Dealing with sleep issues

[Hastur]

I have the feeling from this past quarter (not that many class hours, but early morning classes) that how well I manage to deal with my peculiar sleep problem is going to be what makes or breaks me, so...

Throughout my entire life, from the time I was a small child, I've had some trouble falling asleep. I seem to have delayed sleep phase syndrome (http://en.wikipedia.org/wiki/Delayed_sleep_phase_syndrome) - not precisely the same thing as insomnia: basically, once my brain tells me it's nighttime, I can fall asleep pretty well, but my brain often doesn't recognize it until the wee hours. If I try before then, I either don't make it to sleep or I sleep badly and wake up after a few hours. It also usually takes me a while to get to sleep. And I'm not one of those people who can function well on minimal sleep (the first night I seem to get an emergency power boost, but if I don't make it up the next night, I start having cognitive trouble.)

I'm realizing that more pressing than getting time for sleep is the need to (a) fall asleep faster and (b) get to sleep earlier.

Anyone have this problem here? Anyone tried light therapy or similar recourse?

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[Excelsius]

I have the feeling from this past quarter (not that many class hours, but early morning classes) that how well I manage to deal with my peculiar sleep problem is going to be what makes or breaks me, so...

Throughout my entire life, from the time I was a small child, I've had some trouble falling asleep. I seem to have delayed sleep phase syndrome (http://en.wikipedia.org/wiki/Delayed_sleep_phase_syndrome) - not precisely the same thing as insomnia: basically, once my brain tells me it's nighttime, I can fall asleep pretty well, but my brain often doesn't recognize it until the wee hours. If I try before then, I either don't make it to sleep or I sleep badly and wake up after a few hours. It also usually takes me a while to get to sleep. And I'm not one of those people who can function well on minimal sleep (the first night I seem to get an emergency power boost, but if I don't make it up the next night, I start having cognitive trouble.)

I'm realizing that more pressing than getting time for sleep is the need to (a) fall asleep faster and (b) get to sleep earlier.

Anyone have this problem here? Anyone tried light therapy or similar recourse?

I have looked into sleep since I do research on the brain. The evidence seems to show that sleep, which is characterized by slow-wave thalamocortical oscillations, is a result of hyperpolarization of neuronal pathways in the cortex. What this means is that you need lack of sensory input for sleep to ensue. The best way to do this is to simulate autogenic training, aka, self-hypnosis, where you concentrate on each part of your body and imagine that it is weightless.

You can also try to go the easier route: supplements. One of my friends who had insomnia didn't want to ingest addictive sleeping pills, so I suggested she try melatonin. It helped her and she eventually did not have to take it every day. There is also 5-HTP and valerian if that doesn't work.

I have to say though that the gym might be your best bet. I know of a case where a person had severe insomnia which disappeared within a few months after she quit smoking and started going to the gym. You might want to look at your chemical habits, if you have any.

You can also try to skip a night of sleep to see how you respond. I do that with some regularity, like today, and by the time I am on my 41st hour I have no problem going to sleep (in fact, you might find that you have developed a mild narcolepsy as you will slip into REM as soon as you relax a bit). But there are times when even after that sleeping for just two to four hours will be enough to get back to normal. I don't have any problems with insomnia.

You have many options here. Experiment.

 

[todipotent]

I often have a hard time falling asleep, I think my worst episode was the weeks before the MCAT, which means it was probably stress induced. I know exericise helps with me and so does Tylenol PM, but dont become addicted!

 

[Hastur]

5-HTP is useful, I have noted, but not useful taken just before bedtime; the few times I've taken it before going to sleep, I've slept lightly and had strange dreams. This likely has to do with the serotonin/melatonin conversion cycle - since it's a serotonin precursor, it improves the waking half of the cycle. If I take it 6-8 hours before bedtime, my brain has more to work with. Haven't tried valerian yet, but I do have some to play with.

