Anyone else suffer from insomnia?

[leaverus]

I realize that the nature of our field and being on call and woken up sporadically and randomly throughout the night (negatively) affects sleep cycles so even when I'm in the comfort of my own bed at home I don't sleep well; and then it just becomes a really vicious circle. I've tried all the "usual" remedies (melatonin, cherry juice, no screentime before bed, darkened room, meditation, etc.) and don't want to resort to meds at all. Any suggestions?

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[fittipaldi1of1]

Counting sheep

 

[deleted162650]

Have a couple kids.

 

[abolt18]

I realize that the nature of our field and being on call and woken up sporadically and randomly throughout the night (negatively) affects sleep cycles so even when I'm in the comfort of my own bed at home I don't sleep well; and then it just becomes a really vicious circle. I've tried all the "usual" remedies (melatonin, cherry juice, no screentime before bed, darkened room, meditation, etc.) and don't want to resort to meds at all. Any suggestions?

Melatonin and good bedtime habits (no bright lights, less screens, etc.) Have worked very well for me.

 

[dabears505]

I have found interval training exercise a few hours prior to sleep help me.

 

[GASPER20]

What's your sleep schedule currently? Do you take naps, afternoon caffeine, worried about something?

 

[MirrorTodd]

Was gonna suggest a gold old fashioned O usually does the trick.

 

[vector2]

1. Force yourself into a regular schedule if possible. Every day, bed at 9-10p, wakeup at 5a etc.
2. Exercise in the morning or early afternoon. Not too close to bed time.
3. Make sure the room temperature is appropriate. Don't take a hot shower at night. Your body needs to be a bit cooler when sleeping.
4. If you're off the next day and you have insomnia that night, start reading something until you can't keep your eyes open any longer. Even if you go til midnight or 1am, force yourself to get up at your normal weekday wake up time.
5. Limit caffeine, no naps
6. If you have a modern cellphone, turn on the blue light filter. Do the same for your computer and tablet.
7. Get laid more

 

[deleted162650]

6. Get laid more

Dovetails nicely with my advice above.

 

[dchz]

In this thread: if you can't sleep, orgasm.

 

[deleted697535]

5k, gin, sex

 

[deleted697127]

This is counterintuitive but try restricting your hours in bed. Bad sleep is partially a learned behavior. If you’re tossing and turning, you’re teaching yourself it’s hard to fall sleep. Try only allowing yourself to be in bed for 6 or 7 hours for a few days. No naps. No coffee after noon.

Also, address any other underlying stressors. If it’s work, money, or whatever, talking to someone may help.

 

[rightonn_dude]

Reading a boring book. Out in 5 seconds

 

[nimbus]

Reading a boring book. Out in 5 seconds

I recommend Miller. Worked every time when I was a resident.

 

[deleted59964]

exercise ... cycling is great because you can do it for a long time. Get in a 3 hour cycle, sleep like a baby

 

[HalO'Thane]

I have gotten pretty particular with my sleep routine in my older age. A few things that have worked for me:

1. Going to bed at the same time each day
2. No caffeine after Noon
3. No red wine in the evening. Just my own personal experience. I don't have a problem falling asleep but I do notice a poor quality of sleep. Beer and Liquor seem OK in moderation
4. Exercising after work
5. Melatonin
6. Sex (as mentioned by others)
7. Not too much greasy food for dinner

 

[dhb]

I'm not sure about the routine thing: i go to bed when i'm tired and voila i fall asleep.
Regarding alcohol i'm pretty sure it's easier to fall asleep after a bottle than a glass. (Not that i recommend it as a daily therapy)

 

[deleted697127]

This is counterintuitive but try restricting your hours in bed. Bad sleep is partially a learned behavior. If you’re tossing and turning, you’re teaching yourself it’s hard to fall sleep. Try only allowing yourself to be in bed for 6 or 7 hours for a few days. No naps. No coffee after noon.

Also, address any other underlying stressors. If it’s work, money, or whatever, talking to someone may help.

This study below showed good efficacy at 6 months vs control. Formula for calculating restricted number of hours allowed seemed a bit complicated but number needed to treat was 4. Full paper available in link.

