Debunking Sleep Myths

From NPR
MYTH 1: It doesn’t matter what time of day you sleep
“Unfortunately, the time of day does matter,” says Robbin. Our circadian rhythm — the internal circuitry that guides the secretion of the essential sleep hormone melatonin — is “significantly influenced by natural sunlight in our environment.”

When the sun comes up and we go outside, that sunshine “stops the floodgates of melatonin and switches the ‘on’ phase of our circadian rhythm,” she says.

“Conversely, going into a dark environment is what allows for the secretion of melatonin,” she adds.

Because of the importance of light, individuals who commonly work on overnight schedules or outside the typical 9 to 5 p.m. window can experience health issues, says Robbins. One study published in the journal Occupational Medicine in 2011 found that physicians and nurses who worked during these shifts were more likely to experience an increase in negative health outcomes such as diabetes and breast cancer.

They may be able to get good sleep that supports their health if they are “very diligent about the exposure they get to natural sunlight,” she says. For example, avoiding sunlight in their work environment as they approach the end of their shift, wearing sunglasses on the drive home to protect their eyes from the sunrise and sleeping in a room with very thick blackout curtains.

MYTH 2: One night of sleep deprivation will have lasting effects

If you had a bad night of sleep, don’t stress — just get back to your normal sleep routine as soon as possible, says Robbins.
Your sleep isn’t going to be perfect every night, says Robbins. “Every now and then we might struggle. If we experience some stress during the day, our sleep suffers that night.”

Sleep deprivation, or lack of sleep for at least 24 hours, can lead to short-term adverse effects such as a lapse in attention or an increase in resting blood pressure, write Robbins and her colleagues in their research paper.

But they likely resolve with recovery sleep. So if you have an off night, don’t beat yourself up about it, says Robbins. Instead, try to get back on track with your normal sleep schedule as soon as possible.

MYTH 3: Being able to fall asleep anytime, anywhere is a good thing

Being able to fall asleep in random places … like your desk … isn’t a good thing. It takes a well-rested, healthy person about 15 to 20 minutes to fall asleep, says Robbins.
“It’s a myth that a good sleeper would be able to hit the pillow and fall asleep right away,” says Robbins. “This is because sleep is a process.”

It takes a well-rested, healthy person about 15 to 20 minutes or maybe a little bit longer to fall asleep, she adds.

If you’re able to fall asleep immediately, it may be a sign of a chronically sleep-deprived state, write Robbins and her colleagues in their study. “If you were starved for food and sat down at any opportunity to eat a huge meal and ate voraciously, that would probably be a sign you’re not getting enough nutrition. It’s the same thing with sleep.”

MYTH 4: You can survive on less than 5 hours of sleep

Not getting a full night’s sleep — about 7 to 9 hours — can result in weight gain, obesity, diabetes and hypertension.
Some people brag about needing only a few hours of sleep at night. That may come from the notion in our high-performing society that “well-rested people are lazy,” says Robbins — “which is a myth.”

The reality is that adults need about 7 to 9 hours of sleep a night, she says. “That’s where we see the most optimal health [outcomes]: improved heart health, longevity and brain health into our older years.”

Sleeping less than 7 hours a night can result in weight gain, obesity, diabetes and hypertension, according to a statement from the American Academy of Sleep Medicine and Sleep Research Society. It’s also associated with impaired immune function, impaired performance and increased errors — like “sending an email to the wrong person or entering incorrect numbers in a spreadsheet,” says Robbins.

So if you can, try to hit that goal of sleeping 7 to 9 hours as many nights of the week as possible, she adds. You’ll know that you’ve hit your sweet spot when you “wake up feeling refreshed, have energy throughout the day and are not reaching for coffee or energy drinks in the afternoon.”

MYTH 5: Watching TV is a good way to relax before bedtime

Watching a show on a device that emits heat, like a laptop positioned on your stomach, can deter your ability to fall asleep, says Robbins.
Some people like to wind down before bed by watching TV. But that’s not a good idea, says Robbins. “You’re starting to associate your bed with things other than sleep.”

