Spoiler alert: prescription sleep aids aren’t on the list
At some point, we all experience a few nights of terrible sleep. We wake up in the middle of the night only to lie in bed wide awake, counting the hours left until we have to get up. Whether it’s stress-related, trauma-induced, or an inability to shut our brain off, there are times we simply can’t fall asleep and/or stay asleep.
Health care practitioners call these temporary sleep issues acute insomnia, and most people eventually go back to normal sleep patterns with time. However, chronic insomnia is present for at least 3 nights/week for at least 3 months and can’t be linked to other sleep, medical, or mental disorders. Various studies worldwide have shown the prevalence of insomnia in 10%–30% of the population, some even as high as 50%–60%.
Anyone with insomnia, regardless of how long it lasts, knows exactly how much lack of sleep can impair their day-to-day lives. In fact, depression and anxiety orders often go hand and hand with insomnia. And the consequences of daytime drowsiness can be long-lasting and severe.
Matthew Walker, Ph.D., author of Why We Sleep: Unlocking the Power of Sleep and Dreams, and professor of Neuroscience and Psychology at UC Berkeley, is famous for his stance on the power of good sleep.
Every disease that is killing us in developed nations has causal and significant links to a lack of sleep,” he says. “So that classic maxim that you may [have] heard that you can sleep when you’re dead, it’s actually mortally unwise advice from a very serious standpoint.
We are a nation of individuals who are wired and tired, he explains. We either pump ourselves up with caffeine to get through the day, only to find ourselves too caffeinated to fall asleep at a decent hour, or we lie down with so many anxieties flowing through our minds we can’t shut it down. It’s tempting to turn to prescription sleep aids (or over the counter remedies) to knock ourselves out.
But Walker warns,
Unfortunately the current set or classes of sleeping pills that we have do not produce naturalistic sleep. So they are all a broad set of chemicals that we call the sedative hypnotics, and sedation is not sleep, it’s very different. It doesn’t give you the restorative natural benefits of sleep.
So what are we supposed to do when we can’t fall asleep, or we wake up only to toss and turn for hours? Here are five remedies that don’t involve ingesting something to induce less than high-quality sleep.
1. Move to Another Room
Walker explains our brains are remarkable adaptors. If we lie in bed while awake, the brain will learn that this thing called your bed is the place of being awake and not asleep. We have to break the association. After 15–20 minutes of wakefulness, do something else, and return only when you are sleepy.
I’m staying at my parents’ house for the holidays and woke to find my dad sleeping on the couch. It turns out he wasn’t banished from his room for snoring. He woke up and couldn’t go back to sleep, so he changed venues. It may seem weird, but it works.
Walker uses the following analogy. You don’t sit at the dinner table waiting to get hungry, so don’t lie in bed waiting to get sleepy. Make your bed a destination place for sleep (and, well, maybe one other thing) and nothing else.
Whether we’re going to sleep or waking up in the middle of the night, lying there with no distractions can cause our anxieties to rise to the surface. This may trigger a rush of adrenaline that causes our heart to race and starts a vicious cycle where we’re too anxious to sleep, then incredibly tired the next day and even more anxious when we lie down again.
Meditation can help, but who wants to meditate at 3:00 in the morning? I get it. Yet, using a guided meditation app or focusing on breathing in and out slowly and deeply for five to ten minutes will calm the ‘fight or flight’ branch of your nervous system, allowing you to fall asleep.
Being quite a stoic, hard-nosed scientist, I actually didn’t really believe the data [about meditation as a sleep aid], even though the data is very strong. And I started doing it myself, particularly when I was traveling with jet lag, and I found it to be very effective. …
It just quiets the mind and it dampens down what we call the “fight or flight” branch of the nervous system, which is one of the key features of insomnia. And that can really have some efficacious benefits too.
3. Write in a Worry Journal an Hour Before Bed
Part of the problem with anxiety is it can take over our thoughts at any moment. Ruminating on what’s causing the pit in our stomach or the wringing of our hands only makes the problem grow.
Worries are like a plant, and our thoughts are the water and sunshine, allowing the plant to thrive. Stop thinking about them, and you’ve cut off their food source.
Give yourself 15–30 minutes each night, about an hour before bed, to allow your mind to go crazy. Think of every little thing that could go wrong. Financial devastation? Sure. Life-threatening medical diagnoses (based on this morning’s headache and an Internet search)? Knock yourself out.
Sit down and write all the things on your mind. Worried that you won’t be able to sleep? Get it on paper. The physical act of journaling gets the worry out of your brain, freeing your mind to think about other things. Walker says you’ll fall asleep in half the time you would otherwise.
4. Build Up a Sleep Deficit
Be careful with napping or sleeping in if you’re experiencing acute insomnia. Sonia Ancoli-Israel, Ph.D., director of education at the UCSD Sleep Medicine Center, explains,
While sleeping in is tempting, it’s actually the worst thing you can do. The truth is, after one bad night of sleep you should change very little in your routine. You should still get up at the same time you do every other morning, even if it’s the weekend.
Getting up at your usual time instead of sleeping in will help you sleep better the next night, as you’ll naturally be more tired. Go to bed at your usual time, even if you have to force it. If you need to nap to get through the day, keep it short (around 20–25 minutes), and don’t nap after 3 p.m. Ancoli-Israel cautions a long nap can disrupt your sleep-wake cycle making you unable to fall asleep at your regular bedtime.
5. Cognitive Behavioral Therapy (CBT)
If you have chronic insomnia and nothing helps, you may be better off seeking therapy to help reframe your thoughts around going to sleep or waking up in the middle of the night.
The cognitive portion of CBT addresses the specific anxieties keeping you awake. Unfortunately, having trouble sleeping makes us worry we’ll never sleep normally again, making the problem worse. Therapy helps us understand the connection and correct our thoughts around sleep.
The behavioral portion focuses on your sleep hygiene and making sure you create the optimal sleep environment.
The Mayo Clinic writes,
Cognitive-behavioral therapy for insomnia may be a good treatment choice if you have long-term sleep problems, you’re worried about becoming dependent on sleep medications, or if medications aren’t effective or cause bothersome side effects.
CBT goes to the root of insomnia rather than only treating the symptoms (like with medication). It may take weeks to months, but ultimately it’s likely the best treatment for long-term sleep deprivation.
There are few things in life more frustrating than lying awake at night wanting nothing more than to fall asleep. It’s tempting to reach for a sleeping pill or use alcohol as a sedative. However, not only can they become addictive, they often disrupt REM or deep sleep.
Try these five natural remedies the next time you find yourself suffering from a bout of insomnia:
- Move locations
- Write in a worry journal before bed.
- Stick to a regular bedtime and wake time regardless of how you slept the night before. Keep naps short and before 3 p.m.
- Seek cognitive behavioral therapy if none of the above tactics work.
Also, make sure to get sunlight during your day that isn’t behind a windshield, window, or sunglasses. Sunlight helps regulate your circadian rhythm and signals to your brain when it’s time to be awake and when it’s time to go to sleep. Here’s to a great night’s sleep!
Photo credit: By Sergey Mironov