Say Goodbye To Insomnia

Have you ever lay awake at night, exhausted, tired, and ready for sleep but found that your body would not cooperate? You were ready to saw some logs but your brain stubbornly refused to switch into ‘sleep mode?’

If so, you are not alone. Sixty million Americans struggle with insomnia at some time throughout any given year. For many it is a chronic problem with a huge impact. A lack of sleep can ruin your attention span, make emotions swing like the lead singer in Rumba band, ruin attempts to stay with a healthy diet, torpedo efforts to exercise and just generally make you feel as though you are one of the cast of the Walking Dead.

Chronic Health Conditions Related to Lack of Sleep

A lack of sleep is not just inconvenient, or frustrating, but also is associated with an increased risk of significant health problems.

Research shows that those who sleep less than seven hours a night are more likely to develop coronary heart disease, experience a heart attack or stroke, have arthritis, chronic obstructive pulmonary disease, asthma and diabetes.

In addition to these health concerns, diminished sleep has a huge impact on one’s performance. As you can see from the graph below, performance is greatly diminished over the course of just a few days when one is unable to get enough sleep.

This graph shows the number of mistakes people made, on average, when faced with a simple task over the course of seven days. Some individuals were allowed to sleep 9 hours a day, other 7 hours, still others 5 and 3 hours respectively.

By the end of the week those people who had gotten by on 3 hours of sleep each night made 18 times more mistakes than those who had been getting 9 hours of sleep. Even those who had slept 5 hours a night ended up, by week’s end, making 6 times more mistakes than the group who had slept 9 hours per night. The 5 hours/night group also made nearly twice as many mistakes as the 7 hours/night group.

What might the trend look like if it were extended beyond one week? Perhaps for a month, two months, or a year? Such long periods of poor sleep are not unusual for someone suffering with insomnia.

What Causes Insomnia?

There are multiple reasons why people develop insomnia. Some of these are physical, (e.g., hormonal changes), others are psychological (e.g., stress/anxiety), and still others are environmental (e.g., sleeping next to someone who snores).

Medical News Today provides a nice summary.

“Insomnia is commonly caused by:

Disruptions in circadian rhythm - jet lag, job shift changes, high altitudes, environmental noise, extreme heat or cold.

Psychological issues - bipolar disorder, depression, anxiety disorders, or psychotic disorders.

Medical conditions - chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson's and Alzheimer's diseases, hyperthyroidism, arthritis, brain lesions, tumors, stroke.

Hormones - estrogen, hormone shifts during menstruation.

Other factors - sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, pregnancy.”

WHAT CAN YOU DO TO FLIP THE SLEEP SWITCH TO “ON”?

If you struggle with getting to sleep, it is important to know that there are many ways to cure this problem. Prescription medication is one of the most common solutions. The major shortcoming of taking this route to getting some sleep is that medications usually offer only a short-term fix. When you stop taking the medication, insomnia frequently returns. Solutions that do offer longer lasting restful sleep, and don’t include the potential side effects of medication, are what most people prefer.

In the sections below, I will discuss some of the most common, and useful, non-medication approaches for solving your insomnia. We can start with a summary (below) and then work through each part in more detail.

TIP #1: ESTABLISH A HEALTHY SLEEP ROUTINE

Make sure you have a good “pre-sleep” routine. This is similar to the “pre-game” routine that some athletes use. With regard to getting some ZZZZs, however, a pre-sleep routine is referred to simply as having good “sleep hygiene.”

The benefit of having a standard routine that you go through each night before bedtime is that you begin to train yourself to sleep. Routines build habits, so the idea is to have a routine that leads to the habit of falling asleep. This usually includes:

·        Going to bed at the same time each night

·        Turning off the television and internet an hour before sleep

·        Taking a shower or bath

·        Avoiding arguments or working on things that are stressful

·        No caffeine

·        Performing some light stretches or meditation

·        Taking a few quiet moments to consider what went well in the day

·        Writing one or two things down for which you are grateful

·        Listening to calming music

·        Saying one’s prayers

·        Meditating

Do you see a pattern in the above suggestions? It includes avoiding stimulation (e.g., television, internet, caffeine, arguments, etc.), and focusing on what is calming and relaxing (e.g., what went well in the day, taking a shower, calming music, prayer, etc.).

