I’ve written one article about sleep, and yet it’s a topic I’m asked about often. Granted, I have talked about my sleepless nights a fair bit.
Since writing my one piece – which tracks the time I spent at sleep school with my baby son – I’ve visited a sleep shrink, tried pills, meditation, mind exercises, naturopathy, and read about sleep. In response to another email asking me if I ever conquered my insomnia (and if so, how so), I figure it’s time to share what I’ve learned.
1. Here’s a summary of the advice offered by the expensive sleep doctor over a period of eight months.
Make your bedroom a good place to sleep. The professionals use the term ‘sleep hygiene’, and counsel you to remove as much clutter as possible – no clothes draped over the end of the bed, no mess of work-reading on the floor, no splay of cosmetics across the dressing table – dust and clean, let in some fresh air, take out loudly coloured items. Make the room as visually calm, quiet and minimal as you can. A sanctuary. Make your bed comfortable: get rid of itchy sheets, buy a good pillow. If you like the smell of lavender, sprinkle a few drops on your pillow and then turn it over (don’t let the essential oil touch your face). You’ll sleep better in a cool – not cold – room than a hot one.
Keep electricity to a minimum in your bedroom. Withhold your cynicism – I think this makes a difference. Get rid of the electric blanket, take the television out of the bedroom, put whatever device you use to wake you up (alarm clock, phone) out of eyesight. The last one is crucial since you don’t want to see the time when you wake up in the wee hours of the morning; you think you do, but it will only make you anxious and not help in any way. The only exception to this is a light box. You can read about those here: http://health.howstuffworks.com/mental-health/sleep/basics/how-to-fall-asleep2.htm
Stick to a peaceful pre-bedtime routine as often as you can. Your routine needs to start several hours before you turn the light out. It might include a warm shower, reading (print – no devices. See below), meditation, or padding around the house doing whatever you need to so that you don’t fret about it in bed (get the next day’s clothes out, put whatever stuff you need in your workbag). Keep it low key. Going straight from an intense episode of your favourite show/an argument/an unpleasant phone call/a wild night out to bed is asking for trouble. You’ll either lie awake for hours or crash and then rewake a few hours later. Your body and brain need a calm transition period between waking and sleeping life.
Early in the day, write down anything that’s bothering you, no matter how small. Spend no more than ten minutes doing this. Just pour it out. Your troubles could be work-related, relationship-related, the fact you’re annoyed at yourself for forgetting to do something, an unreturned phone call, your weight, money…anything. Write it down a long time before you plan to go to bed. Use pen and paper. Don’t show anyone else. The idea is that you purge yourself of all the things that wake you with a sharp pang at three a.m or have you fretting at midnight. If there is a solution, write that down too. Then put it away (not in the bedroom) and leave it alone.
Don’t exercise too close to bedtime, but do exercise. Tired muscles will relax more easily. But if you can’t sleep, get up and stretch out your legs, arms and back. Rotate your wrists and ankles. Keep it slow and fluid. If space allows, stretch in the darkness next to the bed. Don’t go into the light to stretch or read or take a break from relentless hours of insomnia – your brain will think it’s daytime.
When sleep will not come, don’t care. I know… But don’t try to sleep, try to rest.
2. Here are the pills and potions I’ve tried in the name of sleep.
Temazapam: My GP is very anti-pills so I’ve had these on only three occasions. Temazapam will put you to sleep in a half-hour or so but only lasts for about five hours, after which you may wake up. It worked less and less well for me over time, and I woke feeling groggy and slightly depressed.
Melatonin: I heartily recommend this. It’s worked better for me than anything else. I think it’s still the case that you can’t get the heavy-duty Melatonin over the counter in Australia. I ask friends visiting the United States to buy it from a drugstore (hooray FDA). The theory is that melatonin resets the body’s biological clock so you can, in time, sleep without it. Sleep is an unpredictable beast though, and even something that works well for a while can stop working. Melatonin has health benefits, too, including guarding the immune system against degenerative diseases (melatonin levels are low in sufferers of Alzheimers Disease, production of melatonin is disrupted when people develop Parkinson’s). Some people say it has the byproduct of being good for your skin, since melatonin is an antioxidant.
Melatonin levels peak at about 2 a.m. in normal, healthy young people and about 3 a.m. in elderly people. The maximum amount of melatonin released in the bloodstream of the elderly is only half of that in young adults, which is why many scientists and health professionals believe that melatonin levels are a good marker of ageing and longevity. Melatonin levels are low during the day. At sunset, the cessation of light triggers neural signals, which stimulate the pineal gland to begin releasing melatonin. This rise continues for hours, eventually peaking around 2 a.m. (3 a.m. for the elderly), after which it steadily declines to minimal levels by morning. The delay in timing and decrease in intensity of the melatonin pulse is a result of the aging process.
A side note here on the pineal gland. It’s the size of a pine nut and sits between the two brain hemispheres, right in the middle. Those inclined to believe in energy centres say the pineal gland is the site of the sixth chakra, also called the Third Eye. The pineal gland produces your body’s melatonin, which is actually a hormone. This tiny powerhouse is – some say – the main determiner of whether or not you sleep.
