From forbes.com
If you’re like most people, you’ve been affected by stress-related sleep problems at some point or another, lying awake at night filled with anxiety about your career and the future. You may feel exhausted during the day but wired at night, desperate to shut off your racing mind so you can finally rest.
It may be hard to believe, but your brain wants (and knows how) to sleep well. You simply need to reset your relationship with sleep, so that instead of it feeling like a battle or a chore, it becomes the easy and enjoyable experience it should be.
That’s where Dr. Jade Wu comes in. As a board-certified behavioural sleep medicine specialist, she’s on a mission to help the 25 million Americans who struggle to fall asleep or stay asleep find rest at last. In her new book, Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications, she offers insights based in the latest sleep science, providing a step-by-step roadmap to better sleep whether you’ve had insomnia for three months or three decades.
In this interview, Dr. Wu shares some of her favourite tips to help even the most high-strung among us get better rest.
Melody Wilding: Tell us about your career journey. What sparked your interest in helping others overcome insomnia?
Jade Wu: I’ve been working with people with insomnia for almost ten years, and it never fails to strike me how lonely people feel in their experience of struggling with sleep problems. Even when they intellectually know that insomnia is common, people feel that there must be something wrong with themselves, or that they’re uniquely bad at turning off their brains, or that they’re doomed to be a “bad sleeper” forever. They end up alternating between desperately trying anything to sleep better and resigning themselves to hopelessness. This strained relationship they develop with sleep makes their nights even more of a struggle, and makes sleep medications seem like the only option.
But what insomniacs don’t know is that there are non-medication treatments for insomnia. In fact, behavioural treatments are considered the first line treatments for insomnia by the American Academy of Sleep Medicine and other medical authorities– they are more effective and have fewer risks and side effects. I want to shout this from the rooftops because relief from insomnia is so much closer than people realize, usually only a few weeks away.
This is why I wanted to write Hello Sleep. I wanted to help people rekindle their relationship with sleep, to approach it as if it’s a friend instead of an engineering problem. I want them to know that there absolutely is hope, and that some surprisingly simple (but often counterintuitive) changes to their sleep-wake behaviours can turn their nights (and days) around.
Wilding: What are the biggest myths about sleep or insomnia that we need to be aware of?
Wu: One popular myth about sleep is that everybody needs to have 8 hours per night, every night. Does this apply equally for Lebron James and couch potatoes? For pregnant women and nursing home residents? How much sleep we need differs between people, depending on our individual genes, lifestyles, and environments. How much sleep we need also changes over time, as we get older and take on different challenges. Holding a rigid 8-hours-per-night expectation is not only unrealistic but unhelpful, because when sleep doesn’t meet this expectation, we become frustrated or anxious, which makes it harder to get good sleep.
Another common myth is that sleep hygiene is the answer to insomnia. Sleep hygiene practices can be good habits for preventing sleep problems, but it’s just like dental hygiene–it’s too little too late once there’s already a cavity (or persistent insomnia). In fact, sometimes focusing too much on sleep hygiene can backfire for those with insomnia, because doubling down on having “perfect” sleep hygiene increases anxiety about sleep, which makes insomnia worse. It’s more helpful to have a flexible attitude about sleep hygiene, so that even as you’re giving your sleep a good chance of success, you’re also living your life (e.g., enjoying an extra cocktail sometimes, staying out late with friends).
My favourite myth about sleep is the idea that we can or should “sleep through the night” without waking up. A healthy sleeper actually wakes up about a dozen or more times per night! Usually, these awakenings are brief enough that we don’t even realize they’ve happened, but it’s also very normal to remember a couple of longer awakenings (e.g., getting up to use the bathroom). In fact, people in preindustrial Europe used to get up and do chores or socialize for a couple of hours in the middle of the night, splitting their night into “first sleep” and “second sleep.” Waking up during the night isn’t bad for your sleep quality–it’s like taking a break during a meal. It only becomes a problem when it happens very frequently (many times per hour) due to sleep disorders like obstructive sleep apnoea, or when you’re so anxious about waking up that you end up staying awake for a long time ruminating about the experience.
Wilding: What are ways we can work with our bodies, instead of against them, for better sleep?
Wu: One way to work with, instead of against, your body is to simply sleep as much (or little) as it wants to. If you hold a pretty consistent rise time in the mornings, your body will tell you how much sleep it needs by making you sleepy at the appropriate time at night. Don’t fight those sleepy cues, whether they come earlier or later than you think they should.
Another important way to work with your body is by sleeping and waking at the times it prefers. Everyone has a chronotype—a more-or-less hardwired tendency to be sleepy/alert at certain times of the 24-hour clock. Extreme night owls, for example, feel and function best in the evenings but hate to be up early in the morning. Extreme morning larks feel great getting up with the dawn but get sleepy pretty soon after the sun sets. Most of us are somewhere in the middle. The easiest way to know your chronotype is to ask yourself, “If I were on vacation on a deserted island for a month, what time would I naturally want to go to sleep and wake up?” Of course, there are real life constraints that might not allow you to live by that ideal timing, but see if you can get as close as possible by getting creative with your morning/evening routines.
Wilding: How do you get your brain to “shut off” at night?
