Answers to 20 Questions About Getting a Good Night’s Sleep (Published 2022) (2024)

Sometimes I am physically tired but can’t fall asleep. How is that possible?

This is what’s known as the tired but wired syndrome. Usually, it’s driven by stress and anxiety. Even if you’re exhausted, a racing mind can activate the “fight or flight” branch of your nervous system, making you alert and unable to fall asleep. “For us to fall asleep and stay asleep, we need to go in the opposite nervous system direction,” said Matthew Walker, a professor of neuroscience and psychology at the University of California, Berkeley, and the author of the best-selling book “Why We Sleep.” “We need to shift over to the calming branch of the nervous system called the parasympathetic nervous system.”

If you have this experience night after night, you’ll want to do relaxation exercises before bed to quell your stress and anxiety, such as breathing exercises, progressive muscle relaxation or guided meditation, which we’ll discuss in more detail below.

When I put my head down at night, my thoughts and heart start racing. How can I quiet my mind and body and fall asleep?

One of the best ways to calm your mind before bed is by doing meditation. In a 2014 study published in the journal Sleep, researchers split 54 people with chronic insomnia into groups and assigned some of them to practice mindfulness meditation. The others served as a control group. After eight weeks, the researchers found that the people assigned to practice meditation gained nearly 45 extra minutes of sleep each night, while the control group showed almost no change. The meditation group had substantial reductions in the overall severity of their insomnia. After six months, between 40 percent and 50 percent of people practicing meditation were in “remission” from their insomnia, the researchers reported.

If you struggle with insomnia, the best time to do meditation is at night, said Dr. Walker. “Practicing meditation throughout the day but particularly in the evening seems to have a beneficial effect,” he said. “It helps people fall asleep faster, and they report superior quality of sleep.” If you’ve never tried meditation, don’t fret: A number of popular meditation apps have entire sections devoted to sleep, such as Calm, Headspace and Insight Timer. Most of these guided mediation apps offer free versions and trial periods, as well as premium versions that you can access with a subscription.

I’ve tried meditation without success. What else can I do?

I often fall asleep and wake up 15 minutes later feeling anxious and short of breath. My chest feels tight, my mind races and my skin tingles. Why does this happen?

There are a couple likely causes, said Dr. Bhanu Prakash Kolla, an associate professor of psychiatry and a consultant at the Center for Sleep Medicine at the Mayo Clinic. One explanation could be that you have sleep apnea. People with this condition tend to snore loudly and gasp for air at night because the muscles in the back of their throats relax so much that they constrict their airways. When your brain senses you’ve stopped breathing, it goes into “fight or flight” mode, causing a surge in heart rate, blood pressure and adrenaline. This can jolt you awake and make you feel panicked, explaining the anxiety and shortness of breath you describe.

Another possibility, said Dr. Kolla, is that you have panic disorder. People who have this condition often experience sudden, intense bouts of dread and terror that strike out of the blue. When these episodes occur during sleep they are known as nocturnal panic attacks. If you do indeed have sleep apnea or a panic disorder, there are treatments that can help. But you should see a primary care doctor or sleep specialist to get a proper diagnosis, said Dr. Kolla.

I need help falling asleep. What’s the safest sleep supplement I can take?

If I decide to take melatonin, how do I know which brand of supplement to buy?

Dietary supplements are not subject to strict government oversight, and as a result, consumers do not always get what they pay for. A study published in the Journal of Clinical Sleep Medicine found that the content of more than 70 percent of melatonin supplements varied widely from their label claims, with the concentration of melatonin in the bottles ranging from 83 percent less than the amount listed on the label to more than 470 percent.

To avoid being scammed, look for products that carry a “USP Verified” seal, which means that it’s been vetted by the United States Pharmacopeial Convention, an independent group that sets high standards for medicines and supplements. Companies whose melatonin supplements carry the label include Nature Made and Natrol. You can also look for products that carry a blue and white seal provided by NSF International, another group that vets dietary supplements and their ingredients. Lastly, Consumberlab.com and Labdoor routinely test and publish reports on dietary supplements.