I recommend this fascinating podcast about the pineal gland: http://blogs.howstuffworks.com/2013/01/31/pineal-optics-my-third-eye
Kava: Yes, the same thing they drink in Fiji is available from health-food stores as a tablet. It’s made from a plant root, and it works as a nervous system depressant, but I wouldn’t recommend it long term. You may wake feeling heavy-headed and thirsty. And it is hard on your liver and kidneys. It does put me to sleep though.
Naturopathic cocktail: I have no idea what my naturopath mixed into the vile, dark-brown liquids she gave me for so many months. They worked but, again, this is a short-term solution since it’s expensive. However, I do know she mixed ingredients that were intended to bolster my immune system, give my tired adrenal system a break, and force tight muscles to relax. None of which can be bad.
Magnesium: This is a muscle relaxant and calmative (low levels of magnesium can cause a build-up of lactic acid, which causes tightness), so if anxiety is at the root of your insomnia this might help. It’s a mineral that many people are deficient in and – since all things are connected in one way or another – when magnesium is low the production of melatonin and seratonin by the body are disrupted. You can buy magnesium in powder form from health food stores.
Mersyndol: Desperate times call for desperate measures. Anyone who’s suffered from insomnia knows that despite one’s best efforts at making a nice space, steering clear of caffeine (no caffeine after 11a.m – seriously, any later than that and it will keep you awake), eating bananas (they contain tryptophan which makes you sleepy) and drinking warm milk, thinking about clouds…there are times when you can’t sleep. When you are desperate from awakeness, night after night. When you are in tears from it, can’t remember your own name, are raging/flailing/hurt everywhere from exhaustion, and really should not be driving or doing any job at all. And no one understands how fearful you are that the cycle will never end, that sleep will never come easily again. That is the point you tell the chemist you suffer from migraines, go to bed at 10p.m, tell your partner (should you have one) that they must deal with wakeful children (should you have them), take a Mersyndol and let the chemicals knock you out and break the cycle. Codral night time also works. It’s not natural, you shouldn’t do it often but when you are struggling to function on even the most basic level, take it. Sleep.
3. Meditation tapes and calming music work for some people.
I’ve listened to loads of these. They’re fine. I like the sounds of waves, Eastern music and a somnolent voice. They’ve made me feel relaxed; they’ve never put me to sleep. I think having a plug in one’s ear, or knowing the music will end at some point, or sitting in a chair listening to a guided meditation on your computer stops you from completely letting go.
4. Wide Awake by Patricia Morrisroe is the best book I’ve read about sleep.
This book is about Morrisroe’s attempt to deal with her own insomnia, and about the politics of the medical profession making money off our awful nights.
Robert Pinsky reviewed it for the New York Times. He says he won’t give away her ending, the thing that allowed her, finally, to sleep. But I will. For Morrisroe the answer was meditation.
And, having tried everything under the sun, I agree with her. While the music tapes and murmurings don’t put me to sleep, unaided meditation – sitting quietly and focusing on my breath, not judging my wandering thoughts – followed by getting straight into bed, does seem to work, if you do it night after night. Regularity is the key to success. I haven’t yet exercised the discipline to reep the full rewards of meditation but I’ve benefitted enough to declare it a very good idea. Some people do have deficiencies (magnesium, seratonin, melatonin, vitamin D) or disorders that make it impossible for them to sleep. Chronic pain will keep you awake. But for those whose bad nights are the result of a brain that will not let go, shut down, quiet or step off the treadmill, meditation is worth a try.
5. There are things that consistently kill sleep.
Babies. My own insomnia started when my oldest son was a baby. He woke and woke. Sometimes I was able to sleep for two hours, sometime fifteen minutes, sometimes five hours, sometime one. It was torture to be woken by a piercing scream, at unpredictable intervals, for a year on end. My second son did the same thing. It rewired me. I thought for a while that I might actually die – it sounds ridiculous but I felt that bad. I looked for reasons my sons didn’t sleep: they were boys (a nurse told me that seven out of every ten women who came to her sleep school had sons), they had bad digestive systems (but who knows, really?), my milk, my diet, the wrong routine. My GP told me people are not genetically predisposed to insomnia but I think if you have a shaky nervous system perhaps that’s passed on. I blamed myself on every level. Nothing worked but time – they grew out it, I did not.
Computers and all back-lit devices. Do not have these in the bedroom, ever. And do not use them at night if you want to sleep. They mess with your melatonin. Light shining straight into your eyes from a close proximity tells your brain to wake up. I know people think they need to keep using their devices until bedtime, and can do so without ill-effect, but I’m calling bullshit on that. Read about why: http://articles.chicagotribune.com/2012-07-08/news/ct-met-night-light-sleep-20120708_1_blue-light-bright-light-steven-lockley
Sugar. For me, sugar at night – in desserts, sweet wine or champagne, even juice – is as bad as caffeine.
Dehydration, hunger, alcohol, eating too much food late at night. The body is an incredibly complex machine and too much or too little of something can derail it. As Seinfeld once said, if a car required as much maintenance and care as the human body you wouldn’t buy it.
Exciting television and arguments. If you are worked up you can’t let go, physically or mentally.
I truly hope some of this is helpful or at least steers you towards something that might work for you. If you have any advice or thoughts about sleep I’d love to hear them.