Simplified sleep restriction for insomnia in general practice: a randomised controlled trial

Insomnia is common in primary care. Cognitive behavioural therapy for insomnia (CBT-I) is effective but requires more time than is available in the general practice consultation. Sleep restriction is one behavioural component of CBT-I.To assess whether ...

www.ncbi.nlm.nih.gov

Simplified sleep restriction for insomnia in general practice: a randomised controlled trial
Karen Falloon, PhD, FRNZCGP, Senior lecturer, C Raina Elley, PhD, FRNZCGP, Associate professor, [...], and Bruce Arroll, PhD, FNZCPHM, FRNZCGP, Professor

Additional article information

Abstract
Background
Insomnia is common in primary care. Cognitive behavioural therapy for insomnia (CBT-I) is effective but requires more time than is available in the general practice consultation. Sleep restriction is one behavioural component of CBT-I.
Aim
To assess whether simplified sleep restriction (SSR) can be effective in improving sleep in primary insomnia.
Design and setting
Randomised controlled trial of patients in urban general practice settings in Auckland, New Zealand.
Method
Adults with persistent primary insomnia and no mental health or significant comorbidity were eligible. Intervention patients received SSR instructions and sleep hygiene advice. Control patients received sleep hygiene advice alone. Primary outcomes included change in sleep quality at 6 months measured by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and sleep efficiency (SE%). The proportion of participants reaching a predefined ‘insomnia remission’ treatment response was calculated.
Results
Ninety-seven patients were randomised and 94 (97%) completed the study. At 6-month follow-up, SSR participants had improved PSQI scores (6.2 versus 8.4, P<0.001), ISI scores (8.6 versus 11.1, P = 0.001), actigraphy-assessed SE% (difference 2.2%, P = 0.006), and reduced fatigue (difference −2.3 units, P = 0.04), compared with controls. SSR produced higher rates of treatment response (67% [28 out of 42] versus 41% [20 out of 49]); number needed to treat = 4 (95% CI = 2.0 to 19.0). Controlling for age, sex, and severity of insomnia, the adjusted odds ratio for insomnia remission was 2.7 (95% CI = 1.1 to 6.5). There were no significant differences in other outcomes or adverse effects.
Conclusion
SSR is an effective brief intervention in adults with primary insomnia and no comorbidities, suitable for use in general practice.

 

[caligas]

Go! to Sleep

clevelandclinicwellness.com

Recommend

 

[pjl]

Go! to Sleep

clevelandclinicwellness.com

Recommend

Also recommend a good book.

 

[GA8314]

O.k...... So, we need more information. Are you ruminating? Can't shut down the thoughts?
Do you think you have increased anxiety?

 

[D P356]

Difficulty sleeping?
Decreased interest in activities?
Any feelings of guilt?
Decreased energy through the day?
Difficulty concentrating?
Decreased appetite
Agitated?
Thoughts of hurting yourself?

If you’re depressed, definitely talk to someone about it.

 

[GA8314]

I personally think insomnia can be a harbinger of an anxiety disorder or depression (even if mild "dysthymia"). It is worth mentioning, that's all.

 

[finalpsychyear]

I realize that the nature of our field and being on call and woken up sporadically and randomly throughout the night (negatively) affects sleep cycles so even when I'm in the comfort of my own bed at home I don't sleep well; and then it just becomes a really vicious circle. I've tried all the "usual" remedies (melatonin, cherry juice, no screentime before bed, darkened room, meditation, etc.) and don't want to resort to meds at all. Any suggestions?

How do you sleep when you know you are off the next day? if its a lot better than like mentioned above stress is probably part of the issues:

In addition to all that was said before a few gems i discovered after spending years researching sleep and more precisely ideal sleep.

1) sleep before midnight and the closer you can get to 9pm you will actually spend more time in NREM sleep which is the deepest level of restoration. Anecdotally, I did this self experiment where i went to bed closer to 3-4am and would get 8 hours of sleep for a few weeks and compared it to going to bed at 930-1030pm. It was no comparison. Not only did i sleep much deeper, i hardly ever woke up in the middle of the night to go to the bathroom when going to bed early and it turned out i ended up sleeping only closer to 7-7.5 hours which interestingly was shown in a very large harvard retrospective strudy to be linked to the least mortality. Its like a diet. You won't be tired to "think" you can sleep at that time but you will. Kind of like when you diet you have to make an effort to adjust your natural tendencies.

2) I dropped coffee and limited green tea to 2-3 cups all before noon and also cut out caffeine completely for several days. Assuming your not using any substances from etoh to cigs.

As much as you don't "feel" caffeine trust me nothing compares to none in your system.

3) have your last food 2-2.5 hours of sleep. Effects levels of Growth Hormone released which may be linked to that "rested" feeling.

4) temperature is big. I sleep best in the 65-67 degree range with a white noise fan. Contrary to what was said above a hot shower followed up going into a cool room can promote a natural drop in your temperature aiding sleep. Also, black out blinds. My room is so dark i can't see my hand in front of my face.

