January 22, 2021 • 19 mins
There's a name for the inability to sleep well during this pandemic. It's called "Covid-Somnia." Dr. Saltz gives great, practical advice in answer to listener questions about falling asleep, and staying asleep.
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Episode Transcript
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Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to How can I Help? I'm doctor
Gale Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. Today, I'm here to
help with your questions about falling asleep and staying asleep.
Before we get to our listeners questions, let me first
give you a little bit of background on today's topic. Sleep.
Everyone wants to get a good night's sleep, and there's
(00:47):
nothing more frustrating than having trouble falling asleep or having
interrupted sleep when you wake up in the middle of
the night and can't get back to sleep. There's been
a tremendous rise in the number of people experiencing sleep
difficulties of many different kinds. Loss of sleep has specifically
risen in the setting of the fears, the losses, and
(01:07):
stresses associated with the COVID pandemic, so much so that
sleep specialists have a special name for this COVID psomnia.
Less than seven to nine hours of sleep at night
causes difficulty with your memory, with concentration, with mood, and
even with your immunity. An important point when you think
(01:28):
about the fact that we're in a pandemic. Besides feeling lousy,
it's important for your mental and your physical health to
treat insomnia. Given that it's January, one of the darkest
and coldest months, in the middle of an ongoing pandemic,
it's not a surprise that one of the most common
questions I get has to do with some form of
(01:49):
COVID somnia. So let's get to it and see how
can I help. Here's question one, hide actor salts. I
try to go to sleep at a reasonable hour, but
the minute my head hits the pillow, my mind starts
racing with terrible worries about whether I or someone I
(02:09):
love will get COVID, whether my job will keep me
on through, and how much socialness in school my kids
are missing. I just can't fall asleep, and the next
day I'm exhausted. What can I do? Well? As I
mentioned earlier, this is a really common and ever increasing
problem right now, and worries do tend to happen at night.
(02:34):
The reason for that is the minute your head hits
the pillow, you don't have something else distracting you. And
when you don't have other thoughts what you have to
get done during the day, or what you're paying attention to,
and your mind is left to wander, it's a very
common time for the worries to really creep in. And
as worries creep in, they make your mind and your
(02:55):
body feel more anxious. And when your body feels anxious,
it is less relaxed and therefore has difficulty going to sleep.
What you want to do is the hour before you
go to bed, try to create as much relaxation in
your mind and your body as possible. We typically don't
(03:17):
do this right. A lot of people are maybe watching
the news or scrolling on their phone or looking at
their tweets in the hour before they go to bed.
But I would really advise you in this hour to
remove all screens as much as possible for two reasons.
One is that blue light, which is something that is
emitted from screens. All screens really tends to stimulate us.
(03:39):
It's a light that says to our brains time to
be awake. Avoiding your phone, your tablet and even the TV,
although if you're at least let's say six ft especially
even maybe twelve ft from your TV, then the blue
light is less of a factor, but the content is
still a big factor. So staying away from news particularly,
(04:03):
but anything that's arousing or could arouse worry in the
hour before bedtime is a good idea. Next, I'm going
to advise you to really try to regulate your sleep schedule.
It's very common, particularly in these times when people are
working from home, and you have to not necessarily get
up at a regular time or go to sleep therefore
(04:23):
at a regular time to have an erratic schedule, but
that makes going to sleep more difficult. So try to
set yourself a regular bedtime and set your alarm for
a regular wake up time. It takes about a week
or two to create a situation where your mind gets
(04:43):
used to, or basically commits to a certain circadian rhythm,
a time to go to sleep, a time to wake up,
and you have to impose that on yourself to create
that circadian rhythm and make it easier there for to
go to sleep when you are going to sleep. Another
thing you can do to help with circadian rhythm is
(05:04):
when you do get up. Let's say you set your
alarm for seven thirty. Sometime in the two to three
hours after you've gotten up, go outside and get some sunlight.
It might not even be that sunny. It doesn't matter
if there's cloud cover, but the point is to get
some rays from the sun, which actually helps set your
(05:26):
circadian rhythm if done in the hour or two after
you wake up. So this is really important as well.
