When the Clock Strikes 12 and You’re Still Awake

Let’s face it, getting quality sleep can be difficult at times. Whether it be the result of more hours at the office, bad habits formed during injury recovery, or added stress because of the COVID-19 pandemic, life events can wreak havoc on your sleep. Tell me, have you ever had sleep problems? I’m not talking about the one night last week when you slept seven as opposed to eight hours. I’m talking about the times when you’ve crawled into bed at 9:00 PM, equipped with a one-way ticket to Snoozetown, and then proceeded to flop like a fish (as my dad would say) for three hours without even so much as a wink of sleep. If that sounds like something you have experienced in your lifetime, or that you are currently experiencing, I want you to know that you are not alone. According to the Sleep Health Foundation, one in three people have insomnia. The good news is, there are several things that you and other insomniacs can do to fix the problem.

If you’ve experienced consecutive sleepless nights before, it’s possible that you’ve tried everything over-the-counter to help you catch those Zzz’s. This includes Benedryl, Zz Quil, Melatonin, Afteril, so on and so forth. If your case is special (like mine), and none of those miracle drugs helped you to achieve sleep, it’s likely that you decided to take the next step and make an appointment with your primary care physician (PCP). Or perhaps you attempted to try all the options prior to visiting your PCP and contacted that friend of yours who is an insomniac and ever-so-kindly lent you some of their Ambien or Lunesta. If this sounds like you, I’m narrowing my eyes at you from behind the safety of my computer screen…just kidding. I understand that when you’re panicking about getting no sleep, you’ll likely do anything and everything to try and fix the problem, which includes self-medicating with stronger sleep meds. Even so, please don’t do this, there are more effective solutions.

If you are the person who visited your PCP, you likely heard the spiel about good sleep habits, received a prescription for a stronger sleep medication, or both. You know the spiel I’m referring to…Nix the blue light two hours before bed (i.e., phone, tablet, tv, etc.), exercise during the day (not before bedtime), take a bath, meditate, read before bed, and stand on your head while singing a lullaby. Okay, I might have added that last one, but you get the point. It’s possible that you tried all of those recommendations and none of them worked for you. If they didn’t, keep reading, I’m going to introduce you to something called Cognitive Behavioral Therapy-Insomnia edition. You may be rolling your eyes and thinking this is just adding more things to my list. But, as a person that has struggled with severe insomnia in the past, let me just say that if these methods worked for me, they will work for you too.

Steps to Fixing Your Sleep

Step 1. Sleep Restriction Training

You may be thinking, I’m already getting little sleep and you’re asking me to get even less? Bingo! Let’s say you need to get up at 5:00 AM for work every day. In an effort to ensure a full night’s rest, you habitually hop into bed at 9:00 PM in hopes that you’ll fall asleep by 9:30 PM. Let’s also say that, because of insomnia, you usually don’t fall asleep by 9:30 PM and instead toss until 12:00 AM. If you are that person, I’m telling you that getting into that routine is not doing you any good. Instead, force yourself to go to bed when you usually fall asleep (i.e., 12:00 AM). The goal, as Dr. Michael Perlis, Associate Professor of Psychiatry and Psychology at the University of Rochester states, is for you to eventually feel sleepy at bedtime. While it may take some time for you to feel this way, and you may achieve less sleep for a little while, it’s worth sticking to it. Also, if you’re taking naps during the day due to exhaustion, don’t!

Dr. Fotuhi’s Sleep Restriction Schedule

If that doesn’t work for you, try a variation of Dr. Fotuhi’s (Neurogrow’s founder and neurologist) sleep restriction schedule. Here’s how it works. For three nights, go to bed at 11:30 PM and set your alarm for 5:00 AM sharp. The following three nights, go to bed at 11:00 PM and wake up at the same time (5:00 AM). Continue to push your bedtime back by 30 minutes every three nights until you’ve achieved a bedtime of 10:00 PM. Do not take any sleeping medications while adhering to the sleep schedule.

Step 2. Keep a Sleep Diary

No, you’re not expected to write down your dreams, nor spend more than 10 minutes on an entry. However, for three weeks, you should at least include the following in each of your entries:

– The time you went to bed and the time you woke up

– The number of hours that you slept

– The number of times that you woke up throughout the night

If you’re feeling a little overzealous, also try documenting the way you felt at bedtime (e.g., anxious, stressed, etc.) and your exercise routine for that day (i.e., what you did, the time that you started, and the duration of the routine). As a reminder, if you’re exercising at night, make sure you’re not doing it close to bedtime (no less than two hours before bed).

Step 3. Stimulus Control

This is a fancy way of saying that you should look at your sleep habits, (try to) identify the things that may be prohibiting you from sleeping, and change the habits. For instance, when I took a careful look at my sleep habits, I recognized that I was consistently using my bed as a relaxation space. Specifically, I was using my phone and watching tv both before I was trying to get to sleep and throughout the day. I wasn’t sure which one of these habits was doing the most harm, but I figured that neither of them was doing me any good. So, I made a change. Although it took some adjustment, I no longer use my bed/bedroom as a hangout space. I use it only for sleep and getting dressed in the morning.

Step 4. Educate Yourself on Sleep Hygiene

In addition to a couple of the things that I mentioned earlier (e.g., no blue light or exercise before bed), sleep hygiene education also includes things like adjusting your sleep space (e.g., making sure your room is cool and dark) and avoiding caffeine, alcohol, and tobacco after 4:00 PM. If none of those things apply to you, you can always meet with a clinician who will work with you to identify sleep hygiene practices that best fit your lifestyle.

How Neurogrow can fix your sleep

If you prefer not to take this journey on your own, we at Neurogrow understand and we are here to support you. When you start our program, you will meet the neurologist and founder of Neurogrow, Dr. Fotuhi. During his examination, he will assess your sleep and may recommend medication changes. As a part of your full work-up, he may discover that you have thyroid problems, iron deficiency, restless leg syndrome, or an anxiety disorder that may improve with a biofeedback treatment called neurofeedback. Lastly, he may suggest that you receive cognitive behavioral therapy by the social worker/therapist on our team.

Fixing insomnia 101:

– Don’t go to bed and lay there for several hours: Go to bed only when you’re tired and nix the daytime naps. If that doesn’t work, try a sleep restriction schedule. Yes, you may be more tired during the day for a short period of time, but it will get better. The goal is to re-train your brain to get sleepy at night!

– Write away: Write about the quality of your sleep the night before. No, you don’t have to include your hopes or the content of your dreams, but the more you write about your habits, the easier it will be to track your progress!

– Use your bed/bedroom only for sleep: If you’re using your bed as a relaxation and workspace during the day and at night, don’t. Find a new spot. You’ll thank yourself later for making the change, trust me.

– Educate yourself: Learn about best sleep practices and, if you think you’re doing everything right and nothing is working, talk to a clinician (like Dr. Fotuhi).

– Don’t take your friends’ Ambien: It may be tempting if it’s offered, but you shouldn’t take stronger sleeping medications without a prescription. Also, sleeping aids don’t solve the problem, they only patch the hole temporarily.

To learn more about how Neurogrow can help you achieve a restful night’s sleep, check out Dr. Fotuhi’s Brain Fitness Program at NeuroGrow.com.

Written by Brianna Sirkis and edited by Dr. Majid Fotuhi

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