually work.
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Sleep Better With These Bedtime Rituals

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Sleep Better With These Bedtime Rituals

Sleep Better With These Bedtime Rituals

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ALLISON AUBREY, HOST:

You know, when it comes to falling asleep, we'd like to think that you just put on your PJs, hop into bed, flip off the light and - boom - you're asleep. But that's not the way it works, right? Falling asleep is a little bit more like landing a plane.

MATTHEW WALKER: You've just got to gradually bring the brain and the body down, sort of from that altitude of wakefulness onto the hard, safe landing pad of sleep at night.

AUBREY: That's Matthew Walker. He's a sleep researcher at UC Berkeley and the author of "Why We Sleep." And I told him about this little technique I use to wind down at night. I think of it as, like, channelling my inner Carl Sagan. I say to myself, Allison, you are just recycled stardust in an ever-expanding universe.

WALKER: Staring at a blue dot, yeah.

AUBREY: Exactly. And in a weird way, it calms me down. I'm floating. I'm completely detached. But my way isn't the only way.

MEGHAN KEANE, BYLINE: Hi. So I have a less existentially...

(LAUGHTER)

KEANE: ...Big...

WALKER: Conflicting...

KEANE: ...Conflicting way of getting to sleep than Allison does.

AUBREY: That's our producer Meghan Keane. She has a different approach.

KEANE: It's so silly. But I just had this little stick, and it's infused with lavender. And I - every night, I just put, like, a little dab on my temples and a little under my neck. And I swear to God, it makes me fall asleep, like, instantly.

AUBREY: Ah, the essential oil trick.

KEANE: Yeah. I know it's probably in my head. I think it's just telling me it's time to go to bed. I think that's what's really doing. But now I'm, like, hooked on it.

AUBREY: So Matthew, what do you think?

WALKER: It does seem to be one of those tricks - I'm hastened to use the word hack. But it is interesting. You're actually latching onto a very ancient evolutionary process of what we call associative memory within the brain.

AUBREY: You've got a lot of inner wisdom there, Meghan.

KEANE: It's a lot cheaper than sleeping pills, I'll say that.

(LAUGHTER)

AUBREY: And better for you.

(SOUNDBITE OF MUSIC)

AUBREY: You know, a lot of sleep rituals are really just about this; they're linking two things together. So for me, it's the stardust and sleep. And for Meghan, it's the lavender stick and sleep.

WALKER: I think whenever you pin an association in the brain - whenever you make a positive association that binds two things together, then one will prime the other.

AUBREY: This is your NPR LIFE KIT for sleep - in this episode, sleep rituals. We're going to answer some of your questions about sleep - everything from melatonin to meditation to kids who won't sleep, even socks.

(SOUNDBITE OF MUSIC)

AUBREY: Let's start with the oldest sleep strategy known to humanity. It's basically a cliche at this point. Does counting sheep actually work?

WALKER: Does counting sheep work? This is one of the myths that, unfortunately, I bust in the book. Counting sheep - it was actually done at - a study done here at UC Berkeley, not by my sleep center but by a colleague Allison Harvey, another wonderful sleep scientist. And what they found was that counting sheep actually did the opposite. It made it harder to fall asleep, and it took you longer to fall asleep if you were counting sheep.

AUBREY: It sounds like it's just so dull that it doesn't distract you enough from the rumination. Is that right?

WALKER: I think that's one possibility - or that sheep are remarkably anxiety-provoking and we've never quite known it until that study. I don't have a problem...

AUBREY: (Laughter) Scary sheep.

WALKER: Yeah. I don't have a problem with sheep. I quite like them. I find the very endearing. But overall, the science is pretty clear: don't count sheep.

AUBREY: OK. So that doesn't work. And we did hear from one listener, Gloria Jimenez (ph). And she wants to know what's better.

GLORIA JIMENEZ: So oftentimes when I'm counting, my mind does tend to wander. So in cases like that, what would be a good practice or method to use other than counting to draw my mind back to sleep?

