Q: What's a proper pre-bedtime routine to help promote a good night's sleep?

There are a few simple pre-bedtime principles that have been shown to promote a good night's sleep. Falling asleep is not a simple on/off switch. Therefore it is important to unwind and ease your mind and body into a state of relaxation before bed. Ideally, I recommend that you try to protect the hour before sleep as a wind-down time. During this time, you want to have the same routine every night (when possible) to help signal to your mind and body that you are getting ready for bed. Although the wind-down routine can vary from person to person, a typical routine could consist of the following: washing face/brushing teeth, dimming the lights, reading something relaxing and non-stimulating (ex. you don't want to start a fantastic novel just before bed!), listening to calming music, and then getting in bed. This is not the time to be talking on the phone, texting, returning emails, cleaning, planning your next vacation, or paying your bills. The goal is to wind down, relax, and prepare yourself for bed.

Also important is to make sure you only use your bed for sleep (with sex being the only exception). Any of these pre-bedtime routines should be done outside of your bed (and ideally outside the bedroom). Though this is a difficult rule for some, it is extremely helpful in associating the bed for only sleep, and not as a place to read, talk, think, etc. Also, don't take your worries to bed with you. Instead, before you begin your wind-down routine, write down anything you are worrying about or anything you need to accomplish. Get it out of your head and onto a piece of paper.

In addition, staying in a dim environment before bedtime helps to prepare your body for bedtime, allowing for sleep-inducing melatonin (we produce this naturally) to be released. It is best to avoid using your computer or watching TV during this time as they can be quite stimulating. In addition, the light from these electronics can help prevent the release of melatonin and may keep you awake.

Other things that are helpful to promote a good night's sleep are: taking a 20 minute warm bath or shower roughly 1.5 to 2 hours before bed, avoiding alcohol and any liquids within 3 hours of bed, and refraining from caffeine (coffee, soda, tea, chocolate) within 6 hours of bedtime. Also, don't exercise too close to bedtime, though exercising 5-6 hours before bed has been shown to help induce sleepiness.

If you find that these solutions are not sufficient to help you obtain a quality night of sleep, talk with your primary care physician or a sleep specialist about your concerns.

Shelby Freedman Harris, Psy.D., C.BSM is Director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center and Assistant Professor of Neurology as well as Psychiatry at the Albert Einstein College of Medicine. She is board certified in Behavioral Sleep Medicine by the American Academy of Sleep Medicine. A graduate of Brown University, Dr. Harris received her doctorate in clinical psychology from Ferkauf Graduate School of Psychology, Yeshiva University. Dr. Harris completed her predoctoral internship at Montefiore Medical Center where she trained in the Sleep-Wake Disorders Center, and has received advanced postdoctoral training in Cognitive Behavior Therapy (CBT) for anxiety and depressive disorders.

As a licensed psychologist, Dr. Harris specializes in behavioral sleep medicine and CBT for anxiety and depression. She has published and presented research on the neuropsychological effects of insomnia in older adults as well as behavioral treatments for insomnia, parasomnias, narcolepsy and excessive daytime sleepiness. Dr. Harris currently supervises students from the Montefiore Psychology Internship, Ferkauf Graduate School of Psychology Cognitive Behavior Therapy Program and the Sleep-Wake Disorders Center Fellowship. Dr. Harris is a consultant for the
New York Times "Consults Blog" and is frequently quoted in the media, including The New York Times "Well Blog", The Huffington Post, The New Yorker, Wall Street Journal, Cosmopolitan, and Fitness Magazine. She has appeared on ABC7-NY's Eyewitness News and ABC's Primetime: Live.