I keep hearing that cannabis can help me sleep better. Is that true?

Cannabis has gained a reputation as a sleep aid, but evidence is limited on whether it actually works. One problem is that cannabis comes in different strains, and each contains varying amounts of compounds such as THC, its primary psychoactive component, and cannabidiol, popularly known as CBD. Researchers are still trying to determine whether certain strains or compounds may be good for sleep and others less so.

Some studies have found that cannabis helps people fall asleep faster, but there are concerns that it might also cause disruptions by suppressing slow wave sleep, which is the deep, restorative kind. Some experts liken it to alcohol. “It may help you doze off, but it doesn’t mean that you’re going to get better quality sleep throughout the night,” said Dr. Fariha Abbasi-Feinberg, a spokeswoman for the American Academy of Sleep Medicine and the medical director of sleep medicine at Millennium Physician Group in Florida

In a report published in the journal of Sleep Medicine Reviews, researchers looked at 39 different studies involving the effects of cannabis on sleep. They found that cannabis generally did not affect the amount of sleep that people got, and they concluded that it was probably most helpful as a sleep aid for people who use it to alleviate medical conditions that keep them awake at night, like chronic pain.

One recent study concluded that there was “insufficient evidence to support routine clinical use of cannabinoid therapies for the treatment of any sleep disorder.” And the American Academy of Sleep Medicine published a position statement discouraging people from using cannabis for sleep apnea, warning that there was “insufficient evidence of effectiveness, tolerability and safety.”

Still, many people swear by CBD and other cannabis products for insomnia. Dr. Abbasi-Feinberg does not necessarily discourage patients who believe it works for them. “I tell folks that if it helps you and there are no side effects, then take it,” she added. “But there’s just not enough research out there for me to recommend that someone take it for their insomnia.”

Can my weight affect the quality of my sleep?

Yes. Being overweight can fuel poor sleep because it promotes soft tissue development in your throat, which increases your risk for sleep apnea. The good news is studies also show that shedding excess weight can lead to “significant and clinically relevant” improvements in sleep apnea. Studies also show that losing sleep can itself lead directly to weight gain: It increases levels of ghrelin, the so-called hunger hormone, decreases leptin, the “satiety hormone,” and causes people to consume more snacks and high-calorie junk foods throughout the day.

This brings up an important factor that is often overlooked in how well people sleep: Their diet. We know from studies that diets high in sugar, saturated fat and simple carbs — think donuts, pizza, cheeseburgers and sugary drinks and snacks — are linked to both weight gain and poor sleep. Instead of eating junk foods, fill your plate with foods high in protein, fiber and unsaturated fat, fish, fruits, vegetables, nuts, olive oil and avocados. These foods have been shown to promote good sleep. If you suffer from insomnia, then consider adding more complex carbs to your diet, such as beans, whole grains, sweet potatoes, quinoa and oatmeal. Studies show that eating complex carbs can help you fall asleep faster. But sugar, white bread, pastries and other processed carbs can cause more frequent wake-ups throughout the night.

How does the temperature of my bedroom affect my sleep?

So what temperature should I keep my bedroom for optimal sleep?

What’s the best way to keep my bedroom cool — besides using a fan or air conditioner?

One way that your body lowers its temperature at night is by sending heat from your core to your hands and feet through a process known as vasodilation, a relaxation of the blood vessels that increases blood flow to the extremities. You can facilitate this process by wearing warm socks at night. It might seem paradoxical, but warm socks will help to pull heat from your core to your extremities, said Dr. Sabra Abbott, an assistant professor of neurology in sleep medicine at the Northwestern University Feinberg School of Medicine in Chicago.

Second, stop exercising at least a few hours before bedtime, as this could raise your body temperature and make it harder to fall asleep.

