Sleeping well
Better sleep comes mostly from what you do during the day and in the hour before bed. This plan builds one habit each week.
From Dr. Kenny Civello, cardiologist and electrophysiologist
The most effective treatment for poor sleep is changing behavior. Sleep specialists use a program called CBT for insomnia (CBT‑I) before any sleeping pill, because it works as well and the results last after you stop. Teas and supplements can help you relax, but they work best on top of good habits.
Sleep is part of heart health. Short or broken sleep raises blood pressure, blood sugar, weight, and the risk of atrial fibrillation (AFib), heart attack, and stroke. Most adults need 7 to 9 hours a night.
The core habits
If you only remember one part of this page, make it this list.
Wake up at the same time every day
Weekends too. A steady wake time sets your body clock more than anything else.
Use your bed only for sleep
No TV, phone, work, or worrying in bed. Your brain should link bed with sleep.
If you can't sleep, get up
After about 20 minutes awake, go to another room and do something quiet in dim light. Return when sleepy.
Go to bed when sleepy, not just tired
Lying in bed wide awake teaches your brain that bed is for being awake.
Get morning light
Go outside for 10 to 30 minutes soon after waking. Dim the lights in the evening.
Wind down for an hour
Screens off, lights low. Read, stretch, take a warm shower, or sip a caffeine free tea.
Stop caffeine by early afternoon
Caffeine stays in your body for hours. Have your last cup at least 6 to 8 hours before bed.
Skip the nightcap
Alcohol helps you fall asleep but breaks up sleep later in the night and can trigger AFib.
The 12 week plan
Add one new habit each week and keep the ones before it. Keep a simple sleep diary the whole time: bedtime, wake time, how long it took to fall asleep, times you woke up, and how rested you felt (1 to 5). Bring it to your visits.
1Start your diary and set a schedule
Start of the week
- Write down how you sleep now and what bothers you most.
- Set a goal of 7 to 9 hours.
- Pick one bedtime and one wake time and keep them every day.
Rest of the week
- Fill in your sleep diary each morning.
- No caffeine or heavy meals in the 4 to 6 hours before bed.
- Build a calm pre‑sleep routine: reading, meditation, gentle stretches.
2Fix your bedroom
- Make the room dark, quiet, and cool (about 65 to 68°F).
- Check that your mattress and pillow are comfortable.
- Move phones, tablets, and the TV out of the bedroom. Use a regular alarm clock.
- Try white noise or calm music if your room is noisy.
- Start slow deep breathing or progressive muscle relaxation at bedtime.
3Adjust what you eat and drink
- Look for things that hurt your sleep: caffeine, sugar, big late meals, alcohol.
- Finish dinner 2 to 3 hours before bed.
- Try foods linked to better sleep: kiwi, tart cherries, almonds, walnuts.
- Start a caffeine free bedtime tea (see the tea guide below).
4Move every day
- Note how active you are now.
- Aim for a 30 minute walk, bike ride, or yoga session most days.
- Morning or afternoon exercise outdoors gives you light and activity together.
- Avoid hard workouts in the 2 to 3 hours before bed.
5Manage stress
- Write down what stresses you and keeps your mind busy at night.
- Set a "worry time" early in the evening. Write worries and a next step on paper, then close the notebook.
- Practice 10 minutes of mindfulness or meditation daily.
6Change your thoughts about sleep (CBT‑I)
- Notice thoughts like "If I don't sleep 8 hours, tomorrow is ruined." Replace them with "I have handled short nights before."
- Stop watching the clock at night. Turn it to face the wall.
- Follow the "get up after 20 minutes" rule strictly.
- If you are still struggling, ask us about a CBT‑I therapist or a CBT‑I app.
7Cut evening screen time
- All screens off at least 1 hour before bed.
- Replace them with a paper book, music, a podcast with the screen off, or a conversation.
- Charge your phone outside the bedroom.
8Manage light
- Get outdoor light within an hour of waking, even on cloudy days.
- Spend time near windows or outside in the early afternoon.
- Dim lights and use warm bulbs after sunset.
9Review and adjust
- Look back over 8 weeks of your diary. What helped most? What still gets in the way?
- Adjust your schedule and routine based on what you see.
- Keep the habits that are working.
10Consider teas and supplements
- If sleep is still not where you want it, review the tea guide and melatonin section below.
- Talk with us before starting any supplement, especially if you take a blood thinner or heart rhythm medicine.
- Try one thing at a time for 2 to 4 weeks so you know what works.
11Look at work and social life
- Note how shift work, late events, travel, or family duties affect your sleep.
- Protect your wake time even after a late night. Take a short nap (20 minutes, before 3 pm) instead of sleeping in.
- Talk with family about quiet hours if needed.
