Ezekiel20

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Dear all

As med students, our time is limited and there is much work to be done. I always try to give myself 7 hours sleep, since I feel too tired if I sleep less, and feel like I wasted time if I sleep more.

So If I have class at 8am the following morning, I try to go to sleep at midnight so I can wake up at 7am. If I have class from 10am, I try to study until 2am so I can wake up at 9am.

My problem is this. I have exactly 7 hours between the time I go to bed, and the time I have to wake up. But I can never fall asleep any sooner than 30 mins to 1 hr after I go to bed, which means that I am wasting my precious sleep time wide awake due to disturbed sleep rhythm.. :(

Is there any way (and don't say benzodiazepines or worse yet barbiturates) to make you go to sleep when you want to? If you know a way that works, please lets share it..

(This post might seem lame to you, but it took courage to ask. So please no making fun of my question..!)

Thanks

Ezekiel
 

priu

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I haven't tried this myself, but I plan to and I know that one of my friends does this:

Use an iPod with one of the speaker systems or boomboxes it can dock into.

On the iPod you can set a sleep timer and alarm clock... and when you select the sound to play you have the option to select a playlist. iTunes has these playlists you can buy called iMixes (user made and rated) and Essentials (playlists with a certain theme... such as "Evening Chillout"). Each essential has three playlists with 25 songs. You might consider that, or if you already have songs that help ease you or put you to sleep just make your own playlist.
 

robotsonic

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The first thing you should do is try to go to bed at the same time every day. You said that you change when you go to bed every day based on when you have to be up. That is a bad idea because you will have to reset yourself every day. So go to bed and get up at the same time every day - and then spend those 2 extra hours in the morning studying before lecture (or surfing the web, whatever).

And Ambien really works. Trust me. It will not leave you tired the next day like a benzo, and you *will* go to sleep.

And there are the obvious things like no caffeine in the evening, no exercise right before bed, etc.
 

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robotsonic said:
The first thing you should do is try to go to bed at the same time every day. You said that you change when you go to bed every day based on when you have to be up. That is a bad idea because you will have to reset yourself every day. So go to bed and get up at the same time every day - and then spend those 2 extra hours in the morning studying before lecture (or surfing the web, whatever).
Totally agree with this. It used to take me at least 45 min. every night to fall asleep, but now that I have a regular sleep pattern where I go to bed at the same time every night, I'm usually asleep within 5 minutes of my head hitting the pillow.
 

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do something for 10 or 15 mins after studying but before you sleep so you arent thinking about school when you hit the pillow
 

dinesh

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Have a run/some form of excercise. earlier in the evening. Helps you fall asleep faster.
 

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I usually try to shut off everything electronic at least an hour or two before I want to go to bed (i.e., no internet, online neuroanatomy tutorials, TV, etc). Then I relax a bit with some mellow music, and sit down with a book for a while. Reading in bed for 30 min before you go to sleep is also a neat way to help you relax and sleep better...

Read something non-medical like Harry Potter or your favorite fiction author, or something loosely medical like non-fiction written for the lay-public about your favorite health issues--"Complications" or "When the Air Hits your Brain," "Bedside Manners" are all fun books. Stuff like that.

Don't study right before bed. You'll stress yourself out and all you'll do is go over things in your head when you should be chilling.

Just my two cents.

Good luck. :thumbup:
 

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I agree with going to bed at the same time each night. And some destimulation before you go to bed. Things that work for me: mellow music, herbal tea, a tv documentary with a soothing voice...

Every once in a while I can't fall asleep due to insomnia or because I've done something to mess up my sleep schedule, so I take an OTC melatonin. Works like a charm.
 

Iwy Em Hotep

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Agree with some of the comments above: Exercise everyday, and go to sleep at the same time. Study in the morning if up earlier than necessary.
 

emack

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I was having major problems sleeping my first 3 months of med school. Then it turned out I have Graves. So, if you think there might be something medically wrong that's preventing you from sleeping, get it checked out sooner rather than later.

