Sleep hygiene first step in getting a good night's rest


Dear Doctor: Even before the pandemic, I had trouble with sleep. It’s hard to fall asleep and to stay asleep. I don’t want to use any pills or medicines. Are there nondrug approaches that can work? What about lavender, CBD or magnesium?

Dear Reader: In the past year, stress, fear, worry and the unexpected changes to daily routines due to the coronavirus pandemic have caused a spike in the number of Americans struggling with sleep. We wish there were a quick and easy fix, but reclaiming the ability to get a good night’s sleep is a process. It takes consistency and discipline, and even then, the path to success is often an uneven trajectory.

Start with good sleep hygiene. That means a sleep environment that’s dark, cool and quiet. Eye shades, ear plugs and lighter bedding can help. Our bodies’ internal clocks run on chemical triggers tied to the waxing and waning of daily light. We’ve already affected those signals with our artificially lit world. New research continues to suggest that the blue light from electronic screens also scrambles the brain’s sleep signals and plays a role in sleep issues. So, in addition to choosing and sticking to a regular bedtime, it’s very important to stop looking at screens -- not even a quick peek at your phone -- for at least a few hours before bedtime. (We warned you this would take discipline.)

When used in conjunction with other sleep hygiene practices, the scent of lavender has been found to help with both sleep quantity and quality. So have meditation, deep breathing and relaxation techniques, when practiced consistently.

Elizabeth Ko, MD and Eve Glazier, MD

Once that’s all taken care of, you’re ready to consider nonpharmacologic approaches to insomnia. You asked about magnesium, a mineral that’s crucial to our body’s functions. It’s important to bone density, normal heart rhythm and blood pressure control. Research shows that many American adults don’t get the recommended daily 320 milligrams needed for women and 420 milligrams for men. Some small studies have linked magnesium to longer sleep duration and better-quality sleep in older adults. Magnesium supplements are available, of course, but we recommend adjusting your diet instead. The mineral is abundant in high-fiber foods like nuts, seeds, whole grains, beans and dark leafy greens. And good news for chocolate lovers -- an ounce of dark chocolate has 65 milligrams, which is 16% of your daily requirement.

As for cannabidiol, better known as CBD, the jury is still out on its efficacy as a sleep aid. CBD is one of the many cannabinoid compounds found in cannabis, which, because it doesn’t have psychoactive properties, won’t get you high. Some studies have found it can improve sleep duration and sleep quality, but the effects were spotty and not sustained over time. The manufacturing process of CBD remains unregulated, and it’s still illegal in some states. There’s also evidence that it can interfere with the efficacy of some prescription drugs. Some people find it helpful, but more study is needed for a definitive understanding of its role in sleep.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)