Most of the sensory input I seem to have trouble with is internal, not external - AKA I think too much -- although I think self-hypnosis may help with that as well. When I'm getting into the "sleep groove" the main difference I feel in my physical perceptions is that my autonomic system responds less to passing thoughts, vs. when I'm having trouble getting to sleep. (For instance, if I think of a bill coming due and I'm having trouble, I'll tense up and have to start all over again; if I'm not having trouble, the thought sort of spirals off into dreamy loops.)

I do work out from time to time, but it's never especially seemed to help. If I go to sleep shortly after exercising, I tend to have the problem where I pass out right away and then wake up shortly after. One main issue seems to have to do with how quickly or slowly my brain fires up in the morning, which is why I'm thinking of getting a light box - if I'm slow to wake, it's like the internal 16-hour circadian timer starts ticking from a few hours after I get up, meaning that I get to bed late.

I'm glad to hear from a sleep research person - ironically, one of the main reasons I'm interested in med school is a fascination with neurology, especially weird brain states. (I'm a big Oliver Sacks fan, I'm fascinated with the unusual sets of sleep states that I've experienced that I know people with other sleep disorders also experience, and also fascinated with temporal lobe epilepsy.)

I have looked into sleep since I do research on the brain. The evidence seems to show that sleep, which is characterized by slow-wave thalamocortical oscillations, is a result of hyperpolarization of neuronal pathways in the cortex. What this means is that you need lack of sensory input for sleep to ensue. The best way to do this is to simulate autogenic training, aka, self-hypnosis, where you concentrate on each part of your body and imagine that it is weightless.

You can also try to go the easier route: supplements. One of my friends who had insomnia didn't want to ingest addictive sleeping pills, so I suggested she try melatonin. It helped her and she eventually did not have to take it every day. There is also 5-HTP and valerian if that doesn't work.

I have to say though that the gym might be your best bet. I know of a case where a person had severe insomnia which disappeared within a few months after she quit smoking and started going to the gym. You might want to look at your chemical habits, if you have any.

You can also try to skip a night of sleep to see how you respond. I do that with some regularity, like today, and by the time I am on my 41st hour I have no problem going to sleep (in fact, you might find that you have developed a mild narcolepsy as you will slip into REM as soon as you relax a bit). But there are times when even after that sleeping for just two to four hours will be enough to get back to normal. I don't have any problems with insomnia.

You have many options here. Experiment.

 

[FuturaDocta]

exercise and eatwell... Or, I could send you a tape of me reading you a bedtime story. I can put anyone to sleep as long as they have an ounce of imagination!

PS. Sorry about your disorder. Sounds like a mystery to me. Though, I think my dad has that. He has worked in the medical field for years and learned to go off like four hours of sleep or less. Now, I swear he is a zombie, he never sleeps! haha

 

[marele86]

While I doubt this applies to the OP, it seems worth mentioning that caffeine can also mess up your sleep cycle, if you're very caffeine-sensitive or are drinking coffee in the late afternoon.

I stopped drinking coffee about a month ago, had some wicked withdrawal effects for the 2nd and 3rd day, and have been falling asleep by 10pm since then. It's beyond nice.

 

[Compass]

Have you tried white noise? It's relaxing.

 

[FuturaDocta]

While I doubt this applies to the OP, it seems worth mentioning that caffeine can also mess up your sleep cycle, if you're very caffeine-sensitive or are drinking coffee in the late afternoon.

I stopped drinking coffee about a month ago, had some wicked withdrawal effects for the 2nd and 3rd day, and have been falling asleep by 10pm since then. It's beyond nice.

That so true! And, I am definitely sensitive to caffeine. I try to stay away from it. It totally screws up you circadian rhythm. Unfortunately, I think the OP is more concerned with that disorder he/she has. If you haven't already, I would definitely go to a doctor for an issue like that.

 

[iheartsnow]

I've always had sleeping issues as well. As a kid, I would just stay up for hours after my parents went to bed, just reading because I could not fall asleep. I actually remember realizing at around age 12 that its not normal to have that much trouble falling asleep. Someone commented "Wow, it took me like, an HOUR to fall asleep last night..." Any I thought, an hour, that would be nice...

