Last edited on 5-16-20.

I am not a doctor, and this advice should not be taken as coming from such a person.

Insomnia’s not really my idea of fun.  You’re trying to sleep, but for some reason, you just can’t. You toss and turn, and your anxiety gets worse and worse through the night because you’re worried about not going to sleep, being alone, etc.

There are three general types of insomnia for when it occurs: initial insomnia for when you can’t get to sleep to begin with, middle insomnia where you wake up and have trouble getting back to sleep (but it’s not impossible), and terminal insomnia where you wake up and usually don’t get back to sleep. I started out having initial, and during the past few months it’s been more terminal, but now initial insomnia is rearing its ugly head again – in fact, I’m writing this on a morning after no sleep. While it’s still a bit early to confirm this is the case, I think it may be brought on by winter (a bit more on that later). No matter what type you have, though, you can use many, if not all, of the same techniques on it.

Insomnia can also be named by how serious it is: acute insomnia for something that just happens from time to time, while chronic insomnia is more serious – at least two to three days a week for the better part of a month. Acute, while unpleasant, should be helped by the tips listed in this post. The same goes for chronic too, but if you’re struggling that much, it may merit a visit to the doctor because self-help usually takes a while to reach its full potential.

For anxiety sufferers, it’s very likely that they can’t sleep because there’s something on their mind preventing them from doing so. Some unfinished business, some worry about tomorrow, etc. For this post, I’m going to assume that’s the case. If you are convinced that you are not worrying about anything at night but still not sleeping, these tips MAY help, but you might want to get help from a doctor to investigate other causes. Like anxiety in general, there’s no real way to confirm anxiety-induced insomnia. It’s simply the absence of anything more serious, usually coupled with significant cause for worry in your life. Since ruling everything else out will cut some of the anxiety anyway, if in doubt, definitely see a doctor.

(This is definitely going to be the theme for these posts – if in doubt, don’t take chances. Get checked out. But if you know you’re experiencing a heightened amount of work and worry and have no reason to believe that anything else is wrong, anxiety’s high up on the list of possible diagnoses)

So… if you can’t sleep, what do you do? Well, let’s start by listing what to do in the short-term, at night or just before it.

DO get out of bed and do some menial activity after 15-30 minutes of not being able to sleep. This means doing chores or reading a not-too-exciting book. This meant, for me, a textbook, which is doubly effective: in addition to focusing on something other than anxiety about not being able to fall asleep which is the point here, you get to understand course material better (granted, you may not be absorbing all the info as if you were 100% awake, but it’s better than nothing). And usually after another 15-30 minutes or so, I would start getting drowsier. Another thing you might want to do, if it is safe to do so during the night, is to take a small walk outside. Just two blocks and back is sufficient for me, or perhaps just chill out in the backyard. This helps me a lot when I have trouble staying away from fearful thinking, and sometimes after it I do in fact fall asleep. Try to completely avoiding TVs, computers, phones, etc. Reading in soft light is better. The instinct is to want to stay connected rather than toughing it out on your lonesome, but the latter DOES tend to work out better for me, when I have the discipline to stick with it. I recently started to enforce on myself a rule where I do 20 minutes of mindfulness (more on that in future posts) in addition to what I already did before bed if I am unable to get to sleep in 15-20 minutes and feel myself beginning to think about not sleeping. Since I did that a month ago, I have not had a bad night’s sleep (Before, I usually had one every week or so). Plus, I am trying to get myself off my anxiety medication and thus I had more of a reason to be anxious, so yeah. It works.

– DO have a before-bed routine 1 1/2 hours before bed, which includes (you can pick and choose) a hot shower (which when taken 90 minutes in advance of bedtime helps you sleep!), reading, listening to soft music, doing relaxation exercises, or any other relaxing activities. Use as little light as possible, especially from electronic devices. I tend to experience insomnia if I have a significant instance of anxiety within a few hours of going to sleep (or during the night). The before-bed routine is one way to avoid this. For electronic devices, consider using f.lux to make the screen more conducive to sleep (and easier on the eyes!). Many computers/phones now have functionality that natively does this.

– DON’T consciously try to sleep like your life depends on it. Sleep is one of those things that just comes. Don’t force it. You’ll only be mad at yourself if it doesn’t come. In fact, some people have had paradoxical success by just laying there in bed, trying to stay awake – the key being to try to relax, not to sleep.

– DO try to get as much natural light as you can during the day. Ever wonder how the body knows to sleep at night? Daylight triggers the suppression of melatonin, a chemical in the body that makes you sleepy. At night, it gets released. This is why winter can be a bit harder on insomniacs – less daylight hours and the sun shines less overall. As an aside, investigate melatonin as an over the counter (OTC) supplement, especially if you deal with nighttime schedule shifts a lot. While it’s not as effective as a sleeping pill for sleep onset, you don’t need a prescription for it and it does help if a tiny extra push is all you need to get to sleep. I’ve heard melatonin is more effective for schedule shifts. There are other OTC supplements for insomnia (5-HTP, Calms Forte, Valerian and Valerian Root, and some others), but I cannot tell you the details about them, never having tried them. Make sure you inform your doctor about taking these supplements. I CAN, however, talk about Bach’s Rescue Sleep, a homeopathic spray. It did not work for me. Rescue Remedy for general anxiety was better, but there is a lot of argument about if homeopathic mixtures work anyway (note: Calm’s Forte as listed above is also homeopathic). All I know is some people online swear by them, and Rescue Remedy does provide some quick relief for me when anxious.

