(Please read article dealing with natural remedies to insomnia prior to this article.) Chronic Insomnia debilitates the body and mind. Studies show that insomnia deleteriously affects the body by lowering life expectancy and increasing your chances of infections, obesity, and cancer. Mentally, it diminishes cognition, memory and leads to general anxiety, depression, and possible paranoia.
Insomnia afflicts a large percentage of Americans. Some choose to stay up late to engage in work or recreational activities but the sleep deprivation is nevertheless insidious. This articles focuses on those individuals who strive to sleep 7-9 hours a day, but cannot. For those who suffer from crippling insomnia.
First, rule out any physiological explanations for your insomnia, such as sleep apnea, heartburn, thyroid irregularities, medications and alike. Consult a Naturopathic Doctor (ND) or allopathic one (MD) first.
Engage in sleep hygiene
As mentioned in the previous sleep hygiene article, adhering to a strict sleep hygiene regiment increases the likelihood of good night’s sleep. Ideally, you want to adapt your daily routines to that of your Circadian rhythm. To review, make your room dark as possible, implement “white” noise (noise reduction machines, ceiling fan), make your room very cold, drink chamomile tea, indulge in a hot bath, and take a nice evening walk. Most importantly in this technological era is to restrict the use of computer screens, smart phones, or TV. These emit blue light which hampers the production of melatonin, your drowsy hormone, and increases cortisol, your stress one. If you feel you don’t have the discipline to omit screens at night, then purchase blue-light blocking glasses. Also, only use your bedroom for sex and sleep. Don’t use it for TV watching or work. By solely using it for sleep and sex, your mind automatically connects to solely those functions. If you do stressful work in there, it will connect it to stress.
Let’s say, you have a horrible night and only sleep 1-3 hours or none at all. If your insomnia stems from psychological reason, such as anxiety, please try these simple actions to help prevent this experience again.
It is quite normal to panic after a sleepless night. The fear sets in. “I known I am not going to sleep tonight.” “I am going to have to admit myself to the psych ward if I don’t sleep tonight.” “I am going to die if I don’t sleep.” These are all examples of jumping to the worse possible scenario. This is called Catastrophizing. Engaging in this thinking will only increase your anxiety about sleeping thus making you less likely to sleep when the night arrives.
Engage in Cognitive Behavior Therapy for Insomnia (CBT-I)
Cognitive Behavior Therapy for Insomnia (CBT-I) strives to change dysfunctional beliefs/attitudes about sleep An offshoot of CBT deals with insomnia. As Yoda said in Empire Strikes Back, you must “Unlearn what you have Learned.” Instead of catastrophizing come up with more positive statements that won’t exacerbate your anxiety such as “It’s okay if I don’t get a full night sleep tonight. I might be groggy the next day but that is okay.” “I won’t be admitted to the psycho ward.” “I won’t die.” “I know that this is a phase; my sleep will return.” The point is fearing your lack of sleep is NOT going to enhance your chances of sleeping well. Though it is
difficult at the time, you must relax and not stress over it. Your sleep will return. It might not return to 7-9 hours, but it will increase to 3-4 and eventually back to normal. Click here and here to review well-received CBT-I manuals.
Sleep restriction therapy attempts to limit the time spent in bed to ACTUAL sleeping time as well as increase sleep efficiency by extending sleep time. Limiting the time spent in bed creates a mild sleep deprivation which promotes you to actually fall asleep sooner. To see the efficacy of sleep restriction, let’s look at a typical insomniac’s night.
- You go to sleep at 10:00 pm even if you are not sleepy.
- You toss and turn in bed trying to fall asleep.
- This increases your anxiety, thus mitigating sleep achievement.
- You look at the alarm clock or phone every hour, thus increasing your anxiety.
- Catastrophizing and panic fixation kicks in and you don’t sleep at all.
Sleep restriction tries a different route. For example, go to your bedroom only when you feel drowsy. If it is at 9:00 pm, then 9:00 pm; if it’s midnight then midnight. Going to the bedroom when you are not sleepy is counter-intuitive and thus increases your chances that insomnia will reoccur. Listen to your Circadian rhythm.
Try the following steps.
- Go to your dark, cold, slightly noisy room only when you are drowsy.
- If you can’t fall asleep within 30 minutes, then leave the bedroom and engage in a relaxing activity (e.g. reading fiction, listen to music, watch relaxing TV at a low volume).
- The key is do NOT stay in the bedroom when you can’t sleep. You will soon connect the room to anxiety and frustration. This period is an excellent time to engage in relaxation techniques and/or deep breathing exercises.
- Engage in that activity until you get drowsy again, then return to the bedroom (or another room or couch) to sleep.
- If you cannot sleep within 30 minutes, leave the room again. Rinse, lather, repeat.
Though much of sleep hygiene and restriction seems counter-intuitive, it is in fact effective. Keep a rough estimate of the times at which you get drowsy, sleep, and wake up and you will notice a pattern. Try to adhere to that pattern as much as possible. Always look on the bright side. Instead of seeing 4 hours as bad, see it as better than 2 hours and that you are working toward 6-7 hours. Try to not to label nights as “good” or “bad.” Some people have excellent results using ASMR (e.g. whispering, crumpled paper, dripping water sounds) or listening to a boring audiobook or podcast to lull themselves to sleep.
True chronic insomnia is terrifying. Before opting for the prescription medications, or even OTC melatonin and valerian root, try to utilize the aforementioned naturopathic practices. (If you currently on prescription medications, please peruse the adverse effects and talk to a doctor about future usage.)
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