AUBREY: It turns out that the same group of researchers Matthew just mentioned looked into this.

WALKER: And what they found is that if you just use, kind of, mental imagery and you take yourself on a pleasant walk that you know of - if it's kind of like a hike in the woods or if it's a walk down on a beach that you do on vacation or - and you just sort of navigate your way through that, that tended to hasten the speed of the onset of sleep.

AUBREY: So takeaway number one - don't count sheep. Instead, imagine yourself on a beautiful walk.

WALKER: You are shifting from being internally ruminative to just externally focused, thinking about going on a journey elsewhere, not thinking about your own problems.

AUBREY: Now maybe you haven't done this kind of visualization before and you'd like a little help. A lot of you told us that you like relaxation or meditation apps. And here's a listener named Meredith Raimondi (ph).

MEREDITH RAIMONDI: So I'm generally a pretty anxious person. And at the start of the year, I wanted to focus more on my sleep. So I looked around. And I found the Calm app. And they have different meditations and stories you can listen to. And those really helped me relax a lot more than a podcast or the radio.

AUBREY: So our podcast does not relax you? OK. I am not going to take that personally. We don't want this podcast to put you to sleep. But it does seem that everybody is talking about these meditation apps. We asked Chris Winter - he's a sleep doctor in Charlottesville, Va. - his take on the apps.

CHRIS WINTER: I'm a big fan of these things. You know, the ability to settle your mind and initiate sleep is a skill. It's like, you know, hitting a curveball. The more you practice it, the better you'll get at it and the more confident you become.

AUBREY: So think of it this way. The app can train you to meditate. And what that means is you clear away all of your regrets about the past, your worries about the future, and you learn to be in the moment.

WINTER: Your brain is changing. It's moving from that more active state into the state that sort of lends itself to that first stage of light or transitional sleep. Our breathing is slowing down, becoming more regular.

AUBREY: So takeaway number two - if you want to train yourself to meditate, there are lots of tools out there. Check them out. But of course, you don't need an app. Here's a tip we got from Jessica Waldinger (ph).

JESSICA WALDINGER: My favorite strategy for going to sleep is imagining that I'm being erased by a giant eraser from toes to head. By the time I reach my knees, I'm usually asleep.

AUBREY: It's a little wacky, but I like it. And you see, I'm not the only one who gets all existential here.

(SOUNDBITE OF MUSIC)

AUBREY: OK. So next up, melatonin supplements - a lot of you asked about them. Now, melatonin is naturally occurring in our bodies. It's a hormone. They call it the darkness hormone. But what about taking a supplement version? Well, we heard from this listener, Tyler McDonald (ph). He says he takes it occasionally. But he's got some doubts.

TYLER MCDONALD: Part of the reason I don't take it more often is because I've heard that there might be a risk of dependency or that it might not even be that effective at all, that it might be mostly the placebo effect. So I'm wondering - is melatonin really effective? Is it really helping me at all?

AUBREY: So Matthew, what do you think?

WALKER: So firstly, melatonin can be efficacious. It can help you with the timing of your sleep, especially under conditions of jetlag. And that data is pretty robust. But when you're stable in your typical time zone, the impact of melatonin on the quantity of your sleep and the quality of your sleep has been debatable. The early studies in - from sort of, like, 2000 to 2010, it was equivocal. It wasn't very clear.

AUBREY: And the bottom line is it's still not very clear. Melatonin seems to help some people. It could be the placebo effect. But to answer Tyler's question about whether it can be habit-forming, that does not seem to be the case.

WALKER: There's not great data demonstrating dependency. There is some suggestion that if you're taking too high a dose, that that higher dose stops your body from making its own normal dose of melatonin. And so typically, most people in the medical community would recommend somewhere between 0.5 milligrams up to 2 milligrams. Most people typically tend to take too much. I would say try and throttle that back just with that concern in the back of your mind.