Watching a show on a device that emits heat, like a laptop positioned on your stomach, can also deter your ability to fall asleep. “Keep the body cool as you approach bedtime,” she says. Your bedroom should ideally be under 70 degrees. Hotter temperatures can lead to “tossing and turning, sleep disruption and more nightmares.”

In addition, watching upsetting programs like the nightly news could cause the stress hormone cortisol to spike in your body and “hinder your ability to power down,” she says.

But if watching 20 or 30 minutes of a comforting TV show like Friends or Seinfeld is a big part of your sleep routine and helps you relax before bed, then “carry on,” she adds. If your sleep routine “isn’t broken, don’t worry about fixing it.”

MYTH 6: Exercising within 4 hours of bedtime will disturb your sleep

If you want to exercise before bedtime, go for it — it can reduce stress and may help you fall asleep, says Robbins
For many years, sleep experts told people to “avoid exercise close to bedtime,” says Robbins, because it can raise body temperature, heart rate and adrenaline levels, leading to poor sleep. “But we actually don’t have any good data to back that up.”

What the research does show is that exercise and sleep appear “mutually beneficial,” write Robbins and her colleagues in their paper. One analysis of several research papers found that people who consistently exercised saw “small to moderate improvements in sleep.”

“Exercise releases endorphins which are mood elevators that can help with the No. 1 cause of sleep difficulties: stress,” she says.

For that reason, Robbins encourages people to exercise — even if it’s close to bedtime. “If that’s the only time you can get a workout in, go for it.”

Healthy Ways to Reduce Abdominal Bloating

Bloating usually happens when excess gas builds up in the stomach or intestines. When bloating occurs right after a meal, it usually resolves itself, but it is often possible to speed up this process.
Many home remedies can help to manage the pain and discomfort of bloating. The following quick tips may help people get rid of a bloated belly quickly:
1. Go for a walk
Physical activity can get the bowels moving more regularly, which can help to release excess gas and stool. Getting the bowels to move is especially important if a person is feeling constipated. A walk around the block can provide fast relief from gas pressure.

2. Try yoga poses
Certain yoga poses can position the muscles in the abdomen in a way that encourages the release of excess gas from the GI tract. This can reduce bloating. Child’s Pose, Happy Baby Pose, and squats can all help people to relieve a buildup of gas quickly. Learn more about yoga poses for flatulence.

3. Use peppermint capsules
Peppermint oil capsules may also be helpful for indigestion and related gas. Manufacturers usually market them as a treatment for the symptoms of irritable bowel syndrome (IBS), but people without IBS can also use them to relieve bloating.
Peppermint works by relaxing the intestinal muscles, which allows gas and stool to move along more effectively. People should always follow the instructions on the packet. Anyone who is prone to heartburn may need to avoid peppermint.

4. Try gas relief capsules
Simethicone pills and liquid are anti-gas medications that can help to move excess air out of the digestive tract. It is essential to always take medication according to the instructions on the label.

5. Try abdominal massage
Massaging the abdomen can help to get the bowels moving. A massage that follows the path of the large intestine is especially helpful. People can follow the steps below to do this:
Placing the hands just above the right hip bone.
Rubbing in a circular motion with light pressure up toward the right side of the ribcage.
Rubbing straight across the upper belly area toward the left rib cage.
Moving slowly down toward the left hip bone.
Repeating as necessary.
If the massage causes any pain, it is best to discontinue it immediately.

6. Use essential oils
A study from 2016Trusted Source tested the effectiveness of supplements containing a combination of fennel and curcumin essential oil in 116 people with mild-to-moderate IBS. After 30 days, people reported an improvement in their IBS symptoms, including bloating and abdominal pain.
People should not consume essential oils without speaking to a doctor first. This is because some formulations may be toxic or can interfere with medication, and there is no regulation of dosages.

7. Take a warm bath, soaking, and relaxing
The heat of the bath can provide relief for a sore abdomen. Relaxation can reduce stress levels, which may allow the GI tract to function more effectively and help reduce bloating.

