Getting sufficient, restorative, and deep sleep every night is vital to your health and overall well-being. While conditions such as back and neck pain, sciatica, and other sources of pain may keep you from falling asleep, not gaining enough sleep can likewise cause or exacerbate these problems.1Watson NF, Badr MS, Belenky G, et al. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–844. Published 2015 Jun 1. doi:10.5665/sleep.4716

As a general rule, a minimum of 7 hours of sleep is required each night for optimal health.1Watson NF, Badr MS, Belenky G, et al. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–844. Published 2015 Jun 1. doi:10.5665/sleep.4716 Read on to learn unique and effective insights into gaining a healthy sleep routine and how to fall asleep and stay asleep for longer.

1. Exercise during the day

Some research has found that exercising anytime during the day can help promote a good night’s sleep, and others observed that exercising an hour and a half before bedtime was associated with better sleep outcomes.2Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between Sleep and Exercise: A Systematic Review [published correction appears in Adv Prev Med. 2017;2017:5979510]. Adv Prev Med. 2017;2017:1364387. doi:10.1155/2017/1364387 A process of trial and error may help you figure out the best time to exercise.

If you have back pain or other medical issues that make it difficult to exercise, find another way, such as water therapy, to get your heart rate up. The water in the pool supports your joints and provides gentle resistance, making it possible for you to get a good amount of workout with lesser or no pain. You could also try regular or brisk walking for 5 to 10 minutes.3Yeung T, Martin JL, Fung CH, et al. Sleep Outcomes With Cognitive Behavioral Therapy for Insomnia Are Similar Between Older Adults With Low vs. High Self-Reported Physical Activity. Front Aging Neurosci. 2018;10:274. Published 2018 Sep 13. doi:10.3389/fnagi.2018.00274

See Water Therapy Exercise Program

Exercising to the point of elevating your heart rate has the added benefit of producing more of your body's own feel-good hormones: endorphins.

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2. Avoid caffeine late in the day

Caffeine can significantly lower your body’s ability to fall asleep. Caffeine can last in your body for up to 10 hours after consumption, some people storing higher concentrations than others. Every individual's body is different—while some may get less or light sleep with even little traces of caffeine, others may not be affected by large concentrations.4O'Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Manag Healthc Policy. 2018;11:263–271. Published 2018 Dec 7. doi:10.2147/RMHP.S156404

While you may not be able to give up your coffee during the day, consider staying away from beverages containing caffeine at least 5 to 6 hours before your bedtime. This time period allows your body to develop enough melatonin (your sleep hormone) without being obstructed by the effects of caffeine.4O'Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Manag Healthc Policy. 2018;11:263–271. Published 2018 Dec 7. doi:10.2147/RMHP.S156404

3. Have an early dinner

The best time to have your dinner is 2 to 3 hours before going to bed.5Nakajima K. Unhealthy eating habits around sleep and sleep duration: To eat or fast?. World J Diabetes. 2018;9(11):190–194. doi:10.4239/wjd.v9.i11.190 When you have a late dinner, you are at a higher risk of developing gastroesophageal reflux syndrome, which can cause disturbed sleep.5Nakajima K. Unhealthy eating habits around sleep and sleep duration: To eat or fast?. World J Diabetes. 2018;9(11):190–194. doi:10.4239/wjd.v9.i11.190,6Lin Y, Peng Y, Liang B, et al. Associations of dinner-to-bed time, post-dinner walk and sleep duration with colorectal cancer: A case-control study. Medicine (Baltimore). 2018;97(34):e12038. doi:10.1097/MD.0000000000012038 Eating late also prevents your body from warming up, which is important to initiate your sleep cycle. Several body functions, such as insulin and glucose metabolism are also disrupted when you have a late evening meal.5Nakajima K. Unhealthy eating habits around sleep and sleep duration: To eat or fast?. World J Diabetes. 2018;9(11):190–194. doi:10.4239/wjd.v9.i11.190