Other than that, especially good strategies (some already mentioned here) include:
-stick to a schedule (at least on school nights, and as much as possible on weekends).
-No studying right before bed.
-No eating right before bed (although I find it's essential to eat an hour or two beforehand).
-Do something quiet & relaxing before you hit the sheets: read, draw, write, listen to music, etc.
-Never do anything stressful in your bed (ex. homework). Beds are for sleep (and, if you wish, sex) and that's it.
-Try associating very specific things with your pre-sleep schedule: tunes, reading, a warm (non-caffeinated) beverage, watching the news... whatever works & trains your body to know when it's time to get sleepy.
-If you're having trouble sleeping, don't toss & turn: get out of bed, have a glass of water, stare out the window for 10 minutes... don't just stay there getting frustrated.
-Give yourself an extra 15 minutes in the morning so you can hit snooze a couple of times if you need it (apparently this is the healthiest & least jarring way of waking up).
 
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Ezekiel20

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Thanks for the great (and sincere) responses everyone. They are great ideas, and they will hopefully help :)
 

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I find having a fan on helps me. So that it's not totally quiet but not disruptive either - it's just white noise.

Of course now that I've associated fans with sleep, I can't study with a fan on anymore :laugh:.
 

Psycho Doctor

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a hot soak in a spa helps a lot for almost instant sleep. too bad i only have one at home and not med school.

seriously though, i have a mjor problem with that as I never go to sleep at the same time. sometimes I fall asleep out of pure exhaustion; other times I'd take something like tylenol PM but that's really rare b/c I need to allow 8 hrs of sleep and i never ever get that. also it's not good to get dependent. Something I did when i was really sick (was exhausted and yet had insomnia) is use one of those heated aromatherapy eye pillows (I have no idea what it's called) but you heat it in the microwave and put it one your eyes when you go to bed and it helped me more than anything did. It sort of soothes you to sleep. (Then my problem was I woke up and couldn't fall back asleep unless I wanted to keep heating that up again, which i did many times.)
 

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that ought to put anyone to sleep...works great for me.
 
A

angel5

hmmmmm.

I have three alarm clocks in my room. Two require me to physically get out of bed and shut them off, and the other is my cell phone which I keep in my bed.

Now, I don't have a problem waking up, but I hit the snooze button at least 15 times before I start my day (an hour + of snoozing!!). I set my alarm clock much earlier from when I need to wake up...I'm scared if I set it too close to normal I need to wake up I won't...

I used to have 5 alarms in my room, and have weaned down to 3...

What should I do?
 

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mackability729 said:
I like to drink about 7 or 8 shots of vodka.

My recipe for a good night's sleep is some booty and Hennessy-- works everytime!!!

Seriously though, I read myself to sleep-- even school-related stuff. The major drawback I have found though, is that on some level I equate reading with sleepytime, so I tend to get drowsy when I study during the day. I counteract that by moving around, and breaking up my reading-based studying by switching texts, web-browsing on the topic, reviewing class notes, etc.

But consider the booty too, it does a body good.
 

banana k

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from one very experienced insomniac to another: give up on the shifting 7-hour scheduling. it's hopeless.

other advice is good: don't lie in your bed if you can't sleep & don't do anything in your bed EXCEPT sleep (or get action) like watch tv, tho reading a good soporific in bed is good. i wouldn't advise harry potter--you WON'T fall asleep that way! :) eat your last for the day at least about an hour before turning in, skip the caffeine, try not to surf the net or TV after about 8 pm because that'll get you sort of into a semi-interested media trance mode that doesn't let you calm down enough. i've also found that a warm bath helps. and if you have time (right, i know...) to work out during the day, do it.

last, if you're stuck in a cycle & you've started to get the psychological stress of bed = insomnia = more stress = more insomnia, make an appointment and get a short term prescription for ambien. break the rut before it gets ingrained.

these are short term fixes... but if you want to be less tired, more zesty, and more functional, it's all about lifestyle... *sigh*
 

liverotcod

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Go to biochem lecture. Works every time for me.
 