Long-term solutions for bloating
Quick fixes are not always effective for some causes of bloating. However, people who have frequent bloating may find that certain lifestyle changes can tackle the causes and reduce bloating over time.
People can use these simple steps to try to prevent bloating in the long term:

8. Increase fiber gradually
Eating more fiber helps to prevent constipation and bloating. However, it is important to bear in mind that eating too much fiber or increasing fiber intake too quickly can cause even more gas and bloating.
Including a reasonable amount of fiber in a person’s diet, while making sure to drink enough water, will help prevent this. Most nutritionists recommend that adults eat about 18–38 grams (g) of fiber a day.
That said, only 7% of people meet their recommended daily fiber intake of 25 grams (g) for females and 38 g for males.
When increasing fiber intake, it is best to start slowly and increase the intake over several weeks to allow the body to adjust to this change in the diet.

9. Replace sodas with water
Fizzy, carbonated drinks contain gas that can build up in the stomach. The carbon dioxide that makes soda and similar beverages fizzy can also cause bubbling and bloating in the stomach.
Sugars or artificial sweeteners in the diet can also cause gas and bloating.

10. Avoid chewing gum
The sugar alcohols in gum can cause bloating in some people. Swallowing air while chewing also may lead to bloating and gas pain. People can use ginger mints or peppermints to freshen their breath instead.

11. Get more active every day
Exercise helps your body move stool and gas out of the colon and may make bowel movements more regular. Exercise also releases extra sodium from the body through sweating, which can help to relieve water retention.
It is vital to drink plenty of water before and after exercising to stay hydrated, as dehydration can make constipation worse.

12. Eat at regular intervals
Many people experience bloating directly after a big meal. It is possible to avoid this by eating several smaller meals each day, which can help to keep the digestive system moving.
Swallowing food quickly can introduce air into the digestive tract. Drinking from a straw can also lead to people swallowing more air, which in turn leads to gas and bloating. People who have bloating should avoid using straws if possible and try eating slowly to avoid swallowing air during meals.

13. Try probiotics
Probiotics are good bacteria that live in the intestines. Taking a probiotic supplement may help regulate the colon bacteria that can produce gas and cause bloating.

14. Cut down on salt
An excess of sodium causes the body to retain water. This can cause a swollen and bloated feeling in the belly and other areas of the body, such as the hands and feet.

15. Rule out medical conditions
In some cases, bloating may result from a medical condition. To get rid of this bloating, a person may need help from a doctor to diagnose and manage their condition.
Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis, may cause people to experience bloating. Irritable bowel syndrome (IBS), can also cause this symptom.
Gynecological conditions, such as endometriosis and ovarian cysts, can also cause pain, swelling, and feelings of bloating in the abdominal area.
People with these symptoms should discuss them with a doctor, who will also want to know about any relevant family medical history and other medical conditions. The doctor may order diagnostic tests to look for any problems. These may include an X-ray, ultrasound, colonoscopy, or blood tests.

16. Consider a low-FODMAP diet
Trying an elimination diet such as the low FODMAP diet might help a person exclude specific foods that are causing bloating. However, this should be done in consultation with a doctor or a dietician.
FODMAPs are a type of carbohydrate that occurs in many different foods. A 2020 meta-analysis of 12 studies found that eating low-FODMAP foods reduced IBS symptoms by a mean of 45 percentage points.

17. Keep a food diary
Food intolerances are responsible for many cases of bloating. They can lead to excessive gas in the digestive tract.
Bloating is common in people who have lactose intolerance and are unable to digest the lactose sugar in dairy products. Autoimmune intolerance to gluten, known as celiac disease, is another potential culprit.
For people whose bloating happens after meals, keeping track of food and drink intake for several weeks should help to determine whether specific foods are responsible.
The Centers for Disease Control and Prevention (CDC) provide a food diary template to help people to get started.