4. Take a warm bath prior to but not immediately before bedtime

Warming your body through showers or baths an hour or two before bedtime may help you fall asleep faster and stay asleep longer. Our body functions in a way where initially a higher body temperature (especially in the arms and feet) allows the sleep cycle to kick in, and 2 hours into the sleep phase, the body’s core temperature drops. This process of temperature regulation is important to stay asleep—it is during this time that the body’s sleep hormone, melatonin circulates in higher concentrations.7Harding EC, Franks NP, Wisden W. The Temperature Dependence of Sleep. Front Neurosci. 2019;13:336. Published 2019 Apr 24. doi:10.3389/fnins.2019.00336

5. Try a natural sleep enhancer

Certain herbs or fruit extracts have biologic effects that may promote longer sleep without altering the body’s natural metabolism. Effective options are described below.

  • Valerian herbal supplement. Valerian is an herb and is made from the root of a perennial flower. It is classified as a dietary supplement and available over the counter. Valerian may be effective in helping you stay asleep longer, allowing a deeper and more restful night's sleep.8Valerian: Fact Sheet for Health Professionals. National Institutes of Health Office of Dietary Supplements. 15 March 2013. Available at https://ods.od.nih.gov/factsheets/Valerian-HealthProfessional/. Accessed 24 October 2019.,9Nunes A, Sousa M. [Use of valerian in anxiety and sleep disorders: what is the best evidence?]. Acta Med Port. 2011;24 Suppl 4:961-6.
  • Tart cherry extract. Cherries contain melatonin, which allows your body to regulate its sleep cycle and lets you sleep longer. Cherries also contain tryptophan, a substance that reduces the time needed to fall asleep, letting you sleep faster.10Losso JN, Finley JW, Karki N, et al. Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms. Am J Ther. 2018;25(2):e194–e201. doi:10.1097/MJT.0000000000000584 Cherry extracts are commonly available in grocery stores; you can consume them in the form of supplements or as juice.

If you prefer a warm drink, try chamomile tea. Chamomile is a medicinal plant and drinking chamomile tea before bedtime is known to improve sleep quality.11Adib-hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: A clinical trial. Complement Ther Med. 2017;35:109-114.,12Miraj S, Alesaeidi S. A systematic review study of therapeutic effects of Matricaria recuitta chamomile (chamomile). Electron Physician. 2016;8(9):3024–3031. Published 2016 Sep 20. doi:10.19082/3024

See Natural Remedies and Herbal Supplements as Sleep Aids

6. Go to bed at the same time every night

This rule may seem more suitable for children, but even adults need to prepare themselves for sleep at a specific time every night. Sleeping at the same time strengthens your sleep routine and is helpful in achieving good quality sleep. Even a 2-hour shift in your routine bedtime without making up for the missed hours in the morning can decrease your mental and physical functioning during the day.13Herzog-Krzywoszanska R, Krzywoszanski L. Bedtime Procrastination, Sleep-Related Behaviors, and Demographic Factors in an Online Survey on a Polish Sample. Front Neurosci. 2019;13:963. Published 2019 Sep 18. doi:10.3389/fnins.2019.00963,14Kang JH, Chen SC. Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan. BMC Public Health. 2009;9:248. Published 2009 Jul 19. doi:10.1186/1471-2458-9-248

7. Read a printed book and keep your electronic devices away

Reading from light-emitting electronic devices, such as phones and tablets can disturb your sleep rhythm. The effects include falling asleep later, a decrease in the quality of sleep, feeling sleepier in the morning, and a lower rate of alertness after waking.15Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci U S A. 2015;112(4):1232–1237. doi:10.1073/pnas.1418490112

If you like to read before sleeping, read from a printed book in reflected light.15Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci U S A. 2015;112(4):1232–1237. doi:10.1073/pnas.1418490112

8. Make sure your mattress is comfortable

The type of mattress that you use can impact the quality of your sleep. 16Wong DW, Wang Y, Lin J, Tan Q, Chen TL, Zhang M. Sleeping mattress determinants and evaluation: a biomechanical review and critique. PeerJ. 2019;7:e6364. Published 2019 Jan 25. doi:10.7717/peerj.6364,17Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004 If you shift positions often, wake up several times, and/or wake up with shoulder or back pain, your mattress may be to blame. If your mattress sags—meaning that you can see a compression in some part of the mattress, it will almost always create sleep discomfort and can worsen back problems.

