My entire life, but especially in graduate school, I've had horrible sleep. Both falling asleep, and staying asleep.<p>I did multiple sleep studies, used sleeping medications, took supplements, tried to meditate, etc. and had no luck.<p>I went and did CBT-I, where they had me change my sleep hygeine (all your standard recommendations of "no TV in the bedroom", etc). But the biggest thing was they had me start off by going to bed at 1 am and waking up at 5am every day for a week or two. I'd be so insanely tired, I would start falling asleep quicker and staying asleep less interrupted (this was recorded on a worksheet). Then they had me go to bed an hour earlier, record it. After a while, we found my optimal schedule (bed at 11am, wake up at 630am), and I stick to it no matter what, every single day.<p>It's solved my sleep issues, full-stop. I get tired by 11 pm, and wake up at 6:30 am feeling just fine.<p>FWIW, grad school - with no solid schedule - was disastrous on my sleep. Moving to my 9-5 corporate job has made scheduling my sleep a whole lot better.<p>Just my experience.
I have seen multiple doctors, including sleep specialists, about my insomnia, and all they wanted to do is put me on prescription sleep meds for life. Those meds are addictive. I didn't want sleep meds. As a software engineer I was more interested in finding and fixing the underling problem -- there has to be one -- as opposed to the quick fixes the doctors were offering me. But that's not how doctors think, at least the ones I saw.<p>After much research I believe I have succeeded in finding the root cause. Cells in your body need calcium to go into ON state, and to turn OFF magnesium needs to go in and displace the calcium. Stress depletes magnesium. When your body runs out of magnesium your cells can't turn off. Then your muscles become stiff and when your brain cells can't go into OFF state you can't sleep. The solution that works well for me: magnesium supplements, especially magnesium l-threonate, which can pass through what is known as the blood brain barrier. This solved my insomnia as well as muscle stiffness.
When I was younger, I'd be able to play intense video games and fall asleep right after.<p>Now, the older I get, the more I need to force myself to relax 1-2 hours before bed -- meditation, massage, quiet reading, chill music, whatever it takes -- just to be able to fall asleep.<p>It's a big bummer, really. It's so easy to want to code into the night -- to make that final commit at 12:30 am and then hop into bed satisfied with real progress on a project. But the reality is, I'll be wide awake until 2:30 am thinking "oh if I refactor it that way!" "what if I did <i>that</i> as a next step" "did I account for that edge case? can't remember...".<p>So now I force myself to stop at 10, to give myself 2 hours to let all the thoughts fade away (and often put them in a notebook as they pop up during those 2 hours so I can let go of them), but it's frustrating.
More than Insomnia I used to have sleep patterns where my mind wouldn't quiet down. After I started practising meditation, specifically the 8 point "Passage Meditation", I started experiencing a much better quality of sleep.
<a href="http://bmcm.org/" rel="nofollow">http://bmcm.org/</a><p>For those who do not have time for meditation, you may find the second point called Mantram (repetition of holy name) useful:
<a href="https://www.bmcm.org/learn/mantram/" rel="nofollow">https://www.bmcm.org/learn/mantram/</a>
I have a form of insomnia where I just can't convince myself that I should just go to sleep and stop checking YouTube, hackernews, Wikipedia, various interesting articles.<p>At it's core, solution presented in the article -- apart from methods for dealing with anxiousness -- is to deprive oneself of sleep, but making sure to always wake up at the same time.<p>My issue is that I don't have any major problems when getting little sleep and I don't have anxiety. I just want to do more than there are hours of the day.<p>Several days of too little sleep do end up being detrimental, however, so I would really like to break this habit.<p>I would love to hear if anyone here knows of a way to deal with not wanting to go asleep, because there are other more interesting things to do. How do you convince yourself that you want to go to bed most of all, and not do anything else?
Here's what works for me:-<p>Where blue-blocker glasses 2-3 hrs before bed. This has a big impact for me.<p><a href="https://www.swanwicksleep.com/products/swannies-blue-light-blocking-glasses" rel="nofollow">https://www.swanwicksleep.com/products/swannies-blue-light-b...</a><p>Swanwick make prescription blue-blocker glasses which I havent seen anywhere else.
Try Uvex brand if you want something cheaper.<p>A teaspoon of magnesium powder in a glass of water (about an inch full) before bed<p>A hot shower about an hour before bed.<p>Nasal spray before bed to improve breathing.
