Biological Psychiatry & Psychopharmacology
Diplomat American Board of Psychiatry & Neurology
Strategies for Insomnia:
1. Get out of bed at same time each day even on weekends even if you did not get much sleep. Your internal sleep clock starts from the time you get up out of bed (literally out of bed and standing) and starting moving.
2. Avoid naps during day to build up body’s natural sleep medicine called Adenosine. Naps will drain Adenosine and confuse your internal clock. Napping is for people who has no insomnia problems. You might be able to add some back in once your problem is solved but not until then.
3. Bed is only for sleep and sex and nothing else including reading or watching TV or even thinking. Only go lay in bed when your are falling asleep or close to it. Sex is ok because orgasm releases sleep inducing neurohormones.
4. Exercise especially morning or late afternoon deepens sleep.
5. Avoid caffeine. Caffeine block Adenosine. If you must, pease do not drink before 2 pm. Of course, if you are a heavy drinker, slowly taper the amount so you do not induce withdrawal symptoms like headaches.
6. Avoid Alcohol. Usually, alcohol stimulates then sedates but it lightens sleep and does not improve memory, concentration and energy like normal natural restorative sleep. Then often a person goes through alcohol withdrawal early morning often feeling dehydrated and hung over at the same time. Also, even the sedating effect eventually wears off over time.
Preparation for Sleep:
1. Blue light wavelength is how the brain decides if it is light or dark outside. We want the brain to think it’s pitch dark to release all the neurohormones like melatonin. All light including from TV, computers, lamp has blue in it. Consider www.lowbluelights.com for glasses/goggles or clip-ons that blocks blue light and tricks the brain into thinking outside is pitch dark. Cheaper option recommended is Uvex Ultrapec (S1933X) from Amazon for just over $10. Using these for an hour or two prior to sleep can be helpful. People in Bipolar manic/hypomanic phase should try wearing these from 6pm til 8am. Here is a link for more details: https://psycheducation.org/blog/dark-therapy-in-6-steps/
2. Sleep in pitch darkness using sleep mask or if must have nightlight (studies suggest nightlights impact sleep), use low blue light ones.
3. Sleep specialists recommend 60 – 65 degrees Fahrenheit as ideal.
4. Consider white noise, nature sounds or relaxing music like “Weightless” by Maroni Union on YouTube, a song produced from a collaborative effort between sleep researchers and musicians.
5. Aromatherapy especially scents like lavender, bergamot, chamomile and cypress.
6. If you still do not fall asleep after about 20 minutes, get out of bed and move to another room and sit in total darkness or at least with blue light blocking glasses until you do then go back to bed.
7. Some feel weighted blankets has been helpful.
8. Use sleep apps like CBT-I coach.
For more advance cases:
If these initial steps do not do the job, please get trained in CBT-Insomnia. Therapists trained in this technique are hard to come by. I would, therefore, try book therapy and recommended “Say Good Night to Insomnia” or “End the Insomnia Struggle”.