A mattress with ergonomic standards and the right level of firmness may help promote better sleep, typically by providing an even surface and reducing body aches and pains.16Wong DW, Wang Y, Lin J, Tan Q, Chen TL, Zhang M. Sleeping mattress determinants and evaluation: a biomechanical review and critique. PeerJ. 2019;7:e6364. Published 2019 Jan 25. doi:10.7717/peerj.6364,17Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004 A medium-firm mattress may provide adequate body support to enhance your sleep quality.17Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004

See Choosing the Best Mattress for Lower Back Pain

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9. Cool your bedroom and use cozy bedding

Optimal room temperature and comfortable bedding can be effective in getting you to fall asleep.7Harding EC, Franks NP, Wisden W. The Temperature Dependence of Sleep. Front Neurosci. 2019;13:336. Published 2019 Apr 24. doi:10.3389/fnins.2019.00336 To cool your room—use a fan, open the window, or turn up your AC.

Use these tips to make yourself comfortable:

  • A combination of a cold bedroom, heavy blankets or comforters, and several pillows may be soothing, as nestling in under the covers can have a cocooning feeling that nurtures sleep.18Tsuzuki K, Okamoto-Mizuno K, Mizuno K. The Effects of Low Air Temperatures on Thermoregulation and Sleep of Young Men While Sleeping Using Bedding. Buildings. 2018;8(6):76. doi:10.3390/buildings8060076
  • Wear bed socks to keep your feet warm, which can help you sleep faster and longer.19Ko Y, Lee JY. Effects of feet warming using bed socks on sleep quality and thermoregulatory responses in a cool environment. J Physiol Anthropol. 2018;37(1):13. Published 2018 Apr 24. doi:10.1186/s40101-018-0172-z
  • Use pillows to support your lower back and hips and maintain the natural curve of your spine.

Using white noise may help cancel out the background sounds, which means that you won't be woken up with every little thump that the house makes. You can use a fan, buy a white noise machine, or download an app that will provide several white noise options like the sound of rain, wind, and more.

10. Replace worries with positive thoughts

Often times, worries, negative emotions, and thoughts related to stressful events may keep you from falling asleep. Instead of trying to suppress the negative feelings, cultivating positive emotions through mindfulness may help you fall asleep sooner and attain good sleep.20Ong JC, Ulmer CS, Manber R. Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia. Behav Res Ther. 2012;50(11):651–660. doi:10.1016/j.brat.2012.08.001

Mindfulness includes techniques to divert your mind to positive thoughts through focus and meditation.

11. Soak in the sunlight during the day

Exposure to sunlight can affect your sleep time, quality, and duration. Getting outdoors during the day when the light intensity is higher is more beneficial than lower-intensity evening sunlight.21Wams EJ, Woelders T, Marring I, et al. Linking Light Exposure and Subsequent Sleep: A Field Polysomnography Study in Humans. Sleep. 2017;40(12):zsx165. doi:10.1093/sleep/zsx165 It is also important to not spend too much time outdoors during noon or when the UV rays are high, which may cause sunburns.

Aim to spend a few minutes in the morning and late afternoon, which can help your internal body clock to get ready for sleep in the evening.

Everyone is different, so figuring out what works best for you may take some trial and error. Try several of these tips to help yourself get better sleep. If you work a night-shift job, these tips can still help you get adequate sleep during the day. If your sleep problems worsen over time or do not improve with these tips, there may be a medical cause, such as sleep apnea or periodic limb movement disorder, which requires a doctor’s evaluation and treatment.