5) No electronics 1 hour before bed. Light reading of something very mild with dimmed light. I keep my phone on airplane mode and limit any type of electronics in the room and keep everything 10 feet away.

The last thing i will say is almost everyone screws up these things which is why they don't feel rested and hence look to caffeine to get them going.

The basic foundations of health are diet, exercise, and sleep. Most people like 95% don't know what is ideal for these 3 things. Maybe 99% aren't doing them all correctly. It took me 30 years of my life to master all 3. Not trying to brag but I maintain a six pack and can run a 5:30 mile while squat/dead lifting 400 pounds and i would never have been able to do that without mastering my sleep. The perfect diet and exercise are only so good but your body's restoration physical and mental all take place at night.

In this day and age it is incredibly hard to stay fit since phone apps make it so easy to get take out so quickly, so many shows/entertainment to distract you from every wanting to workout, and we live in a world where the idea of going to sleep at 9-1030pm is almost a joke. I assure you almost everyone is doing it wrong and if you get these 3 things correct you will find something incredible.

 

[dhb]

How do you sleep when you know you are off the next day? if its a lot better than like mentioned above stress is probably part of the issues:

In addition to all that was said before a few gems i discovered after spending years researching sleep and more precisely ideal sleep.

1) sleep before midnight and the closer you can get to 9pm you will actually spend more time in NREM sleep which is the deepest level of restoration. Anecdotally, I did this self experiment where i went to bed closer to 3-4am and would get 8 hours of sleep for a few weeks and compared it to going to bed at 930-1030pm. It was no comparison. Not only did i sleep much deeper, i hardly ever woke up in the middle of the night to go to the bathroom when going to bed early and it turned out i ended up sleeping only closer to 7-7.5 hours which interestingly was shown in a very large harvard retrospective strudy to be linked to the least mortality. Its like a diet. You won't be tired to "think" you can sleep at that time but you will. Kind of like when you diet you have to make an effort to adjust your natural tendencies.

2) I dropped coffee and limited green tea to 2-3 cups all before noon and also cut out caffeine completely for several days. Assuming your not using any substances from etoh to cigs.

As much as you don't "feel" caffeine trust me nothing compares to none in your system.

3) have your last food 2-2.5 hours of sleep. Effects levels of Growth Hormone released which may be linked to that "rested" feeling.

4) temperature is big. I sleep best in the 65-67 degree range with a white noise fan. Contrary to what was said above a hot shower followed up going into a cool room can promote a natural drop in your temperature aiding sleep. Also, black out blinds. My room is so dark i can't see my hand in front of my face.

5) No electronics 1 hour before bed. Light reading of something very mild with dimmed light. I keep my phone on airplane mode and limit any type of electronics in the room and keep everything 10 feet away.

The last thing i will say is almost everyone screws up these things which is why they don't feel rested and hence look to caffeine to get them going.

The basic foundations of health are diet, exercise, and sleep. Most people like 95% don't know what is ideal for these 3 things. Maybe 99% aren't doing them all correctly. It took me 30 years of my life to master all 3. Not trying to brag but I maintain a six pack and can run a 5:30 mile while squat/dead lifting 400 pounds and i would never have been able to do that without mastering my sleep. The perfect diet and exercise are only so good but your body's restoration physical and mental all take place at night.

In this day and age it is incredibly hard to stay fit since phone apps make it so easy to get take out so quickly, so many shows/entertainment to distract you from every wanting to workout, and we live in a world where the idea of going to sleep at 9-1030pm is almost a joke. I assure you almost everyone is doing it wrong and if you get these 3 things correct you will find something incredible.

Who would of thought that laying down and closing your eyes could be so complicated.

 

[finalpsychyear]

Who would of thought that laying down and closing your eyes could be so complicated.

Yeah it wasn't always this way. This is more of the side effect of the consistent advancement of technology. The cell phone is basically like another body part for many and even more so for those 8-10 year olds who grow up with it now.

 

[BIGphysician]

I realize that the nature of our field and being on call and woken up sporadically and randomly throughout the night (negatively) affects sleep cycles so even when I'm in the comfort of my own bed at home I don't sleep well; and then it just becomes a really vicious circle. I've tried all the "usual" remedies (melatonin, cherry juice, no screentime before bed, darkened room, meditation, etc.) and don't want to resort to meds at all. Any suggestions?

Nah dawg why???


Sent from my iPhone using Tapatalk

 

[chocomorsel]

Nah dawg why???


Sent from my iPhone using Tapatalk

Doxylamine12.5 to 25mg. Great drug. I am not giving medical advice, just telling you what works for me.