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durak said:
that ought to put anyone to sleep...works great for me.
particularly Leviticus
 

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either exercise or sex will make you fall asleep faster...choose wisely :)
 

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liverotcod said:
Go to biochem lecture. Works every time for me.
Or radiology! We always have our lectures after lunch in a warm, dark room. It's the most soporific event I think I've ever encountered.
 

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I like having a beer or two a couple of hours before I go to sleep, it helps wind down. But make sure you don't drink them right before going to bed, you'll def have to get up and pee.
 

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My friend swears by diphenhydramine (aka Nyquil) or any other anti-histamine. Be warned though, if you take a "full" dose and don't get enough hours of sleep, you will still be drowsy in the morning.
 

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No kidding. Recently when I had a cold I slept better than ever because I was downing a cup of Neo-Citran before bed every night.
 

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Hi there,
If you only have a few hours to sleep, Melatonin can help you get quality sleep in short period of time. Melatonin helps you get into REM sleep more quickly. Take no more than 1mg about 30 minutes before you go to bed. Then telly off, radio off and alarm clock on. Even when I have only two hours to sleep, melatonin helps me make every minute count. I have never slept through an alarm clock on melatonin no matter how tired I was.

Drop the caffeine late in the day. Don't drink any caffeinated drinks after 3pm and stay away from the alcohol. Actually, since I started residency, I have no problem falling asleep and getting up. You just get into a pattern.

njbmd :sleep:

P.S. If you find that 1 mg does not make you drowsy, cut the tablet in half. For melatonin, less is more. If you are having vivid dreams, you are on the correct dose. I have found that 3 mg gives me a headache (too much).
 

banana k

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no no no no NO on the antihistimines dimenhydrinate (sp?) and diphenhydramine, they'll put you in non-restful trip mode! augh! never! unless last resort, and then only ONCE! (more than that and you're tempting the trip.)
 

Gregg

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DrPharaohX said:
My friend swears by diphenhydramine (aka Nyquil) or any other anti-histamine. Be warned though, if you take a "full" dose and don't get enough hours of sleep, you will still be drowsy in the morning.
You mean Nyquil, the "stuffy head, sneeze, cough, so you can wake up on the kitchen floor wondering how you got there" medicine? Guaranteed to keep me out for at least 12 hours.
As others have said, melatonin works great. If it doesn't work for you (and sometimes it doesn't for me) try benedryl. You can buy a 100 count bottle at Costco for less than a blisterpack at a drugstore.
 

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Gregg said:
You mean Nyquil, the "stuffy head, sneeze, cough, so you can wake up on the kitchen floor wondering how you got there" medicine? Guaranteed to keep me out for at least 12 hours.
As others have said, melatonin works great. If it doesn't work for you (and sometimes it doesn't for me) try benedryl. You can buy a 100 count bottle at Costco for less than a blisterpack at a drugstore.
even benadryl didn't work for me, however it was the best for getting a couple hours of sleep when i was really desperate.
 

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What I do when I have problems sleeping (especially if my mind's spinning all crazy like) I concentrate on my breathing and just listen to it. For a little extra help, I try to imagine that each time I exhale, I'm sinking deeper and deeper into a big black hole....called sleep.

It sounds totally weird and abstract, but you should try it. It works for me every time I need it to.
 

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The average person takes around 20 min to fall asleep I think, and if you fall asleep within 5-10 minutes of lying down it supposidly means you are chronically sleep deprived. It takes me over a half hour to fall asleep most days. It used to bother me a lot more, now I just kind of live with it. I've been on perscription meds for sleep and found them sometimes helpful. Over the counter I still occationally take tylenol PM when I have a headache at night and can't sleep and I find it helps. I've never tried any other over the counter sleep aids, if my sleep bothers me enough I'd go back on a perscription again before I'd try over the counter stuff since they are only supposed to be taken occationally. Alcohol screws up your REM sleep so it isn't good to use as a sleep aid. I try not to have any caffinated beverages after around 2 PM, occationally if I do I find it really makes it hard to sleep that night. Often I'll read until I'm just about to fall alseep and then put the book down and be able to fall asleep pretty quickly. I also watch movies sometimes that I've seen a lot. The Lion King works the best for me, I have a hard time watching it without falling alseep now.
 

