ShareThisimprove sleep hygiene
Completed
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I will try a sequence of individual strategies to improve my sleep, which as been off for months due to recent, large stressors. I haven't yet clarified which I'll try, and in what order, but I want to capture the experiment here in Edison. |
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As a minimum I'll measure number of hours slept, notes about each night (such as why I stayed up, though feeling tired), and how much overall energy I have during the day. |
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To average out the results, I'll give each change I make 1-2 weeks before I try something else. It could be that each change should itself be an experiment (i.e., that this is the master one), but it's a start. |
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I'll look for a suitable iPhone app to add the gadget factor. I'll enjoy the days where I feel energetic. I'll get into the spirit of healthy detachment by exploring myself as a creature in the wild. |
Comments & Observations
Matthew Cornell as a starting point I might take these tests: http://discoveryhealth.queendom.com/questions/sleep_hygiene_abridged_1.html, http://psychologytoday.tests.psychtests.com/take_test.php?idRegTest=1329
Jul 29, 2010
Matthew Cornell Just a catch up: I've been running this experiment for a few weeks, with the following results (prepare yourself - I've tried a lot):
o I've stopped using the computer from ~9p on. This has been a big improvement, because one thing I do is get sucked into wasting time on it, which causes me to stay up past when I'm tired. This is a new habit, but I like it, though I'm still tempted most nights. A tactic that works well, though, is to make it inaccessible - in my daughter's room so I can't sneak in without waking her up. Result: Highly recommended; continuing.
o Create a nightly routine, and start it early. Right now I start my new oral care regime (http://edison.thinktrylearn.com/experiments/show/149) at around 9p. The key is to begin right when I realize I'm getting tired. Doing so is a new habit, as opposed to pushing through the tiredness. Result: Highly recommended; continuing.
o Not eating before bed. Result: Didn't seem to matter; discontinued.
o Doing something boring in bed when I can't sleep. I've done both reading and iPhone solitaire, which are fine. The idea is not to stimulate, which goes along with the No Laptop idea above. I read thrillers at night, but I don't think the subject matters. The point is to do it until I feel sleepy, then to close my eyes and let sleep happen. Result: Not yet sure; continuing.
o Temporarily cut out extreme exercise. I stopped mountain biking a few weeks ago, which has helped my energy level. I'm still doing milder biking and walking, but the idea is to reduce the demands on a taxed system. Result: Still helping; continuing.
o Avoiding bright lights at night, primarily the iPhone. I tried this, but decided that although the light probably has an impact, it's worth the tradeoff of the above boring game-play. It's just too hard to fall asleep without something. Result: discontinued.
o Napping. I don't like to do it, but if I'm really tired I'll lie down 15 minutes a day as needed. Actually, whether I need a nap might be a good measure of the last night's efficacy. Result: Mandatory if I'm feeling tired; continuing;
o Med change: I'm on two medications for a mood disorder, and one (Neurontin) has as side effects drowsiness and tiredness. I cut my dosage by 2/3, and I'm taking the remaining 1/3 just before bed. I did this change after cutting out the Neurontin completely to gauge the impact on the disorder. (That in itself was an experiment, which resulted in my continuing to not take it.) Result: Seems to help both the anxious thoughts at night, but capitalizes on the drowsiness; continuing.
o Cut out caffeine. I'm already not a caffeine user, though I do drink chocolate daily, and have a decaf green tea a few times a week. Cut out the chocolate, but I didn't notice any impact. Plus, I love it so!
o Going to bed when I first feel tired. This is extremely important. Liza has researched cortisol levels and its role with energy and the sleep cycle. My main take-away is that practicing this is very important. Result: Highly recommended; continuing.
o Melatonin. I tried taking 3mg of melatonin in a prior experiment (http://edison.thinktrylearn.com/experiments/show/63), then stopped because it didn't seem to make a difference. Result: discontinued.
o Counting breaths: I tried a simple breathing meditation where I count each exhalation. For fun I thought I'd do this until I fall asleep. The idea being it calms the mind. At around 250 I tended to give up. Result: discontinued.
Jul 29, 2010
Matthew Cornell Clearly I've not been doing good science, where I should have 1) changed one variable at a time, 2) measured more carefully, and over more time for each change, and 3) formulated theories about causes. Then again, the point is to sleep better, so it might be that "any experimenting is good experimenting." However, the process feels too loose.
Possible causes: Psychological (not feeling satisfied, anxious thoughts running through head); physiological (excessive exercise, medications).
Other theories?
Jul 29, 2010
Matthew Cornell Next steps:
o Get the iPhone app
o explore possible theories with my psychologist
Future experiments:
o Apply some sexy psychological techniques that my new therapist will recommend (manage anxious thinking).
o Make my routine include reviewing my completed daily plan for the day (satisfaction of a day well spent).
Jul 29, 2010
Matthew Cornell Some meds I've tried: Ambien (works, boy) and Xanax (helped some, but not drammatic). Of course the problem with these is that using them isn't sustainable. Also, there are side-effects, including addiction.
Jul 30, 2010
Matthew Cornell I decided to do a 1:15 mountain bike ride this afternoon as a test on sleep tonight. I kept it relatively low key, just in case. Interestingly, my mood went south a bit after the ride.
Jul 30, 2010
Liza Cunningham Mood going south after extreme exercise could be directly tied to your adrenals being over-taxed. Or a drop in cortisol. It sounds like it could be time for a saliva test. Have you been tracking body temp? Does it fluctuate more than 0.2 in the afternoon?
