Wide Awake at 3. a.m.? Our Readers Offer Advice

From nytimes.com

Most sleep experts offer standard advice to people who occasionally wake up at 3 a.m. and can’t fall back to sleep after 20 minutes or so: Ignore the clock, get out of bed and do a calming activity. Then, return to bed when you start to feel sleepy again.

As rates of insomnia skyrocketed this past year during the pandemic, many people struggled to overcome their sleepless nights. Our readers were no exception. We spoke to many of them to find out what techniques work for them when they find themselves awake in the middle of the night. Here’s what they had to say.

Count sheep … or whatever.

When Maria De Angelo, a teacher in Los Angeles who also renovates houses, has trouble getting back to sleep at 3 a.m., she closes her eyes and thinks of a complicated electrical wiring scheme in a kitchen she once renovated. The mental exercise induces boredom, much like counting sheep, which helps her drift back to sleep.

On other nights, to mix things up, Ms. De Angelo shuts her eyes and recites the names of every state in America in alphabetical order. “I haven’t yet made it past ‘N,’” she said. “Either method — or both — will work 95 percent of the time.”

Take a trip.

Jerry Schulz in Milwaukee developed a ritual of his own to overcome insomnia. When he has trouble falling back to sleep late at night, he takes a mental journey to another city. To make himself sleepy, he thinks about the trip in painstaking detail. He visualizes himself packing his luggage, walking down his steps, loading his car, pulling out of his driveway and driving along familiar highways to get to Seattle, Portland or San Francisco.

“Part of the trick is you want to make an itinerary that is going to take awhile to play out,” he said. “But oddly, to make this work, you don’t actually want to get to your final destination — you want to fall asleep along the way. This is the one time when falling asleep at the wheel is a good thing.”

Consider underlying medical causes.

For most people, occasional bouts of insomnia are normal. But when sleeplessness occurs at least three nights a week for three months or longer, sleep experts refer to it as chronic insomnia. When that happens, it might help to see a sleep doctor to find out if you have an underlying health issue.

Some people experience insomnia because of medical conditions like sleep apnoea, which causes intermittent pauses in breathing throughout the night. Others have restless legs syndrome, which causes an irresistible urge to move the limbs. Many women going through menopause have difficulty sleeping because of hot flashes, night sweats and hormonal fluctuations. A sleep doctor can help to diagnose these and other issues and provide medical treatments, medications or psychological interventions like cognitive behavioural therapy.

A number of people who were plagued by insomnia told us that their sleep only improved after they discovered they had an underlying condition. Among them was Julie Zuckman in Massachusetts, who for years would wake up at 3 a.m. multiple nights a week and struggle to fall back to sleep. Then she went to a sleep doctor and learned she had moderate sleep apnoea, which she now treats with a CPAP machine that improves her breathing while she sleeps. Ms. Zuckman now gets roughly six to eight hours of uninterrupted sleep most nights. “As a side benefit for my husband, I also no longer snore,” she said.

The American Academy of Sleep Medicine maintains a directory of sleep centres on its website, which can help you find a local clinic if you suspect you have a sleep disorder.

Tame the anxiety.

For many people who wrestle with occasional insomnia, the cause of their sleep woes is often psychological: They wake up at night and their minds start racing. They look at the clock and worry that they won’t fall back to sleep. Or they start thinking about work, relationships, their finances or other things that cause them anxiety. This activates the body’s fight-or-flight response, causing a surge of adrenaline that prevents them from becoming relaxed enough to fall back to sleep.

Not surprisingly, the strategies people use to quash their insomnia often work by shifting their attention from stressful thoughts to pleasant ones. Hilary Collins in Philadelphia told us that she alleviates her insomnia by reminiscing about her childhood, which focuses her mind on soothing memories. “In my mind, I take a tour of my childhood home and I quickly fall asleep,” she said. Others told us they conjure up similarly nostalgic memories: They picture themselves in a former school or library they used to frequent and visualize small details such as the wallpaper, a stack of books or a collection of framed photographs.

If you find yourself routinely kept awake by anxiety, one potential solution is cognitive behavioural therapy, a form of treatment that helps address the underlying thoughts and behaviours that can cause insomnia. Any sleep clinic can connect you to a cognitive behavioural therapist. You can also download a free app developed by the federal government, called CBT-i Coach, that will teach you psychological strategies to alleviate your insomnia. “Cognitive behavioural therapy for insomnia helped me immensely,” said a reader named Matteo in Chicago.

Lull yourself to sleep.

Others told us that they make themselves sleepy by listening to audiobooks, Gregorian chants, BBC Radio, sleep apps like Calm, or the tranquil, underwater sounds of whales. “Whales talking at low volume seems to do the trick for me,” one reader told us. Another said he prefers classical music. “If I lay awake, at least I get a little taste of culture,” he said.

You can also try breathing exercises to help you get relaxed. One popular exercise is the 3-4-5 technique. It involves breathing in for three seconds, holding your breath for four seconds, and then slowly exhaling to the count of five.

Another suggestion: Make sure your bedroom isn’t too warm. Keeping your space fairly cool, ideally between 60 and 68 degrees Fahrenheit, can promote better sleep.

Bore yourself to sleep.

For some of our readers, the most effective sleep aid at 3 a.m. is a boring book or pleasant sound. Several told us that these distractions stop them from thinking about the state of the world and getting agitated.

Karen Sandness in Minneapolis said that anytime she wakes up in the middle of the night she grabs a nonfiction book, “preferably a difficult and detailed one.” With the right book, she said, “there’s none of the ‘I can’t wait to see what happens next’ problem. The book will fall out of my hands and onto my face after a couple of pages.”

Don’t always listen to sleep experts.

A few of the methods we heard about might raise some eyebrows among sleep experts. Susan L. Paul, a retired nurse in Asheville, N.C., told us that when she finds herself awake in the middle of the night, she brings her laptop into bed and watches the “Great British Baking Show” on Netflix.

Sleep doctors typically urge people not to use computer screens in bed because they emit sleep-disrupting blue light. But Ms. Paul likes to bake, and she finds that watching her favourite baking show has a calming effect that quickly sends her back to sleep. “It helps if you have seen it all at least a few times and remember the bakers as old friends,” she said. “It’s very relaxing, and I’m usually asleep again before the dough has a chance to rise a second time.”

The biscuit cure.

Food is something that many people told us they rely on. Juliet Jones in Memphis said that over the years she has tried various strategies to combat her occasional insomnia. She has counted sheep, taken melatonin, listened to calming music and used pleasant scents like lavender oil. But the only thing that seems to work for her is getting out of bed, going down to her kitchen and having a small glass of warm milk with a digestive biscuit, which she learned about as a child growing up in Britain.

Ms. Jones speculated that it works for her because she eats early dinners and tends to get hungry at night. Indeed, studies have shown that certain foods can impact how you sleep, including carbohydrates, which tend to help people fall asleep faster. “A little something bland in the stomach seems to do the trick,” she said. “This is what my father used to do, and now at age 70 so do I.”

Is your nightcap the cause of your insomnia?

In the food and drink department, a number of readers who grappled with insomnia told us that their sleep rapidly improved after they quit drinking alcohol. If you drink most nights of the week, it could be undermining your sleep. A nightcap or two might help you fall asleep faster. But it can also lead to more late-night awakenings. If you tend to drink in the evenings, try cutting back on alcohol for three to five days to see if it has an impact on the quality of your sleep.

