As a therapist, I regularly meet with teens and adults. Most report insomnia to some degree. Insomnia is defined simply as habitual sleeplessness but for years, I resisted applying the term insomnia to my own sleep woes. I thought I was having just trouble sleeping. Somehow insomnia seemed like a bigger problem. Maybe something incurable. No matter what I called it; it was a very disruptive pattern. I have learned that doesn’t have to be the case. How we prepare for sleep and how we respond to any sleeplessness we may encounter are equally important factors in overcoming insomnia.
Most of us are quite familiar with insomnia’s impact; we know it well. However, here is a modest review. Lack of sufficient sleep is tied to a higher risk high blood pressure, heart disease, obesity, diabetes, accidents of all kinds, depression and irritability. Chronic sleep loss is also tied to a decrease in resiliency, ability to focus, memory retention, pain tolerance, sex drive and immunity from illness. I see the many ways lack of sufficient rest impacts our emotional wellbeing and relationships. I find articles that only sound the alarm maddening. Most of us want to sleep more and/or better. We just can’t figure out how to do it.
I believe the majority of us need to address our insomnia by changing our habits. Good sleep habits invite sleep, We often try to take shortcuts. For some, sleep medications are an attempt at a shortcut. We go, go, go and then want to fall asleep right away. Sleep medications can be helpful occasionally to break a streak of sleeplessness. However they aren’t a good long-term solution for most people, since they can cause problems of their own.
As I was contemplating this article I had some nights of not-so-great sleep. I questioned my authority to write this piece. Who was I to write about sleep if I couldn’t pull off continuous restful nights? I do have some restless nights. However my sleep woes have taught me much. Overall I sleep significantly better and what I’ve learned can benefit others.
Being proactive and cultivating a positive sleep-inviting bedtime routine is important. Set the groundwork for relaxation. The bedtime routine I recommend, starts about an hour before you want to be asleep. You can adjust the time after you try this for a bit. Begin by turning off all screens: TV, computer, phones, etc. Next with pen in hand, check in with yourself. Note if there are there tasks that need to be carried over to tomorrow. Are there emotions or ideas that you need to offload so they don’t delay or interrupt your sleep? Write them down and keep it short. This should take no more than a minute or two. The idea is to download, not rehash. Nighttime is not the time to delve into concerns even though your mind may think so. Be firm with yourself; just make notes. In a future article, I’ll talk about how setting up a “worry time” as a way to lessen the space that worry and anxiety take up in our heads.
Move on to finishing up your bedtime routine, whatever that is for you, perhaps with some relaxing music playing in the background. I like the Spa station on the Pandora app. No words, just soothing waves, birds, guitars and violins. Once in bed, read (not on your phone, but a dimly lit Kindle is fine) until you feel sleepy. Listening to a calming podcast or a guided relaxation recording are also good options. Did you know that many meditation apps include soothing readings of bedtime stories for adults? They’re called sleep stories. I fell asleep recently listening to David Ji reading The Velveteen Rabbit on the Insight Timer app. When you feel sleepy enough, turn off the gadget or close your book. Repeat nightly. Perhaps that routine alone will make a significant difference for you.
A predictable bedtime routine works magic for toddlers, and is a good foundation for the rest of us as well. If, however, it doesn’t make enough of a difference, consider adding in one or more of the following. Pick one of these that you aren’t already doing and stick with it for at least a week:
- Meditate 5–30 minutes or more daily, any time during the day or especially before bed
- Exercise regularly, but not within 2 hours of bedtime
- Reduce or eliminate caffeine
- Eliminate all forms of nicotine
- Reduce or eliminate all alcohol
- Set and adhere to consistent sleep and wake times, 7 days/week
- Move your cell phone at least 10 feet from your bed or even out of the room
- Turn your clock so you can’t see the time
- Add more of these, if your sleep is severely compromised
For some, falling asleep isn’t the problem. Are you someone who has trouble staying asleep? Consider keeping a notepad, pencil and a booklight (or other low watt light) near your bed, if you wake up during the night, with a nagging thought. Write it down. All of us can relate to those ill-timed suggestions to rehash a conversation that didn’t go well or add something to your to-do list. Don’t try to reason with yourself at midnight. Just write it down. Get that pesky thought out of your head ASAP. If it is a worry, then firmly remind yourself that you will problem solve the issue later. Once morning light hits your window, those nocturnal worries inevitably seem way more manageable and you wonder why you were losing sleep over that!
If you are awake for more than 20 minutes during the night, get up and move to another room. This is hard. I get it. Do it anyway. You want your bed to be associated with sleep and not restlessness, so it is important to get out of bed when you aren’t sleeping. Do this calmly. Don’t chastise yourself. Occupy yourself with something easy but not productive. Read, doodle, listen to gentle music, or write in a journal. Do not attend to e-mails, dust the living room, or watch TV. Basically don’t do anything that might engross you. You want to be able to drop whatever you are doing like a hot potato and go back to sleep. Return to bed only when sleepy. Remember it is okay if that doesn’t happen. Watch the stars and relish the quiet.
Tempting though it is, avoid focusing on the important tasks awaiting you tomorrow and how much harder it will be to accomplish those tasks without good sleep. My advice: don’t add adrenaline or anxiety to the mix. Previewing the next day with dread will not help you sleep. Instead remind yourself that you will manage. Remind yourself that you have indeed made it through class, work, a big presentation or travel with little sleep. You can function or else you can make changes to your schedule. Not ideal but you will survive the day. Take the stress out of the situation so you are simply awake when you’d rather not be without also being anxious about it. When I stopped worrying about my loss of sleep, I relaxed and often got more sleep.
I’m convinced that your secret weapon in combating insomnia is to remain as indifferent as you possibly can when your eyes pop open at 3 a.m. In guided imagery and mindfulness, we often talk about the ”neutral eye of the camera” as a way to describe the detached, observing stance I am suggesting you adopt. Observe. Let the worry slide past without hooking you. You might say “I’m awake, oh well,” then move on to doodling or reading. Taking the anxiety out of your reaction will take a big chunk of the stress away making it easier to return to slumberland. You may not get back to sleep, but you won’t be as worried about it and will feel overall more rested and relaxed than if you stressed about it.
What if you have tried all this and are still struggling? Don’t resign yourself to not sleeping. Counseling can help if, like many, your sleep problems are tied to stress, worry, or anxiety. Address these concerns directly so they don’t harass you when you are relaxed, vulnerable and trying to sleep. Talk to your medical doctor in case there may be other reasons for your sleep problems. Ask for a referral to a sleep specialist, if necessary.
There are also many more ideas about fostering sleep. My suggestions in this article are by no means an exhaustive list. Very few tips work for everyone. What may make a big difference for one person, may have little effect on someone else. Keep experimenting to find out what works for you. Remember though, to give each idea a fair chance and some time before evaluating its effectiveness. Don’t accept insomnia as “just the way it is” and at the same time don’t lose sleep over it (pun intended).