Talk yourself to sleep with short-term therapy
Q: I get plenty of exercise, but I still have trouble falling and then staying asleep. What else can I try?
A: Exercise can improve sleep quality and duration for many people. But timing may influence how effective it is: Studies show that some folks can work out right before they hit the hay, while others find it too stimulating. For most people, afternoon exercise is the best option. It boosts your body temperature for four to five hours, and then once it begins to go lower, that signals your body's internal clock to head into sleep mode.
But there are many folks who still struggle to fall asleep or stay asleep, even with exercise, meditation and sleep-inducing drugs.
Now, research from the Department of Veterans Affairs and the Department of Defense shows the most effective and safest solution to insomnia is a specialized program using cognitive behavioral therapy. The researchers found that short-term CBT of two to four weeks was just as effective as anti-insomnia drugs, and longer-term CBT was substantially more effective. In both versions of CBT, there are no negative side effects, except for increased sleepiness during initial stages, which resolves quickly as CBT continues.
Both short- and long-term CBT for insomnia uses behavioral treatments, including sleephygiene education, sleep-restriction therapy (no daytime snoozing), stimulus control (no TV or digital devices in the bedroom), relaxation therapy and having quiet time for 30-60 minutes before getting in bed, then in bed doing deep breathing exercises. The long-term version adds cognitive components that target flawed and unhelpful thoughts and beliefs about sleep.
Given the potentially risky side effects of prescription anti-insomnia medications (sleepwalking, rebound insomnia, anxiety and memory problems) and the health risks that come from lack of sleep (depression, anxiety, accidents, heart disease, high blood pressure, obesity and Type 2 diabetes), CBT should be your first stop in managing insomnia.
Q: I’m trying to lose weight (I'm 5 feet, 6 inches tall and weigh 195 pounds), but sometimes I cannot stop myself from enjoying a piece of cake or two ... or eating a full plate of leftovers in the middle of the night. It happens even though I am not really hungry. What should I do?
A: The brain compels you to eat foods excessively through two independent processes — the enticing, craving phase and the now-I’m-gonna-eat-it phase. Now, that’s not quite what researchers from University of Missouri called them when they studied the reactions in the brains of rats and saw that craving-eating is a twostep process, but it gives you a pretty good idea.
The craving part is associated with the pleasure- and rewarddelivering neurotransmitter dopamine. The stimulation to actually eat happens in another area of the brain where a molecule called orexin influences whether or not you will consume more than you need.
There’s not a medication that can unlink those and let you feel the binge without acting on it, but you can create that disconnect by using some brain-tricking techniques:
1. Write a list of the foods you commonly crave or binge on. Becoming aware of your cravings when they hit is the first step to
acting on them.
2. When a craving hits, stop — drink two big glasses of water. Wait.
3. Figure out other ways to stimulate pleasure-giving dopamine. A hug from your honey; a call to a good friend; a hot bath; aromatherapy. One appetite suppressing blend of essential oils that you can put into a diffuser contains eight drops bergamot, five drops grapefruit and two drops ginger.
4. Short-circuit stress eating by walking 10,000 steps a day and meditating.
5. Try spinach extract: One study showed 5 grams of spinach extract daily reduced daytime cravings for snacks and sweets by 36 percent. However, much more data is required to verify these findings, so if you try it, let us know how it works.