18. Look at supplements and medications
Some supplements, such as iron, can cause constipation and other symptoms of indigestion. This can increase bloating. Potassium, on the other hand, may reduce bloating by helping to balance the body’s sodium levels.
Medications may also cause side effects that affect GI function or cause indigestion. If this happens, a doctor or pharmacist can suggest alternatives that are more gentle on the digestive tract.

Differences Between a Healthy and Unhealthy Plant Based Diet

From Medical News Today

What makes a healthy plant-based diet?
The healthful plant-based index, defines a nourishing plant-based diet as centered around whole foods such as nuts, legumes, fruits, vegetables, whole grains, tea, coffee, and vegetable oils.

Vegetables are rich in prebiotic fiber, which supports the health of the microbiome and digestive system. They also contain various phytochemicals like indoles, found in broccoli and Brussels sprouts, which contain benefits that range from protecting cellular DNA to deactivating carcinogens we take in from our environment.

Fruits are a powerful source of antioxidants, and these phytochemicals, with compounds such as ellagic acid, can lower the risk of certain cancers. Legumes, nuts, and seeds contain amino acids, and whole grains contain B vitamins and trace minerals such as manganese and copper.

What are unhealthy plant-based foods?
Unhealthy plant-based foods can include highly processed products, like vegan burgers or sugar-sweetened snacks, which often contain added sugars and unhealthy fats like trans fats or over-saturated fats.

High-fructose and low-sugar versions of these foods may have fewer nutrients than unprocessed whole-plant foods, and some may contain artificial additives, preservatives and flavorings.

There are plenty of foods that are ‘plant-based’ but are not necessarily the most healthful. Oreos, for example, as well as potato chips, are technically plant-based.

Commercial oils are also a concern. These types of vegetable oils are high in omega-6 fatty acids, and while these are essential for normal inflammatory immune responses, when we consume them in excess, we can put our body in an overly pro-inflammatory state.

Additionally, excessive sugar is an ingredient in low-quality plant-based foods.

Brain Exercises to Improve Memory, Cognition, and Creativity

From Medical News Today
1. Meditation
Meditation generally involves focusing attention in a calm, controlled way. Meditating may have multiple benefits for both the brain and the body.

According to the National Center for Complementary and Integrative Health, research suggests that meditation may benefit the brain by slowing brain aging and increasing the brain’s ability to process information.

2. Visualizing more
Visualization involves forming a mental image to represent information. The mental image may be in the form of pictures or animated scenes.

A 2018 review notes that visualization helps people organize information and make appropriate decisions.

People can practice visualization in their day-to-day lives. For example, before going shopping, people can visualize how they will get to and from the grocery store, and imagine what they will buy when they get there. The key is to imagine the scenes vividly and in as much detail as possible.

3. Playing games
Playing card games or board games can be a fun way to socialize or pass the time. These activities may also be beneficial for the brain. A 2017 study found a link between playing games and a decreased risk of cognitive impairment in older adults.

4. Playing memory card games
Memory card games test a person’s short-term memory and ability to remember patterns. They are a simple and fun way to engage the brain and activate areas related to pattern recognition and recall.

5. Practicing crossword puzzles
Crossword puzzles are a popular activity that may stimulate the brain. An older study from 2011Trusted Source notes that crossword puzzles may delay the onset of memory decline in people with preclinical dementia.

6. Completing jigsaw puzzles
Completing a jigsaw puzzle can be a good way to pass the time and may also benefit the brain. A 2018 study found that puzzles activate many cognitive functions, including:
perception
mental rotation
working memory
reasoning
The study concluded that doing jigsaw puzzles regularly and throughout life may protect against the effects of brain aging.

7. Playing sudoku
Number puzzles, such as sudoku, can be a fun way to challenge the brain. They may also improve cognitive function in some people.

A 2019 study of adults aged between 50 and 93 years found that those who practiced number puzzles more frequently tended to have better cognitive function.

8. Playing chess
A 2016 meta-analysis notes that chess and other cognitive leisure activities may lead to improvements in:
memory
executive functioning, which is the ability to monitor and adapt behavior in order to meet set goals
information processing speed
9. Playing checkers
A 2015 study found that there is a connection between regular participation in checkers or other cognitively stimulating games and larger brain volume and improved markers of cognitive health in people at risk of Alzheimer’s disease.

