rkarkowski/Pixabay
Source: rkarkowski/Pixabay

If you've ever had bad sleep night after night, you know how maddening it can be. You lie awake in bed for hours feeling exhausted, bewildered, and frustrated, longing for sleep that eludes you.  

When we're struggling with insomnia, we want something that will make us fall asleep—some trick to knock us out. Given the demand (as many as 23% of adults in the US report poor sleep in the past month), it's no surprise that proposed remedies for sleep problems abound.

Many people turn to sleep medications, either over-the-counter ones like ZzzQuil and Unisom (which rely on the sedating properties of diphenhydramine, an allergy medication), melatonin supplements, or prescription drugs like Ambien, Lunesta, and Sonata.

Others may try teas like valerian root, chamomile, or "Sleepytime," a mug of warm milk, or lavender on the pillowcase. There are also plenty of behavioral techniques we might look to, like counting our breaths, progressive muscle relaxation, a meditative body scan, or listening to a meditation recording.

Any of these techniques can be helpful for some people, and if you've found something that works for you, great—keep doing it. But if you've struggled with sleep and are looking for something to help, keep in mind these potential drawbacks of relying on tricks to fall asleep:

  1. Too much to think about. When we're longing for sleep, the last thing we need is more on our minds. If we have several tools we could use, we can create a lot more mental activity: "Should I get up and have a cup of tea? Or maybe I'm closer to sleep than I think. If I'm not asleep in a few minutes, I'll grab my iPad and listen to a meditation for sleep. I hope the blue light isn't bad. Did I remember to take my melatonin?" These internal discussions can add extra stress around sleep.
  2. Anxiety about "whether it's working." When we have a trick for getting to sleep, we may feel like it's our last best hope of salvaging the night. If we decide to use it, there's a good chance we'll have some anxiety about whether it will work. And if we don't start getting sleepy, we may start to worry that our "ace in the hole" will let us down—and then what? Even if it does start to make us sleepy, we may get anxious that it will stop working. In the past I used to rely in a breathing technique to get back to sleep. Eventually, it became stressful because I knew if it didn't put me to sleep, that was it for the night. Any technique that can fail may set us up for disappointment and more bad sleep.
  3. gentlegiant27153/Pixabay
    Source: gentlegiant27153/Pixabay

    Effort chases sleep away. When we rely on tricks to fall asleep, we emphasize effort—that I have to do something to sleep. For most things in life, more effort leads to better outcomes; sleep is one of the few exceptions—it's a state of non-doing, and we invite it by stepping into that frame of mind. If we try to fall asleep, we're likely to start evaluating our efforts: Is it working? Am I getting sleepy? The anxiety that results moves us further from sleep, which may cause us to double our efforts—I'm not trying hard enough. As our distress and effort build, we move further and further from sleep.

  4. Inconsistent sleep associations. When we teach a baby to sleep, we understand the importance of building strong sleep associations: a consistent nighttime routine, predictable level of parent involvement, and so forth. The consistency leads to better sleep. As adults, we need the same things—maybe not a bedtime story on a parent's lap, but consistent cues that signal "Bedtime" to the body and brain. Maybe it's a cup of tea and a few minutes of reading before brushing and flossing, or some light stretching and meditation. When we routinely alter our behavior at night—trying various techniques in a desperate attempt to make ourselves sleep—we don't train our brains with reliable signals for "time to sleep." Thus we may not know which trick our minds are expecting in order to sleep, and can end up like a frustrated parent, unsure what this person needs to get to sleep.
  5. Needing props to get back to sleep. Our brains come to expect the same conditions for falling back asleep that were present when we fell asleep at the beginning of the night. Most parents teach their babies to fall asleep on their own for just this reason—so the child can easily fall back asleep in the middle of the night, without the parents' help. Many of us will come to rely on watching TV, listening to music, or reading to fall asleep; the problem comes when we wake up in the night and struggle to fall back asleep—our brains may be demanding whatever sleep aid we used before. It's not a problem if we don't mind getting out our music, turning the TV back on, or turning on the light to read. For the majority of people who want to avoid these things in the nighttime, it's better to fall asleep as unassisted as possible.
  6. Not learning you can sleep on your own. Thankfully we can train ourselves to sleep with minimal external assistance or special techniques; all we'll need is a dark, quiet, comfortable place to lie down. When we fortify ourselves with tricks and gadgets to help us sleep, we don't have a chance to learn how simple sleep can be. Like Dumbo with his magic feather, we come to believe that sleep is possible only because of the arsenal we bring to it. As we practice healthy sleep habits, we learn that sound sleep can be a very simple affair. Your mind and body can do this, given the right conditions. 