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starwisher said:
The average person takes around 20 min to fall asleep I think, and if you fall asleep within 5-10 minutes of lying down it supposidly means you are chronically sleep deprived. It takes me over a half hour to fall asleep most days. It used to bother me a lot more, now I just kind of live with it. I've been on perscription meds for sleep and found them sometimes helpful. Over the counter I still occationally take tylenol PM when I have a headache at night and can't sleep and I find it helps. I've never tried any other over the counter sleep aids, if my sleep bothers me enough I'd go back on a perscription again before I'd try over the counter stuff since they are only supposed to be taken occationally. Alcohol screws up your REM sleep so it isn't good to use as a sleep aid. I try not to have any caffinated beverages after around 2 PM, occationally if I do I find it really makes it hard to sleep that night. Often I'll read until I'm just about to fall alseep and then put the book down and be able to fall asleep pretty quickly. I also watch movies sometimes that I've seen a lot. The Lion King works the best for me, I have a hard time watching it without falling alseep now.
sometimes when i'm really sleep deprived and exhausted I can't fall asleep...strange :confused:
 

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robotsonic said:
And Ambien really works. Trust me. It will not leave you tired the next day like a benzo, and you *will* go to sleep.
I totally agree with this. I used to be scared to take Ambien (worried about being drowsy the next day, getting addicted, etc.) but it has truly improved my quality of life since I basically never have insomnia anymore. And I can count on getting a good night's sleep before something important and stressful!
 

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I had (key = past tense) the same problem. I found that the main reason why I was staying awake was because I would be up too late studying and my mind would race when I tried to get to sleep. I tried many things but the only thing that worked was discontinuing going to class. My school has a good coop system and almost all lectures are on power point online, and class attendance is usually not required. I study during the day like a full time job and have plenty of down time before I try to sleep.
 

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This whole med school thing has really been messing with my sleep and I got pretty scared as I was approaching test block that I'd be a complete zombie. So for about 2 months now I've been on Unisom (Doxylamine Succinate) and my sleep has been of pretty good quality so far. The bad thing is that I can't sleep without it now and I've been rewarded with a couple crappy-ass nights when I forgot to take it. I started out at 25mg, but I've been working my way down and cutting the tablets into fourths, so I'm roughly on 6-7mg per night and still getting "good" sleep.

I've heard of melatonin before (in regards to folks using it to prevent jet-lag), but I hadn't really heard of anyone who's been on it. Where can you get ahold of it, is it a walgreens or CVS otc thing? I've never had vivid dreams except once or twice in my life and I usually wake up tired even after a normal night of sleep (Plus I need 5 freakin' alarms!). That'd be sweet if I could get some dreams going with melatonin. :idea:
 

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I love Melatonin. The 1mg works great and I never wake up tired after taking it. It's also great near exams if I dont have a lot of time to waste falling asleep and if I may have had too much caffeine that day... :luck:

njbmd said:
Hi there,
If you only have a few hours to sleep, Melatonin can help you get quality sleep in short period of time. Melatonin helps you get into REM sleep more quickly. Take no more than 1mg about 30 minutes before you go to bed. Then telly off, radio off and alarm clock on. Even when I have only two hours to sleep, melatonin helps me make every minute count. I have never slept through an alarm clock on melatonin no matter how tired I was.

Drop the caffeine late in the day. Don't drink any caffeinated drinks after 3pm and stay away from the alcohol. Actually, since I started residency, I have no problem falling asleep and getting up. You just get into a pattern.

njbmd :sleep:

P.S. If you find that 1 mg does not make you drowsy, cut the tablet in half. For melatonin, less is more. If you are having vivid dreams, you are on the correct dose. I have found that 3 mg gives me a headache (too much).
 

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Man, apparently my bod doesn't recognize melatonin at all. I tried it 2 nights in a row and I didn't get any sleep (nor trippy dreams) even at 3mg. I think I must be hooked on the doxylamine succinate at this point. I wonder if I'll ever be able to sleep well again.... :eek:
 

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try soaking in a hot bathtub, as hot as you can stand it, for 20 minutes. About 10-20 minutes after you get out you should get drowsy. Never fails for me.
 