Anyhow, I still have months-long bouts of insomnia, especially when I am not on a strict schedule. I've tried melatonin, tylenol pm, low dose clonidine (sp?, it's a prescription), etc. My best results come from taking clonidine and melatonin AND exercising a lot. I mean, like, running 5 miles a day. On days that i don't exercise, I often can't sleep. I'm definitely not looking forward to having a crazy sleep schedule. I'll be exhausted but then just lay awake all night long! But my advice is to start experimenting now and figure out what works for you. Also, the exercise regimen did not start working right away. I noticed after several weeks of working out regularly that I was just sleeping better. I wish i'd figured that out years ago.

 

[OpalOnyx]

I have hard time sleeping unless I'm really tired. That's probably why I'm on SDN - right now. haha

The exercise is a really good idea. Yea it's good to address sleep issues now, better to do it now than in a med school setting. make sure you're eating a balanced diet and get all your neccessary vitamins. If not, take a supplement. I know that helped me quite a bit with balancing my energy level. And switching between "on" periods and "off" periods - able to relax more.

 

[Hastur]

Yeah - iheartsnow, I totally feel ya. I was the one who stayed up reading by the light from the hallway from about the age of eight simply because, if I didn't, my thoughts would go off in crazy spirals and I wouldn't sleep. (I might consider blaming caffeine otherwise, but I started drinking coffee and tea much later than that, and wasn't a big soda drinker, either.)

I haven't tried heavy cardio, but it sounds like it might be worth it, since the exercise I do is mostly light cardio and lifting.

As for seeing a doc, I think I'd need to talk to an actual sleep specialist; and on the college health plan I'm on, I'm not sure that's feasible. They seem to have the usual "birth control and antibiotics" bent that most student health services do - drive-thru health care.

Thanks for the advice, folks. Now since I'm actually exhausted enough to make it to sleep... off to bed.

 

[searun]

I also endorse major exercise in the late afternoon before dinner. It gets rid of stress and then after dinner, you relax and get tired. I usually am a good sleeper, but in periods of stress (like right now with Step One next week), I will drink some red wine or have a melatonin tablet to help me relax. I try to go to bed at the same time each night and get up at the same time in the morning, just find a rhtymn. Not being able to sleep is a bitch.

 

[Omni]

I have some disability (or rather, a very strong ability) to immediately fall asleep (within 5 minutes). And I'm talking deep sleeping.
I don't think that's too good.
Is there any way we can trade with each other? Like, trade part of our attributes to reach a middle point?

 

[IndianVercetti]

I also strongly believe that the feeling of being "sleepy" is largely psychological and not physiological. For instance, imagine if you went to bed at 1 PM, and woke up at 11PM. Obviously you'd feel alert when you woke up, but I'd guess that around 12:30 AM or so, you'd start to feel a little inkling to go lie down at least. My point in saying this, is that our state of feeling tired is largely dependent on our realization of time. In that situation, if you weren't aware of the time, I'd really doubt you'd feel sleepy.

Also, the circadian rhythm by no means mandates 8 hours of sleep to feel rested. I took an anthropology course and my teacher made a great point when she said that 8 hours is largely a culturally developed ideal for a good night's sleep.

Just a couple of points to consider

 

[Rendar5]

I have delayed sleep phase disorder actually and it did affect me in my clinical years until I saw a specialist and got the right diagnosis (I had no idea of this condition before I went there). The problem here is that while you may be correct, you might not be correct. People in their late teens/early twenties have a naturally late sleep cycle. Some people have other sleep disorders. Some people just have very poor sleep hygeine. You need to see a doctor to figure it out.

I medically control mine when I need to be on a regular sleep schedule. But it's silly to try and medically control it if you haven't even had a sleep study. AS for general sleep hygeine, you want a regular schedule, you want natural sunlight during the day, you want to limit your caffeine intake and computer time before going to bed.