12Make a long term plan
- Compare your diary from week 1 and week 12.
- Choose the 3 habits that matter most for you and commit to them.
- Plan what you will do after a rough week: go back to the diary and the core habits.
- Bring your diary to your next visit with us.
Keep your wake time steady, keep practicing your wind down and stress routines, and check your habits whenever sleep slips. If problems last more than a few weeks, let us know.
Bedtime teas
A warm, caffeine free tea is a good signal to your body that the day is ending. Some herbs also have a mild calming effect. The research is modest, so think of tea as a helper for good habits, not a replacement for them.
How to use bedtime tea
- Drink it 60 to 90 minutes before bed, so you are not up at night to use the bathroom.
- Steep covered for 5 to 10 minutes to keep the plant oils in the cup.
- Check the label: it should say caffeine free. Some "relax" blends contain green or black tea.
- Skip the honey and sugar, or keep it to a small amount.
- Give it 2 to 4 weeks. Herbal effects build over time.
Chamomile
Best place to startThe classic bedtime tea. Gentle, calming, and safe for most people. Small studies show modest improvement in sleep quality, especially in older adults.
- Brew
- 1 to 2 tea bags or 1 tablespoon dried flowers
- Taste
- Mild, apple like
Valerian root
Strongest herbThe most studied herbal sleep aid. It may help you fall asleep faster and sleep more deeply. It usually takes 2 to 4 weeks of nightly use to notice a difference.
- Brew
- 1 teaspoon dried root, steep 10 minutes
- Taste
- Earthy and strong. Many people blend it with chamomile or mint.
Passionflower
Good for a racing mindUsed for anxiety and restlessness. A small study found better sleep quality after a week of nightly passionflower tea.
- Brew
- 1 teaspoon dried herb, steep 10 minutes
- Taste
- Mild, grassy
Lemon balm
Pairs wellA member of the mint family that eases stress. Often blended with valerian, and the pair has shown better results than either alone.
- Brew
- 1 to 2 teaspoons dried leaves
- Taste
- Lemony, fresh
Lavender
Calming scentRelaxing as a tea or as a scent in the bedroom. Studies of lavender aroma show small gains in sleep quality.
- Brew
- 1 teaspoon dried buds, or blend with chamomile
- Taste
- Floral; a little goes a long way
Rooibos and tart cherry
Easy swapsRooibos is a naturally caffeine free red tea. It is a good evening swap if you miss black tea. Tart cherry juice contains natural melatonin, and small studies show it can help sleep.
- Amount
- Rooibos: 1 cup. Tart cherry: 8 oz unsweetened, once or twice a day
"Natural" does not mean free of side effects or interactions. Tell us about any tea or supplement you use, especially if you take:
- A blood thinner (warfarin, Eliquis, Xarelto) or an antiplatelet drug
- Heart rhythm medicines
- Sleeping pills, anxiety medicine, or opioid pain medicine
Avoid kava. It has been linked to serious liver injury.
Melatonin and sleeping pills
Is melatonin a good idea?
Melatonin helps most with timing problems such as jet lag, shift work, or a body clock that runs late. It is less helpful for general insomnia.
- Less is more. Start with 0.5 to 1 mg, taken 1 to 2 hours before bed. Higher doses often cause grogginess without better sleep.
- Supplement doses vary widely from the label. Look for a "USP Verified" seal.
- Use it for a few weeks at a time, not as a nightly habit for years, unless we have discussed it.
What about over the counter sleep aids?
Products like Benadryl, ZzzQuil, Tylenol PM, and Unisom contain antihistamines. They can cause next day grogginess, confusion, falls, constipation, and trouble urinating, especially after age 65. Long term use has been linked to memory problems. We do not recommend them for regular use.
What about prescription sleeping pills?
Prescription sleep medicines can help in the short term, but they carry risks of dependence, falls, and next day impairment. CBT‑I works as well and the benefit lasts. If you think you need a sleep medicine, let's talk about it together.
When to call us
- Loud snoring, gasping, or pauses in breathing that someone else notices
- Waking up with a headache or a very dry mouth
- Feeling sleepy during the day even after a full night in bed
- Nodding off while driving
- Restless, crawling feelings in your legs at night
- Trouble sleeping most nights for more than 3 months
Sleep apnea is common in people with high blood pressure, AFib, and heart failure. Treating it can improve blood pressure and make AFib easier to control. A home sleep test is simple. Ask us.
Other guides
Lowering your AFib riskEating for your heartLowering your blood pressureLiving with POTSMy watch says I have AFibGetting ready for your ablationLiving with a pacemaker or ICDThis page is general education for my patients. It does not replace advice from your own doctor. Talk with us before starting any supplement or herbal product, or if your sleep problems continue.