And lastly, the next time you purchase a new mattress, look for one that helps cool you down at night. “If you go mattress shopping, you’re going to see that a lot of them specify whether they ‘sleep cool,’ ’” Dr. Abbott said. “They have technology that helps to dissipate heat at night.” For help finding a mattress with cooling technology, read the Wirecutter article “The Best Mattresses for 2021.”

I’m a bad sleeper and so were my parents. Do my genes affect how I sleep?

Yes, in several ways. First, we know that there’s a genetic basis for your circadian rhythm, which determines whether you’re a night owl, a morning person or somewhere in between, said Dr. Walker. If you sleep in a way that goes against your biology — for example, a night owl who stays up late and then has to wake up early for work — that could hamper both the quality and the quantity of your sleep.

Your genes also influence how much time you spend in the different stages of sleep. Some genetic variants appear to increase a person’s “slow-wave” stage of sleep, which is important for memory consolidation. Your genes can influence your risk of sleep disorders such as restless legs syndrome, which causes significant sleep disruptions. And they play a role in insomnia, the most common of all sleep disorders: Studies of twins have found that there’s a strong hereditary component to insomnia, especially among women. So if one or both of your parents routinely grappled with sleepless nights, then it may be in your DNA.

Do women have more difficulty sleeping than men?

I’m approaching menopause and my sleep is worse than ever. What can I do?

Sleep disruptions are one of the most common symptoms of perimenopause, the final years of a woman’s reproductive life, just before menopause, when her period stops. During this time, periods become irregular and reproductive hormones rise and fall sharply, causing hot flashes, night sweats and other symptoms that can rouse women from their sleep or prevent them from dozing off. Making matters worse, these symptoms can last for many years, beginning in perimenopause and continuing long after menopause. One study found that women, on average, experienced hot flashes for five years after menopause, and a third of women continued having them as long as a decade after menopause.

This can spell disaster for sleep. Another study found that more than 80 percent of women with severe hot flashes suffered from sleepless nights. Over all, the study found, about 37 percent of women over 35 who had regular menstrual cycles had insomnia. But among women who were perimenopausal, the rate soared to 57 percent, and after menopause it reached roughly 51 percent. “I take care of a lot of women in their 50s who were fairly good sleepers until they went through the hormonal changes,” said Dr. Abbasi-Feinberg.

But there are some things that can help. If your sleep troubles are related to menopause, then hormonal treatments could make it easier to get a good night’s rest, said Dr. Abbasi-Feinberg. Certain antidepressant medications such as selective serotonin reuptake inhibitors can also help, as can some forms of alternative medicine. One study found that four weeks of acupuncture reduced anxiety and prevented sleep awakenings in people with insomnia. If stress and anxiety are contributing to your sleep troubles, then another potential solution is cognitive behavioral therapy.

My sleep is always abysmal when I’m getting my period. Why does this happen?

First off, you’re not alone. While cramps, bloating and mood swings are some of the most common signs that your period is coming, many women also experience insomnia, nightmares and frequent awakenings. Women with premenstrual syndrome are twice as likely as other women to have insomnia. And about seven in 10 women who have a more severe form of PMS called premenstrual dysphoric disorder, or PMDD, routinely struggle to get a good night’s sleep in the days before their period.

So what gives? Cramps, muscle pain and headaches can wreak havoc on a woman’s sleep. Plus it is normal for core body temperature to rise during menstruation, which makes it harder to doze off. On top of that, the abrupt rise and fall of progesterone, estrogen and other hormones during a woman’s period can influence her circadian rhythm and alter the different stages of her sleep, worsening her sleep quality. Women with severe premenstrual syndrome have also been shown to secrete lower levels of melatonin, the hormone that ushers us to sleep at night.

So what can you do? For starters, if you use birth control pills, consider whether they’re impacting your sleep. Some research indicates that women who use hormonal contraceptives experience more insomnia and daytime sleepiness than women who are not on the pill. On the other hand, some experts speculate that certain contraceptives, particularly those that contain progestin only, might actually help with insomnia. Unfortunately, there is not a lot of data on how contraceptives may impact sleep, but it may be worth discussing their potential impact on sleep with your doctor.

