What is good 'sleep hygiene'?

According to the Centers for Disease Control and Prevention, about 75 million Americans — more than one-quarter of the population — say they don't get enough sleep. Almost 30 million say they suffer from chronicinsomnia.

This restlessness, the CDC warns, can lead to a number of chronic illnesses and conditions, including diabetes,cardiovascular disease, obesity and depression.

It can also take an economic toll as productivity lags and workplace safety comes into question. Lack of slumber results in an average of 11.3 days, or $2,280, in lost productivity per worker each year, and the total cost to the nation is more than $63 billion annually, according to a recent study by Harvard Medical School.

"Sleeplessness has become an epidemic in the United States," said Dr. Douglas Prisco, director of sleep medicine at Keck Hospital of USC. "People are having an extremely hard time turning off."

This is National Sleep Awareness Month, so it's a good time to focus on what all the experts say is a problem that's getting bigger. But before we get to possible solutions for the sleep-deprived, let's look more closely at the reasons for our sleeplessness.

Dr. Ronald Popper, who runs the Southern California Pulmonary & Sleep Disorders Medical Center in Thousand Oaks, said he's seen a roughly 30% increase in patients since the economy tanked a few years ago.

"People have more on their minds," he said. "They have a hard time shutting down when they go to bed."

And it's not just anxiety about our jobs, homes and future keeping us awake at night. Popper and USC's Prisco also cited busier lifestyles, a culture of 24-hour news and entertainment and the ubiquity of gadgets like smartphones and iPads that can keep people gazing at electronic screens well into the wee hours.

"Bright lights suppress melatonin secretion," Popper observed. "That makes it harder to fall asleep."

The nonprofit National Sleep Foundation reported last year that nearly all of the more than 1,500 people surveyed interacted with some sort of electronic device within an hour of bedtime. That included watching TV or going online.

By the same token, the poll found that 43% of respondents ages 13 to 64 said they rarely or never get enough rest on weeknights. Most said they would like about 71/2 hours of shut-eye, but typically get fewer than seven hours.

About 15% of adults 19 to 64, and 7% of young people 13 to 18, reported sleeping fewer than six hours on weeknights.

"We're particularly having a problem with teenagers, who end up being overly sleepy in school," said Dr. George LaBrot, a sleep specialist at Santa Monica-UCLA Medical Center and Orthopaedic Hospital. "The best solution is to remove all the electronic devices from their room."

Easier said than done, as any parent will attest.

Meanwhile, people are doing everything they can to keep pace with a faster world. We schedule activities early in the morning or late at night. We skip meals when they interfere with other stuff. We keep ourselves heavily stimulated with regular doses of caffeine.

In 1987, Starbucks had just nine outlets, all in the Seattle area. Now it has more than 19,000 worldwide.

So what's a would-be sleeper to do?

Many people turn to quick fixes like Ambien, Lunesta or other prescription drugs. The research firm Global Industry Analysts estimated in a report last month that the worldwide market for sleeping pills will be worth $9 billion by 2015.

But sleep experts say this merely places a Band-Aid on the problem. To achieve lasting results, they say, you have to address the causes of sleeplessness and change your behavior accordingly.

In the sleep trade, this is known as having good sleep hygiene.

The CDC recommends avoiding caffeine, alcohol and nicotine anywhere near bedtime. It also advises skipping large meals and vigorous exercise as rock-a-bye time approaches.

A key element of good sleep hygiene is acclimating your body to a regular schedule. That means trying to go to bed and wake up around the same time every day.

The National Sleep Foundation recommends turning your bedroom into "a cool, comfortable sleeping environment that is free of distractions."

The foundation also advises keeping a "worry book" next to the bed. If anxiety is keeping you up, write down what's on your mind, jot down a few ideas about how to cope with things, and then forget about everything until morning.

There's also a technique called "sleep restriction" that's worth considering (It worked for me). If you get into bed and often toss and turn for an hour or more, start going to bed later at night, while still getting up at the same hour each morning.

That may sound counterintuitive for someone who wants more sleep — and it certainly wipes you out for a while — but the idea is to provide deeper, more restful sleep by limiting your time under the covers to the hours you're actually catching z's.

As you become more proficient at staying down, you gradually try to lengthen the amount of time in bed until you get closer to the seven or eight hours most experts say is preferable.

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