Even just thirty minutes can be a help. Another important
factor for sleep hygiene, which again will help you to
go to sleep once you lay down, is to keep
your bed only for sleep or for sex. Why is
(05:47):
that because your mind starts to associate your bed with
certain things that can be positive like sleep and sex hopefully,
or they can be negative like I'm doing work in
my bed or I'm lying here not going to sleep
in my bed and worrying, and then it becomes an
unpleasant place to be. Try to only have sleep time
(06:11):
or sacks in your bed, and don't work in your
bed or on your bed, don't spend huge amounts of
time watching news on your bed, And frankly, if you're
lying down and not sleeping, I'm going to advise you
to not spend more than fifteen minutes lying awake before
you get up and do something that's an activity. The
(06:33):
activity should be something kind of boring and relaxing, like
maybe reading a book, maybe listening to soothing music, even
just walking around your apartment. But lying in your bed
for more than fifteen or twenty minutes is actually going
to make you feel, as you're asking me this question, anxious, uncomfortable, miserable,
(06:54):
which tends to churn you up more, which actually makes
it again harder to go to sleep. So get up,
move around, down, don't worry that you're not sleeping, go
back to sleep. After you've walked around or read your
book and feel a little more relaxed and like you're tired,
then get back in your bed. These are all methods
that you can use to create what's called good sleep hygiene,
(07:16):
which helps set your clock makes it easier to go
to sleep. Keep the room dark, keep the room cool,
turn your clock around so that you're not staring at it,
and try to keep it as sound free as is possible.
Then people will ask me, well, shouldn't I just take
maybe a sleep medication go to sleep. The answer is maybe,
(07:37):
if you're having weeks of problems with insomnia, it's possible
that a sleep medication would help you, but it's not
a no brainer, meaning there are always potential side effects
from medications, even non addictive sleep medications, of which there
are numerous types. So a sleep medication can help you
have quick onset to sleep, which can be a very
(07:58):
good thing. It shouldn't be used for a very long time.
It's supposed to be used in order to help you
set your circadian rhythm and get you sleeping and get
you rested, but not indefinitely used. But of course, sleep
medications can potentially have side effects, such as in the
middle of the night behaviors that you're unaware of, eating,
(08:19):
moving around, sleep walking, sleep activity. You really only want
to new sleep medication if you truly need it, which
is a discussion you should have with your doctor. But
there are things you can take that are not that
kind of medication. For example, melatonin. Melatonin is a hormone
(08:40):
that your body naturally produces, and it rises about two
hours before you usually go to sleep. It helps relax
you and it helps initiate the onset of sleep, and
even though you are undoubtedly having a normal rise hopefully
in melotonin. Sometimes adding extra melatonin can help with the
(09:01):
onset of sleep. Again, it's not something that you want
to use indefinitely, but it is something that can help
you if you take it two hours before bedtime, so
acting like your natural body, not taking a huge amount.
One to three milligrams is enough. And again, if you're pregnant,
if you're breastfeeding, if you have a seizure disorder, depression,
(09:23):
high blood pressure, diabetes, or an autoimmune disorder, it's probably
not advisable. But if you don't fit in one of
those categories, using melatonin for one to two months to
set your sleep and to actually get well rested, and
then to taper off and see if you've attained your
own circadian rhythm is actually a safe and healthy thing
(09:45):
to do. How can I help with Dr Gaale Salts
will be back after this short break. Here's our second question.
(10:07):
I'm so exhausted at night. I fall asleep right away,
but I often wake up around three AM or four
AM unable to fall back asleep. My thoughts start racing
and I am up. The more upset I get about
not falling back asleep, the more awake I am. This
is getting worse and worse, please help. General high anxiety
(10:31):
during the day can present as waking up during the
night and feeling anxious. Your mind feeds your body, and
your body feeds back to your mind. So when you
are anxious for a good chunk of the day, your
sympathetic nervous system stays on overdrive and keeps adrenaline pumping
(10:54):
and makes you feel generally jittery and nervous. And the
thoughts that come along with that, which is you're describing,
are a bunch of worries. So it's not unusual, unfortunately,
when you're anxious to wake up in the middle of
the night because you are frankly not sleeping that deeply,
you are over aroused in terms of anxiety, and that
(11:16):
presents as an awakening and then a flood of anxious thoughts.