10. Playing video games
A 2015 review notes that some types of video games — such as action, puzzle, and strategy games — may lead to improvements in the following:
attention
problem solving
cognitive flexibility
11. Socializing
Enjoying company of friends may be a mentally engaging leisure activity and may help preserve cognitive function. A 2019 study found that people with more frequent social contact were less likely to experience cognitive decline and dementia.

Some social activities that may help stimulate the brain include:
having discussions
playing games
participating in social sports

12. Learning new skills
Learning new skills engages the brain in different ways and may help improve brain function.

A 2014 study of older adults found that learning a new and cognitively demanding skill, such as quilting or photography, enhanced memory function.

13. Increasing personal vocabulary
Increasing one’s vocabulary range is a great way to broaden knowledge while exercising the brain.

A simple way to increase vocabulary is to read a book or watch a TV program and note down any words that are unfamiliar. A person can then use a dictionary to look up the meaning of the word and think up ways to use the word in a sentence.

14. Learning a new language
“Bilingualism” refers to the ability to speak two languages.
A 2019 review notes that bilingualism increases and strengthens connectivity between different areas of the brain. The researchers propose that this enhanced connectivity may play a role in delaying the onset of Alzheimer’s disease and other forms of dementia.

15. Listening to music
A 2018 study published in Brain Sciences found that listening to music a person enjoys engages and connects different parts of the brain.

The researchers propose that this may lead to improvements in cognitive function and overall well-being.

16. Learning a musical instrument
Learning an instrument exercises parts of the brain that are responsible for coordination.

According to a 2014 study, playing an instrument may benefit cognitive development in a young brain and help protect against cognitive impairment in an aging brain.

17. Taking up engaging hobbies
Taking up a new hobby can be mentally stimulating and exercise the brain in new ways.

Hobbies that require coordination or dexterity will activate a person’s motor skills. Such hobbies may include:
knitting
embroidery
drawing
painting
dancing
learning a musical instrument
18. Exercising regularly
Regular physical exercise is beneficial for both the brain and the body. Authors of a 2019 review note that exercise improves the following aspects of brain health:
memory
cognition
motor coordination
19. Dancing
According to the Centers for Disease Control and Prevention (CDC), exercise has beneficial effects on the following aspects of cognitive health:
memory
planning
organization
Dance is a form of exercise that may also engage areas of the brain involved in rhythm and balance.

20. Engaging in sports
Certain sports are both physically and mentally demanding. Some require a range of cognitive skills, such as:
sustained attention
planning
multitasking
the ability to adapt rapidly to changing situations
A 2019 review notes that elite athletes who participate in high demand sports tend to have improved attention and faster information processing speeds.

21. Practicing tai chi
Tai chi is a form of physical exercise that involves gentle body movements, rhythmic breathing, and meditation.

A 2019 study compared brain function and connectivity among tai chi practitioners and those who did not practice it.

The researchers found that the tai chi practitioners had enhanced connectivity between different regions of their brain. They proposed that this may improve cognition and decrease the rate of memory loss.

22. Sleeping
While not necessarily an active exercise, sleep is crucial for both the brain and the body.

According to the National Institute of Neurological Disorders and StrokeTrusted Source, most adults need between 7 and 9 hours of sleep each night, although many people get less sleep than they need.

A 2015 review notes that sleep has been proven to:
boost memory recall
reduce mental fatigue
regulate metabolism
As such, making sure to get enough sleep each night is an important step toward maintaining a healthy brain.

Medical Myths About Vegetarian and Vegan Diet

1. Plant-based diets are always healthful
In recent decades, an increasing number of studies have demonstrated links between red meat consumption and poorer health outcomes. For instance, processed and red meat intake is associated with colon cancer, obesity, heart disease, and diabetes.
This might suggest that a diet without meat is better for the body. But, just as not all meat is red, not all vegetarian or vegan diets are healthful. Additionally, lean white meat and fish are not associated with the same health issues as processed and red meats.

