Get Some Sleep

By Christine Gorman

It's 2 A.M. and you've counted enough sheep to fill a paddock, but you still can't get the shut-eye you need. Do you a) start counting goats; b) get out of bed and read; or c) take a sleeping pill? If you picked reading, your restless nights may soon be over. According to a report in last week's Journal of the American Medical Association, adopting a few basic habits--like limiting the amount of time you spend in bed--works better than pills or goats in controlling chronic insomnia.

Led by Charles Morin, a professor of psychology at Laval University in Quebec, the J.A.M.A. study is the latest in a series of sleep experiments stretching back 50 years. Much remains mysterious. Despite thousands of hours measuring the brain waves of unconscious subjects, monitoring their breathing and noting the effects of sleep deprivation, scientists still don't know the answers to some of the most basic questions, like why we need to sleep in the first place. That hasn't stopped some wild ideas from gaining popularity. In December, Pocket Books paid a whopping $200,000 advance for a yet-to-be published book that claims you can lose weight by sleeping longer. (Darn! Why didn't I think of that one?)

But back to reality. Almost everyone experiences a sleepless night or two at some point in their lives. The subjects in Morin's study--all of whom were over age 55--had been fluffing up their pillows in vain for 15 to 20 years. Most of them had no trouble falling asleep. The hard part was staying asleep through the night.

After excluding patients whose insomnia may have resulted from some other condition, such as depression, researchers divided the remaining 78 subjects into four groups. One group took the sleeping pill Restoril. The second group underwent cognitive-behavior therapy designed, among other things, to promote better sleep habits. The third group received both medication and behavior therapy, and the last group took a placebo, or sugar pill. Each of the groups was treated for eight weeks.

Not surprisingly, the sleeping pills helped test subjects sleep longer right away. But the results were not really different, at least in the short term, from those provided by behavior therapy and the combined treatment. And when the researchers contacted their subjects two years later, only the behavior- therapy group had maintained its initial recovery. As soon as participants stopped taking sleeping pills, the sleepless nights returned.

How can you improve your chances of getting a good night's sleep? Start by restricting your time in bed to two activities: sleep and sex. If you don't fall asleep within 20 minutes, get up and read quietly in another room so that your brain associates your bed with sleep, not anxiety. Meanwhile, work with your body instead of against it. Don't nap after 3 p.m. Cut back on caffeine, especially in the afternoon or evening. Don't drink alcohol at night; it may allow you to fall asleep more easily but you're likely to suffer a rebound effect in a few hours. Getting up at the same time every morning is also important, because that makes it easier to synchronize your body's biological clock. Whatever you do, don't panic if you become sleepless once again. Most folks find they can't break the cycle of insomnia overnight.

Learn more about the latest sleep research at time.com/personal or www.jama.com

E-mail Christine at [email protected]