 

[iMD]

I have some disability (or rather, a very strong ability) to immediately fall asleep (within 5 minutes). And I'm talking deep sleeping.
I don't think that's too good.
Is there any way we can trade with each other? Like, trade part of our attributes to reach a middle point?

good lord i wish i had your problem. i couldnt sleep if my life depended on it. i have to be completely worn out to sleep

 

[BJPENNSTATE]

http://www.stevepavlina.com/blog/2005/05/how-to-become-an-early-riser/

good experiment...i'm gonna try to wake up at 7 am every morning to get really for med school classes at 8 am in august...hopefully, the experiment will WORK!

 

[Kaustikos]

I've gotten used to the idea that regardless of whether or not I get 8, 7, 6, 5 or whatever hours of sleep, I'm still tired in the morning. I stay up till 2-3 am drawing my comic and then wake up at approx 6:30. Shot of espresso with a regular coffee does the trick. I just stop even trying at this point to sleep 8 hours. Only on weekends, but it ruins my schedule/pattern. I do feel sorry for your inability/difficulty in falling asleep. I have inability to stay asleep - waking up 3-4 times a night - which I know affects me but I can't afford seeing a doctor/testing for this. I've gotten used to it.

I would recommend benadryl or melatonin. Melatonin works with circadian rhythm and benadryl just makes you drowsy. If not, talk to a doctor about other options. I'm not offering medical advice, but I think that certain OTC meds have shown to help people in getting into the mood for sleep.

 

[tiedyeddog]

I just recently voided my MCAT mostly due to sleep problems....

About a month before the test I started to really freak out and stress over if I was going to be prepared. I am super Type-A and I am also high strung. I do fine most nights with around 6 and a half hours each night.... I probably got around 3 to 4 hours each night for a whole month before the MCAT. Lets just say I voided immediately after the PS section... I had never felt so horrible in my life. It has now been a week since the MCAT. For four days in a row I slept between 10-11 hours each night.... I normally have trouble sleeping more than 8.

In hindsight, I should have done these things:
1. Exercise EVERY day. I was went from running 2-3 miles a day and lifting to doing nothing for an entire four months. You need to work out, or at least try to, before dinner or at least four hours before bed-time. Working out right before you try to sleep is not a good idea.
2. Don't drink anything caffeinated within 6-7 hours of trying to go to bed.
3. Don't use sleep aids. They can throw your sleep cycles even more out of whack.
4. Don't use alcohol as a sleep-aid. Seriously, I was running out of options... It might make you go to sleep quickly but your rest will not be quality.
5. Sleep in a cool area with almost zero light.
6. Don't study or do anything mentally taxing within the hour before sleep. Maybe read a magazine in a low light setting...

/end ramble

 

[ERScribe]

I have the feeling from this past quarter (not that many class hours, but early morning classes) that how well I manage to deal with my peculiar sleep problem is going to be what makes or breaks me, so...

Throughout my entire life, from the time I was a small child, I've had some trouble falling asleep. I seem to have delayed sleep phase syndrome (http://en.wikipedia.org/wiki/Delayed_sleep_phase_syndrome) - not precisely the same thing as insomnia: basically, once my brain tells me it's nighttime, I can fall asleep pretty well, but my brain often doesn't recognize it until the wee hours. If I try before then, I either don't make it to sleep or I sleep badly and wake up after a few hours. It also usually takes me a while to get to sleep. And I'm not one of those people who can function well on minimal sleep (the first night I seem to get an emergency power boost, but if I don't make it up the next night, I start having cognitive trouble.)

I'm realizing that more pressing than getting time for sleep is the need to (a) fall asleep faster and (b) get to sleep earlier.

Anyone have this problem here? Anyone tried light therapy or similar recourse?

My sleep problems resolved immediately after I moved in with my girlfriend..................
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The cuddling really helps me get to sleep. Try hugging a pillow.

 

[Kaustikos]

I just recently voided my MCAT mostly due to sleep problems....

About a month before the test I started to really freak out and stress over if I was going to be prepared. I am super Type-A and I am also high strung. I do fine most nights with around 6 and a half hours each night.... I probably got around 3 to 4 hours each night for a whole month before the MCAT. Lets just say I voided immediately after the PS section... I had never felt so horrible in my life. It has now been a week since the MCAT. For four days in a row I slept between 10-11 hours each night.... I normally have trouble sleeping more than 8.