Jul 31, 2010
Matthew Cornell Thanks for the suggestions, Liza. Sleep was OK last few nights.
Aug 01, 2010
Matthew Cornell This is fascinating: http://curetogether.com/blog/2010/05/12/does-masturbation-work-for-insomnia/comment-page-1/#comment-1561
Aug 04, 2010
Matthew Cornell This experiment is tough because there are so many vars. Exercise (too little, too much, wrong timing), diet, meds, psychology (obsessive thoughts trying to fall asleep), environment, etc. How do you do good science in this case? The CureTogether approach is the way to go, obviously - lots of people trying different things over time.
Aug 04, 2010
Fredrik One thing that helps me is to focus on what I am doing before going to bed. Dim the light, put on really soft clothes, play some soft music on quite a low volume. To spend some time in a room like this sitting and reading or actually just relaxing helps a lot. The trick is to have done everything else needed to sleep (brush teeth etc) first so the next step from this "area" is the bed...
Aug 05, 2010
Matthew Cornell Note sure I understand, Fredrik. Is the goal to start associating the space with sleep? Or is the routine important? Curious to know!
After talking with psychologist and psychiatrist today (busy day) I came away with three new experiments to possibly try: 1) Increase Gabapentin dose at night, 200mg, 300..., 2) Take Benadryl (Diphenhydramine), 25mg or 50 to start, say, or 3) schedule a 20 minute max nightly review and worry time (details follow).
Here's what I'll do: Stop the Gabapentin (I'm sharper when I'm off it and it's not working) and use the Benadryl PRN when I first decide I'm tired but can't fall asleep (it takes ~30 minutes to act). I'll start up the nightly session in a few days - it's too much right now. Resources for it follow.
* Nightly session:
o reflect on the day's accomplishments
o savor the day's interactions with people I like
o look at what lies ahead
o briefly process worries saved up during the day
o credit myself for self-improvement and experiments I did that day
* Handling Worries: Keep A List, Schedule Them, And Have A Worry Place
http://matthewcornell.org/blog/2005/11/handling-worries-keep-list-schedule.html
... setting up a time and place to worry:
* set a time
* do nothing else
* reduce disturbance
* be a little uncomfortable
* make it accessible
* always worry when in your worry place
* keep a worry list
* go to your worry place when a worry comes on
* instruct yourself - "This is a nonproductive worry. I'll write this on my list for worry time. Right now I will use my time to get something else done."
* pat yourself on the back often
* do something pleasant after worry time
* Self Help For Anxiety - Schedule Your Worry Time
http://ezinearticles.com/?Self-Help-For-Anxiety---Schedule-Your-Worry-Time&\1id=4048903
Schedule you're worrying. Pick a time and place that you will allow yourself to worry full time. Don't make it to close to bedtime because you don't want to carry those thoughts into the bed with you. An excellent way to schedule this is by taking a daily walk.
* Psychotherapy Brown Bag: What if?!?! - How scheduling time to worry each day can decrease how often you worry
http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2009/08/what-if-how-scheduling-time-to-worry-each-day-can-decrease-how-often-you-worry.html
Paradoxical as it seems, CBT therapists encourage their clients to schedule "worry time" every day. Oftentimes, the plan will be for the client to schedule 30 minutes of worry time each morning. Outside of this 30 minute window, the client is told to acknowledge that there is a topic that prompted worry, but to delay that worry until the next scheduled worry time. In this sense, they are not ignoring the topic, but rather allotting a specific time for it during the day. When the worry time window arrives, the client is to sit down and do nothing but worry for the entire span. Sounds awful, right?
Aug 05, 2010
Fredrik Yes, what I was trying to explain is that is helps to prepare the whole area for sleep. I usually spend my last waken time in the living room but before I get to that time I prepare the apartment :
* Turn down the lights everywhere
* Brush my teeth
* Get a shower and dress down
* Get pen and paper ready
* Dim the light in the room
etc
So then I can do a braindump like you have described your self, sit down and read my book, listen to some music, solve a crossword or whatever I feel like until I get tired. And also I just realized that I if possible I try to wear clothes that is quite thin. Being just a little cold and getting to get into the warm bed is quite a good trick.
So the whole idea is to do everything needed to go to bed a while before going to bed and then making the "path to the bed" as straight as possible.
I have never tried any medicine or anything and still fight with sleeplessness now and then. Hope it works for ou!
Aug 06, 2010
kelli One more thought on top of a huge list... have you had your iron levels checked? I had some serious sleep issues one summer. I did most all of the good things you've tried and nothing was working. Turns out my iron was just really low which can lead to anxiety and insomnia. Iron pills for a few months (which some will argue with but when you're desperate for sleep you'll do anything) worked for me. I think iron deficiences are more common in women but thought I'd pass the idea along just the same.
PS - i love the "worry time" idea. Sometimes I have to do whole "worry days". Usually I schedule them and then end up not needing them.
26 days ago
Matthew Cornell That's a great suggestion, Kelli. In fact I was wondering about iron, and your story is just the prompt I needed - thank you. Re: worry days: Wow! It's neat that you use the technique successfully - i.e., that you don't need them. That must feel great.
25 days ago
kelli You're welcome. You never know. It could be that easy. Yes some days I don't need them. Others... well, I could use 2 back to back :)
25 days ago
Matthew Cornell I'm marking this Completed because it's more of a "super" project - fixing my sleep patterns. I'll run individual experiments separately, and incorporate the suggestions above.
20 days ago