Posted tagged ‘mental-health’

Can’t wake up, sleep through multiple alarms — help!

October 21, 2019

Q:  I need several alarms to wake up.  Sometimes I sleep through them all or even turn them off, then go back to bed without knowing it.  Why can’t I wake up?

A:  Start with the idea that you “can’t wake up”.  Of course you can. 

Unless you’re Rip Van Winkle, at some point you do wake up.  Every day in fact, do you not?  So for you the keys are to both more accurately understand your experience and to better manage the sleep-wake process.

Presuming you have no underlying medical or psychiatric issues causing this (see a doctor if you aren’t sure), then you might look at a couple of likely factors.  One is sleep deprivation, and the second is motivation — or rather a lack of it.

Ideally — and if you plan a consistent wake time and schedule enough time for proper sleep —  you will awaken spontaneously and refreshed after the last of your sleep cycles completes, with no alarm clock at all.

For many people, keeping a very consistent sleep-wake schedule over time — especially important is a consistent wake time — results in awakening without the need for an alarm clock.  If you aren’t doing this now, it might be a good idea to start with as much regularity as you can.  Be sure to schedule enough time in bed for proper sleep, but be aware sleep duration is a moving target that changes as we age.

So you can expect to awaken when you’ve had enough sleep.  It’s as simple as that.  You won’t even need an alarm to get up because you won’t be sleep deprived.

And if you plan something you really want to do first thing in the morning, then you have good reason to get up and get going.

As for a good reason to get up and get out of bed, for most us work or school are sufficiently motivating.  But if you need more, try planning something you really want to do first thing so you have something to look forward to.

You are the best judge of this, but if you draw a blank on something to look forward to, then you might consider the possibility that your issue isn’t so much sleep as it is a healthy outlook on life.  In that case, counseling might help.

By better managing your sleep schedule, and by feeling more positively motivated about your day, there’s a very good chance you will permanently solve this problem.

What should I think about to fall asleep fastest?

June 24, 2019

Q:  What type of thoughts are recommended to fall asleep the fastest?

A: Great question. This actually has been studied. The conclusion:  Nothing.

That doesn’t mean not think, which isn’t possible. It does mean thinking about “nothing in particular”.

While it’s normal for all of us to replay our day to some extent before falling asleep, insomniacs tend to fret and worry about events that have already passed, and these thoughts tend to be negative and stressful.  This then typically results in a faster heartbeat, increased respiration, and a higher body temperature — the opposite direction you want to go to fall asleep.

Another variation is to excessively focus on one thing or another, which is a form of the occupying thought.  It may be listening to the slightest sounds in your bedroom, or replaying a tune over and over in your mind.  In either case, this kind of thinking is not conducive to falling asleep.

What the research has found is letting your thoughts wander pleasantly without any force or direction is associated with faster sleep onset.  This might be simply described as just letting go.

We suggest that’s a good way to conceptualize sleep:  a process of letting go.

So for faster sleep onset, find a place in your mind where your thoughts can just meander pleasantly and then just go with it.  When you begin recognize this, you can return to it again and again to help yourself fall asleep.

To enhance this process there’s many additional supportive actions and behaviors you can use.  Of particular importance is consistency in your circadian rhythm.

For a comprehensive, substance-free, and permanent solution that includes all these methods, check out CBT sleep training programs.

Desperate for sleep and need help

September 11, 2018

Q:  I’ve now gone almost 5 days without sleep.  I’ve tried everything and nothing works:  benadryl, weed, alcohol.  Melatonin and exercise have no effect.  I’m desperate for sleep and just want to know what’s wrong.

A:  What’s wrong is probably at least in part your attitude that you in fact “can’t sleep” — and need drugs to do it.

What’s wrong is likely your belief that you’ve really gone almost 5 straight days without any sleep whatsoever.  Are you saying you never even once laid down with your eyes closed during that time?  How do you know you didn’t sleep — did you use a sleep tracking device or some sort of written log?

Far more likely: you slept, but don’t realize it.  Or dismiss what sleep you did get as meaningless.

If you’re like millions of others with primary insomnia, your solution at least in part includes changing your beliefs and attitudes about the idea of sleep.  This is something you can control.