2. Vegetarianism guarantees weight loss
Sadly, no. As the section above makes clear, not all vegetarian and vegan diets are equally healthful. It is incredibly easy to consume thousands of calories each day without any of them being associated with animals.
The key to weight loss is a healthful diet and regular exercise, and neither requires the avoidance of animal products.

3. Vegetarians and vegans cannot get enough protein
This is perhaps the most common of all the myths that we cover today. But it is still a myth. In the world of food, protein abounds.
For people who eat them, dairy products and eggs are high in protein. Vegans also have an array of options, including seitan, tofu, lentils, chickpeas, many types of bean, spelt, spirulina, quinoa, oats, wild rice, seeds, and nuts. Even some vegetables contain protein, including spinach, asparagus, broccoli, artichokes, potatoes, peas, brussels sprouts, and sweet potatoes.

4. You can’t build muscle without meat
This myth follows on from the protein myth above. In short, the most important nutrient for building muscle is protein, which can easily be found in abundance beyond the animal kingdom.

5. Dairy is essential for strong bones
Dairy is not essential for strong bones, but calcium is. In fact, calcium is important for a number of bodily functions, including maintaining blood pressure, muscle contraction, transmitting signals along nerves, and blood clotting.
Vegans, therefore, need to ensure that they take in enough calcium from plant-based sources.
As with protein, there are plenty of places to pick up calcium, including soy-based foods, beans, lentils, peas, spinach, turnips, figs, flax, chia, sesame seeds, seaweed, and some nuts — almonds, in particular.

6. You cannot get B12 from a vegetarian diet
This is a myth. While vegans often take B12 supplements to ensure that they have adequate levels, vegetarians have a wealth of other options.
Vegetarians can derive B12 from eggs and milk products, including cheese.
Meanwhile, a range of vegan-friendly foods are fortified with B12, including some cereals, tofu, nondairy milks, and spreads.

7. Soy increases the risk of breast cancer
As it stands, there is no convincing evidence that eating soy-based foods increases the risk of breast cancer in humans.
A study published in February 2020 searched for associations between soy, dairy intake, and breast cancer risk. The scientists had followed 52,795 cancer-free women in the U.S. for an average of 7.9 years.
They found no clear association between soy intake and breast cancer, but they did identify a link between dairy milk and breast cancer.

However, the full picture is, perhaps, slightly more complex. Some women use soy-based supplements as a natural alternative to hormone therapy during menopause. One large study investigated whether these supplements might be associated with breast cancer risk.

The researchers found “no association between past use of soy supplements and breast cancer.” But, they also found that taking soy supplements, for some women, might increase the risk of breast cancer, particularly for those with a family history.

8. Pregnant people need meat and dairy
During pregnancy, it is important to take in all the nutrients that a growing baby needs. But, as we have seen along the way, plant-based foods can provide the vast majority of them.

Someone who is vegetarian or vegan may need to do a little extra planning to be sure that have enough nutrients, especially at the beginning of pregnancy.

As we mentioned above, it is important to ensure an adequate intake of vitamin B12, through supplements or fortified foods, and this is especially true during pregnancy and breastfeeding. The American Dietetic Association recommend vitamin B12 supplementation throughout pregnancy and breastfeeding for people with vegan or vegetarian diets.

As the authors of a review of research about plant-based diets during pregnancy explain, “The available evidence shows that well-planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients.”

For people considering plant-based diets, Medical News Today have published useful guides to vegetarian and vegan eating. For anyone with a preexisting condition, it might also be worth discussing the change with a doctor.

6. You cannot get B12 from a vegetarian diet
This is a myth. While vegans often take B12 supplements to ensure that they have adequate levels, vegetarians have a wealth of other options.
Vegetarians can derive B12 from eggs and milk products, including cheese.
Meanwhile, a range of vegan-friendly foods are fortified with B12, including some cereals, tofu, nondairy milks, and spreads.