“For years I would wake up in the middle of the night and stay awake for at least an hour, usually more,” said Brett Loomis in North Carolina. “Then I finally quit drinking all alcohol. It was the cause of my problem and I sleep much better now. So, if you’re reluctant to give up alcohol as I was, just try it for three days and see if it makes a difference. You might be surprised.”

https://www.nytimes.com/2021/08/30/well/insomnia-better-sleep.html

6 types of insomnia exist, and each responds to a different kind of treatment

From msn.com

"Insomnia" is one of those buzzwords with which most of us wish we were way less acquainted. But alas, the persistent problem with sleeping that keeps us from falling and staying amid our dreams affects an estimated 50 percent of us. A lesser-known fact, though, is that the condition is actually something multifaceted and varied. That's right—there are six types of insomnia that may be keeping you from accessing peak snooze.

First, to be clear, the clinical criteria for insomnia clarifies that it takes place when a regular lack of a good night’s sleep is messing with your ability to function normally. According to the International Classification of Sleep Disorders, difficulty sleeping can be considered insomnia when someone has “a persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment.”

Since there are different types of insomnia (and a person can suffer from different types concurrently) knowing the kind plaguing your lack of dreams is important intel for being able to effectively treat it, says neurologist and sleep specialist Kenneth Sassower, MD. Rounded up below are the types of insomnia doctors look for.

Learn about the 6 types of insomnia below, and how each is commonly treated.

1. Acute insomnia

Acute insomnia happens when a person has trouble sleeping, but it doesn’t last for three months or more, says sleep medicine specialist Aneesa Das, MD. This is usually different from having one bad night of sleep. Rather, it's persistent and impacts some aspect of your life. “It has to be bothersome to you,” Dr. Das says. “If someone says, ‘It takes me an hour to fall asleep but it doesn’t bother me,’ that’s not [acute insomnia].”

Acute insomnia can often be the result of a stressor, like losing a loved one or taking on a new, intense job, says sleep-medicine researcher and neurologist W. Christopher Winter, MD, author of The Sleep Solution: Why Your Sleep Is Broken and How to Fix It. The good news, he says, is that of all the types of insomnia, this one tends to resolve itself without any treatment.

2. Chronic insomnia

Difficulty sleeping can be classified as chronic insomnia when it happens at least three times a week, for more than three months, Dr. Winter says. And to clarify, Dr. Das adds that people with chronic insomnia can either have trouble getting to sleep or staying asleep.

"Difficulty sleeping can be classified as chronic insomnia when it happens at least three times a week, for more than three months." —sleep-medicine researcher W. Christopher Winter, MD

Treatment varies, but Dr. Winter says sleep specialists generally recommend chronic insomniacs to undergo Cognitive Behavioral Therapy for Insomnia (CBT-I), a form of counselling that aims to reframe a patient’s perception of sleep.

Dr. Das says this can take effect in several ways, one being changing the patient's perception of how much sleep they actually need. “People who have chronic insomnia often think, ‘If I don’t fall asleep tonight, the world is going to end.’ We work on changing that to ‘I’ve had insomnia before and I’ve survived. I’ll survive again,” she says.

Sometimes medication may be used to help along with CBT-I, but it’s usually just for a short time, Dr. Das says.

3. Comorbid insomnia

This form of insomnia happens as a result of some other underlying illness, Dr. Sassower says. That could mean struggling with anxiety or depression that keeps you awake at night, having acid reflux that wakes you up in the middle of the night, or struggling with back pain that makes it hard to fall asleep.

In the case of comorbid insomnia, you want to try to treat the underlying issue first, Dr. Sassower says. Once you do, the insomnia should clear up.

4. Onset insomnia

Onset insomnia is difficulty falling asleep in the beginning of the night. People with onset insomnia usually take more than 30 minutes to fall asleep, Winter says.

Onset insomnia may be treated with CBT-I or sleep-restriction therapy, Dr. Das says. Sleep-restriction therapy involves a sleep-medicine specialist determining how much sleep you’re actually getting compared to how much time you’re in bed. They then restrict the amount of time you’re in bed to the time you’re actually sleeping (within reason). So, if you’re in bed for 10 hours but only sleeping for six to seven of those, your doctor might recommend that you only be in bed for seven hours. If you’re still struggling, that time will be reduced even more. “Once the patient has consolidated sleep, you slowly stretch it out again,” Dr. Das says.

5. Maintenance insomnia

People with maintenance insomnia are able to fall asleep just fine, but they wake up in the middle of the night and can’t get back to sleep, Dr. Sassower says. Treatment for this varies, he says, but it often involves trying to pinpoint why you’re waking up in the night and then troubleshooting that. For example, it could be that you struggle with sleep apnoea and your own snoring is waking you up, or maybe it's whatever's making you wake up to use the bathroom in the middle of the night. Learning to work with or around those hurdles can go a long way toward treating this type of insomnia, Dr. Sassower says.

People with maintenance insomnia can also benefit from doing more exercise, spending less time in bed, and urging their partner to treat any sleep problems that persist, Dr. Winter adds.

6. Psychophysiological insomnia

Sleep is obviously important and, if you’re having difficulty clocking in your hours each night, that reality alone can stress you out. People who worry about their sleep and, in turn, don’t get enough, struggle with psychophysiological insomnia, Dr. Winter says.

Often, relaxation therapies can help treat this, Dr. Das says. That could mean going through guided imagery to steer your thoughts to a comfortable place, like walking through the woods or floating in the ocean. “You work on controlling your thoughts so that your daily worries aren’t in your thoughts at bedtime,” she adds. Progressive muscle relaxation, where you tense and then relax muscles throughout your body, can also be helpful.

If you’re struggling with sleep, Dr. Sassower recommends your first order of business being to make an appointment to talk about it with your primary-care physician. If problems persist, ask about getting a referral to a sleep medicine specialist.

https://www.msn.com/en-us/health/wellness/6-types-of-insomnia-exist-and-each-responds-to-a-different-kind-of-treatment/ar-AANRKgB?li=BBnba9O

Russia to produce eyeglasses that cure insomnia, jetlag

From tradearabia.com

For people who are constantly struggling with sleep disorder and jetlag, there is happy news.

 

A Russian company will, from next year, start producing eyeglasses that will help cure insomnia and jetlag.

 

Depending on the material used, the glasses will be priced between 7 to 30,000 Russian rubles ($0.095 to $406.80).

 

Wearing the glasses half an hour per day in indicated time intervals will help completely restore the sleep cycle, Emirates news agency WAM reported.

 

Technodinamika Holding, under the Rostec State Corporation, has presented the prototype of "anti-insomnia Blue Sky pro glasses" at the Army 2021, an international military exhibition being held in Moscow.

 

Rostec Executive Director Oleg Yevtushenko said: "The glasses enable one to control sleep disturbance and restore human biorhythms in a couple of days. Glasses will definitely be of interest to individuals suffering from insomnia or those regularly challenged by jet lag because of business trips.

 

"At the same time, they can also benefit servicemen, including pilots, helping them to recover more rapidly (from sleep disorder and jetlag)."

 

A press release issued by Rostec explained that the product helps get rid of drowsiness in the morning and to postpone sleep until approximately 23.00 hours in the evening.

 

Glasses can also be used in case of changing time zones for more than three hours and for night shift. They will also help the user tackle depression, neuroendocrinal diseases and impaired concentration. 

 

The efficacy of the invention has been proved in the course of neurophysiological studies, the release said.

 

The prototype of Blue Sky is made of eco-friendly high-strength composite material produced in Russia. The product contains a kit of changeable nose pads and the user can select the most convenient one. 

 

Furthermore, glasses are fitted with a type-c format universal connector for charging.

 

Technodinamika Holding General Director Igor Nasenkov said: "We plan to start serial production of glasses from 2022. In terms of production volume, we are going to produce around 15,000 pieces."