Second, there are things you can try besides sleep medications. Cognitive behavioral therapy, which can help ease stress and anxiety, is one of the best ways to combat insomnia. Another treatment for sleep problems called bright light therapy has been shown to help women with severe PMS. Scientists are not exactly sure why light treatment works. But it involves using a light box to get regular exposure to artificial light, which affects melatonin as well as the hypothalamus, a region in the brain that regulates mood and sleep. You can learn about the best light therapy lamps in this article from Wirecutter.

Lastly, focus on your sleep hygiene in the days before you get your period. Avoid alcohol, which can affect hormone levels and stir you awake at night. Keep a strict sleep schedule, going to bed and waking up at the same time every day. Don’t overdo it on caffeine, and be sure to exercise daily, which can help promote a smoother night of slumber.

Will a nap help me “catch up” on sleep or just contribute to my insomnia?

If I do nap, should I keep it short? Is napping in the afternoon bad?

My partner snores so loudly that it constantly wakes me up. How can I sleep soundly with a noisy bed mate?

“This is one of the most common questions that I get,” said Dr. Abbasi-Feinberg. “Quite frequently, patients are brought in not because they themselves think there’s an issue but because their bed partner thinks there’s an issue.”

Snoring itself is not necessarily a medical problem. But it can be a sign of sleep apnea or another underlying sleep disorder. Your best bet is to encourage your partner to see a sleep specialist or primary care doctor for an evaluation.

What else can I do? I have tried using ear plugs but they are uncomfortable.

If your partner is unwilling or unable to see a doctor, then you should do everything you can to make your sleep environment as comfortable as possible. Try a white noise machine. Often, it is not just the loudness of the snoring that wakes people up but the rising and falling sound of the snoring, or crescendo and decrescendo, which a white noise machine can help to mitigate. “Sometimes, that change in tone is what bothers people, not so much that the snoring is constant,” said Dr. Abbasi-Feinberg.

You can encourage your partner to sleep on his or her side, which helps reduce snoring and apnea episodes. There are devices that can help with this, which you can read about in our Guide to Sleep Apnea. Another thing you can do is buy small earbuds that fit snugly in your ears, which may be more comfortable than what you’re currently using. You can also buy an adjustable bed and raise the upper portion of your partner’s side, which may reduce their snoring. You can find some of the best adjustable beds in this guide from Wirecutter.

Lastly, if nothing is working, then you may just have to sleep in separate rooms. “I’m not a big fan of people sleeping separately because there is sometimes a loss of intimacy,” said Dr. Abbasi-Feinberg. “But if it’s so bad that you can’t sleep, then having separate sleeping arrangements can be helpful.”

I’ve had some of the most bizarre dreams of my life this pandemic year. I’ve heard that a lot of people are having more nightmares. Why is that?

Weird and unusual dreams were certainly an element of “Coronasomnia,” the cluster of sleep problems tied to the pandemic. Studies found that people across the globe reported more vivid dreams than usual, often involving the threat of Covid-19. Most dreaming occurs during the stage of sleep known as REM, or rapid eye movement, which gets progressively longer throughout the night and into the morning. The later you sleep, the more REM sleep — and thus the more dreams — you are likely to experience. Combine high anxiety levels with the fact that people tended to sleep a little longer and later than usual this past year, and it may be no surprise that our dreams seemed to get stranger.

But dreams, even bizarre ones, have an upside. They act as therapy, helping us process stressful events like those of the past year so we can recall them without reliving the fraught emotions that were involved, said Dr. Walker. Some studies have found that experiencing more intense and emotional dreams during traumatic events can help protect people from depression. “Dreaming acts like a nocturnal soothing balm,” said Dr. Walker. “It takes sharp edges off the painful sting of difficult emotional experiences so they don’t feel as painful anymore. You’ll still have memories of the emotional event. But it’s no longer emotional itself because REM sleep has come along and stripped the bitter emotional rind from the informational memory orange, as it were.”