When you do go to bed make the room as quiet as possible, and as dark as possible. Even the light of a digital clock has been shown to disturb the sleep of many people. Once your head is on the pillow take a deep breath and slowly exhale.

Repeat this several times while imagining a peaceful scene (the end of the day is NOT the time to review the day, or solve problems that await you in the morning).

It takes some practice to develop this sort of routine but with a little time and effort it works very well for many people.

TIP #2:  Consider using supplements.

There are many supplements that may help you get a better night’s sleep. If you would like to explore a variety of these potential aids for sleep, you can look at reviews by Consumer Labs, and another review by Psychology Today.

For our purposes, however, I will just mention one of the most popular supplements, melatonin (available over the counter at pharmacies and health food stores).

Melatonin is a naturally occurring hormone that your body uses to regulate cycles of sleep and wakefulness. In the evening, your brain’s production of melatonin rises. This helps in preparing you to go to sleep.

Common sense suggests that if you can increase your melatonin production in the evening you will be better prepared to sleep. But this is difficult to do. It’s not as though you can tell you brain “Please ramp up the melatonin production now because I would like to be snoozing in an hour.”

So, how can you increase the melatonin in your system on demand?  Supplements.

The melatonin that you take as a supplement is a synthetic form of the hormone your body produces. Early research on melatonin and sleep was very promising, but later research has been more mixed. Put somewhat differently, “Your mileage may vary.”

I’ve known people for whom melatonin is a huge help, and others for whom it appears to have little impact.

The good news is that melatonin appears to be safe, and it is not expensive. So if you want to try it, the current research suggests there is little to lose (OK, maybe five dollars).

Let me be clear, I'm not a physician and I'm not recommending that you use melatonin. Do a little research, consult your doctor, and decide if this is something you would like to try. (If you are interested in prescription drugs used to treat insomnia the Harvard Medical School News Letter is a good start). 

TIP #3:   Get out of bed!

Well that’s an odd way to fall asleep you say to yourself. Yes, but an odd way that works for most people. Here are the details of how to make it work.

If you get into bed, and after twenty minutes are still awake, then it’s time to get up and leave the room. Why? Because you want your brain to associate bed with sleep, not with being awake (again, we are looking to develop habits for your brain).

Once you are out of bed, go to another room and find a book. The most boring book you can find. If you don’t have boring books borrow one from your neighbor, or better yet buy one. Sit down in a comfortable chair and begin to read. Soon you’ll feel sleepy.

Keep reading (by the way, if for some reason you become interested in the boring book put it down and grab a book that is twice as boring).

Within a short while you will become even sleepier. At that point you head back to bed, repeat the deep breathing routine once more, think of a relaxing scene and fall asleep.

But what, you ask, should I do if I still cannot fall asleep? Cursing the fates that have resulted in your being awake would be a good start. Not too loudly though – there are probably others in the home who are sleeping.

I should add this if you are married it would be a very bad idea to wake your soulmate. There is a great deal in life that you want to share with your spouse, but insomnia is not one of those things.

OK, so what to do this second time when repeating the ‘get out of bed’ routine? Sadly, you do exactly what you did the first time. Find a comfy chair and a boring book. Read until you are sleepy. How sleepy? To the point where you feel that you might doze off any minute.

How many times should you repeat this routine in a given night? As many times as it takes to get to sleep.

Yes, it can be very tough the first night or two, but eventually you will sleep (see the CAUTION below about not napping later in the day).

Once you have repeated this routine to the point that you are finally asleep, a milestone will have been reached. That is you will have successfully taken a major step toward teaching your brain to shut down when your head hits the pillow.

If that takes a few nights of getting out of bed, well, that's not too bad compared to spending months, or years, wrestling with insomnia.

The bottom line is this: most people who follow the advice I’ve given will find that they can eventually fall asleep at their normal bedtime. Sometimes it takes several tries before success is reached, but don’t give up, it will happen.

One caution. Don’t take naps while you are trying to get your sleep back to normal. Only after your sleep has returned to a healthy pattern should you go back to taking a nap. Even then, try not to nap late in the afternoon.

