Today’s topic is something that until recently I was sadly all too familiar with: insomnia.
Anyone who has ever suffered from it knows how miserable it is. Tossing and turning in bed all night. Or perhaps quickly going to sleep only to be jarred awake a few hours later unable to resume your dreams. Stressing out because you know that in just a few hours you’ll need to be up to deal with the obligations of the day. Wondering why the hell your mind is racing with thoughts that you just can’t seem to shut off no matter how inane.
So what exactly is insomnia?
According to the National Sleep Foundation:
“Insomnia, which is Latin for “no sleep,” is the inability to fall asleep or remain asleep. Insomnia is also used to describe the condition of waking up not feeling restored or refreshed.”
Insomnia is at record levels in the United States. According to the CDC, sleeplessness afflicts over one-quarter of the U.S. population. Ten percent experience chronic insomnia, although I suspect that figure is much higher. It is associated with diabetes, cardiovascular disease, obesity and depression. Because of this, you’ll hear many health authorities gravely pronounce how important it is to get a good night’s sleep. I couldn’t agree more.
But honestly, do you really think people who aren’t getting a good night’s sleep don’t know that already? Trust me, they do and many are desperate to try anything to fix it.
Speaking from experience, I’ve tried everything under the sun: melatonin, Valerian Root, tryptophan, 5-HTP, warm milk, hot baths, alcohol, relaxation exercises and more. I hate to think how much I’ve spent on various supplements over the years.
Ambien always does the trick, but I hate that hung over-zombie feeling the next morning and drug-induced sleep is not as refreshing. Plus, the rebound effect of not taking it always made my insomnia worse.
After a lot of personal experience and research, I’ve concluded that chronic sleep problems are caused by three things: bad sleep habits, disease (with gut inflammation at the top of the list) and diet.
Because this topic is so big, I’ve decided to cover it over three posts. Today I’ll write about behavioral issues that affect sleep.
I owe a lot of what follows to trial and error, info gleaned from the National Sleep Foundation and an excellent book titled The Effortless Sleep Method by Sasha Stephans. I recommend you pick up a copy.
That said, like most self-help books on this topic, there is no mention of how disease and diet affects sleep. This is a huge error of omission which I find all too common in authors covering this topic. I’ll have more to say about that in the next two posts.
So what exactly is sleep hygiene? It’s those habits that promote your chances of getting a good night’s sleep. Conversely, bad sleep hygiene are those behaviors that sabotage sleep.
The first bad habit I want to talk about is using the bed for anything other than sleep or sex. By doing so you risk associating your bed with being awake.
I know a lot of you out there enjoy reading in bed or watching TV or typing on your laptops or texting on your cell phones. Many of you may even be reading this post in bed. Unfortunately, all these activities tell your subconscious that the bed is a place that requires alertness, not rest. Just as Pavlov’s dog learned to associate a bell with food, you train your brain to associate your bed with being awake. Is it any wonder you have trouble getting to sleep or staying asleep once the lights go out?
Speaking of lights, light, especially bright light from the blue spectrum, reduces levels of melatonin in the brain. Melatonin is a hormone produced from serotonin in the pineal gland. It causes drowsiness and influences the sleep-wake cycle. Production of melatonin is inhibited by light, although as you’ll read in the next post, this isn’t the only thing affecting melatonin for the worse.
So the bright light emanating from your fancy flat-screen TV or iPad isn’t doing you any favors especially if you’re doing this for hours at a time before bedtime. This is a lesson I often forget much to my detriment. I will prop open my laptop to add to or revise a post I’m working on or check my email right before bed even though I know better and pay the price when I try to fall asleep. Don’t make the same mistake. You should stop watching TV or fiddling with your electronic gadgets one to two hours before you plan on going to bed. Keep the lighting dim in your bedroom prior to turning in for the night.