 

The innovative product is developed in partnership with the Samara State Medical University and serial production is scheduled to be launched at Samara Electromechanical Works.

http://tradearabia.com/news/HEAL_386229.html

Nocturnes and Max Richter: The best music for falling asleep

From bbc.com/culture

From Chopin and Debussy to modern-day composers of Nocturnes, people have always felt a need to create night music. Arwa Haider explores how that can help us now, as we navigate pandemic-induced insomnia

Sleeplessness was a symptom of the pandemic lockdowns for countless people. For award-winning orchestral, electronic and film composer/musician Craig Armstrong, the long restless nights would lead him on late walks in his Glasgow neighbourhood, where he'd find the eerie solitude ruptured by the blare of ambulances rushing to the city hospital. These nights would also draw him to his home studio, where he'd stay up composing pieces that would eventually form his latest album, Nocturnes: Music for Two Pianos.

"I found myself regularly in my little studio at home at two, three, four o'clock in the morning; I just started writing away on my piano," Armstrong tells BBC Culture. "I think the motivation was to take my mind off the nightmare that was going on. It was a very dark period for a lot of people; I know a lot of people who've had such a hellish time, and I wanted there to be some light at the end of the tunnel."

The 14 intimate tracks that comprise Armstrong's Nocturnes might seem relatively simple in contrast with much of his expansive catalogue (which has spanned movie scores including Baz Luhrmann's Romeo + Juliet and the music legend biopic Ray, as well as collaborations from Massive Attack to the Royal Shakespeare Company); still, they prove richly emotive and absorbing. They also extend the deep-rooted and creatively fluid tradition of nocturnes, or night music. Influential Irish composer/pianist/teacher John Field published the first specifically-named nocturnes in 1814. The form (music created to be played after 11pm) took further flight through the works of artists such as Frédéric Chopin (who published 18 nocturnes between 1832 and 1846, with an additional three published after his death in 1849), Claude Debussy (whose Trois Nocturnes, published in 1900, were inspired by Henri de Régnier's French symbolist poetry), 20th-Century composers from Erik Satie to Benjamin Britten, and many more.

With his latest album, Armstrong has shifted to a different kind of soundtrack (Credit: Simon Murphy)

"The idea of calling this album Nocturnes was a practical thing; they're all written in the middle of the night," smiles Armstrong. "The form of a nocturne is not set. I think for a lot of musicians, it was a form that gave a lot of freedom; it doesn't have the straitjacket of making a massive statement. They're little vignettes that capture a moment. It's a concise emotional musical space."

At night-time, sounds also have a very different quality to the day; these senses probably do seem heightened – Armstrong

Armstrong's Nocturnes are fairly brief, ranging from between one and five minutes, but they're heartfelt and consciously hopeful expressions. He plays both piano parts himself, as lockdown precluded meeting other musicians ("With two pianos, you could get into very textural sounds; your ear doesn't quite know who's playing what, it's almost ambient"). The night moods are headily reflective rather than linear; Nocturne 11 is a tribute to much-loved Japanese artist Ryuichi Sakamoto's seemingly simple (yet intricately multi-layered) compositional style, while the elegant Nocturne 12 takes inspiration from a music box that once belonged to Armstrong's paternal grandmother.

"I guess there's the question of how you perceive time, at different points of the day," says Armstrong. "At night-time, sounds also have a very different quality to the day; these senses probably do seem heightened."

Blurred lines

Creative boundaries are arguably most blurred after dark. Night music obviously isn't restricted to Western classical realms; jazz standards are steeped in sleepless atmospheres (take Thelonious Monk's 1944 bebop classic 'Round Midnight). Awake late at night, we might feel drawn to revelry, or devotion (or both); Indian classical music has spiritual ragas associated with different times of the day (as well as various seasons). In The Times of India (September 2016), classical vocalist Pandit Jasraj described mesmerising Hindustani Malkauns as a form "sung during small hours of the morning, just after midnight. The effect of the raga is soothing and intoxicating."

The academic essay collection Nocturnes: Popular Music and the Night explores multi-genre night music scenes around the world, from London to Berlin, Tokyo and Yogyakarta, and posits that music is "redeemed" late at night, when it transforms from "background noise" to a pivotal force. Editors Giacomo Bottà and Geoff Stahl write: "Music animates the night by both mirroring and contributing to its tempo, stimulating movement within and between nightclubs, bars and music venues to give the city its nocturnal tenor and social power. Each feeds and amplifies the other's intensity, a cordoning off of social energies that affirms again night's difference to the more sedentary trappings of the day."

Max Richter has performed his eight-hour Sleep composition around the world, including in Sydney, Paris, London and LA (Credit: BBC/JA Films and Globe Productions/Mike Terry)

As a child, I sensed that the night-time could be an otherworldly playground (although I was also scared of the dark). By my late teens, staying up all night was a rite of passage, whether I was clubbing or completing essay deadlines. Night music always seemed to sharpen the senses – not just on the dancefloor, but beyond it: sound-tracking these nebulous hours, where one date bleeds into the next. Many contemporary songs capture that sleepless atmosphere, whether it's Faithless's 1995 club stormer Insomnia (with its "I can't get no sleep" refrain), The KLF's majestic rave-pop hit 3am Eternal (1991) or Tyree Cooper's seminal Chicago house track I Fear The Night (1986); enigmatic producer Burial also summoned heavy nocturnal moods on his self-titled 2006 album (including the elegiac track Night Bus). This year, British singer-songwriter Puma Blue (aka Jacob Allen) explored his personal long-term struggles with insomnia, on his excellent debut album, In Praise of Shadows. Puma Blue's expressions sound both exquisite and intensely raw, on woozy electro-soul melodies such as Opiate ("Sleep much longer than I did before… Bless these angels hanging over my head/ Still as a tomb, though, I'm scared instead because/ I must be losing my mind").

One of the most incredible live concerts I've ever experienced was an 11pm-7am continuous performance of Max Richter's "eight-hour lullaby" Sleep (2015), played to an audience in sleeping bags. I recall drifting in and out of slumber throughout the eight-hour set, and each time I resurfaced, I felt reassured by the musicians' presence, and cradled by the sounds – from womb-like sub-bass rhythms to an eventual "musical sunrise", gently elevating in volume and pitch.

We're on the screen all the time, which means we have to be 'on' all the time. I wanted to make a piece that could function as an antidote to that – Max Richter

Richter developed Sleep in collaboration with neuroscientist David Eagleman, with nods to classical inspirations such as Johann Sebastian Bach's Goldberg Variations (1741), which were commissioned by an insomniac diplomat; rising star pianist Pavel Kolesnikov will also perform the Goldberg Variations as a highlight of this year's BBC Proms, on 10 September. 

When I interviewed Richter, he explained: "Sleep comes out of a really personal feeling. I was getting really exhausted by the increasing virtualisation of our lives; we're on the screen all the time, which means we have to be 'on' all the time. I wanted to make a piece that could function as an antidote to that and reclaim some basic human things from the technological mode of existence. I've always felt like sleep is the great reservoir, where we can connect to something that's bigger than us – so I wanted to encourage that, and also make a political piece that's about stepping off the treadmill.

Richter calls Sleep a "personal lullaby for a frenetic world… a manifesto for a slower pace of existence" (Credit: Getty Images)

"One of the other starting points with Sleep was very direct; when our kids were little, I would go off and play a show which would be streamed or on the radio, and Yulia [Mahr, Richter's wife] would often hear the show in some weird time zone, in the middle of the night. This boundary layer when you're half-asleep, we started thinking about that as a space for music to happen. Performing Sleep live is kind of like extreme sports," he added. "I have hundreds of pages of piano music, and it's a physical challenge. I have to get 'jetlagged' so that it's 'morning' when I go on."

