The second set of steps in your energy-boosting plan.

Last week, in this blog, I wrote about the first three steps of a 7-step plan to boost your energy. Here are the next two steps, which were originally published in Boosting Your Energy, a Harvard Medical School special health report.

It may sound strange, but in order to get more energy, you have to do the very thing you don't feel you have enough energy to do: exercise. Regular exercise helps in several ways. For one thing, it almost guarantees that you will sleep more soundly.

Exercise also increases the body's fuel-making capacity. When you use your muscles, more energy-producing mitochondria form in your muscle cells, and your cells have more energy to burn. Exercise creates more capillaries, the tiny blood vessels that ferry oxygen to your cells. And by making you breathe deeply and increasing your heart rate, it gets more oxygen circulating. Finally, when you work out, your body releases epinephrine and norepinephrine. In large amounts, these stress hormones cause the energy-draining fight-or-flight response, but in the modest amounts induced by exercise, they make you feel energized.

If you suffer from a disorder such as sleep apnea, you'll need to see a doctor who specializes in sleep disorders. But most people with sleep problems such as insomnia don't need to visit a sleep laboratory or specialized center. They can usually help themselves by changing their habits. Occasionally, medications can also be helpful.

Smoking harms your health in many ways, including siphoning off your energy by causing insomnia. Smoking can ruin your sleep with a kind of one-two punch. As a central nervous system stimulant, the nicotine in tobacco speeds the heart rate, raises blood pressure, and stimulates brain-wave activity associated with wakefulness, making it harder to fall asleep. What's more, once you do fall asleep, its addictive power can kick in and awaken you with cravings.

People who quit smoking fall asleep more quickly and wake up less often during the night. Although at first many former smokers experience sleep disturbance and daytime fatigue, they often report improvements in their sleep quickly.

If you think you may be sleep-deprived, try getting less sleep. That's right: get less sleep, at least for a few days. This advice may sound odd, but the goal is to determine how much sleep you actually need and to reduce the time you spend in bed not sleeping. This process makes it easier to fall asleep and promotes more restful sleep in the long run. Here's how to do it:

·         Avoid napping during the day.

·         The first night, go to bed later than normal and get just four hours of sleep.

·         If you feel that you slept well during that four-hour period, add another 15 to 30 minutes of sleep the next night.

·         As long as you're sleeping soundly the entire time you're in bed, slowly keep adding sleep on successive nights.

You can thus extend the time you spend in bed until you're getting a full night's sleep, ideally at least seven hours. Once you've done so, try to establish regular times for going to bed and getting up, seven days a week. Even though your schedule may be very different on the weekends, try not to vary your routine. If you get back to a solid seven hours of sleep on weeknights, you probably won't have as much need to "sleep in" on the weekends.

People who have difficulty sleeping often come to associate their bedroom with the frustration and anxiety of trying and failing to get to sleep. These associations create anxiety, worsening the insomnia. Reconditioning is a behavioral technique for breaking such negative associations. Here's what to do:

·         Use the bed only for sleeping or sex. Watch TV or read reports for work in a different room.

·         Go to bed only when sleepy. If you're unable to sleep, get up and go to another room. Stay up until you're sleepy again, then go back to bed.

·         If you don't fall asleep quickly, repeat the process. In other words, don't lie in bed tossing and turning and worrying about not sleeping. If you're not likely to fall asleep, get up.

If these techniques don't help, talk with your doctor about sleep medications. Although such medications can be helpful in the short term to break a pattern of insomnia, when used long-term, they may actually worsen your fatigue by leaving you groggy during the day.

Prescription sleep medications should be used cautiously because they can cause tolerance (the need for progressively larger doses over time to get the same effect). Over-the-counter sleep aids (which typically contain antihistamines) are often ineffective and, in some people, cause irritability, but when used occasionally they may work well for some individuals.

Have you implemented any of these strategies into your life? Do you feel more energetic?

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

Boosting Your Energy

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