Another problem that can cause nighttime awakening is that many
people who are anxious during the day will have a
drink of alcohol of some sort in the evening to
quote relax. And while it's true that alcohol actually fits
(11:36):
in the class of drug that does relax you in
the evening and may even make it feel like it
helps you to go to sleep more quickly. It actually
causes more nighttime awakenings because in fact, during the night
you are essentially withdrawing from the alcohol. It causes you
to potentially wake up. And alcohol is known to what's
(11:58):
called interrupt your leap architecture, meaning it may help you
have the shallower forms of sleep, but it interrupts the
ability to move into the deeper forms of sleep, and
so you wake up in the middle of the night
and you have anxious thoughts. When you wake up with
(12:18):
those anxious thoughts, your instinct is to fight the worry,
to say, no, that can't be true, or maybe I
can come with up with a solution in my mind
so that I can fix it right now. And that
answering of the worries, or that fighting with the worries
actually provides positive feedback that keeps the worries coming. The
(12:42):
more that you fight with them, the stronger they feel.
So even though it might feel like what you should
be doing is problem solving or fighting with them, you
actually kind of want to do the opposite, which is
to allow the worry to be there or the anxious
thought to be there and let it float, let it
just be present, as if if you could imagine that
(13:04):
worry is a cloud or on a cloud, and it's floating.
It's sitting there. You can't get rid of it, but
it's just kind of passing by. Because the more that
you accept and allow the presence of the worry without
struggling with it or answering it over time, the more
that worry will diminish. That's the way to approach it
(13:27):
at night, and what can help with that is to
use some relaxation techniques when you wake up. Those can be,
for example, progressive deep muscle relaxation, where you squeeze each
muscle group in your body to account of five and
then relax it, starting with your feet, moving to your legs,
(13:49):
to your body, to your arms, even to your face
and head. Muscle relaxation calms your body, and actually that
will help calm your mind and it's giving you something
to think about that doesn't have to do with the worries.
Another technique could be taste deep breathing, something that does
take a little practice, but basically you want to be
(14:11):
breathing in your nose to account of five and out
your mouth to account of seven. Towards the end of
that breath, the exhil causes your heart rate to decrease
a little bit, which causes your body to relax. And again,
that's something one can focus on that doesn't have anything
to do with the worries that you feel are plaguing you.
(14:35):
If alcohol is in the picture, I would advise you
to decrease or even avoid your alcohol intake at night altogether,
at least until you get this problem solved. A very
little amount of alcohol probably won't be a major problem,
but if you're drinking more than you want, to taper
back little by little each night until you're having either
(14:55):
very little or none. And again, think about your sleep hygiene.
Does your room have cooler temperatures? Are you having no
light so that if you do wake up, you're not
aroused by the light in the room? Did you turn
the clock around so that when you wake up in
the middle of the night, you're not looking at the
time and then start worrying about what time it is
(15:16):
and how long you're not going back to sleep. Using
these techniques of focusing on your body and being in
sync with your body will help you to relax and
fall back asleep. One other thing I want to suggest,
if this has really become a chronic problem for you.
Are two ideas that fall in the realm of cognitive
behavioral therapy. Some of them are things you can do
(15:39):
for yourself, and some of them are things that you
might want to talk with a sleep specialist about. One
is the concept of sleep restriction. The idea is basically
everybody has a different amount of efficiency, and sleep efficiency
is how much you're actually sleeping, divided by how how
(16:00):
much time you're spending in bed. You're spending a lot
of time in bed trying to sleep i e. Staying awake,
then you have very inefficient sleep, and that's what people
end up feeling is insomnia. But you improve your efficiency
by basically logging for about a week how much sleep,
(16:21):
not how much time in bed, but how much sleep
you're actually getting. And then you take that number of
hours let's say it's five, and you stay in bed
for only five hours of night until you are sleeping
the majority of that at least let's say of that,
(16:44):
and then you're going to add fifteen minutes. Every time
you get up to eight of your total goal, you're
going to add fifteen minutes. What is this doing? This
is actually in a way restricting how much time you
and sleep, and your body gets a little tired and
(17:05):
will be more efficient about dropping off to a deeper
sleep and staying in that sleep. This actually really helps
a lot of people to develop a much better sleep pattern. Now,
I do want to say that if you're sleeping fewer
than four hours, you never want to go under four
hours in this practice, So it's always going to be
(17:25):
above that. And the plan is that you want to
bring it up fifteen minutes until you get to a
number that feels good. Let's say somewhere between seven and
nine hours, and you're maintaining an eight five sleep efficiency.
