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Sleep Well -- Self-Help for Insomnia

Sleep deprivation is yet another health epidemic Americans face these days.  Fatigue is considered a major risk in traffic safety, being compared to intoxication in terms of the driver impairment that results.  In addition to wrecking our cars more, we are having more accidents of all other kinds, like trips/falls, kitchen accidents, etc.  We are making more mistakes generally, working less productively, having more trouble remembering things, gaining weight (directly connected to sleep deprivation), feeling more stressed and depressed, and generally experiencing greatly reduced quality of life.

Some of this is consciously self-inflicted, by those of us who feel that we are too busy to allow time for a full night’s sleep.  For those to whom this applies, just know that you are making a big mistake in trading away sleep, and that you are best advised to stop this practice immediately.

For many of us, however, insufficient sleep is not only involuntary, but a source of great frustration.  Bedtime becomes a time to be dreaded, with concerns about how long it will take to fall asleep this time.  How many awakenings will there be in the middle of the night?  How long will it take to get back to sleep, or will sleep return at all?  Will this be another night that prematurely ends at some unnaturally early time, regardless of how exhausted the would-be sleeper may be?  The act of trying to get a good night’s sleep becomes a source of torment for many, and a true thief of both emotional well-being and physical health.

What You May Not Know About Sleep

First, it may help to dispel a basic myth about the nature of sleep.  We all yearn for the ideal night of unbroken, deep sleep; we tend to feel deprived and extra tired when we see that we haven’t gotten it.  The truth is that very few people "sleep through the night" ever, though many think they do.  The norm is to cycle through the stages of sleep, "surfacing" periodically through the night, sometimes to the point of actual wakefulness, or just beneath it.  Waking without memory of doing so is common when the duration is very short.  To have a night of broken sleep that you are aware of can actually be fairly close in structure to what you would perceive as an uninterrupted night's sleep – the only real difference may be how close to the “surface” (actual wakefulness) you cycle.  Therefore, the perception of broken sleep is not always the bad news you might think. 

There appears to be evidence that the kind of sleeper you are has some genetic basis.  If you tend to be a light sleeper, that may just be the way you’re built.  There may be nothing to do about it other than to support quality sleep in the best ways that you can and get on with your life.

Age brings unwelcome changes in that the older you get, the less – and less well – you’ll tend to sleep.  Proper sleep hygiene practices become ever more important as you age.

The Biggest Sleep-Management Mistake You’re Likely to Make

That all said, there certainly is such a thing as a bad night’s sleep, and many of us are having lots of them.  Most of us do the same thing in an attempt to compensate: we spend more time in bed, trying to allow for more sleep. 

If you’re already spending lots of frustrated time awake in bed, spending more time there will create a couple of problems.  First, your bed will become a place of increasingly negative emotional associations.  The more you are accustomed to being stressed there, the harder it will be to relax into a state conducive to sleep. 

Worse than that, however, is that you will unwittingly train your system to have many small episodes of shallow sleep through the night, rather than fewer episodes of deeper-stage sleep.  This is important because essential maintenance functions for both your body and brain occur only during deeper-stage sleep -- this is when healing, growing, memory consolidation, and immune system recharging occur, for example.  Without adequate deeper-stage sleep, you will get sick more often, have more trouble remembering new information, be more vulnerable to depression, and be more prone to accidents and mistakes.  You will also experience higher appetite and more cravings for junk food, so you may also gain and maintain more weight.  No amount of light sleep will fix this, so spending more time in bed getting shallow sleep adds to the problem rather than helping.

What to Do – Sleep Hygiene 101

The list is simple and will reward you well if you adopt as many of these practices as possible.

1. Get treatment for any medical conditions that may interfere with your sleep.  Common examples include pain (temporary or chronic), sleep apnea, and Restless Leg Syndrome.

2. Discuss with your doctor or pharmacist whether any medications you take may increase your risk of sleep problems.  If so, ask whether alternative treatments are available. 

3. Reserve your bed and bedroom for sleep and sex, only.  Otherwise, your brain will be in the habit of being geared up for work when you’re there.

4. Eat the most nutritious diet you can.  Maximizing your physical health improves all of your physical functioning, including your ability to sleep.  Going to bed either over-stuffed or hungry will interfere with sleep, so seek to go to bed satisfied but not at all full.  You should be ready for breakfast in the morning; if not, you may be overeating at night.

5. Minimize alcohol and caffeine after dinnertime.  Monitor your personal sensitivity to these substances to determine how long before bed you must stop intake to assure that you can sleep when it is time. 

6. Exercise regularly.  This is not only for maximizing health as mentioned above, but gives your body an outlet for the stress-related hormones that may be in circulation as a result of your life challenges.  Most people achieve best benefit from exercising earlier in the day rather than later.  Evening exercise may leave you too keyed up for sleep.

7. Maintain as much consistency as possible in the times that you go to bed and get up in the morning.  If there must be variation, keep your awakening time the same if humanly possible.  This anchors your sleep-wake cycle, enhancing your ability to be ready for sleep at about the same time each night.

