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Sleep

When You've Tried Everything and Still Can’t Sleep

The more urgently we try to fall asleep, the more elusive slumber gets.

Key points

  • The more urgently we try to fall asleep, the more elusive slumber often gets.
  • Diverse strategies are needed for responding to insomnia.
  • Strategies may include avoiding caffeine after noon, exposure to daylight, and establishing regularity in sleep and wake times.

Waking up at 3 in the morning and being unable to get back to sleep is nerve-wracking. Twisting, turning, shifting from one side to the other and back again. Blanket off, blanket on, blanket looser, blanket tighter—finally wrapped into a cocoon, turning the light back on and grabbing a book, determined to stop the churn of worries. Get up to pee, even more awake. Counting, subtracting by sevens, picturing placid pursuits, but sleep just doesn’t come.

 Wendy Lustbader
Crossed Trees
Source: Wendy Lustbader

Stop fretting! Sometimes I order the noise in my mind to cease. Thought replacement, a tried-and-true CBT technique, works wonders for me in the daytime. In the middle of the night, however, when I push forward a far more pleasant line of thought, it only works for a short while. Then something else rises up from the sewer where regrets and unresolved dilemmas fulminate, often even worse than what was tormenting me in the first place. I hate this more than anything.

Insomnia feels like the mind turning on itself, a kind of trickery where every good and restful thought gets countered with the most anxious possible rebuttal. Desperately, we want this barrage to quiet down and let us go into the great forgetfulness, solid hours of not having to contend with life. But the more urgently we try to fall asleep, the more elusive slumber gets.

At this point, a terrible sense of isolation often creeps in. It feels like everyone else in the world is sleeping soundly, that this siege of wakefulness is a personal curse. We might know rationally that insomnia is legion and that we are far from alone in grappling with this malady, but such loneliness is insistent and convincing in the dark of the night. Without daytime’s assurances, we feel like the only one.

All that can impede sleep compounds in complex ways—biological rhythms, physical contexts, psychological factors, and current stresses. This is why diverse strategies for responding to insomnia should be considered, perhaps simultaneously:

  • Shut off screens at least an hour before bedtime.
  • No caffeine after noon.
  • Keep pets out of the bed.
  • Read an interesting book that still manages to be dull.
  • Make sure any pain issues are medically investigated and treated.
  • No vigorous exercise a few hours before bed.
  • Avoid drinking more than one ounce of alcohol.
  • Be sure to get some exposure to daylight, even on cloudy days.
  • Settle arguments with a bed partner out of the bedroom.
  • No cellphones or clocks near the bed; no checking what time it is.
  • Establish regularity in bedtimes and wake times.
  • If necessary, consider doctor-prescribed medications.

Many people try all of these and still can’t sleep because what is keeping them awake is a genuine threat to their security. Worries about money, for instance, can be insidious. A woman who hadn’t been able to get a good night’s sleep in months finally pushed down her pride, called Salvation Army, and received a substantial one-time payment to catch up on her most important bills. That same day, she negotiated fiercely with a health care provider’s billing office and got them to reduce her balance 90% in exchange for her paying off her remaining debt at $50 a month for two years. That night she slept eight hours straight.

In this regard, wakefulness might be a kind of dipstick into the soul. When we shut off the light to go to sleep, we meet ourselves in silence without distractions. The periods in my life when I’ve had the most trouble sleeping were times when difficult things were going on. One strategy I have found useful, though not necessarily successful, is to heed what is keeping me awake at 3 a.m. I tell myself that what is gnawing at me matters. On the pad beside the bed, I note what’s bothering me in as much detail as I can muster. The act of writing it down and then setting it aside sometimes works. The gesture is at once a promise to myself to start dealing with what’s wrong and permission to get away from it for the time being—perhaps the next five or six hours, a decent expanse.

Dolphins have it right. One side of the brain sleeps while the other side stays awake and watches for sharks. Since we can’t manage to be watchful and be asleep simultaneously, each of us has to devise a way to cordon off our worries and anxieties so that we can rest. It’s better to face the sharks during the day, after a good night’s sleep.

Copyright: Wendy Lustbader, 2022.

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