Like many people here, I've been through a long period of suffering from insomnia and tried a large number of approaches to cure it. From what I can tell, there are essentially two main causes, which can be interrelated:<p>1) Physiological. Things like low levels of magnesium, muscle pain, noise, temperature, light, circadian disruption, etc.<p>2) Psychological. Anything that leads to being anxious about not sleeping.<p>Both can manifest either as sleep onset insomnia (getting to sleep) or sleep maintenance insomnia (waking up in the night).<p>But here's the thing: sleep anxiety trumps all other causes of insomnia in terms of its power to prevent you going to sleep. Nobody ever felt a quiet nap coming on while running away from a lion.<p>Not everyone who suffers from insomnia also experiences sleep anxiety (at least at first). Those people are probably only one step from a cure because they can usually find a physiological cause (hence the number of comments here about magnesium or regular sleep/rise times, for example).<p>But grasping this fundamental point about sleep anxiety is extremely important. Regardless of whether you need more magnesium, less clocks in the bedroom, or to sleep naked etc., if you're anxious when you're trying to go to sleep then it's instantly game over.<p>So it follows that anything that increases anxiety about getting or maintaining sleep should be avoided, even if the underlying cause is something else. For example, CBT-I's prescription of getting out of bed after 15-20 minutes of wakefulness was counter-productive for me. It made me even more anxious about going to sleep after that. So too was sleep restriction. Waiting for what seemed like an eternity every night before being allowed to get into bed at 1:00am left me a nervous wreck. Better instead to go to bed at 11:00, stay in bed and work on something that alleviates any anxiety (I used mindfulness meditation).<p>So, if you suffer from sleep anxiety, prioritising strategies to reduce anxiety at night should be your number one aim. Everyone seems to find their own way in this. Mine was to follow the principles of ACT-I, but others may need different methods.<p><a href="https://contextualscience.org/acceptance_and_commitment_therapy_for_insomnia_act" rel="nofollow">https://contextualscience.org/acceptance_and_commitment_ther...</a>
I naturally stumbled upon this method but it's nice to have it formalized. At first I noticed how insomnia fed on itself and noticed how I start to question my ability to fall asleep and as the night comes around I start feeling anxious.<p>I'm familiar with CBT methods for treating other issues so I naturally tried to break the cycle by doing basically what Ilya's talking about. It worked well for me but I always reverted to my old ways when I think I'm "cured" only to have insomnia strike back.<p>I'm going to try to be regimented about it and see if this helps me long-term.
I also have pretty serious stress induced insomnia like the author describes. This sleep deprivation stuff didn't really help me. In fact, I wonder how much it really helped the author. I know I've tried various strategies and proudly proclaimed myself cured on a number of occasions only to have the sleeplessness return the next time shit hit the fan.<p>I recently bought this sleep tracking thing which works really well: <a href="https://www.beddit.com/" rel="nofollow">https://www.beddit.com/</a> It's a thin strip that goes under your sheets and talks to your phone. It tracks heart rate and respiration and as far as I can tell it's quite accurate.<p>The things I've found most helpful are cognitive restructuring and the relaxation response. Both of which are recommended in this book: <a href="https://www.amazon.com/Say-Good-Night-Insomnia-Drug-Free/dp/0805089586" rel="nofollow">https://www.amazon.com/Say-Good-Night-Insomnia-Drug-Free/dp/...</a><p>Cognitive restructuring is part of the CBT stuff mentioned by the author. You catch yourself thinking thoughts like, "Oh shit I'm going to be so stupid tomorrow" and argue against them with thoughts like, "I've managed to do my job on no sleep before and I can do it again. Worrying won't help."<p>The relaxation response is very similar to mindfulness meditation: you systematically relax every muscle in your body while taking slow deep breaths that expand your belly. You do this for 15 minutes at some point in the middle of the day. You can also do mini versions of it for shorter sessions integrated into your regular activities. The point is to lower cortisol levels. If your cortisol levels get elevated during the day, they tend to still be high at night which makes it hard to sleep.
I suffered from insomnia as a child and it peaked when I hit 12-14 yo. My pediatrician told me to do EXACTLY as you suggest, namely "If you’re in bed for more than 20 minutes and haven’t fallen asleep yet, get out and do something else.". Basically, don't use your bed as the place to TRY to sleep. Only sleep there. This worked like a charm for me and I haven't had sleep issues since.
Cognitive behavioral therapy for insomnia was the biggest improvement I have ever made to my quality of life. Like OP, I struggled with insomnia my entire adult life. I didn't realize that sleep was a thing that you could see a doctor about. I was sleeping about 4-6 hours per night before CBT and 6-8 hours afterward.<p>One of the amazing things about CBT is that instead of building up a tolerance, like you would with a sleep aid like Ambien, it gets more effective over time. It's self reinforcing, positive feedback loop.<p>My sleep isn't perfect, and I still take an Ambien every once in a while like on a red eye flight. However, if you're having trouble with sleep, I can't recommend CBT highly enough.
I have had also wonderful results from CBT. However, the 'sleep restriction' part requires a lot of willpower and determination and was no easy feat for me to hold on. However, after restricting my time in bed to 5 hours for 2 weeks, I had definitely no problem getting to ZZZland after crashing in bed at midnight.<p>By the way, there is an online digital CBT-I course available called Sleepio.