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I used to a have a problem sleeping. I tried all the solutions I could find: reading, counting sheep, warm milk. Then, I tried jamming an electrode into my raphe nuclei.

Now, one quick press of a button and I'm out like a light! I highly recommend it.
 

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angel5 said:
hmmmmm.

I have three alarm clocks in my room. Two require me to physically get out of bed and shut them off, and the other is my cell phone which I keep in my bed.

Now, I don't have a problem waking up, but I hit the snooze button at least 15 times before I start my day (an hour + of snoozing!!). I set my alarm clock much earlier from when I need to wake up...I'm scared if I set it too close to normal I need to wake up I won't...

I used to have 5 alarms in my room, and have weaned down to 3...

What should I do?
Put the alarm clock in a safe! By the time you enter the combination in order to turn the clock off, you will be too awake to go back to sleep. :)

Seriously, I have the same problem in the morning. On days I don't have school (weekends), I will just turn off the alarm clock across the room and then go back into bed, thinking I will just stay there for a few minutes, but then I fall asleep by mistake and get up a couple hours later. On school days I've tried setting my alarm earlier, but I realized I'm just wasting time that I could have spent sleeping because I don't really fall asleep properly after hitting the snooze button. I have two ideas I'm going to try. One is to put an empty chair right by the alarm clock across my room. I will just sit there until I am awake enough to think, and then I'll realize I shouldn't get back in bed for fear of falling asleep. The other thing is to think of all the exciting things I am going to do that day so I will be happy to get out of bed. One thing I've tried in the past that has worked is to put one alarm clock across the room, and put a sheet of computer paper on top of it with the words in bold and caps, DON'T GET BACK IN BED!! Silly, but it worked.
 

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zeloc said:
Put the alarm clock in a safe! By the time you enter the combination in order to turn the clock off, you will be too awake to go back to sleep. :)

Seriously, I have the same problem in the morning. On days I don't have school (weekends), I will just turn off the alarm clock across the room and then go back into bed, thinking I will just stay there for a few minutes, but then I fall asleep by mistake and get up a couple hours later. On school days I've tried setting my alarm earlier, but I realized I'm just wasting time that I could have spent sleeping because I don't really fall asleep properly after hitting the snooze button. I have two ideas I'm going to try. One is to put an empty chair right by the alarm clock across my room. I will just sit there until I am awake enough to think, and then I'll realize I shouldn't get back in bed for fear of falling asleep. The other thing is to think of all the exciting things I am going to do that day so I will be happy to get out of bed. One thing I've tried in the past that has worked is to put one alarm clock across the room, and put a sheet of computer paper on top of it with the words in bold and caps, DON'T GET BACK IN BED!! Silly, but it worked.
I do the same thing. I put a postit note on top of my alarm clock, "Get up and save some lives today!" hehe

But to fall asleep. I used to listen to the audio lecture online at my school and I'm out of it less than ten minutes into the lecture. :sleep:
 

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Napoleon1801 said:
Man, apparently my bod doesn't recognize melatonin at all. I tried it 2 nights in a row and I didn't get any sleep (nor trippy dreams) even at 3mg. I think I must be hooked on the doxylamine succinate at this point. I wonder if I'll ever be able to sleep well again.... :eek:
This happened to me too. I've had chronic insomnia for years. For about a year or so I was taking melatonin and it worked beautifully (a little too well in fact, as i could often be out for like 10-12 hours).

Somewhere along there I started taking ambien, as I felt that melatonin was making me sleep TOO much. Ambien works well, but once i got on ambien i couldn't go back to melatonin-it wouldn't work at all. I stopped ambien (b/c prescription ran out) and started using doxylamine. Found I also couldn't switch back to melatonin from doxylamine. I'm back on ambien now. it works well, although lately i've found i'm sleeping more and more (like 10hrs on a normal night), which is something i'm trying to work on, as I really don't want to sleep that much.
 

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Sometimes trying to do PBL puts me to sleep...go figure.