Another contemporary talent who has taken inspiration from sleepless hours is composer/musician Anna Meredith, in her beautifully haunting 2011 work Four Tributes To 4am, based on nocturnal recordings around the city of Derby. "I think I'd read this depressing statistic that more people die at 4am than at any other time," muses Meredith. "I've always found 4am a bit of a 'no-man's time'; 3am is like good times from the night before, and 5am might be an early start, but you might not know where 4am fits in terms of yesterday and the next day.

"I had an idea of doing these mini-portraits of what different parts of the town feel like at 4am. My sister [film-maker Eleanor Meredith] and I did an all-nighter, trawling around the dual carriageway with our recorders – the houses, the clubs at the end of the night, the park, the dual carriageway with cars passing by, an out-of-town shopping mall that was totally deserted apart from a few security guards. I remember deliberately slowing the tempo down to create this weighty, unwieldy atmosphere, before gradual awakening in the final movement. You're awake at this 'magic hour' when everyone else is asleep and at their most vulnerable. It feels like you've tapped into a secret."

That sense of discovering secrets and subverting codes is also what makes night music so powerful; we are sleepless but hyper-sensitive – and as Armstrong also notes with his Nocturnes, there is the promise of emerging through the darkness, into a new light.

https://www.bbc.com/culture/article/20210825-nocturnes-and-max-richter-the-best-music-for-falling-asleep

Everything You Need to Know About Pregnancy Insomnia (And How to Treat It)

From instyle.com

By Mara Santilli

Your body might be fighting sleep in the first or third trimesters — but all hope isn't lost

To all you middle-of-the-night Googlers, welcome. You're in good company if you're also experiencing pregnancy insomnia: It affects up to 80% of people at some point during pregnancy, according to research.

Pregnancy insomnia — a persistent pattern of trouble falling asleep, staying asleep, or waking up early — is common during the first trimester when your body is adjusting to the sudden rush of pregnancy hormones, and in some cases, the morning (or all-day) sickness you might be experiencing. And it's even more likely that you'll have issues sleeping during the third trimester, as you get closer to delivery and have the anxiety and physical discomfort that goes along with it.

Here, some of the culprits of your pregnancy insomnia, and the best ways you can treat it, whether you have six more months to go or are about to deliver any day. 

What causes pregnancy insomnia? 

Being pregnant in general (especially during a pandemic) may cause you stress and anxiety: about your health, your baby's health, about delivery, or about being a parent. And that doesn't help with your sleeping habits, says Mary Jane Minkin, MD, an ob-gyn and clinical professor of obstetrics, gynaecology, and reproductive sciences at Yale School of Medicine. But being uncomfortable, particularly as you get further along, may prevent you from finding the right sleeping positions and is likely a big reason you're having trouble staying asleep. 

Of course, there are plenty of other discomforts during pregnancy, like nausea or constipation, that could contribute to insomnia and restlessness. Pregnancy heartburn is also a thing you might end up dealing with. "The acid in the stomach refluxes into the oesophagus because the valve between the stomach and the oesophagus relaxes with the hormones of pregnancy," Dr. Minkin explains. And if you've ever tried to drift off to sleep with heartburn, you know that it's no picnic. 

The symptoms that cause insomnia may vary throughout each trimester. During the first trimester, feeling sick may keep you awake, along with the hormonal changes your body is undergoing in early pregnancy. "It's often nausea and vomiting that are the culprits in the first trimester, along with elevated levels of progesterone that can cause increased daytime sleepiness and night-time insomnia," says Jane van Dis, M.D., an ob-gyn and Modern Fertility medical advisor. Pregnancy insomnia tends to hit hardest in the third trimester, she adds. It can often be attributed to back pain and discomfort, heartburn, leg cramps or restless legs, needing to get up to pee frequently because of pressure on your bladder, and anxiety leading up to delivery. All the fun stuff about pregnancy! 

It's best to track your insomnia symptoms, and take note if they get really serious, including blurred vision, severe headaches, or sharp pain in the upper right side of your abdomen, says Dr. van Dis. Contact your ob-gyn if you experience any of these symptoms, or if the insomnia is becoming a major disruption to your daily routine. 

So, how do you treat pregnancy insomnia?  

While treating pregnancy insomnia is similar to treating insomnia outside of pregnancy, it's not safe for people who are pregnant to use supplements like CBD or melatonin. Luckily, there are a few other ways you can regulate your sleep schedule and your comfort. 

Get comfy pillows. 

The first thing you have control over is how cosy your bed is when you're trying to get to sleep. Invest in a full-body pillow that will offer support, especially for your abdomen and back, the experts say. Try this one from Boppy or splurge on this Yana organic pregnancy pillow. 

Sleep on your side. 

Laying on your side, with a pillow in between your legs, is another great position to try during pregnancy. "This can ease backaches, heartburn, and improve circulation and reduce foot swelling," says Dr. van Dis. If that doesn't work for you and you want to sleep on your back, sleeping on some couches may offer the right support for you. 

Prop yourself up. 

For pregnancy heartburn sufferers, changing your position so you're more upright may help reduce some of that awful reflux. "Putting the head of the bed on blocks, or using some pillows to prop you up can be helpful," says Dr. Minkin. 

Try to eat foods that won't irritate you. 

This is not to say that you always have to ignore those taco cravings, but with heartburn, some foods are just going to make it worse. Dr. van Dis recommends staying away from those heartburn trigger foods (like fatty, greasy, and spicy dishes) as much as possible — it'll help your stomach and sleep in the long run. 

Be mindful of your eating and drinking habits. 

The way you eat may have an effect on your ability to stay asleep. For your digestion, it's ideal to eat smaller meals throughout the day, and not too close to bedtime, says Dr. van Dis. (This can also help keep heartburn from acting up.) Limiting your coffee intake is a given, too, so you're not up for half the night. Also, you want to stay hydrated, especially throughout the day, but taper off your water intake in the evening so you don't need to make as many sleep-interrupting trips to the bathroom. 

Make sure you're getting healthy (pregnancy-friendly) exercise. 

Exercising regularly could help your body fight pregnancy insomnia. "It's helpful for reducing back pains, swelling, and bloating, easing constipation, and relieving some stress," according to Dr. van Dis. Prenatal yoga could be a great mind-body exercise for you, as could certain modifications to your regular gym routine and stretching gently before bed. Dr. Minkin also recommends swimming as another great form of low-impact exercise to tire you out in the evening. 

Help your body wind down naturally.

Just as you would if you weren't pregnant, practice good sleep hygiene. That means minimizing blue light in the form of phone screens, TV screens, and laptop screens, at least an hour before you go to bed, Dr. van Dis advises. Try other mindfulness practices, like journaling or taking a warm bath, to help release anxiety and get you in the right mental space to fall right asleep. 

https://www.instyle.com/lifestyle/well-well-well/pregnancy-insomnia

5 natural sleep aids and remedies to beat insomnia and fall asleep fast

From businessinsider.com.au

Taking melatonin before bed could help you fall asleep faster. Hollis Johnson/Insider

• Some of the best natural sleep aids and remedies include melatonin, CBD, or meditation before bed.
• If you want to fall asleep faster, try exercising regularly and maintaining good sleep hygiene.
• For good sleep hygiene, try to go to sleep and wake up around the same time each day.
• Visit Insider’s Health Reference library for more advice.

Insomnia is often acute, or short-term, meaning that you have occasional sleep troubles for less than three months.

Acute insomnia is mostly caused by stress, like an important life event or big test, and it will generally resolve itself once the stressor passes. However, there are also a few key lifestyle changes that can drastically improve the quality of your sleep.