(17:45):
Cognitive behavioral therapy for insomnia can be very helpful for people.
You need to do this with a psychologist or psychiatrist
who does practice CBT for sleep, and basically the techniques
have to do with the examine your thoughts around sleep,
correcting incorrect thoughts which tend to be worry thoughts about sleep,
(18:08):
and practicing and learning relaxation techniques that will help you
go to sleep and stay asleep. Most people are able
to do this for eight to ten sessions and really
treat their insomnia. So these are techniques that one can
use that don't have to do with taking medications and
can be super helpful. I hope that was helpful. Here
(18:33):
are some things to remember to get the good night's
sleep you deserve, generally speaking. If you're struggling to sleep,
whether at the start of the night or in the middle,
avoid lying in bed for more than fifteen to twenty minutes.
If you're still awake, get up and do something. Read
a book, no screens, listen to music, walk around the house.
(18:55):
When you feel tired again, lie back down. Being endlessly
miserable in bed start It's a negative association with your bed,
so avoid looking at your clock and remember worries at
night are common content, but that doesn't make them important content,
so try to accept and not fight with them. If
(19:15):
the problem persists, consider talking to a sleep specialist for
a few sessions of CBT sleep therapy. Do you have
a problem I can help with? If so, email me
at how Can I Help? At Seneca Women dot com.
All senders remain anonymous and listen every Friday to how
Can I Help with Me? Dr Gail Salts
Bees are challenging times, but you don't have to navigate
them alone. Welcome to How can I Help? I'm doctor
Gale Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. Today, I'm here to
help with your questions about falling asleep and staying asleep.
Before we get to our listeners questions, let me first
give you a little bit of background on today's topic. Sleep.
Everyone wants to get a good night's sleep, and there's
(00:47):
nothing more frustrating than having trouble falling asleep or having
interrupted sleep when you wake up in the middle of
the night and can't get back to sleep. There's been
a tremendous rise in the number of people experiencing sleep
difficulties of many different kinds. Loss of sleep has specifically
risen in the setting of the fears, the losses, and
(01:07):
stresses associated with the COVID pandemic, so much so that
sleep specialists have a special name for this COVID psomnia.
Less than seven to nine hours of sleep at night
causes difficulty with your memory, with concentration, with mood, and
even with your immunity. An important point when you think
(01:28):
about the fact that we're in a pandemic. Besides feeling lousy,
it's important for your mental and your physical health to
treat insomnia. Given that it's January, one of the darkest
and coldest months, in the middle of an ongoing pandemic,
it's not a surprise that one of the most common
questions I get has to do with some form of
(01:49):
COVID somnia. So let's get to it and see how
can I help. Here's question one, hide actor salts. I
try to go to sleep at a reasonable hour, but
the minute my head hits the pillow, my mind starts
racing with terrible worries about whether I or someone I
(02:09):
love will get COVID, whether my job will keep me
on through, and how much socialness in school my kids
are missing. I just can't fall asleep, and the next
day I'm exhausted. What can I do? Well? As I
mentioned earlier, this is a really common and ever increasing
problem right now, and worries do tend to happen at night.
(02:34):
The reason for that is the minute your head hits
the pillow, you don't have something else distracting you. And
when you don't have other thoughts what you have to
get done during the day, or what you're paying attention to,
and your mind is left to wander, it's a very
common time for the worries to really creep in. And
as worries creep in, they make your mind and your
(02:55):
body feel more anxious. And when your body feels anxious,
it is less relaxed and therefore has difficulty going to sleep.