Wu: We actually can’t shut off our brains. There’s no on-off switch! Often, we think it’s because of our racing thoughts that we can’t fall asleep. But really, it’s because we’re not sleepy that there’s room for the thoughts to race through our minds. That’s why one of the best things to do when you’re experiencing “busy brain” in bed is to make sure you’re actually sleepy, instead of merely feeling tired. If you’re not sleepy, it’s time to get out of bed and enjoy some extra “me” time until you are. Staying in bed and trying really hard to clear your mind will only invite your thoughts to swirl faster.
If you know you’re sleepy, but it’s still hard to drift off because there’s a big event coming up or a stressful problem you can’t stop worrying about, you can practice getting out of your head and into your body. Turn your attention to your breath, or notice how your body feels, slowly walking your attention from your head to your toes. If insistent thoughts come into your mind, it’s okay. Simply notice them, without judgment, and gently turn your attention back to your body.
And of course, there’s always the option of simple distraction. It’s okay to get up and read a book or listen to a podcast to get your mind off of nagging thoughts until you’re sleepy. But be aware that this is only a short-term solution. If there are important problems in your life, kicking the can down the road with distraction may only make things worse. So, make time during the day—even just 15 minutes daily—to write down what’s on your mind. This can be either a great starting point to solving problems or letting go of problems you can’t control.
Wilding: What are some tips for those of us who are type A to set ourselves up for better sleep?
Wu: Those of us who are Type A can be particularly prone to insomnia because we are so goal-oriented and we work so hard. Unfortunately for us, sleep is not a goal we can reach simply by working harder. If anything, trying too hard to fall asleep can backfire and make sleep even more elusive. Think of sleep as your loyal but shy friend… she does want to hang out with you, but if you are too overbearing in chasing her down, she will run away and hide.
One tip for resisting our Type A urges around sleep is to clarify what you can and cannot control when it comes to sleep. For example, you can set a wind-down time in the evening, but you can’t set a fall-asleep time. You can make your sleep environment inviting, but you can’t make sleep accept your invitation right now. So do what you can to set your sleep up for success, and rest assured that this is enough. Your body will take care of the rest in the big picture of your life, even if it doesn’t feel like it on some nights.
Another tip for Type A’s is to make a very clear divide between the “doing” day and the “being” night. I recommend setting a reminder for putting away goal-oriented tasks by a certain time in the evening, after which you’re not allowed to do anything “productive.” Instead, use this time to get out of your head and into your body. Take a bath. Cuddle your dog (or partner). Do some stretches. Simply experience the here and now with your body.
My last tip is simply to remember that sleep doesn’t have to be “perfect” for you to have good sleep health. Just as you don’t need to have a “perfect” meal at every meal in order to maintain nutritional health, you don’t need to have flawless sleep every night. In fact, sleep is designed to be elastic, because your body’s needs and the environment’s conditions are constantly changing. Letting go of sleep perfectionism can take a lot of pressure off of the moment when you aren’t falling asleep right away or wake up during the night.
Wilding: How do negative thoughts relate to sleep and what can we do about it?
Wu: I actually don’t tend to make a distinction between “negative” and “positive” thoughts, because all thoughts are just thoughts–snippets of stories our brains tell us. Sometimes they’re helpful, sometimes they’re not, no matter their emotional flavour. When you find a lot of thoughts swirling around in your mind when you’re trying to sleep, this is a sign that you’re either not yet sleepy enough, or that your brain and body need some help winding down. In both cases, you can get out of bed and get out of your head. Let go of the goal of falling asleep and do something else you enjoy.
If you have unhelpful thoughts specifically about sleep (“if I don’t fall asleep soon, I won’t be able to function tomorrow”), remember that you and your sleep are resilient. Ask yourself whether you’ve ever been able to cope after difficult nights before, or whether you’ve always been unable to function. Do you have other strengths that will help you through? Is there a more fair and helpful assessment of your situation? And again, get out of bed and get out of your head.
Wilding: Any other favourite tips about combating insomnia as a busy professional that you haven’t mentioned yet but want to share?
Wu: If you often travel for work, your sleep can take a hit when you’re in unfamiliar hotel rooms or dealing with the stress of traveling. I like to have cues for sleep that I can take with me on the road. For example, I never leave home without my eye mask. It shuts out the light no matter how thin the drapes are, and the association my brain has made between its gentle pressure on my face and the experience of drifting off to sleep help to bring along that same process.
As a busy professional, possibly juggling parenting and other family obligations, it’s hard to find time for yourself. That can make it hard to fall asleep, or even hard to motivate yourself to go to bed, because the evening is the only “me” time you can get. If possible, aggressively trim back whatever obligations you can (I’m especially looking at you, women who volunteer to take on the unpaid emotional labour in their teams or families), and purposefully protect time each day for yourself.
During this “me” time, don’t just scroll social media! Spend time doing something with your hands, or catching up with a friend, or simply let your mind wander. Slow everything down and give your brain and body this opportunity to tell you what they need. I’ve even had patients tell me that the first time they took a walk without listening to a podcast at the same time, they immediately felt tears welling up…it turns out they had been holding so much tension they didn’t even know they had.
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