8. Have a relaxing wind-down routine each evening that conveys to your whole system that it’s time to slow down and prepare for rest.  Consider meditation or muscle relaxation exercises.  Avoid demanding brain-work later in the evening, as your brain may insist on continuing to run at full speed when you’re ready to quit for the night. 

9. Avoid smoking immediately before bedtime.  Nicotine is a stimulant.

10. Stay up until you feel tired and really want to go to sleep.

11. Create as much physical comfort for yourself in bed as possible.  Think comfy, clean sheets, a mattress and pillows with the proper amount of support, comfortable sleepwear, a quiet, dark environment (perhaps with white/pink background noise if desired), and a comfortable room temperature (cool room with warm blankets works well). 

12. If you are having trouble sleeping when you’re in bed, spend less time there.  Remember that if you must choose between them, you want limited amounts of deep-stage sleep rather than more, patched-together hours of shallow sleep.  Reduce your time in bed (maintaining the same awakening time) by going to bed later until you start sleeping more consistently.  Only then, you can try gradually adding back 15 minutes at a time by going to bed earlier, but only if you are sleeping fairly consistently while you’re in bed.  You may ultimately find that you actually need less sleep than you thought.  You may also find that having more hours for conscious relaxing is a nice addition to your overall schedule.

13. Practice soothing, accepting self-talk when getting less sleep than you’d like.  Try auto-suggestions as you go to bed, like, “I’ll get enough sleep to have a good day.”  Focus yourself on results rather than hours achieved, being open to the fact that really good days can and do occur even on a short night’s sleep.  The more acceptance you practice about missing sleep, the more you’re likely to sleep, ironically.  This may not always happen for you during a given night, but will tend to be the case across time.

14. Nap strategically, and only when necessary.  Daytime drowsiness is usually best countered with some kind of physical activity, but if you must rest (and sometimes that is the healthiest choice), set a timer for 20-30 minutes, then get up promptly when time is up.  If you sleep longer, you risk interfering with the coming night’s sleep.

15. Write down any thoughts that are stuck in your head when you’d rather be sleeping.  This way, you’ll know that you won’t forget to deal with them tomorrow, and may be able to let go of them so that sleep can come. 

Consistent practice of these strategies is often enough to solve – or at least improve – sleep problems.  If you do all of these and still have difficulty sleeping, then it’s time to consult with your doctor to see if there are medical reasons for your insomnia.  You will already have eliminated the most common reasons that people sleep poorly, so your doctor will be able to home in much more quickly on whatever the underlying problem may be.  This will result in a faster diagnosis and more effectively targeted treatment.   

A Few Words on Sleep Aids

It must be emphasized that regular use of sleep aids is not a desirable circumstance.  They tend to produce psychological and sometimes physiological dependence, can interfere with the body’s natural mechanisms for sleep regulation, and can alter the activity of the brain during sleep in ways that do not support optimal rest and health.  In addition, all have some risk of side effects and the potential to interact badly (even dangerously) with other medications also in the system.  Using substances to promote sleep is a last resort, to be undertaken only in consultation with a medical professional. 

There are times and circumstances when medically-assisted sleep is the best idea and the most therapeutic intervention.  Sleep is essential to health, and if there are reasons beyond your control that adequate sleep is not possible, then medication may well make sense.  It’s a powerful tool that is best used under the guidance of someone who fully understands the implications of its use, and who can teach you how to use it safely and effectively.

Fortunately, quality sleep for most people is more effectively achieved through healthy living, purposeful management of time and energy, and consistent attention to the sleep hygiene practices described above.

When You’ve Done All You Can, Acceptance is the Best Strategy

As mentioned earlier in this article, some people just don’t sleep very well, even with exceptional sleep hygiene practices.  If you are such a person, your best bet is to facilitate quality sleep in all the ways that you can, perhaps with occasional, supervised use of sleep aids, then work at finding your peace with what you have.  It helps to remember that it is possible to have worthwhile, productive days even when somewhat fatigued.  It is not ideal, but it is possible and people do it every day.  It is also true that shorter sleep periods mean longer waking periods – more opportunities for both productive and relaxing activities of living.

Some of us are just destined to go through life with less sleep than we would like, despite our best efforts.  Doing so with a peaceful, positive attitude gives you the highest quality waking experiences and also sets the stage for the best night’s sleep possible.

Copyright © 2010, Elizabeth Babcock, LCSW, LLC.  All rights reserved.
 

Some other articles you may find useful:

When is It Time to Consider Psychotherapy?

Depression Series, Part One: Depression -- Myths and Facts

Depression Series, Part Two: Who Gets Depressed, and Why? 

Depression Series, Part Three: What to Do about Depression 

Depression Series, Part Four: When Someone You Love is Depressed

Stress Management Series, Part One: Introduction

Stress Management Series, Part Two: Creating Better Connections With Your Loved Ones

Stress Management Series, Part Three:  It's All In Your Head

   

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