Behavioral treatments useful for sleep

Q:igetplentyofexercise, but I still have trouble falling and then staying asleep. What else can I try? — George G. Andover, Massachusetts

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.

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.

Such therapy uses behavioral treatments, including sleep hygiene 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.

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? — Janice F., Franklin, Tennessee

A: The brain compels you to eat foods excessively through two independent processes: the enticing, craving phase and the nowI’m-gonna-eat-it phase.

The craving part is associated with the pleasure- and reward-delivering neurotransmitter dopamine.

The stimulation to eat happens in another area of the brain where a molecule called orexin influences whether 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 :

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 not 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.

4. Short-circuit stress eating by walking 10,000 steps a day and meditating.

Email questions for Mehmet Oz and Mike Roizen to youdocsdaily@sharecare. com.