Chronic insomnia is a more serious condition, where sleep troubles occur at least three times a week for more than three months. It usually requires therapy or medication alongside these lifestyle changes.

Whether your sleeping issues are short-term or long-term, here’s how you can treat your insomnia and get better sleep with these 5 natural remedies.

1. Practice sleep hygiene

Good sleep hygiene can help those with insomnia.

This includes going to bed and waking up at the same time each day, limiting daytime sleep, and not drinking caffeine close to bedtime. It can also be important to create a routine before you go to sleep.

“You can take the hour before going to bed to take a hot bath or drink a cup of chamomile tea, which can be helpful in slowing your mind and body down,” says Nate Favini, MD, medical lead of Forward, a preventive primary care practice.

In addition, you should avoid excessive screen time – especially before bed – as this has also been linked to insomnia.

2. Exercise

A 2018 scientific review found that exercise helped people with insomnia, and in particular, allowed people to fall asleep faster.

In addition, a 2018 study of middle-aged women found that women who exercised at least three days a week had lower instances of insomnia.

Exercise is known to help with hormonal regulation and reduce stress, which could explain why it helps treat insomnia. Plus, Favini says, it’s just easier to fall asleep when you’re more tired from exercising.

For best results, exercise in the morning or evening, but avoid intensive exercise after dinner.

3. Meditate

Insomnia often occurs “when your mind just won’t shut down,” says Michael Jay Nusbaum, MD, medical and surgical director for Nusbaum Medical Centres in New Jersey.

Related Article Module: How to meditate with a complete beginner’s guide to meditation and mindfulness. Mindfulness meditation can treat insomnia by helping you learn to quiet your mind, and research has found many health benefits of meditation, including better sleep.

For example, a small 2015 study looked at 49 adults with sleep troubles. The participants were randomly assigned to a control group or a group that received six weeks of mindfulness instruction. At the end of the study, participants in the mindfulness group had lower rates of insomnia than those in the control group.

4. Try CBD

Some people find that CBD (cannabidiol) – a non-hallucinogenic chemical in marijuana – can be effective for treating insomnia.

In a small 2019 study of 72 adults reporting stress and anxiety, 66.7% of patients using CBD reported better sleep within the first month. Another 2019 scientific review found that CBD is associated with falling asleep faster, staying asleep, and having better-quality sleep.

However, the scientific review cautioned that research on CBD is limited, so you should talk with your doctor before trying it to see if this treatment might be right for you.

Quick tip: For more information, read our CBD guide to learn about benefits, risks, and safety.

5. Take melatonin

Melatonin is a hormone that makes you feel tired. Your body produces melatonin naturally and usually ramps up production around bedtime.

Related Article Module: How melatonin controls your sleep cycle – and whether you should take melatonin supplements to sleep better. However, if you think your insomnia is because you’re not producing enough melatonin at night, you can purchase a melatonin supplement and take it about an hour before bed, Favini says. A 2020 scientific review found mixed results: while studies showed that people who took melatonin supplements fell asleep faster and stayed asleep longer, there wasn’t consensus on whether this was clinically significant.

That means while melatonin had some effects on insomnia, scientists aren’t sure if it really makes a difference in the lives of people with insomnia.

Insider’s takeaway

If none of these home remedies work for you, it’s worth visiting a doctor, who can help you figure out how to effectively treat your sleeping troubles. Further treatments like cognitive behavioural therapy, light therapy, or prescription medication may be necessary.

https://www.businessinsider.com.au/natural-sleep-aids

Putting down my phone and picking up a book has saved my sleep

From theguardian.com

By Naoise Dolan

I dreaded doing without my device’s dopamine dripfeed, but insomnia was out of control. Now I’m not only sleeping but reading with real pleasure

You might not consider sleep a skill, but I can confirm that it is because I am bad at it. The happiest fortnight of my life was when a GP prescribed me sleeping pills. For two blissful weeks I took my tablet and wilted. When I awoke, I was spared the insomniac’s dread. Is it the middle of the night? Have I once again failed at a basic human function?

For most of my adult life I have found waking up to be a high-risk enterprise. I have to guess whether it’s morning, while knowing that all methods of inquiry will make it harder to resume sleep if I’m wrong. Once I’ve established that it is in fact an ungodly hour, the bargaining commences. Maybe I should get up. I’m not an insomniac, I’m just ahead of the sloths. Didn’t some US president only sleep three hours a night?

I have two options at that point: rise, make tea and start my work day, for these early work bursts have a witchy, frenetic energy. (By noon, though, I have a clanging headache and am spelling my own name as “Noise”.) Or, I can stay in bed. Count down from 500. Don’t fidget. Do everything the softly spoken meditation apps say: let thoughts pass you by like cars, pretend your body is an egg, convene with Saint Dymphna. (Or was that one your first communion teacher?) Then give up and look at phone. Scroll, scroll, scroll. Wait for sun.

For a long time, I have known that phones interfere with sleep. Phones release shots of pleasure. As a person with ADHD, I am especially short on dopamine, and if I train my body to expect a spoonful then I’ll stay alert to receive it. When that happens in bed, I’ll get less sleep. Until recently, I chose to ignore this theory because I feared it would be proven correct and I’d wish I’d done something sooner. The longer I put off trying a no-phone regime, the more regret I would feel, which meant I procrastinated further – and so on. Such is the miracle of cognitive loops. Whoever gifted me with rationality should have enclosed a receipt, because I would happily exchange it for the ability to fly.

But this year my insomnia got so bad that I snapped. I marshalled bedside resources: alarm clock, sudoku, pens, notebooks, British Vogue, Penguin Classics too antiquated for me to feel any compulsion to text the group chat. (“Unbelievable scenes in Rochester’s attic!”) And I made one simple rule: phone goes into a kitchen drawer before bed, and does not come out until morning.

My pile of potential solutions is not strictly compliant with sleep hygiene, which says you should do no “awake” activity in bed. But I read every night as a child, before my insomnia developed in my teens. As a kid, I didn’t fight for sleep, but fought it. When I was about seven, and struggling to stay awake, I propped a Goosebumps on my lampshade “just to rest” – then woke to find a brown crisp circle burnt from the middle of the spine. My mother paid the library fine and confiscated the lamp, so I started using a torch. Back then I imagined adulthood as a time when nobody would come between me and reading. Now I can’t concentrate on a book with a screen beside me.

When I put my phone in the drawer, I didn’t really want to cure my insomnia; I wanted confirmation that it was inevitable and that I was suffering bravely, not wilfully ruining my own life. So imagine my annoyance when I slept for six hours straight. That might not be a staggering record to the slumber aficionados among you, but for me it’s a wild amount of sleep.

I’ve tried a little of everything on the bedside table, but most often I read a book. Right now it is Charles Dickens’ Our Mutual Friend. I know the plot inside out and can hum along on autopilot. Dickens wrote to be performed aloud, and the voices are clearer in my head now. I’m laughing aloud more often, and feel less tense, less analytical; I am now reading for fun in a way I’ve rarely done since secondary school. I’ve even brought the novel with me on the tube since lockdown lifted. Reading before sleep is the latest in a long line of my “life hacks” that are, in reality, painfully common. Have you heard about rug tape? Have you heard about decaf? Have you heard about the paperback format and the author Charles Dickens?

The night-time ban has also helped me reduce phone time in general. My average screen time is now two hours a day, and I won’t tell you what that’s down from because you’d have me arrested for crimes against my own person. It is perhaps an indictment on me that two hours a day represents a dramatic reduction – but let’s take our wins where we can.