Suggest you first see a doctor to either treat or rule out an underlying medical or psychiatric condition causing this.  If you have none, then look to nonmedical solutions.

The best are contained in CBT sleep training programs.  These have a component called cognitive restructuring to reality test your beliefs and correct them to something better and more accurate.  Using this method, you can stop these negative thoughts from fueling and perpetuating your insomnia.  As part of a complete CBT solution, you can literally think your way to better sleep.

CBT sleep training also includes sleep hygiene.  Using this method you’ll learn how to lead a healthy sleep-supportive lifestyle, including how the use of drugs and alcohol are no answer for insomnia, only treat the symptom, and may actually worsen the problem.

 It’s highly likely your permanent solution will not come from drugs or any other substance to artificially force sleep.  Ask your doctor about using CBT sleep training methods.  You’ll find real help there to address the true underlying root of the problem.

Can I die from lack of sleep?

July 6, 2018

Q:  I haven’t slept now for 8 straight days.  I don’t know why and no meds work.  What will help me?

A:  Start with the idea that you’ve actually gone 8 straight days without sleep.

Did you not even lay down one time with your eyes closed during those 8 days?  How do you know you didn’t sleep?  Did you keep a log, or use a sleep tracking device?

Sleep state misperception is rampant among insomniacs.  Studies in sleep labs consistently show insomniacs underestimate how much actual sleep they get by at least an hour or more per night.  This happens when we are in fact asleep but don’t realize it because we are, well, sleeping.  All we remember is the aggravation of tossing and turning in bed, frustrated at our inability to sleep.

If you honestly examine your belief that you’ve gone 8 straight days without sleep you’ll likely find that it is false and inaccurate. An overblown exaggeration.

What you probably mean is you haven’t slept as well as you’d like over the past 8 days.  And if so, welcome to the club.  You’re no different than literally millions of others who struggle with sleep.

This is key for you to understand:  your false belief about the reality of sleep, the excessive negativity you are buying into, is probably fueling your insomnia to at least some degree.  And you are hardly alone in this.  Many if not most insomniacs do the exact same thing, and it becomes a vicious self-perpetuating cycle that can be difficult to break.

Fortunately, there is a way out.  There is a proven way to derail inaccurate and negative sleep thoughts, and replace them with something better, more accurate, and more supportive of good sleep.  It’s called cognitive restructuring.  Using this method you can literally think your way to better sleep.

Cognitive restructuring is one of the core tools in CBT sleep training.  What a good CBT sleep training program will do is give you a positive, supportive structure for implementing cognitive restructuring, as well as provide many other proven methods to help yourself sleep — and all without drugs.

As always, you should check with your doctor to either treat or rule out any underlying medical issues disrupting your sleep.  But be confident you can fix this, permanently.

What is the process of falling asleep like?

June 18, 2018

Q:  Please describe what the process of falling asleep is like for a normal person.  I’m having trouble lately.  It’s almost like I’ve forgotten how to fall asleep.

A:  Great question.  There are some consistencies, but it’s also probably safe to say the process is very individual.  There is no absolute right or wrong way to do it, just what works for you.

The commonalities include progressive relaxation of the muscles of the body, and a decoupling of the mind from sensing and perceiving environmental stimuli.  The process is whole person, meaning mind and body working in concert together.  When it comes to sleep, the two are really inseparable.

Worth emphasizing falling asleep is a natural and autonomic process, like breathing, something we really don’t have to think about or try to force.

In fact trying to force sleep can and often does result in taking you in the opposite direction.  Instead of drowsiness, forcing can lead to arousal, including increased heart and respiration rates.

For those with chronic insomnia, the idea of relearning how to fall asleep has some merit.  A significant body of research has shown that intensive sleep retraining (ISR) works, and quickly.

With ISR, patients are hooked up to an electroencephalograph, which accurately determines when sleep onset occurs.  Individuals are immediately awakened after 3 consecutive minutes of any stage of sleep activity.  Over an extended period of time, sometimes 24 hours or more, this understandably builds up an acute level of sleep deprivation.  Even the most chronic insomniacs will generally experience dozens of sleep onsets in an extended session.  By repeatedly experiencing many sleep onsets in a compressed time frame, the recipient by association quickly relearns what the experience of falling asleep feels like.