What you want to do is the hour before you
go to bed, try to create as much relaxation in
your mind and your body as possible. We typically don't
(03:17):
do this right. A lot of people are maybe watching
the news or scrolling on their phone or looking at
their tweets in the hour before they go to bed.
But I would really advise you in this hour to
remove all screens as much as possible for two reasons.
One is that blue light, which is something that is
emitted from screens. All screens really tends to stimulate us.
(03:39):
It's a light that says to our brains time to
be awake. Avoiding your phone, your tablet and even the TV,
although if you're at least let's say six ft especially
even maybe twelve ft from your TV, then the blue
light is less of a factor, but the content is
still a big factor. So staying away from news particularly,
(04:03):
but anything that's arousing or could arouse worry in the
hour before bedtime is a good idea. Next, I'm going
to advise you to really try to regulate your sleep schedule.
It's very common, particularly in these times when people are
working from home, and you have to not necessarily get
up at a regular time or go to sleep therefore
(04:23):
at a regular time to have an erratic schedule, but
that makes going to sleep more difficult. So try to
set yourself a regular bedtime and set your alarm for
a regular wake up time. It takes about a week
or two to create a situation where your mind gets
(04:43):
used to, or basically commits to a certain circadian rhythm,
a time to go to sleep, a time to wake up,
and you have to impose that on yourself to create
that circadian rhythm and make it easier there for to
go to sleep when you are going to sleep. Another
thing you can do to help with circadian rhythm is
(05:04):
when you do get up. Let's say you set your
alarm for seven thirty. Sometime in the two to three
hours after you've gotten up, go outside and get some sunlight.
It might not even be that sunny. It doesn't matter
if there's cloud cover, but the point is to get
some rays from the sun, which actually helps set your
(05:26):
circadian rhythm if done in the hour or two after
you wake up. So this is really important as well.
Even just thirty minutes can be a help. Another important
factor for sleep hygiene, which again will help you to
go to sleep once you lay down, is to keep
your bed only for sleep or for sex. Why is
(05:47):
that because your mind starts to associate your bed with
certain things that can be positive like sleep and sex hopefully,
or they can be negative like I'm doing work in
my bed or I'm lying here not going to sleep
in my bed and worrying, and then it becomes an
unpleasant place to be. Try to only have sleep time
(06:11):
or sacks in your bed, and don't work in your
bed or on your bed, don't spend huge amounts of
time watching news on your bed, And frankly, if you're
lying down and not sleeping, I'm going to advise you
to not spend more than fifteen minutes lying awake before
you get up and do something that's an activity. The
(06:33):
activity should be something kind of boring and relaxing, like
maybe reading a book, maybe listening to soothing music, even
just walking around your apartment. But lying in your bed
for more than fifteen or twenty minutes is actually going
to make you feel, as you're asking me this question, anxious, uncomfortable, miserable,
(06:54):
which tends to churn you up more, which actually makes
it again harder to go to sleep. So get up,
move around, down, don't worry that you're not sleeping, go
back to sleep. After you've walked around or read your
book and feel a little more relaxed and like you're tired,
then get back in your bed. These are all methods
that you can use to create what's called good sleep hygiene,
(07:16):
which helps set your clock makes it easier to go
to sleep. Keep the room dark, keep the room cool,
turn your clock around so that you're not staring at it,
and try to keep it as sound free as is possible.
Then people will ask me, well, shouldn't I just take
maybe a sleep medication go to sleep. The answer is maybe,
(07:37):
if you're having weeks of problems with insomnia, it's possible
that a sleep medication would help you, but it's not
a no brainer, meaning there are always potential side effects
from medications, even non addictive sleep medications, of which there
are numerous types. So a sleep medication can help you
have quick onset to sleep, which can be a very
(07:58):
good thing. It shouldn't be used for a very long time.