Phone dependence is something I’ll always have to manage. I have too many professional obligations and far-away loved ones to go cold turkey, and tech engineers deliberately sabotage moderation. Even assuming I’m as clever as the people who design smartphones to be addictive (and I am someone who thought “directly above a lightbulb” was a good place for a library book), the techies work full-time to make me addicted and I cannot dedicate the same effort to outfoxing them.

As if that weren’t enough, inside me will always dwell a dopamine-starved lizard that shuns slow-release sources if an instant hit is available. The best ideas, smartest risks and swiftest recoveries of my life have come from having ADHD. So has a lot of disaster and frustration. It is what it is, and I manage it as best I can. But there’s no reasoning with cravings, so it’s best to take willpower out of it. The lizard can rage all it wants about missing its screen. I let it, and reach for my book.

Naoise Dolan is the author of Exciting Times, £8.99, Orion.

https://www.theguardian.com/books/2021/aug/12/putting-down-my-phone-and-picking-up-a-book-has-saved-my-sleep-naoise-dolan

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How we can all get more high-quality sleep

From bbc.co.uk/news

Nicole Baker is one of the many people who have struggled with insomnia since the start of the coronavirus pandemic.

"I went from someone who can drop asleep at 9pm every day, to being awake at 3am every night," she says. "It was draining and really worrying, as during the day I would really struggle to stay focused."

Ms Baker, who works as a facilities coordinator, put her sleep issues down to increased anxiety.

"I felt that the constant worry of Covid-19 death rates, job security, my family, not being able to have the freedom of travelling, and the uncertainty of the future, really put great amounts of stress and anxiety on my mind," she says.

"My mind was in absolute overload, constantly running and worrying about life 24/7, making it impossible for me to sleep at night."

In the UK, the number of people experiencing insomnia rose from one in six before the pandemic, to one in four during it, according to a study last year by the University of Southampton.

Meanwhile, the word "insomnia" was Googled in the US in 2020 more than ever before.

As well as increased general stress and anxiety levels, a rise in sleep problems has been put down to other factors caused by the pandemic - such as the enforced changes to daily routines and social lives.

With tired staff less productive, the pandemic has led to a number of companies focusing on helping their employees get a better quantity, and quality, of sleep. Ms Baker's employer, a London-based marketing firm called MVF, is one such business.

When the pandemic hit, MVF expanded its wellbeing support for employees, to offer mental health coaching sessions and workshops focused on sleep, along with free subscriptions to the meditation app, Headspace.

Ms Baker says the extra support has helped her insomnia. "[The resources] helped me learn to recognise and manage how the pandemic has affected me and the people around me, and put my mind at ease a little, which is a big relief," she says.

Katie Fischer, a sleep coach and founder of Circadian Sleep Coaching, works with businesses to provide support to employees. Along with the increase in anxiety, being stuck inside during lockdown has been a contributor to the rise in sleep disruption, she says.

"Many people have been sleeping later [in the day] because they are getting outside less," she says. "They are less active and finding it really hard to decompress at the end of the day.

"It's hard not having that commute, that demarcation that frames the day, gets you up and out into the daylight."

Global advertising company GroupM is one of the businesses that Ms Fischer works with, providing one-to-one sleep-coaching sessions for its employees.

GroupM had already been running a sleep-coaching service for parents of young children on its staff, but during the pandemic it expanded the service to all employees.

In these sessions, Ms Fischer assesses a person's health background, personal circumstances, and the reasons behind their challenges with sleep, to help come up with ways to resolve them.

Jennifer Harley, people business partner at GroupM, says that sleep support will continue to be a critical aspect of the company's health and wellbeing programme. "When we don't have enough sleep, we don't bring our best selves to work, so we need to invest in wellbeing," she says. "Businesses should care about the impact of having people who are happy, healthy and well slept."

Even before the pandemic, sleep-deprived workers cost the UK economy up to £40bn a year, due to tired employees being less productive, or absent from work altogether, according to a 2016 study from research firm Rand Europe.

With many companies set to adopt a hybrid-working model as the world slowly returns to normal after the pandemic - allowing their staff to continue to work from home part of the time - Ms Fischer advises that businesses check in regularly with employees.

She says firms should set parameters around work and home life, and encourage people who are not working in the office to have a regular routine.

"Some companies try to preserve that opportunity at the end of the day for employees to wind down and relax, so they can support that ability to fall asleep and start afresh the next day," says Ms Fischer.

She also advises that people stick to a regular wake-up time in the morning, regardless of whether they are working from home that day, or going into the office, to promote better quality sleep.

Max Kirsten, a hypnotherapist and sleep coach, adds that many of the bad habits people have fallen into during the pandemic, such as increased time spent on phones or tablets, are playing havoc with sleep patterns.

"People are going from screens for work, to screens in their spare time, and then screens at bedtime," he says. "This is not helped by side issues like alcohol, or too much caffeine in the afternoon or evening," he says.

The UK trade body, the Association for Decentralised Energy (ADE), enlisted Mr Kirsten to host a workshop for its employees dealing with sleep problems brought on by the pandemic.

Lily Frenchman, head of operations at ADE, says the organisation has also focused on enabling staff to speak up about the challenges they face regarding their mental health. "If someone was having trouble sleeping I would want to hear, because that's a sign something's not working.

"Whether that's work, or personal, that person needs support," she says.

For those struggling with insomnia, Mr Kirsten advises getting the conditions right for a good night's sleep, such as ensuring the room you sleep in is dark and cool, disengaging from screen time and work-related thinking before bed, and, crucially, making sleep a priority in your life.

"Sleep should never be [thought of as] an inconvenience, it's the pillar that gives you the performance edge," he says. "It's about creating special time for this incredible process called sleep."

https://www.bbc.co.uk/news/business-58148044

Insomnia Is a Common Side Effect of Menopause—If It's Happening to You, Here's Your Action Plan

From parade.com

While there are many well-known symptoms of menopause—hot flashes, hair growth, and weight gain—insomnia is one that isn’t always mentioned. But as it turns out, menopause-related insomnia is quite common.

In fact, the chances of having insomnia go up as you enter menopause, with 61 percent of postmenopausal women experiencing symptoms, according to the National Sleep Foundation.

If you’re struggling to get some shut-eye, here’s everything you need to know about the condition, plus doctor-approved tips that can help.

Symptoms of insomnia

Insomnia is generally characterized by trouble falling asleep or staying asleep, resulting in a lack of sleep that causes distress or difficulty with daily activities, says Dr. Rachel Marie E. Salas, MD and professor of neurology and nursing at Johns Hopkins. “If it happens at least three nights a week and lasts for at least one month, you may have what sleep experts call persistent insomnia disorder.”

When symptoms are left untreated, it can become a negative ongoing cycle that leads to additional health problems.

“Lack of sleep or poor-quality sleep can cause daytime impairments such as fatigue, malaise, difficulties with memory and concentration, mood disturbances, irritability, and difficulty coping with daily stressors,” Jennie Mastroianni, DNP, NCMP, a nurse practitioner at Tufts Medical Centre, explains. “These symptoms can actually cause more stress and worsen insomnia.” 

Is there a connection between menopause and insomnia?

Yes, according to experts.

“Menopause can wreak havoc on women’s sleep. Sleep issues are common during and through perimenopause to post-menopause,” Dr. Salas explains. “The ovaries gradually decrease the production of the hormones oestrogen and progesterone during perimenopause. These hormonal changes contribute to sleep issues that often continue into post-menopause.”

If you are experiencing hot flashes and night sweats, it can cause sleep disturbances and sleep deprivation.