 

[ryanjmy]

i don’t mind blowing money on anything that could improve my health. Sleep is certainly one of those things. High end sheets, pillow, mattress…

I find temperature control to be important. I have a ooler chill pad under my sheets and a bet jet. Cooling off when I’m too hot makes me sleepy as does warming up.

The only problem is your body gets used to these luxuries and I have trouble sleeping in hotel rooms.

 

[vector2]

i don’t mind blowing money on anything that could improve my health. Sleep is certainly one of those things. High end sheets, pillow, mattress…

I find temperature control to be important. I have a ooler chill pad under my sheets and a bet jet. Cooling off when I’m too hot makes me sleepy as does warming up.

The only problem is your body gets used to these luxuries and I have trouble sleeping in hotel rooms.

I didn’t realize electronic cooling pads existed, however I never really needed one for whole body- what I’ve wanted is a damn cooling pillow. So of course since ooler and bedjet exist I figure there’s gotta be a small one meant for just a pillow.

And of course the only thing I can find is this one…which is still in kickstarter development

 

[DG51]

exercise ... cycling is great because you can do it for a long time. Get in a 3 hour cycle, sleep like a baby

I'm guessing that the incidence of insomnia in people who also have the time for 3 hour rides is very low to begin with...

 

[coffeebythelake]

I drink about 1 gram of caffeine a day and I sleep well

 

[abolt18]

I drink about 1 gram of caffeine a day and I sleep well

That is an unreasonably large amount! At my worst I was probably doing 1/3 that daily and half that on call shifts. Weaned myself off completely over a 2 month period 25 months ago and I'll never go back. Sleep better now (though, I THOUGHT I slept fine before), feel better overall with more consistent/stable energy levels, even tolerate overnights and 24s better. I cannot recommend it enough.

 

[abolt18]

i don’t mind blowing money on anything that could improve my health. Sleep is certainly one of those things. High end sheets, pillow, mattress…

I find temperature control to be important. I have a ooler chill pad under my sheets and a bet jet. Cooling off when I’m too hot makes me sleepy as does warming up.

The only problem is your body gets used to these luxuries and I have trouble sleeping in hotel rooms.

You just opened up a whole new world to me! Bed jet is very high on my list now.

 

[vector2]

I drink about 1 gram of caffeine a day and I sleep well

Same, I'm probably at least 6-700 a day

 

[nimbus]

I understand your struggle with not being able to sleep well. I used to have a similar issue, but I eventually found something that worked for me. It may seem a bit unconventional, but it worked. I started putting lavender essential oil on my pillow, and it really helped me relax and drift off to sleep.

A couple of our PACU nurses bring essential oil diffusers and diffuse lavender oil for their patients. I thinks it’s nice. Hopefully the joint commission doesn’t ban it.

 

[GassYous]

My morning pick me up

Careful with the picture

 

[deleted875186]

4. If you're off the next day and you have insomnia that night, start reading something until you can't keep your eyes open any longer. Even if you go til midnight or 1am, force yourself to get up at your normal weekday wake up time.

This is counterintuitive but try restricting your hours in bed. Bad sleep is partially a learned behavior. If you’re tossing and turning, you’re teaching yourself it’s hard to fall sleep. Try only allowing yourself to be in bed for 6 or 7 hours for a few days. No naps. No coffee after noon.

Also, address any other underlying stressors. If it’s work, money, or whatever, talking to someone may help.

These are great tips. Look up cognitive behavioral therapy for sleep. Idea is spend as little time laying in bed if not asleep. Don’t lay in bed trying to sleep, get up and go sit and do something like read a boring book or something mindless until tired, then go try to fall asleep. Keep a schedule and get up in the morning, at first you’ll be tired, but eventually you will be able to fall asleep faster and get more time asleep. Your looking g to maximize your sleep efficiency.

 

[amyl]

There are a few apps that have helped me but Relax and sleep well with Glenn Harold is my favorite. You have to be disciplined and not let your mind wander - focus on his voice and relaxing. I also bought a cheap eye shield off Amazon… I got used to sleeping in it post call and now it’s conditioned me to relax and go to sleep. I don’t even need Glenn anymore… just the eye shield. Good luck - sleep is essential

 

[gasman11]

There's a podcast by a stanford Neuroscience professor called The Huberman Lab, he has some extremely informative podcasts on the science of sleep and things you can do to get the best possible sleep, especially episode 2 "Master your sleep".

 

[Ronin786]

Cutting caffeine out completely for me has done wonders for my sleep. Not only in ability to fall asleep, but I wake up much more refreshed and don't have a desire to stay asleep all day.

Headspace also is really, really good.