Also, even if you have had a sleepless night hopping in and out of bed like a jazzercise instructor on steroids, don't change your bedtime to a later hour in the evening. You are likely to find that this results in the same problem occurring, but just later in the night.

Remember, we are looking to establish habits and routines! That's what trains the brain. 

There are other ways to tame your sleep, but for most people the three approaches just described will do wonders.  

TIP #4: DO SEVERAL, OR ALL, OF THE FOLLOWING

Don’t exercise in the two to three hours before sleeping

No caffeine in the evening. When to cut out caffeine will vary from person to person. You will need to experiment. For some it means no caffeine after 4:00 PM. For others the cutoff time might be two hours before bedtime.

Reduce fluid intake several hours prior to bedtime – drinking too much of anything just prior to bedtime will lead to less sound sleep even if it does not lead you to get up in the middle of the night.

A snack prior to bedtime is fine, but not a heavy meal. Let your body focus on sleep rather than digestion.

Make sure you have had 20 minutes or more of exposure to sunlight in the day: sunlight is important for regulating your sleep cycle (your brain knows when you’ve skimped on getting some rays)

Darken the room that you are sleeping in – close the blinds, close the door, and turn off all the lights. Even the light from a digital clock will cause sleep disturbances in some people.

Experiment with room temperature: the ideal temperature for sleep varies with the individual (Artic cold for me, thanks), and this one change can make a huge difference.

Stop being cheap. You know who you are. Buy a good pillow, and while you are at it make sure you have sheets that are comfortable (you don’t need to buy the most expensive linens, but if you crawl into bed and it feels like you are a monk wearing an itchy hair shirt, it’s time to upgrade your linens). I’m sure I don’t have to talk about the need for a good mattress.

Do not overdo alcohol – a glass of wine/beer is fine, but more than that will disrupt REM sleep, which is the most important stage of sleep in allowing you to feel fresh and ready for the next day.

No naps after 3:00 PM

Take a warm shower or bath before bed

Relax prior to going to bed. More specifically, let your brain relax. That means it is not a good idea to go to bed right after watching a movie, or working on the computer. Yes, some of you can manage that transition with ease. But if you are struggling to get a good night’s rest, try something different. Create a routine where all electronics are off, the house is quiet, and you have a chance to listen to relaxing music, read a book, or engage in conversation.

WHEN TO SEE YOUR DOCTOR

You may have tried several of the ideas discussed above and still cannot get the sleep you need. Perhaps you are wondering if it is time to make an appointment to discuss your sleep problem with your doctor. WebMD has the following guidelines to consider when making this choice. 

  * Fall asleep while driving?

• Struggle to stay awake when inactive, such as when watching television or reading?

• Have difficulty paying attention or concentrating at work, school, or home?

• Have performance problems at work or school?

• Often get told by others that you look tired?

• Have difficulty with your memory?

• Have slowed responses?

• Have difficulty controlling your emotions?

• Feel the need to take naps almost every day?

Because the list above is not a quiz that provides a score, you will need to use your judgment in considering whether the number of symptoms that apply to you reach the threshold for making a doctor’s appointment.

COGNITIVE BEHAVIORAL THERAPY

It is worth mentioning that when all else fails, research shows that Cognitive Behavioral Therapy (CBT) is the most effective way to provide long lasting relief from insomnia. I won’t go into how insomnia is treated with CBT (perhaps in another post), but for those of you who continue to struggle with consistently getting a good night’s rest, CBT offers another way to tackle this problem.

BOOKS YOU MIGHT ENJOY

If you diligently apply yourself to using the strategies discussed above, there is a good chance your sleep problems will diminish, and possibly be resolved altogether. But in case you want dig a little deeper into this subject, there are a couple of books you will find of interest: Why We Sleep (Matthew Walker), and The Sleep Book: How To Sleep Well Every Night (Guy Meadows).

Additionally, if you would just like to dive in and learn a little more about insomnia, but prefer something that takes less time than a book, take a look at Sleep Advisor.

CONCLUSION

Life is too short to be saddled with insomnia. It robs you of energy, diminishes your focus, creates irritation, lowers performance, and increases the possibility of developing a serious health issue. If you are like millions of others who have a difficult time getting a good night’s sleep, try some of the strategies we’ve just looked at, and see if that doesn’t get you started toward a better night’s sleep.