“Women who are undergoing the menopausal transition may be more likely to report decreased sleep quality, particularly if they experience vasomotor symptoms (hot flashes, night sweats). Vasomotor symptoms associated with menopause can cause sleep disruption leading to daytime fatigue, irritability, difficulty concentrating, and overall reduced quality of life,” Dr. Mastroianni states.

How to promote better sleep

If you’re having trouble sleeping, whether hormone-related or not, here are some action steps you can take.

Proper sleep hygiene

In other words, adopt habits that increase your chances of a good night’s sleep.

“Good sleep hygiene includes awakening the same time each morning, increasing daytime exposure to bright light, exercising regularly, and establishing a comfortable sleep environment,” says Mastroianni. “Avoidance of alcohol, stimulants (caffeine, nicotine), and daytime napping are also suggested. Cognitive behaviour therapy (CBT) can also be effective in promoting better sleep.”

Create a sleep schedule and stick to it

According to Dr. Salas, it’s important to make sure your cycle of sleeping and wakefulness is consistent during the week and on the weekends. “While the majority of people require between seven and nine hours of sleep per night, it’s better to focus on the quality (consistent cycle), rather than quantity (amount), of sleep.”

Prepare your brain for sleep

As hard as we try, it’s impossible for most of us to fall asleep on command. That’s why it’s important to help your brain shift into sleep mode. Dr. Salas recommends adopting the following habits:

• Create a pre-bedtime ritual. For instance, repeatedly showering and putting on pyjamas can send your brain the message that it’s time to sleep
• Steer clear of foods, beverages and activities that are over-stimulating. These include caffeinated drinks (as mentioned above) exercising and eating a hearty meal too close to bedtime
• Set aside time to calm your mind. In other words, don’t pick a fight with your partner right before you go to sleep. Avoid doing anything that will stress you out.
• Disconnect from your devices. Turn off your electronics at least a half-hour before bed. The blue light from your phone is scientifically proven to keep you awake.

 Is insomnia treated differently when it’s connected to menopause?

Insomnia related to menopausal-associated vasomotor symptoms can be treated with hormonal and non-hormonal prescription therapies.

“Hormone therapy is the most effective treatment for vasomotor symptoms and can be offered to women who have no medical contraindications to oestrogen or progesterone,” Dr. Salas explains. “Treatment should be individualized using the best clinical evidence to maximize benefits and minimize potential risks.”

Non-hormonal therapies can be used off-label to treat women who are not candidates for hormone therapy.

“These therapies include certain antidepressant medications such as paroxetine, venlafaxine, and escitalopram,” Dr. Salas states. “Gabapentin, a medication used to treat epilepsy, migraines, and nerve pain, is also effective in treating vasomotor symptoms. Since gabapentin can cause drowsiness, it is administered at bedtime and can be a good therapeutic option for women with bothersome night sweats.”

Sources

• National Sleep Foundation: “How Can Menopause Affect Sleep?”
• Rachel Marie E. Salas, MD, professor of neurology and nursing at Johns Hopkins Medicine
• Jennie Mastroianni, DNP, NCMP, nurse practitioner at Tufts Medical Center
• Harvard Health: “Blue Light Has a Dark Side”

https://parade.com/1243685/kaitlin-vogel/menopause-insomnia/

These are the sleep issues you should discuss with your doctor

From newsnationusa.com

Zombies are everywhere. You might even be one. No, not The Walking Dead kind. But what else do you call it when a third of American adults have trouble sleeping to the point where they don’t often get the recommended seven to nine hours of rest each night?

When it’s 2 A.M. and you’re still staring at the ceiling, it’s easy to chalk it up to the extra-shot latte you guzzled that afternoon or being stressed about an upcoming work presentation. If you can fix your trouble sleeping by addressing the habits you think are at fault, great. If you can’t, you need to bring in medical reinforcements.

“There’s a perception that if you make your room dark enough and buy the right mattress, you can sleep well,” board-certified sleep medicine doctor and neurologist W. Christopher Winter, M.D., of Charlottesville Neurology and Sleep Medicine, and author of the book, The Sleep Solution: Why Your Sleep is Broken and How to Fix It, tells SELF. “But people need to realise that, in some cases, there may be a limit to what you can do yourself.”

Not getting sufficient rest can affect every part of your life. “Reduced sleep quality and quantity can lead to workplace errors, motor vehicle accidents, problems with concentration and attention, low mood, and other medical problems,” says Josna Adusumilli, M.D., a sleep specialist in the Department of Neurology at Massachusetts General Hospital.

In order to live your best life possible, both in and out of bed, be sure to mention the following sleep issues to your doctor.

Your partner or roommate says you snore a lot

If you’re a heavy snorer, there’s a chance you could have sleep apnoea, a potentially serious disorder where your breathing repeatedly stops and starts in the night.

The most common form of this condition is obstructive sleep apnoea, according to the Mayo Clinic. Obstructive sleep apnoea happens when your throat muscles relax, creating flexibility that causes a vibration when you breathe, Dr. Winter explains. Voilà, now you’re snoring.

The sleep disruption aspect arises if your throat muscles relax too much, which can cause your airway to narrow, forcing oxygen levels in your body to drop. As a result, your brain basically scares you awake so that you can catch your breath, the Mayo Clinic explains. This can happen five to 30 times each hour in people with sleep apnoea, the organisation notes, making it basically impossible to actually get quality rest.

Obstructive sleep apnoea also raises your risk of serious health conditions. Those sudden drops in your oxygen level increase your blood pressure and strain your heart, which can increase your odds of heart attacks and abnormal heartbeats, according to the Mayo Clinic. In addition, people with sleep apnoea are more likely to develop insulin resistance (when the body doesn’t respond properly to the hormone insulin, which is integral for regulating blood sugar). This can contribute to type 2 diabetes.

It’s possible to have sleep apnoea and not actually be aware that you’re waking up in the night to catch your breath, Dr. Winter says. So you really should take note if your partner or roommate always tells you you’re snoring loudly. It’s not guaranteed to be sleep apnoea, but it might be—and doctors can help you get treatment so you can sleep and breathe better in the future.

You consistently have trouble falling asleep

There are plenty of reasons why this might happen, Rita Aouad, M.D., a sleep medicine physician at The Ohio State University Wexner Medical Centre, tells SELF. Perhaps you’re checking your phone right before bed, so the blue light is affecting your circadian rhythms. Insomnia or restless legs syndrome are also common causes, Dr. Aouad says.

Insomnia is a disorder that can make it hard to fall asleep and stay asleep, according to the Mayo Clinic. Anyone can experience bouts of insomnia that last for days or weeks as a result of stress or a traumatic event, but some people have chronic insomnia that lasts for a month or more. This kind of insomnia can happen all on its own, or it can be linked with medical conditions like anxiety and asthma. Medications like antidepressants, which can affect neurotransmitters that influence sleep, and cold medicines, which may contain caffeine, can also lead to insomnia.

Restless legs syndrome is a condition that causes an uncontrollable urge to move your legs, and it often happens at night when you lie down to go to bed, according to the Mayo Clinic. “A lot of people with restless legs syndrome will get into bed and feel extremely sleepy, but their legs won’t relax enough for them to fall asleep,” Dr. Winter says. It may also make your legs twitch and kick while you sleep, so it’s pretty tough to stay firmly planted in dreamland.

Instead of trying to play sleep detective on your own and determine why you can’t nod off, call a doctor. “Once we figure it out, we can treat the underlying cause,” Dr. Aouad says.

You have trouble staying asleep

The list of things that can rouse you at night is long. This issue could be due to aforementioned problems like sleep apnoea, insomnia, and restless legs syndrome. Another potential cause is acid reflux, which happens when stomach acid backs up into your oesophagus, causing a burning sensation that can disrupt sleep. Bruxism (a disorder that causes you to clench or grind your teeth), can also cause pain that jolts you awake out of nowhere.