It's supposed to be used in order to help you
set your circadian rhythm and get you sleeping and get
you rested, but not indefinitely used. But of course, sleep
medications can potentially have side effects, such as in the
middle of the night behaviors that you're unaware of, eating,
(08:19):
moving around, sleep walking, sleep activity. You really only want
to new sleep medication if you truly need it, which
is a discussion you should have with your doctor. But
there are things you can take that are not that
kind of medication. For example, melatonin. Melatonin is a hormone
(08:40):
that your body naturally produces, and it rises about two
hours before you usually go to sleep. It helps relax
you and it helps initiate the onset of sleep, and
even though you are undoubtedly having a normal rise hopefully
in melotonin. Sometimes adding extra melatonin can help with the
(09:01):
onset of sleep. Again, it's not something that you want
to use indefinitely, but it is something that can help
you if you take it two hours before bedtime, so
acting like your natural body, not taking a huge amount.
One to three milligrams is enough. And again, if you're pregnant,
if you're breastfeeding, if you have a seizure disorder, depression,
(09:23):
high blood pressure, diabetes, or an autoimmune disorder, it's probably
not advisable. But if you don't fit in one of
those categories, using melatonin for one to two months to
set your sleep and to actually get well rested, and
then to taper off and see if you've attained your
own circadian rhythm is actually a safe and healthy thing
(09:45):
to do. How can I help with Dr Gaale Salts
will be back after this short break. Here's our second question.
(10:07):
I'm so exhausted at night. I fall asleep right away,
but I often wake up around three AM or four
AM unable to fall back asleep. My thoughts start racing
and I am up. The more upset I get about
not falling back asleep, the more awake I am. This
is getting worse and worse, please help. General high anxiety
(10:31):
during the day can present as waking up during the
night and feeling anxious. Your mind feeds your body, and
your body feeds back to your mind. So when you
are anxious for a good chunk of the day, your
sympathetic nervous system stays on overdrive and keeps adrenaline pumping
(10:54):
and makes you feel generally jittery and nervous. And the
thoughts that come along with that, which is you're describing,
are a bunch of worries. So it's not unusual, unfortunately,
when you're anxious to wake up in the middle of
the night because you are frankly not sleeping that deeply,
you are over aroused in terms of anxiety, and that
(11:16):
presents as an awakening and then a flood of anxious thoughts.
Another problem that can cause nighttime awakening is that many
people who are anxious during the day will have a
drink of alcohol of some sort in the evening to
quote relax. And while it's true that alcohol actually fits
(11:36):
in the class of drug that does relax you in
the evening and may even make it feel like it
helps you to go to sleep more quickly. It actually
causes more nighttime awakenings because in fact, during the night
you are essentially withdrawing from the alcohol. It causes you
to potentially wake up. And alcohol is known to what's
(11:58):
called interrupt your leap architecture, meaning it may help you
have the shallower forms of sleep, but it interrupts the
ability to move into the deeper forms of sleep, and
so you wake up in the middle of the night
and you have anxious thoughts. When you wake up with
(12:18):
those anxious thoughts, your instinct is to fight the worry,
to say, no, that can't be true, or maybe I
can come with up with a solution in my mind
so that I can fix it right now. And that
answering of the worries, or that fighting with the worries
actually provides positive feedback that keeps the worries coming. The
(12:42):
more that you fight with them, the stronger they feel.
So even though it might feel like what you should
be doing is problem solving or fighting with them, you
actually kind of want to do the opposite, which is
to allow the worry to be there or the anxious
thought to be there and let it float, let it
just be present, as if if you could imagine that
(13:04):
worry is a cloud or on a cloud, and it's floating.
It's sitting there. You can't get rid of it, but
it's just kind of passing by. Because the more that
you accept and allow the presence of the worry without
struggling with it or answering it over time, the more
that worry will diminish. That's the way to approach it
(13:27):
at night, and what can help with that is to
use some relaxation techniques when you wake up. Those can be,
for example, progressive deep muscle relaxation, where you squeeze each
muscle group in your body to account of five and
then relax it, starting with your feet, moving to your legs,
(13:49):
to your body, to your arms, even to your face
and head. Muscle relaxation calms your body, and actually that
will help calm your mind and it's giving you something
to think about that doesn't have to do with the worries.