- I wonder what are the best ways to treat early morning awakening. I guess the sleep deprivation technique mentioned in the article could be a possible solution. Though it wouldn't be very helpful if it didn't last long term.<p>- If one's tired during the day it might be worth getting tested for sleep apnea. You can see if you're likely to have sleep apnea by answering the eight questions here:
<a href="http://www.stopbang.ca/osa/screening.php" rel="nofollow">http://www.stopbang.ca/osa/screening.php</a>
I struggled to get to sleep for years until I realized I could doze off more easily when other people were around making noise. Now I listen to audiobooks and podcasts and fall asleep within 5-10 minutes most nights. Other speech seems to shut down my internal monologue and overly sensitive threat detection circuits :-D Only mentioning in case this clicks with someone else.
What really helps me is to keep my mind occupied when lying in bed at night. In my case, I try to solve P vs NP. That way, I actually enjoy the "sleepless" time, and am not stressed about not being able to sleep.<p>One of the imho very interesting aspects of insomnia is the "self-perpetuating" feature. Can't sleep -> stress about not being able to sleep -> even more difficult to fall asleep. I think this is a common feature of several ailments. Another is not being able to get an erection for men or not being able to orgasm for women ("it doesn't work!" -> stress / adrenaline -> it works even less).<p>Would be interesting to find out what common "pattern breakers" are for short-circuiting the vicious cycle. Does anyone have experiences?
Semi related, I had occasional trouble sleeping at the designated time (I would sleep an appropriate amount, but but not when I wanted to.) After reading gwern’s page on melatonin I tried it since it is easy and low risk, and now I can fall asleep consistently when I want to, by taking melatonin X minutes before.<p><a href="https://www.gwern.net/Melatonin" rel="nofollow">https://www.gwern.net/Melatonin</a>
This is something I discovered awhile ago as well, and it definitely works. Some people call this "sleep restriction therapy". It's not well known, unfortunately, and I agree with the OP: a lot of the advice you find are just so hackneyed.
Why does the "make your target time earlier" branch have the upper limit of 0.95? There's already a "stay the course" region in [0.8, 0.9], shouldn't you move your sleep time earlier for anything above 0.9?
To cure my insomnia I look for >1h long philosophy talks on YouTube, set the video fullscreen, turn the phone face down and let my mind drift into the coziest of sleep.<p>No worries now, only post-freudian communist distopian dreams thank you Žižek.
"Never get in bed and try to sleep because “it’s bedtime”. Only get in bed when you are dying to go to bed"
This is one important thing I've learned. I try to read books until I feel sleepy and then go to bed.
If you have trouble with sleeping and are using computer late at night - remember to use flux[1]. It really helps from my experience.<p>[1] - <a href="https://justgetflux.com" rel="nofollow">https://justgetflux.com</a>
To the author - can you please share the name of the researcher who did the CBT-i program? It would help me and many others. Email me (link in profile) if you cannot post it here. Thanks.
Melatonin and Vitamin D. In modern day life, our bodies do not get enough exposure to sunlight to produce D and Melatonin, which the brain and body need to sleep well.
> Never get in bed and try to sleep because “it’s bedtime”. Only get in bed when you are dying to go to bed<p>This is in contrary to my belief. I have insomnia for many years and I thought one of the reason was because I never had a regular schedule for sleep. Over the years I can only sleep when I am dying to go to bed. Yet, most of the days, I just can't sleep.<p>Anyway, would definitely try out the advice
> <i>CBT</i><p>Yes, good.<p>> <i>don’t nap</i><p>I think the authors insomnia may have been more of a disturbed sleep schedule & I would consider “sufficient sleep but not in a single nightly 7ish hour block” to be different to insomnia.<p>Pedantic blah blah insomnia refers to irreversible awakenings not simply trouble falling asleep blah blah.
Got me to search for more:<p><a href="https://www.reddit.com/r/science/comments/382vyw/a_simple_onehour_therapy_session_has_helped_to/" rel="nofollow">https://www.reddit.com/r/science/comments/382vyw/a_simple_on...</a>
Pseudoscience!<p>If you have sleep issues go see a healthcare professional. Don't follow advice from random strangers on the Internet.<p>The circadian rhythm (aka sleep cycle) is regulated by a hormone called melatonin (not to be confused with melanin). It is produced by the pineal gland after exposure to light.<p>Light intensity from artificial light is usually low (unless you use luminotherapy lamps), leading to melatonin production issues, which affect sleep.<p>You can solve that by spending a bit more time outside. If you happen to live in a place with dark winters, get a luminotherapy lamp.<p>Other than that, there are other aspects that have to do with how tired you might feel... nutrition, hydration, exercise, etc. You can do all of that correctly while still having insomnia.