Given that the list of potential causes here is lengthy and diverse, if you have trouble staying asleep, your doctor will want to do a thorough evaluation and ask questions about your symptoms. If you don’t have symptoms that point to an obvious cause, your doctor may want you to take part in a sleep study, where you go to a sleep centre or hospital so doctors can monitor your sleep patterns. That will help them recommend treatment for whatever is causing you to wake up too often.

You always need over-the-counter sleep aids to actually get some rest

If you’re on a long flight and need a little something to help you sleep, taking an OTC sleep aid isn’t a big deal, Dr. Winter says. With that said, you shouldn’t rely on one every night, because you can build up a tolerance to sleep aids and need more to keep getting the same effect. Beyond that, you’re ignoring the underlying issue behind why you can’t get to sleep in the first place.

These meds can also have side effects like feeling excessively groggy the next day. It’s really best to see a doctor to suss out the issue instead of essentially putting a bandage over it, Dr. Adusumilli says.

You feel tired even when you’re convinced you got a good night’s sleep

It’s actually normal to feel a little zonked after you wake up. The phenomenon is known as sleep inertia, and it should fade the longer you’re awake, Dr. Adusumilli says. But plenty of health conditions can cause relentless fatigue all day, like depression, chronic fatigue syndrome, and having hypothyroidism (when your thyroid doesn’t produce enough hormones, so you might feel sleepy).

Narcolepsy could also be the culprit. Since narcolepsy is a chronic sleep disorder that causes severe daytime drowsiness and sudden attacks of sleep, people who have it usually find it hard to stay awake for long periods of time, even if they got proper rest the night before, according to the Mayo Clinic.

Dr. Winter has attended to patients who have fallen asleep during sports practice, concerts, and even while delivering a baby. However, narcolepsy can also be subtle and just present as feeling tired all day long, he says.

If you’re always wiped out, it’s important to seek help from a doctor. They may have you answer questions from the Epworth Sleepiness Scale, a questionnaire that asks how common it is for you to doze off or fall asleep in certain situations. Each item has a score from zero to three, and the numbers are added up at the end. If you have a high number, your doctor may ask you to do a sleep study, Dr. Winter says. The data they collect can help them come up with a proper diagnosis and get you on the road to treatment.

You keep doing bizarre stuff in your sleep, like snacking or having sex

If you find that you’re regularly eating or wandering around while you sleep, holding late-night conversations with your significant other that you can’t recall, having sex while you’re asleep, or waking up to find you’ve moved items around without remembering, you need to see a doctor. All of these habits could be a sign of a sleep disorder known as a parasomnia, Sabra Abbott, M.D., Ph.D., a sleep medicine physician at Northwestern Memorial Hospital, tells SELF. This basically means you’re doing something strange in your sleep without realising it in the moment. “People are reluctant to bring it up because they can be ashamed of the things they do,” Dr. Abbott says. “But it’s important to talk to a doctor about it.”

Parasomnias can strike when you’re falling asleep or at any point in the sleep cycle, according to the Cleveland Clinic. If they happen when you’re falling asleep, you may have hallucinations or sleep paralysis, which is when you’re awake but can’t move your body for a few seconds or minutes, according to the National Sleep Foundation. If they happen when you’re already asleep, it’s more likely that you’ll do something physical that may be dangerous. Parasomnias usually run in families, so you could have one due to pure genetics, but it can also be due to a brain disorder or issue like sleep apnoea.

If you think you have a parasomnia, you need to checked out for a few reasons, Dr. Abbott says. One is that you could potentially harm yourself or someone else while you’re asleep, and the other is that there may be a treatment available to help. “We just have to find out the specific cause first,” Dr. Abbott says.

Even if your sleep problem isn’t as intense as waking up while unwittingly working on your night cheese, see a medical professional. They’ll help you take care of the problem and finally get a good night’s rest.

https://newsnationusa.com/news/entertainment/these-are-the-sleep-issues-you-should-discuss-with-your-doctor-rather-than-just-pretending-youre-ok-and-suffering-in-silence/

How to combat insomnia with the Constructive Worry method

From phillyvoice.com

By Ashley Weyler

It was the night before the 2014 Blue Cross Broad Street Run and I was mentally preparing myself for the 10-miler after a disastrous first attempt three years earlier. This time, I started training earlier, ran almost every day, and cross-trained on off-running days.

The worrying started around 9:30 p.m. What if the train is delayed on the way into the city? Will I have enough time to stretch and warm-up? What if I miss my starting time? The worry and anxiety consumed me and before I knew it, at 3 a.m., I was worried about not having enough sleep.

Nothing about the worry I felt that endless night was constructive for running a solid ten-mile race the following day. Lucky for me, I ran a better race than the one I ran in 2011. But sometimes I think about if I had turned the worry down from a ten to a three if I would have run an even better race.

More worry equals less living

Clearly, I worry about things before they even happen, and that are completely out of my control. The last year has been especially hard with the state of the world, a pandemic, and life-altering changes in my family. My sleep has greatly suffered in response.

Beginning this year, I knew I had to make a change. It felt like incessant worrying was holding me back from living my life because I’m exhausted and sleep-deprived.

I started to analyse the worries that keep me up at night. What am I worrying about? Why am I worrying about it? And what can I do to fix it? If there is no solution to the worry, then I must move past it because it’s out of my hands. In other words, worrying about things that I can’t control is counterproductive. I must redirect my energy from unproductive worrying to solving the problems that cause the worry.

The Constructive Worry method

One thing that has helped me is the Constructive Worry method, developed by Dr. Colleen Carney, the director of the Sleep and Depression Laboratory at Ryerson University in Toronto. Dr. Carney says that bedtime is the wrong place to start solving your problems because the problems themselves will cause you to worry and have anxiety, therefore, keeping you awake.

Her method of constructive worry should help manage the tendency to worry when you’re supposed to be quieting your mind for sleep. Instead, Dr. Carney says about two hours before bedtime, take 15 minutes to write down the worries you have in one column, then in the next column write down the solution to fix it. Once you’re finished, fold the paper and put it next to your bed.

Once bedtime rolls around, if you begin to worry, you can remind yourself that you have already solved your problems as best as you could because your tangible list of worries and solutions is sitting right next to you.

It may take some time and patience, but if you practice this every night, your worries lessen over time and you will use bedtime for what it’s supposed to be used for: sleep!

Tips for decreasing worry-related insomnia

It’s not easy turning your mind off from worry. Eventually, you become more aware of your worry and take ownership of it. In addition to the Constructive Worry method, there are other ways you can cut back on unproductive worrying.

Keep a journal. Writing is second nature to me since I do it for a living. But I found that the more I wrote my thoughts and feelings down, including the things that were eating away at me, the less they were keeping me awake at night. You can get a nice leather-bound journal and write by hand or even keep an ongoing list on your laptop or phone. It may even be nice to have a record of how far you’ve come!

Meditate. About 35-50 percent of adults experience insomnia, and a lot of that is related to stress and worry. When I have trouble turning my mind off, I use a mediation app called Avrora to help me relax and fall asleep. But there are many others out there that help you meditate at all times of the day.

Stay active. For me, exercise has been a vital part of my daily routine because it helps take my mind off worrying during the day and helps me fall asleep faster at night. In fact, studies show that regular exercise helps individuals fall asleep 13 minutes faster and stay asleep 18 minutes longer.

If all else fails and you’re unable to combat worry and insomnia yourself, consult your doctor for help in determining your best options.

This content was originally published on IBX Insights.

https://www.phillyvoice.com/insomnia-constructive-worry-method-059991-cp/