– DO have a regular sleep and waking time. Even on weekends. If you stick to it, you may even find you don’t need an alarm clock to wake up in the morning – you just wake naturally. And your body will know when it’s time to go to sleep, too. Make sure to provide yourself with enough time to get the sleep you need, but not so much that you have imbalance issues. One of my problems was that I was allowing myself way too much time for sleep – 10 hours a night. I slept 10 hours one night, but I wasn’t tired the next night and thus stayed up all night. And the process repeated itself. For most adults, 7-8 hours is enough.

– MAYBE take short naps in the morning or early afternoon (before 3) if you think you need them. There is some argument on if naps are worth it. You might be able to pair the naps with your scheduled dose of anxiety medication, if it makes you feel sleepy anyway (most medications will, as far as I know). Thirty minute naps at the max seems to be the general rule. Go for much longer and your body will get confused on when it’s time to sleep. For this and the above tip, do not overcompensate for nights with little or no sleep. Just accept it and move on. Sleeping throughout the day will do long-term harm that will most likely outweigh the short-term benefits, since it will mess up your body’s clock.

– DON’T worry about the consequences of not sleeping. If you don’t sleep… accept that that’s what happens. Anxiety will only make it worse. It is a discipline to cultivate peacefulness when your instinct is to fret.

– DO accept that meaningful self-help will take a while. Not everything will go your way, and you may go a few more nights that turn out badly before you see improvement.

– DO try to forget about everything that happened during the daytime, especially bad events. I like that at night, the only person who matters is you. You can let all your worries slip away, even if just temporarily. If you need to make sure you remember something for the next day, use pen and paper to do so and get it off your mind so you’re not occupied with that.

– DON’T eat a ton of food or drink a lot of liquids less than three hours before going to bed. Also, avoid caffeine, sugar, alcohol, etc.

– On the same token, DON’T eat a lot during the night. If you need to eat something, keep it small. No larger than half of a small sandwich. Crackers or nuts are also my go-tos.

– But definitely DO eat a good breakfast once you’ve passed your designated wake-up time. It’ll make you feel better.

– DON’T use your bed, or even your room, if you’re not sleeping (or having sex).

– DO create a consistent worry period each day, 15 minutes or so, to worry about the things that concern you. Try not to worry about those things at any other time. It sounds counter-productive, but if you get in the habit of worrying about stuff ONLY while you’re wide awake and not while you’re trying to sleep, it can help. I have not been able to discipline myself enough to do this, but it is something that could help.

– DO use the time you’re awake wisely. If you’re up for a large portion of the night, how the night is spent can significantly determine how you feel the next day. If I spend most of the time in relaxation, I have a better time coping with the increased anxiety the next day than if I spent the time panicking.

– DO use cognitive behavioral therapy to help you. As for anxiety in general, cognitive behavioral therapy can help correct any mistaken thoughts about sleep. A quick example: Instead of ‘If I don’t sleep during the first 30 minutes in bed, I won’t ever sleep that night’, change the thought to be more realistic: ‘I can go to sleep at any time of night.’ For more on CBT, try http://www.insomnia-free.com/cbt-insomnia.html

Also, insomnia-free (the website from the last paragraph) is my big resource here, as it helped me during my big bout of insomnia starting a year ago. In particular, there is a ten-day tutorial on the site (look under the Insomnia Help tab) that gradually unloads more of the tips and techniques discussed here on you.

There is one other, more extreme, method that I wanted to share because it also did help me. I mentioned that part of my problem initially was allocating way too much time for sleep at night. The method is called sleep restriction, and here’s how it’s supposed to be done from the book ‘Anxiety Free’ by Robert L. Leahy, Ph.D. Go one night without sleep, intentionally. Then look at the week before that and figure out how much sleep you got the night you slept the least. Allow yourself only that much time to sleep, but increase the time by 15 minutes per night until you’re at an amount of sleep that feels comfortable to you. It may be less than eight hours.

For me, there was a problem with that: the least amount of sleep for me was no sleep at all. I did not want to go to that extreme, and nobody really should – you’d start sleeping at random times during the day if you deprived yourself that much. I started from 6 hours, which was an hour over my average sleep, increasing it by 15 minutes per night IF I got a good night’s sleep. I continued to 8 hours. This was probably a vital step for me in addition to the tutorial on insomnia-free.

Well… that’s certainly a lot of stuff! Remember to check out http://www.insomnia-free.com for more info – they have more on the subject that I can ever hope to have here. If there’s something important I’m missing (I’m sure there is), just comment and I’ll add it to the post.

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