AUBREY: And keep in mind that Walker says you want to take this about 45 to 90 minutes before you go to sleep.

(SOUNDBITE OF MUSIC)

AUBREY: Plus, there's one other thing to think about. Melatonin is marketed as a supplement, and so it's not regulated the same way that prescription drugs are.

WALKER: One study looked at 10 to 20 different brands. And what they found is that relative to what was stated on the bottle, the concentration of the pill itself inside of the bottle ranged from anywhere between 80 percent less than what they stated on the bottle to up to 460 percent more than what it said on the bottle.

AUBREY: That is a big difference. So your takeaway number three - some people say that melatonin helps them, and there is evidence to suggest that it can. But buyer beware. Not all brands of melatonin supplements on the market contain the amount listed on the label.

Now let's talk about over-the-counter sleep aids. Some people take Tylenol PM - other people take Benadryl to help fall asleep. They are hugely popular. And we heard from Liz Jennings (ph). She told us that when she's excited or nervous about something happening the next day, she has a hard time falling asleep.

LIZ JENNINGS: So I have turned to over-the-counter medicines like ZzzQuil or Benadryl to try to help me fall asleep. But something that I've been wondering is, you know, am I really getting good sleep with that? Sometimes I feel groggy in the morning. So I'm just wondering, are they really helping me get better sleep?

AUBREY: All right, Chris. Are you doing yourself any good by taking these over-the-counter sleep aids?

WINTER: So let's look at the pills. What are the pills doing? Pills promise to do a lot. But in reality, there's never really been a sleeping pill that's been shown to really add more than just a few minutes to somebody's sleep. And more importantly, there's never been a pill that's been shown to improve performance the next day...

AUBREY: You know, I have to push back just a little bit. I mean, I think everybody's had that experience where - if you take Benadryl, it will knock you out.

WINTER: Sure.

AUBREY: It will get you where you want to be in the next hour, right?

WINTER: No, because sedation and sleep are not the same thing. And a lot of people confuse those two things. So sleep is a physiological state that does - it's a very active state that does things for our bodies. We have deep sleep during the first half of the night, which is when we make our growth hormone. We have dream sleep or REM sleep during the second half of the night. So things need to get done during sleep in a methodical way. So if you're looking to get restored from your sleep, which is what sleep theoretically is trying to do, a lot of medications prevent sleep from doing those things.

AUBREY: We should point out that when it comes to prescription medications, Winter says they also have side effects. But the picture is complicated. So obviously, you check with your doctor on this one. Now, the verdict on over-the-counter sleep aids - and this is your takeaway number four - it's probably best to lay off for better sleep. Winter says think about it this way.

WINTER: So the idea that you are necessarily better having taken the Benadryl than you would have been staying up an extra hour - oh, my gosh - maybe two, and then getting four-and-a-half hours of sleep and going to work, it doesn't really pan out in any research.

AUBREY: Now, sometimes, our sleep rituals aren't necessarily all our own. And we heard from a lot of people who told us that their main obstacle to sleep is - you guessed it - their kids. Here's a question we got from Jeremy Shock (ph).

JEREMY SHOCK: My biggest question is how to hack sleep for toddlers because that directly impacts me and my wife. What are some good strategies for when they do wake up? How do they feel OK about staying in their bed and not running into my bed or the bed of me and my spouse and jumping in, turning around, kicking and punching until I get out of bed and put them back in their own bed for a couple more hours? So that's my biggest question.

(SOUNDBITE OF MUSIC)

WINTER: So when parents come to me for advice about how to get their kids to sleep, you could make an argument it starts before the baby's even born. You know, what kind of schedule is the mother on, et cetera.

AUBREY: You know, it turns out that your kids' sleep habits have a lot to do with your own habits. And there's a whole checklist of good sleep hygiene - I mean, everything from sticking to a routine bedtime each night to creating a calm environment to keeping phones and devices out of the bedroom. And the bottom line is the earlier you teach these to your kids, the better.