Learn more:

Choosing the Best Mattress for Lower Back Pain

  • 1 Watson NF, Badr MS, Belenky G, et al. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–844. Published 2015 Jun 1. doi:10.5665/sleep.4716
  • 2 Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between Sleep and Exercise: A Systematic Review [published correction appears in Adv Prev Med. 2017;2017:5979510]. Adv Prev Med. 2017;2017:1364387. doi:10.1155/2017/1364387
  • 3 Yeung T, Martin JL, Fung CH, et al. Sleep Outcomes With Cognitive Behavioral Therapy for Insomnia Are Similar Between Older Adults With Low vs. High Self-Reported Physical Activity. Front Aging Neurosci. 2018;10:274. Published 2018 Sep 13. doi:10.3389/fnagi.2018.00274
  • 4 O'Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Manag Healthc Policy. 2018;11:263–271. Published 2018 Dec 7. doi:10.2147/RMHP.S156404
  • 5 Nakajima K. Unhealthy eating habits around sleep and sleep duration: To eat or fast?. World J Diabetes. 2018;9(11):190–194. doi:10.4239/wjd.v9.i11.190
  • 6 Lin Y, Peng Y, Liang B, et al. Associations of dinner-to-bed time, post-dinner walk and sleep duration with colorectal cancer: A case-control study. Medicine (Baltimore). 2018;97(34):e12038. doi:10.1097/MD.0000000000012038
  • 7 Harding EC, Franks NP, Wisden W. The Temperature Dependence of Sleep. Front Neurosci. 2019;13:336. Published 2019 Apr 24. doi:10.3389/fnins.2019.00336
  • 8 Valerian: Fact Sheet for Health Professionals. National Institutes of Health Office of Dietary Supplements. 15 March 2013. Available at https://ods.od.nih.gov/factsheets/Valerian-HealthProfessional/. Accessed 24 October 2019.
  • 9 Nunes A, Sousa M. [Use of valerian in anxiety and sleep disorders: what is the best evidence?]. Acta Med Port. 2011;24 Suppl 4:961-6.
  • 10 Losso JN, Finley JW, Karki N, et al. Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms. Am J Ther. 2018;25(2):e194–e201. doi:10.1097/MJT.0000000000000584
  • 11 Adib-hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: A clinical trial. Complement Ther Med. 2017;35:109-114.
  • 12 Miraj S, Alesaeidi S. A systematic review study of therapeutic effects of Matricaria recuitta chamomile (chamomile). Electron Physician. 2016;8(9):3024–3031. Published 2016 Sep 20. doi:10.19082/3024
  • 13 Herzog-Krzywoszanska R, Krzywoszanski L. Bedtime Procrastination, Sleep-Related Behaviors, and Demographic Factors in an Online Survey on a Polish Sample. Front Neurosci. 2019;13:963. Published 2019 Sep 18. doi:10.3389/fnins.2019.00963
  • 14 Kang JH, Chen SC. Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan. BMC Public Health. 2009;9:248. Published 2009 Jul 19. doi:10.1186/1471-2458-9-248
  • 15 Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci U S A. 2015;112(4):1232–1237. doi:10.1073/pnas.1418490112
  • 16 Wong DW, Wang Y, Lin J, Tan Q, Chen TL, Zhang M. Sleeping mattress determinants and evaluation: a biomechanical review and critique. PeerJ. 2019;7:e6364. Published 2019 Jan 25. doi:10.7717/peerj.6364
  • 17 Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004
  • 18 Tsuzuki K, Okamoto-Mizuno K, Mizuno K. The Effects of Low Air Temperatures on Thermoregulation and Sleep of Young Men While Sleeping Using Bedding. Buildings. 2018;8(6):76. doi:10.3390/buildings8060076
  • 19 Ko Y, Lee JY. Effects of feet warming using bed socks on sleep quality and thermoregulatory responses in a cool environment. J Physiol Anthropol. 2018;37(1):13. Published 2018 Apr 24. doi:10.1186/s40101-018-0172-z
  • 20 Ong JC, Ulmer CS, Manber R. Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia. Behav Res Ther. 2012;50(11):651–660. doi:10.1016/j.brat.2012.08.001
  • 21 Wams EJ, Woelders T, Marring I, et al. Linking Light Exposure and Subsequent Sleep: A Field Polysomnography Study in Humans. Sleep. 2017;40(12):zsx165. doi:10.1093/sleep/zsx165

Dr. Zinovy Meyler is a physiatrist with over a decade of experience specializing in the non-surgical care of spine, muscle, and chronic pain conditions. He is the Co-Director of the Interventional Spine Program at the Princeton Spine and Joint Center.

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