Slaying sleep myths: What does and doesn't work when it comes to dozing off

This article was originally published February 12, 2018.

Groggy today? It might startle you awake to know that over 30% of the population is sleep deprived. Aside from the making it harder to focus in that meeting, sleep deprivation has a profoundly negative impact on our health. Inadequate sleep increases our risk of heart disease, obesity, diabetes, and stroke. Unfortunately, getting more sleep is easier said than done and many people struggle with insomnia for most of their lives. Everyone has their own trick for falling asleep, but some have more science backing them up than others. So we're breaking down the myths and providing facts to help you become more successful in the sleep department.

Everyone has heard of counting sheep and the advice has been so oft repeated that no one really knows where it originated. But when it was actually tested in a scientific study, it didn't work. In 2002, researchers from Oxford divided people with sleep problems into three groups. They asked the first group to visualize a calm pleasing scene, the second group to think of something that would distract them like counting sheep, and left the third group as a control. Those who visualized a calming scene fell asleep faster than the sheep counters. Researchers hypothesized that image visualization took up more of the brain's processing power and distracted people from thoughts and worries that were keeping them awake. It turns out that counting sheep is simply too boring to distract the brain for long. As the researchers put it, "Picturing an engaging scene takes up more brain space than the same dirty old sheep."

What about something to drink before bed? Warm milk is another common sleep aid used by people the world over. The theory goes that milk contains tryptophan, which does have a role in sleep. But while tryptophan supplements have been studied, there is little data on milk itself and it's unclear if a single glass of milk has enough tryptophan in it to have any effect. The more mature insomniac will likely prefer a nightcap. Unfortunately though, while alcohol may make you pass out if you drink enough of it (which you shouldn't), it actually decreases the quality of that sleep. So a drink before bed is best avoided if you need to be fresh the next day.

Many people who suffer with insomnia turn to prescription sleeping pills, even if they do so with reservations. This reluctance is somewhat justified. Benzodiazepines, like ativan and valium, are commonly used to help with insomnia. But they have side effects, such as persistent drowsiness the next morning. They are also habit forming, and if combined with alcohol can lead to an overdose. People who are reluctant to use prescription sleeping pills may try melatonin, a hormone produced by the human pituitary gland. The body uses melatonin to regulate the sleep-wake cycle. During the day, light striking the retina of your eye sends a signal back to the brain to suppress melatonin production. At night, when it's dark, that inhibitory signal disappears and melatonin is produced which signals that it's time for sleep. So melatonin is particularly useful for people with a disrupted sleep-wake cycle. For example, shift workers or people suffering from jet-lag after a long trip may benefit from taking it. But it is not that effective for insomnia. Overall, it will make you fall asleep about 7 minutes faster and make you sleep for about 13 minutes longer, which is too small a difference for many people to notice.

If you find yourself tossing and turning, your biggest problem might be sleep hygiene — your bedtime habits. Simple behavioral changes like having a regular bedtime, keeping your bedroom dark and quiet, and avoiding stimulants like coffee seem simple but can have a considerable effect on your sleep quality. However, napping is the one habit people often get wrong. It may seem logical that naps will help you catch up on sleep. But napping, especially napping in the afternoon, can make it harder to fall asleep at night. Naps should also be kept short, ideally under 20 minutes, because longer naps can actually make you groggier when you first wake up. The one group that may benefit from napping are people who do regular shift work at night.

And finally, for you night owls reading this on your phones, there is a growing body of evidence that our electronic devices, phones and tablets are affecting our sleep quality. The light from those screens, especially light from the blue end of the visible spectrum, suppresses melatonin production and makes it harder for you to fall asleep. Most devices offer nighttime filters that either decrease screen brightness or shift the hue of the screen toward the red end of the spectrum. While these options make sense logically there is no good evidence testing their effect. The simpler option of course is to avoid using your phone just before bed. After all, you can tweet this article tomorrow.

Christopher Labos is a physician who writes about medicine and health issues. He co-hosts a podcast called The Body of Evidence and tweets at @drlabos.