Sleeping Better: What Actually Helps, and When to Get Help

Almost everyone has a bad night now and then. When poor sleep goes on for weeks, it affects mood, concentration, pain and energy. The good news is that most sleep problems respond to simple, steady changes, and there is an effective treatment that does not involve pills.

How much sleep do adults need?

Canada's 24-Hour Movement Guidelines suggest 7 to 9 hours of good-quality sleep for most adults, with regular bed and wake times. Some people do well on a little less and some need a little more. What matters is whether you wake feeling reasonably rested and can function during the day.

Habits that help

• Keep a steady wake-up time. This is the single most useful habit. A regular wake time, even on days off, trains your body clock.
• Get daylight early. Morning light helps set your body clock.
• Watch caffeine and alcohol. Caffeine can linger for many hours. Alcohol may make you drowsy but tends to break up sleep later in the night.
• Wind down. Dim the lights and put screens away for the last stretch before bed. A short, calm routine such as reading or stretching helps.
• Keep the bedroom for sleep. A cool, dark, quiet room works best. Avoid working or scrolling in bed.
• Do not stay in bed awake. If you have been awake for a long while, get up, do something quiet in low light, and go back when you feel sleepy. Lying there frustrated teaches your brain that bed is for worrying.
• Keep naps short. A brief nap earlier in the day is fine. Long or late naps can make night sleep harder.
• Move your body during the day. Regular activity usually improves sleep, though intense exercise close to bedtime does not suit everyone.

The treatment doctors usually recommend first

For long-lasting insomnia, the usual first recommendation is cognitive behavioural therapy for insomnia, often called CBT-I. It is a short structured program that changes the habits and thoughts that keep sleep problems going. It is generally preferred to sleeping pills because the benefits tend to last after treatment ends. It is offered by some psychologists, psychotherapists and other trained clinicians, and some programs run online.

Sleeping pills are generally meant for short-term use. Talk to your doctor or pharmacist before starting or stopping any sleep medication, and do not combine them with alcohol.

When to see a doctor

• Trouble sleeping most nights for several weeks, or poor sleep that is hurting your work, mood or relationships
• Loud snoring, gasping or pauses in breathing during sleep, or waking with a headache. These can be signs of sleep apnea
• Strong urges to move your legs at night
• Falling asleep while driving or at other dangerous moments
• Low mood, anxiety or worry that keeps you up

If poor sleep comes with thoughts of harming yourself, call or text 9-8-8 any time, or call 911 in an emergency. For health advice from a registered nurse, you can call 811 or use Health811.

What it costs

A visit with your family doctor for sleep concerns is covered by OHIP. Therapy such as CBT-I with a psychologist or psychotherapist is usually a private fee, although many workplace benefit plans cover part of it. Ask the clinic about its fees up front, and use AffordableHealth.ca to match with a verified professional whose price fits your budget.

This is general information, not medical advice. See a health professional about your own situation.

Sources

• Canadian 24-Hour Movement Guidelines for Adults (CSEP)
• Health811 (Ontario)