WINTER: And toddlers are tough because they're motor-wise able to get out of their bed and come to your bedroom. And cognitively, they probably can't really process a whole lot that's going on. So to me, it really is - it sort of surrounds, you know, setting a clear expectation, certainly praising them when they do a good job but also creating a situation where the toddler coming into the bedroom is not a pleasant experience.

AUBREY: Winter says his own son went through a phase where he would come into the bedroom in the middle of the night.

WINTER: Well, he'd just stand there next to our bed, which is a brilliant way to kind of wake up. It's terrifying. You wake up. And there's this form standing next to you - not saying anything, just staring at you.

AUBREY: I think a lot of us have those memories.

WINTER: Yeah, exactly.

AUBREY: I used to do that to my parents.

WINTER: So we - you know, I believe in making sure that nothing around sleep is stressful. So I would greet him. Oh, my gosh. Well, there you are, Cam. So good to see you. That's great. I'm so glad you're here. I would hand him a little headlamp. I would put one on myself. And I would say it's so much fun to have somebody to come downstairs and clean the garage with 'cause I usually do it by myself. So we would get up...

AUBREY: In the middle of the night.

WINTER: ...In the middle of the night. We would go downstairs. I would hand - and the headlamps I thought were kind of fun because I could've just turned the lights on in the garage. But I thought the headlamps gave it a certain kind of feel that he wouldn't really care for. So he's not a huge fan of spiders. So we would go downstairs. And we would kind of dust and clean the garage. And I would find a couple little cobwebs. And he would hold the dustpan. I would, you know, sweep the dust - the little web or the little spider on to it. And we would throw it away outside or whatever. And that - we'd, you know, spend five or 10 minutes down there. And I'd be like, oh, great. The garage looks fantastic. Thank you so much. I would put him back to bed. And I would say to him, you know, anytime you want to do this with me, this is great.

AUBREY: So I'm imagining after a couple times with the cobwebs, your son never came in your room again.

WINTER: No, no.

AUBREY: Now, obviously, when your kids are newborns, you're going to have to deal with interrupted sleep. But your takeaway number five is this. With toddlers, you've got to set expectations. And use strategies to encourage them to stay in bed. Find your own version of the cobwebs.

WINTER: I really don't like those things that create fear in kids. But you can make it such that - this is not a good time when I wake up mommy or daddy. Like, and you can be creative and figure out what works best for you.

AUBREY: Now, sometimes, when you wake up in the middle of the night, you can't blame your loved ones. Maybe it's your physical environment. We got this question from a listener. His name is Dean Kagawa (ph). And he says he was able to fall asleep at night just fine. But he kept waking up at like 3 or 4 o'clock in the morning. Then he read Matthew Walker's book.

DEAN KAGAWA: And one of the suggestions in there was to wear socks, which sounds kind of weird. But I figured, I have nothing to lose by doing that. So I put the socks on at night. And now I'm typically sleeping right through. Or I'll wake up at 3 or 4 in the morning. But then I'm falling back asleep again. And that's it. So I'm just wondering how the socks help with that.

AUBREY: What is up with that?

WALKER: Well, I'm glad it seems to have worked. And, of course, you know, one report, you know, could be just a placebo effect. But there have been studies that have been done. And there's actually very good science behind this. We know that your body - your core body temperature needs to drop by about 2 to 3 degrees Fahrenheit to initiate good sleep and then maintain deep sleep. Now at this point, you may be saying, hang on a second. Putting socks on sounds like a way to warm up, not cool down. I don't understand.