I use a comfortable chair in the corner of my bedroom to read in until I get sleepy. If my spouse turns off the light and goes to bed before I do, I switch on a low light to continue reading in an otherwise dark room.
Make sure the temperature of your bedroom is cool with black-out drapes to keep light out while you sleep. If you have any charging devices in the room you sleep in, cover any light they emit with a cloth or turn them against a wall or other solid object to prevent them from illuminating the bedroom.
Turn the alarm clock away from you. This serves two functions: 1) you cut light pollution and 2) it prevents you from checking the time during the night. What use is it to know what time you got up to go to the bathroom or how many more hours are left before you have to get up other than to increase your anxiety and the odds of not getting back to sleep? It’s not like knowing what time it is will change anything anyway so why bother?
Don’t make the common error of setting a predetermined time to go to sleep regardless of how you feel. If you don’t feel drowsy don’t do it.
But Ray, what if this means I only get five hours or less of sleep? Then so be it. Chances are they will be five hours of solid sleep and not eight or more hours of tossing and turning. Otherwise you risk associating your bed as a place of torment and not a sanctuary for rest.
Which brings me to my next point. If you can’t sleep, get out of bed and do something else until you feel sleepy enough to go back to bed. Read a book or do some other activity like knitting or writing. However, for the love of God, don’t turn on the TV or fire up the computer or turn on bright lights. Your brain will think it’s morning and not the middle of the night and make getting back to sleep even more difficult.
If thoughts are racing through your head, get out of bed, turn on a dim light, grab a pen and some paper and start writing those thoughts down. If you’re anxious about forgetting something you need to do the next day, write it down. Make to-do lists if you like. If it’s gibberish that’s running through your brain, write it down and keep writing until there is nothing left to write. If you’re freaking out about not getting to sleep, write what you’re telling yourself. Hell, start writing a novel or a screenplay if you like. Many times this is all that’s needed to calm your brain enough to get back to sleep.
Ear plugs can really be a life saver, especially if you live in a noisy neighborhood or share the bedroom with a snorer. Some people find relief with white-noise machines or the hum of a fan to mask distracting noise. Eye masks can also be a great aid especially if you are extremely sensitive to light.
Don’t make the mistake of sleeping in on weekends to make up for lost sleep during the week. While sleeping in an extra half-hour or so probably won’t screw up your sleep cycle, spending the entire morning in bed will make it harder to get back on schedule. Obviously, things like breakfast or reading the newspaper in bed after you awake should be avoided as well. Remember, you don’t want to associate being in bed with anything other than sleep and nooky.
Don’t nap during the day. It’s just going to make it harder to get to sleep later.
Get some strong sunlight during the day if possible. If it’s cloudy, go out anyway. This helps set your internal clock.
Get some exercise. Take a walk, a run, go to the gym, garden, take the stairs instead of the elevator, stand at your computer—anything to increase your level of activity. Just don’t do any strenuous exercise two hours before going to bed. Doing so may prevent you from getting to sleep.
Try not to go to bed angry or upset. If you’ve just had an argument with your significant other or child, try to clear the air before bedtime. Nothing will screw up your sleep like ruminating about an argument you’ve just had.
Avoid the temptation to reach for the Ambien or Valerian Root or whatever sleep aid you’ve used up to this point. Apart from some real risk of addiction to prescription sleep aids, you reinforce the belief that you need an external crutch to get to sleep. You want your mind to believe that getting to sleep is as normal and natural as breathing, not an intractable medical condition requiring a pill.
Finally, avoid eating or drinking lots of liquid, especially alcohol, before retiring for the night. I can’t eat anything less than three hours before going to bed or I risk having it affect my sleep. This varies from person to person but most of us have a good idea how close to bed we can eat something before it affects us.
And nothing disturbs my sleep more than alcohol. While it can help you get to sleep, it rarely helps keep you asleep. I’ll have more to say about that when I post on insomnia and diet.
In part two, I’ll discuss how gut dysbiosis can fuel insomnia.