Another technique could be taste deep breathing, something that does
take a little practice, but basically you want to be
(14:11):
breathing in your nose to account of five and out
your mouth to account of seven. Towards the end of
that breath, the exhil causes your heart rate to decrease
a little bit, which causes your body to relax. And again,
that's something one can focus on that doesn't have anything
to do with the worries that you feel are plaguing you.
(14:35):
If alcohol is in the picture, I would advise you
to decrease or even avoid your alcohol intake at night altogether,
at least until you get this problem solved. A very
little amount of alcohol probably won't be a major problem,
but if you're drinking more than you want, to taper
back little by little each night until you're having either
(14:55):
very little or none. And again, think about your sleep hygiene.
Does your room have cooler temperatures? Are you having no
light so that if you do wake up, you're not
aroused by the light in the room? Did you turn
the clock around so that when you wake up in
the middle of the night, you're not looking at the
time and then start worrying about what time it is
(15:16):
and how long you're not going back to sleep. Using
these techniques of focusing on your body and being in
sync with your body will help you to relax and
fall back asleep. One other thing I want to suggest,
if this has really become a chronic problem for you.
Are two ideas that fall in the realm of cognitive
behavioral therapy. Some of them are things you can do
(15:39):
for yourself, and some of them are things that you
might want to talk with a sleep specialist about. One
is the concept of sleep restriction. The idea is basically
everybody has a different amount of efficiency, and sleep efficiency
is how much you're actually sleeping, divided by how how
(16:00):
much time you're spending in bed. You're spending a lot
of time in bed trying to sleep i e. Staying awake,
then you have very inefficient sleep, and that's what people
end up feeling is insomnia. But you improve your efficiency
by basically logging for about a week how much sleep,
(16:21):
not how much time in bed, but how much sleep
you're actually getting. And then you take that number of
hours let's say it's five, and you stay in bed
for only five hours of night until you are sleeping
the majority of that at least let's say of that,
(16:44):
and then you're going to add fifteen minutes. Every time
you get up to eight of your total goal, you're
going to add fifteen minutes. What is this doing? This
is actually in a way restricting how much time you
and sleep, and your body gets a little tired and
(17:05):
will be more efficient about dropping off to a deeper
sleep and staying in that sleep. This actually really helps
a lot of people to develop a much better sleep pattern. Now,
I do want to say that if you're sleeping fewer
than four hours, you never want to go under four
hours in this practice, So it's always going to be
(17:25):
above that. And the plan is that you want to
bring it up fifteen minutes until you get to a
number that feels good. Let's say somewhere between seven and
nine hours, and you're maintaining an eight five sleep efficiency.
(17:45):
Cognitive behavioral therapy for insomnia can be very helpful for people.
You need to do this with a psychologist or psychiatrist
who does practice CBT for sleep, and basically the techniques
have to do with the examine your thoughts around sleep,
correcting incorrect thoughts which tend to be worry thoughts about sleep,
(18:08):
and practicing and learning relaxation techniques that will help you
go to sleep and stay asleep. Most people are able
to do this for eight to ten sessions and really
treat their insomnia. So these are techniques that one can
use that don't have to do with taking medications and
can be super helpful. I hope that was helpful. Here
(18:33):
are some things to remember to get the good night's
sleep you deserve, generally speaking. If you're struggling to sleep,
whether at the start of the night or in the middle,
avoid lying in bed for more than fifteen to twenty minutes.
If you're still awake, get up and do something. Read
a book, no screens, listen to music, walk around the house.
(18:55):
When you feel tired again, lie back down. Being endlessly
miserable in bed start It's a negative association with your bed,
so avoid looking at your clock and remember worries at
night are common content, but that doesn't make them important content,
so try to accept and not fight with them. If
(19:15):
the problem persists, consider talking to a sleep specialist for
a few sessions of CBT sleep therapy. Do you have
a problem I can help with? If so, email me
at how Can I Help? At Seneca Women dot com.
All senders remain anonymous and listen every Friday to how
Can I Help with Me? Dr Gail Salts
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