The way it works is this. For you to get your heat out of the core of your body, you actually need to release that core heat through the outer perimeter surfaces of your body, namely your hands and your feet. And this is why hot baths actually work, too, for the opposite reason. Most people think you get into a hot bath. You get out. You think, I'm nice and toasty. I get into bed. And I fall asleep better because I'm warm. The opposite is true. What happens with a bath and what happens when you put socks on is that you actually bring all of the blood to the surface. And your hands and your feet are wonderful radiators of that heat. So you are essentially like a snake charmer. You are charming the heat out of the core of your body to the surface of your body.

AUBREY: So takeaway number six, your physical environment can be important to good sleep, including the temperature. So aim to keep your bedroom a little cool. Matthew recommends about 65 degrees. And, of course, you can try the socks.

WALKER: They've even done the studies here where they take rats. And they warm their little paws...

AUBREY: Oh, come on.

WALKER: ...And they bring the blood to the surface. And those rats will fall asleep faster just like human beings...

AUBREY: OK.

WALKER: ...Fall asleep faster.

AUBREY: Well, OK. I'm still thinking maybe it's the placebo effect. (Laughter) I don't know.

WALKER: Which, by the way, I would say the placebo effect is probably the most reliable effect in all of pharmacology. So if it works for you, I usually say keep doing it as long as it's not too deleterious.

AUBREY: Got it. Just like Meghan's lavender oil. If you think it works for you, then it works, yeah?

WALKER: Exactly. I'm not going to suggest it's scientific, necessarily. But I think the placebo effect, for which now there is a wonderful science, actually tells us something profound, which is that there is such a thing as mind over matter, that your brain can actually instigate real biological change just through the act of psychological thought. And it's very real science now.

AUBREY: OK, so I'm just going to keep thinking of myself as that stardust floating through the universe.

So we have covered a lot here. Let's recap what we've learned.

(SOUNDBITE OF MUSIC)

AUBREY: Takeaway number one, do not count sheep. Instead, try mental imagery.

WALKER: Take yourself on a pleasant walk that you know of.

AUBREY: Takeaway number two, if you need some help to unwind, relaxation and meditation apps can help.

WINTER: The ability to settle your mind and initiate sleep is a skill. It's like, you know, hitting a curveball.

AUBREY: Takeaway number three, melatonin supplements - they might help. But studies aren't definitive.

WALKER: It can help you with the timing of your sleep, especially under conditions of jetlag. And that data is pretty robust.

AUBREY: Takeaway number four, over-the-counter sleep aids are not a good strategy for getting good sleep.

WINTER: Are they improving the quality of the sleep and the quality of the work that you're concerned about doing the next day at your job? There's never been a study that showed that those things are beneficial to that.

AUBREY: And takeaway number five, if your kids are waking you up at night...

WINTER: You can make it such that - oh, this is not a good time when I wake up mommy or daddy.

AUBREY: So you may need to reset the whole family's bedtime habits. And your final takeaway, your physical environment can help you sleep better.

WALKER: Your core body temperature needs to drop by about 2 to 3 degrees Fahrenheit to initiate good sleep and then maintain deep sleep.

(SOUNDBITE OF MUSIC)

AUBREY: For more LIFE KIT, check out our next episode. It's all about what to do when insomnia strikes. You'll learn to retrain your thoughts to help you sleep better. If you like what you hear, make sure to check out our other LIFE KIT guides at npr.org/lifekit. And while you're there, subscribe to our newsletter, so you don't miss anything. We've got more guides coming out every month on all sorts of topics. And here, as always, is a completely random tip, this time from Morning Edition producer Kelli Wessinger.

KELLI WESSINGER, BYLINE: If you spread a light layer of mayo, like, on the outside of, like, a grilled cheese and you toast that, it doesn't burn as fast. And it makes it even toastier than butter does. It is going to be so, like, crisp and buttery. And the bread is, like, melt in your mouth but still has that crunch on the outside that just butter just cannot achieve. The mayo somehow makes it better.

AUBREY: If you've got a tip or you want to suggest a topic, email us at lifekit@npr.org. I'm Allison Aubrey. Thanks for listening.

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