Is There Any Hope for Good Sleep?

Fortunately, there are very straightforward things we can do to improve our sleep; I've described some of these principles in this earlier post. They include:

  1. Go to bed and get up at about the same time every day. The most important part of a consistent bedtime routine is keeping our hours in bed predictable. In this way, we develop a strong circadian pattern so our bodies are prepared for sleep each night.
  2. Match your hours in bed to your average amount of sleep per night. If we spend more time in bed than we're able to sleep, we'll end up with broken sleep. For example, if we sleep 6 hours per night on average but spend 9 hours in bed, we're going to be awake in bed for 3 hours per night on average—whether at the beginning, middle, or end of the 9-hour period. We'll also be prone to major unpredictability in our hours of sleep on any given night—sometimes 6, other times 8, still others 3 or 4, but never more than 6 on average. At the same time, the inconsistency will lead to sleep-related stress and worry, compounding our insomnia. By limiting our time in bed to about 6 hours a night, we'll start getting 6 solid hours of sleep most nights—which is more restorative than fragmented sleep
  3. Pexels/Pixabay
    Source: Pexels/Pixabay

    Avoid non-sleep activities in bed. We want a strong association between Bed and Sleep, so our bodies and brains know that the bed is for sleeping. We build this association by getting out of bed if unable to fall asleep, only sleeping in our bed (not on the couch, recliner, guest bed, etc.), and avoiding non-sleep activities in bed (like using a laptop computer, doing work, watching TV, etc.). Sex is the one exception.

  4. Question our worst thoughts when we're not able to sleep. We generally don't do our clearest thinking in the middle of the night. When we're unable to sleep, it's easy to start fearing the worst: This is terrible; I'll be a complete wreck tomorrow; What if I'm never able to sleep? Obviously, these kinds of thoughts only raise our anxiety and our awake-ness. In the clear light of day we usually recognize that while a bad night's sleep is unpleasant, it doesn't spell disaster for the next day. Yes, we may be sleepier at times, and for the most part, we'll take care of our responsibilities just fine. We'll deal. By noticing and challenging our overly negative predictions, we let a rough night be what it is: not better, and not worse.
  5. Limit naps. When we sleep during the day, we borrow from out nighttime sleep—the longer and later in the day, the bigger the risk of disturbing our sleep, just like snacking close to a meal or eating too much can spoil our appetite. Even a 5-minute doze a half-hour before bedtime can spoil our "appetite" for sleep. 
  6. Follow good "sleep hygiene" practices. While not effective on its own to relieve insomnia, good sleep hygiene can be an important part of sound sleep. It includes have a dark, quiet sleeping environment that's a comfortable temperature, a good mattress, avoiding alcohol at night, not going to bed hungry, avoiding too much liquid before bed, limiting caffeine intake (especially after lunchtime), and getting regular exercise.
  7. Accept that you may have an occasional bad night's sleep. None of us is immune from a night of poor sleep from time to time. We may have an idea of what disrupted our sleep, or there may be nothing we can point to. By practicing openness to the inherent unpredictability and uncontrollability of sleep, we decrease our stress and strain when sleep doesn't come. (A brief guided meditation on letting go of stress about sleep is available here.) And by sticking to our normal sleep routine after having a rough night, we prevent turning one bad night into a bigger problem.
Clker-Free-Vector-Images/Pixabay
Source: Clker-Free-Vector-Images/Pixabay

These principles are part of cognitive behavioral therapy for insomnia (CBT-I), a short treatment for long-lasting good sleep (see this earlier post for more information). CBT-I ultimately is about doing less, and simply providing the conditions that lead to healthy sleep. With a few sessions of focused work, the vast majority of people with chronic insomnia can sleep better and feel more restored. 

Questions or comments? Please leave them in the comments section below.

References

Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: A randomized clinical trial. JAMA Internal Medicine, 175, 494-501.

Finan, P. H., Quartana, P. J., & Smith, M. T. (2015). The effects of sleep continuity disruption on positive mood and sleep architecture in healthy adults. Sleep, 38, 1735-1742.

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