7. Soy increases the risk of breast cancer
As it stands, there is no convincing evidence that eating soy-based foods increases the risk of breast cancer in humans.
The researchers found “no association between past use of soy supplements and breast cancer.” But, they also found that taking soy supplements, for some women, might increase the risk of breast cancer, particularly for those with a family history.

8. Pregnant people need meat and dairy
During pregnancy, it is important to take in all the nutrients that a growing baby needs. But, as we have seen along the way, plant-based foods can provide the vast majority of them.

Someone who is vegetarian or vegan may need to do a little extra planning to be sure that have enough nutrients, especially at the beginning of pregnancy.

Cognitive Behavioral Therapy for Insomnia

From The New York Times

Many people mistakenly assume that C.B.T.-I. is entirely focused on sleep hygiene — the routines and environment that are conducive to good sleep, said Shelby Harris, a psychologist with a private practice in the New York City area who specializes in C.B.T.-I.

C.B.T.-I. does use a series of treatments to target behaviors that are inhibiting sleep, like daytime naps or using digital devices before bed, and replaces them with more effective ones, like sticking to a consistent wake time. But it also aims to address anxieties and negative beliefs about sleep.

Much of the time, insomnia can lead to the feeling that sleep has become “unpredictable and broken,” Dr. Prather said. “Every day people with chronic insomnia are thinking about ‘How am I going to sleep tonight?’”

C.B.T.-I. teaches people different ways to relax, like deep breathing and mindfulness meditation, and helps patients develop realistic expectations about their sleep habits.

It is especially important that people with insomnia learn to view their bed as a place for restful sleep rather than associating it with tossing and turning. Patients undergoing C.B.T.-I. are asked to get out of bed if they are not asleep after around 20 or 30 minutes and do a quiet activity in dim lighting that doesn’t involve electronics. In addition, they are told to stay in bed only while drowsy or sleeping.

“C.B.T.-I. leads to more consolidated sleep and shorter time to fall asleep which is a major gain for many,” Dr. Harris said.

How do you find a provider?

If you’re having problems sleeping, first visit your health care provider to rule out any physical problems (like a thyroid imbalance, chronic pain or sleep apnea) or a psychological issue such as depression that might require separate treatment, the experts said.

You can search for a provider who is a member of the Society of Behavioral Sleep Medicine or use the Penn International CBT-I Provider Directory. Your primary care doctor may also provide a referral. If you’re using a general online therapist directory like Psychology Today, be wary of those who claim to offer insomnia treatment but do not have specific training in C.B.T.-I., Dr. Harris warned.

Finding someone who specializes in C.B.T.-I. may prove difficult — especially one who takes insurance — because there are fewer than 700 clinicians trained in behavioral sleep medicine in the United States. And one 2016 study found they are unevenly distributed: 58 percent of these providers practicing in 12 states. The clinic where Dr. Prather works, for example, has hundreds of people on its waiting list.

Can you try C.B.T.-I. without a provider?

A review of clinical trials found that self-directed online C.B.T.-I. programs were just as effective as face-to-face C.B.T.-I. counseling. If you are self-motivated, there are several low-cost or free resources that can teach you the main principles.

One option is the five-week program Conquering Insomnia, which ranges in price from about $50 for a PDF guide to $70 for a version that includes audio relaxation techniques and feedback about your sleep diary from Dr. Gregg D. Jacobs, the sleep and insomnia expert who developed the program.

You can also check out Insomnia Coach, a free app created by the U.S. Department of Veterans Affairs that can be used by anyone. It offers a guided, weekly training plan to help you track and improve sleep; tips for sleeping; an interactive sleep diary; and personal feedback.

Sleepio is another reputable app, Dr. Harris said. There are also free online resources from the A.A.S.M. and educational handouts from the National Institutes of Health, which include a sample sleep diary and a guide to healthy sleep.

And for those who prefer to avoid technology entirely, more than one expert recommended the workbook “Quiet Your Mind and Get to Sleep” by Colleen E. Carney and Rachel Manber.