What Keeps You Awake?

Is a good night's sleep the first thing you sacrifice when life gets too full and busy? If so, this is your wake-up call: You're not just sabotaging your next day's performance, but you're actually harming your health. Sleep deprivation is a serious medical risk, but few people are aware of that. You have to pay as much attention to your sleep as you do to eating a nutritious diet.

A spate of studies is turning up clear links between inadequate sleep and obesity, as well as several related conditions: heart disease, hypertension, and type 2 diabetes. The good news is that with adequate shut-eye, these conditions may be reversible. Drawing on studies about what robs us of quality sleep, they have devised strategies that can help you get the rest you need. Here's a lineup of the most insidious sleep thieves–and the latest recommendations on how to bar them from your bedroom forever.

1. You Think Too Much
The reason you sometimes obsess over a tricky work project or an argument with your best friend when you're trying to fall asleep: You can't refocus your thinking at the edge of slumber the same way you can when you're alert. People have little control over their thoughts, because they may be going in and out of a light stage of sleep, even though they think they're awake. When fretful, get up and go to another part of the house (but leave the lights off). Your anxious thoughts will usually stop right away. Then you can go back to bed and fall asleep. This well-studied strategy, called stimulus control, also prevents you from associating your bed with anxiety. Another tip: Set aside time early in the evening to problem solve. Write down your pressing concerns, along with a possible solution for each, a few hours before retiring.

2. You Overdose on Weekends
Late nights followed by extra sack time the next morning throw off your internal clock, which is controlled by a cluster of nerve cells in the brain that also regulate appetite and body temperature. When Sunday rolls around, you're reprogrammed to stay up past your bedtime, and you feel like a zombie on Monday morning. Even if you've been up late, don't sleep in more than an hour longer than usual. To make up for lost slumber, take an afternoon catnap (no more than 30 minutes, though, because an extended daytime snooze can keep you awake at night).

3. Your Spouse Chops Wood
A snorer's sawing can reach 90 decibels–as loud as a blender. Even if you can get to sleep, his snoring will likely wax and wane through the night and wake you up during REM sleep, the most restful phase. Ask your partner to sleep on his side instead of his back. Try the FDA-approved Sona pillow developed by a Harvard-trained neurologist. It's specially shaped to tilt your head and open your airways. Moreover, the pillow decreased or eliminated snoring in nearly every patient studied and reduced sleep interruptions from an average of 17 an hour to fewer than 5.If that doesn't work, earplugs will work.

4. Your Hormones Change
Fluctuating levels of estrogen and progesterone before or during your period or throughout perimenopause can sabotage sleep. You may notice problems–mainly waking up during the night–long before you start having hot flashes. A hot bath a couple hours before turning in and, if you're often awakened by cramps, an over-the-counter pain reliever at bedtime may be all you need to counter premenstrual insomnia. For a stubborn case, ask your physician whether a short-acting sleep medication, taken two or three nights a month, would make sense.

During perimenopause, stay on a consistent sleep-wake schedule, exercise at least 20 to 30 minutes a day, and avoid caffeine after lunch and alcohol within 3 hours of bedtime (a cocktail helps you fall asleep, but its rebound effect will wake you up). For hot flashes and night sweats, try sleeping in a cool room and wearing light clothing. If you're still tossing and turning, consider hormone therapy. Recent research suggests that it may be safe for many women in their 50s when used for fewer than 5 years.

5. Your Stomach Growls
Going to bed hungry interferes with sleep–hunger pangs simply wake you up–and some evidence suggests that people trying to lose weight may wake up frequently. Research reveal that saving some of your calories for a high-protein bedtime snack, such as a small serving of cheese or a hard-boiled egg. Protein produces greater satiety than carbohydrates and fat.

6. Your Bedroom Is a Mess
You keep a messy pile of papers on your nightstand…and your desk…and the floor. A cluttered sleep environment makes for a cluttered mind–the kind that churns well into the night. Stress is the number one cause of short-term sleep problems such as frequent middle-of-the-night waking and insomnia. Grab a basket, toss in any unfinished work–bills, spreadsheets, that half-done scrapbook–and promptly remove it. “When you eliminate the stuff in your bedroom that isn't related to sleep, your brain starts to associate the room only with sleep and intimacy.

Also keep your computer in another room, or at least place it in a cabinet that can be closed. You'll be shutting the door on stress and late-night screen gazing, which has been proven to hinder sleep, according to a Japanese study in the Journal of Applied Physiology. The monitor's bright display may inhibit your production of melatonin, the hormone responsible for telling the body it's time for bed.

7. Your Room Glows in the Dark
Believe it or not, ambient light from street lamps, alarm clocks, and DVD players could be keeping you awake. Even a small amount of brightness can be strong enough to enter your retina when your eyes are closed. At night, it sends a signal to your brain that upsets your internal clock and makes you feel awake.

If there is light in the hallway, shut the bedroom door. Also, turn your alarm clock toward the wall (or opt for the nondigital variety), and eliminate night-lights. Wearing an old-fashioned eye mask helps signal your brain that, yes, it really is nighttime, as well. To block outside brightness, hang blackout shades and curtains. You can either attach them to the backs of your existing window treatments or hang them on their own.

8. You Can Hear a Pin Drop
For some people, any sound (the television, rowdy neighbors, traffic) keeps them up at night. Surprisingly, it's not the sound or lack thereof that's keeping you awake, it's the inconsistency of sound or silence that's disruptive. Turn on a nearby ceiling or exhaust fan. This will act as white noise, both blocking out disruptive sounds and providing just enough noise for those who can't stand total silence.