In hindsight, I should have done these things:
1. Exercise EVERY day. I was went from running 2-3 miles a day and lifting to doing nothing for an entire four months. You need to work out, or at least try to, before dinner or at least four hours before bed-time. Working out right before you try to sleep is not a good idea.
2. Don't drink anything caffeinated within 6-7 hours of trying to go to bed.
3. Don't use sleep aids. They can throw your sleep cycles even more out of whack.
4. Don't use alcohol as a sleep-aid. Seriously, I was running out of options... It might make you go to sleep quickly but your rest will not be quality.
5. Sleep in a cool area with almost zero light.
6. Don't study or do anything mentally taxing within the hour before sleep. Maybe read a magazine in a low light setting...

/end ramble

Although you offer good advice, if I were to follow some, my mind would be way out of wack. Coffee 6-7 hours?

 

[Hastur]

Rendar5: I know I need professional diagnosis and treatment, but as I mentioned, I don't currently have access to a sleep specialist. I don't think it's "silly" to try things that might help me live my life normally, especially since, if I don't try to live my life normally and work towards a viable career, the money to see such a specialist certainly won't drop into my lap.

...

The exercise timing (right before dinner) actually makes a lot of sense to me based on what I've noticed from my previous experience, so I'll definitely try to work that in.

I've noticed that coffee will often throw me out of whack - there's a very narrow window of the day in which I can drink coffee without getting messed up - but tea doesn't. One day I'd like to study what all the compounds other than caffeine in coffee and tea are and do... Tea's been analyzed more thoroughly than coffee (antioxidants/tannins/etc) but the oils in coffee are NOT inert; The Last Psychiatrist blog has a good rundown of what in coffee is beneficial and what is dangerous. But I digress.

 

[FuturaDocta]

My sleep problems resolved immediately after I moved in with my girlfriend..................
........................
..................
................
.............
...........
.........
........
.......
......
.....
....
..
.

The cuddling really helps me get to sleep. Try hugging a pillow.

I hug my pillow all the time. It is the only way I can sleep. My bf is going to have to deal with that one day.

 

[dmblue]

I hug my pillow all the time. It is the only way I can sleep. My bf is going to have to deal with that one day.

lol...glad i'm not the only one

 

[FuturaDocta]

lol...glad i'm not the only one

I also put one in between my legs. I think it has to do with alignment of the spine and stuff like that. It is very comforting.

 

[Kaustikos]

I also put one in between my legs. I think it has to do with alignment of the spine and stuff like that. It is very comforting.

I've noticed a lot of women do that, that and hugging things. If it works then who cares, right?

 

[tiedyeddog]

I also put one in between my legs. I think it has to do with alignment of the spine and stuff like that. It is very comforting.

I've blown out both of my knees and sometimes they throb at night. When they hurt and I can't sleep because of it I put a pillow between them and bend them a bit. Seems to help a ton.

 

[nontrdgsbuiucmd]

Rendar5: I know I need professional diagnosis and treatment, but as I mentioned, I don't currently have access to a sleep specialist. I don't think it's "silly" to try things that might help me live my life normally, especially since, if I don't try to live my life normally and work towards a viable career, the money to see such a specialist certainly won't drop into my lap.

I understand you can't do this now, but wanted to share an experience.

A close friend has sleep issues. There is a fellowship in sleep; the physicians that my friend saw had specialized in a number of different areas prior to going through this fellowship. The procedure was to first answer a long questionnaire, then see the specialist, then (in this person's case) spend the night hooked up to tons of electrodes to check out what was physically happenning that prevented a good night's sleep. In this person's case, the diagnosis was sleep apnea; next step was to rent a machine to help with this.

This approach is doable if you're in school covered by health insurance, or if you pick up an individual health insurance policy; these are pretty cheap if you're younger & in fairly good health. Other than that, there are lots of things that help some people that you could try, I've heard (seriously) a warm glass of milk can be helpful. But I have no experience in what you're experiencing unfortunately.