The results show ISR rapidly improves the ability of insomniacs to fall asleep quickly and also helps increase total sleep time.

Most of us who won’t undergo a full ISR session and just want to sleep better can learn something valuable from this.  ISR suggests thinking back on what the experience was like last time you fell asleep quickly.  That is the good feeling to dwell on.  You don’t need to necessarily try to recreate that exact same routine or experience night after night; rather just let yourself go in the same way you did when you slept well.

Because that’s what falling asleep really is — a process of letting go.  When you find that place in your mind, and over time you will, stay with it and your sleep system will eventually grow stronger.

For more drug-free ways to help yourself sleep, check out the Sleep Training System.

 

Why can’t I sleep? Nothing helps

May 15, 2018

Q:  What is causing my insomnia?  This happened suddenly.  I am tired but as I start to doze off, I suddenly jerk awake.  I suspect it’s stress, but right now all’s well with me.  I’m physically active, try to eat right, have a good job, happy with my social life.  I toss and turn for hours and obsess all the time about sleep, but just don’t know what to do.

A:  First, see a doctor to either treat or rule out an underlying medical condition.  From the sound of your description, however, don’t be surprised if you have none.

Considering you have no history of insomnia and describe a healthy lifestyle, you may have psychophysiologic insomnia, one of the most common types. One of its root causes is excessive worry about the idea of sleep, which you are expressing.  Your worries about sleep may be potent enough to put you into a hyperaroused state that is the root cause, or one of the root causes, for your insomnia.

So a reality check is in order. No, your life isn’t “all well” at the moment.  You are describing a significant amount of stress about sleep that likely is fueling your insomnia to at least some degree. Moreover, some stress is in life is normal and healthy — the key is managing it effectively.

It’s likely that your hours and hours of frustration tossing and turning in bed — and those jolts awake just at the moment of falling asleep are the worst, aren’t they — has led to a conditioned negative response to your bed, bedroom, and the idea of sleep.  Again very common.

What you’re doing with respect to sleep hygiene is excellent, and you also sound like you’re leading or trying to lead an overall healthy lifestyle.  What is not in your description is any effective method at stress management or cognitive approach to your worries about sleep.

Ask your doctor about using CBT sleep training methods.  What CBT will give you are the sleep hygiene and good sleep behaviors plus powerful cognitive measures to combat the worry, stress, and anxiety.  By using all these proven, drug-free methods simultaneously, you stand a good chance of restoring better sleep.

Is it better to awaken quickly or slowly in the morning?

March 27, 2018

 

Q:  When waking up in the morning, I usually take my time as I still feel sleepy.  Is it generally better to awaken slowly and sort of ease into the day, or get out of bed as soon as possible?

A:  Part of the answer depends on whether or not you allowing enough time for proper sleep.

If you are allowing enough time in bed for your last sleep cycle to complete, sleep inertia — that feeling of sleepiness you described — is reduced.  In this case, most people are in a fully awakened state within about 15 minutes or so.

But if you did not allow enough time to complete that last cycle, and you awaken in the midst of a deeper NREM sleep stage, you can expect significantly more sleep inertia.  In that case it might take far longer than 15 minutes to feel fully alert.

For those who do complete that final sleep cycle, some hop right out of bed and get going immediately.  But most are probably like you and take some time to get going.

If your preference is to lie in bed awhile and frame your day, that can be constructive.  Doing so enables you to visualize your goals for the day, prepare mentally for your challenges, and generally feel more ready with a positive attitude.

Taking some time in bed may also be useful to challenge some of your negative thinking and reality check your self-doubts.  These kinds of pessimistic thoughts are something we all experience from time to time, and they often occur first thing in the morning as well as just before nodding off at night.  When they do, making the effort to put them in proper perspective — safely letting them go — can be time very well spent.

So there’s nothing wrong with taking your time to start your day.  Just be sure to schedule for it so you don’t get stressed about running late.