When Insomnia Strikes
By Larry M. Barber, LPC-S
Insomnia during grief is not uncommon. Grief, anxiety, stress and depression can keep you up at night. Many mourners complain that nighttime, especially bedtime, can be one of their more difficult times. Not getting enough sleep is a big red flag because you can't function well without rest. Here are some tips for getting better and more restful sleep:
Keep a regular sleep schedule
Getting in sync with your body’s natural sleep-wake cycle—your circadian rhythm—is one of the most important strategies for achieving good sleep. If you keep a regular sleep schedule, going to bed and getting up at the same time each day, you will feel much more refreshed and energized than if you sleep the same number of hours at different times. This holds true even if you alter your sleep schedule by only an hour or two. Consistency is vitally important.
Set a regular bedtime. Go to bed at the same time every night. Choose a time when you normally feel tired, so that you don’t toss and turn. Try not to break this routine on weekends when it may be tempting to stay up late. If you want to change your bedtime, help your body adjust by making the change in small daily increments, such as 15 minutes earlier or later each day.
Wake up at the same time every day. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your bedtime, try to maintain your regular wake-time even on weekends.
Nap to make up for lost sleep. If you need to make up for a few lost hours, opt for a daytime nap rather than sleeping late. This strategy allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm, which often backfires in insomnia and throws you off for days.
Be smart about napping. While taking a nap can be a great way to recharge, especially for older adults, it can make insomnia worse. If insomnia is a problem for you, consider eliminating napping. If you must nap, do it in the early afternoon, and limit it to thirty minutes.
Fight after-dinner drowsiness. If you find yourself getting sleepy way before your bedtime, get off the couch and do something mildly stimulating to avoid falling asleep, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.
Discovering your optimal sleep schedule
Find a period of time (a week or two should do) when you are free to experiment with different sleep and wake times. Go to bed at the same time every night and allow yourself to sleep until you wake up naturally. No alarm clocks! If you’re sleep deprived, it may take a few weeks to fully recover. But as you go to bed and get up at the same time, you’ll eventually land on the natural sleep schedule that works best for you.
Naturally regulate your sleep-wake cycle
Melatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Melatonin production is controlled by light exposure. Your brain should secrete more in the evening, when it’s dark, to make you sleepy, and less during the day when it’s light and you want to stay awake and alert. However, many aspects of modern life can disrupt your body’s natural production of melatonin and with it your sleep-wake cycle.
Spending long days in an office away from natural light, for example, can impact your daytime wakefulness and make your brain sleepy. Then bright lights at night—especially from hours spent in front of the TV or computer screen—can suppress your body’s production of melatonin and make it harder to sleep. However, there are ways for you to naturally regulate your sleep-wake cycle, boost your body’s production of melatonin, and keep your brain on a healthy schedule.
Increase light exposure during the day
Remove your sunglasses in the morning and let light onto your face.
Spend more time outside during daylight. Try to take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.
Let as much light into your home/workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.
If necessary, use a light therapy box. A light therapy box can simulate sunshine and can be especially useful during short winter days when there’s limited daylight.
Boost melatonin production at night
Turn off your television and computer. Many people use the television to fall asleep or relax at the end of the day, and this is a mistake. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it. Try listening to music or audio books instead, or practicing relaxation exercises. If your favorite TV show is on late at night, record it for viewing earlier in the day.
Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an e-Reader that is not backlit, i.e. one that requires an additional light source such as a bedside lamp.
Change your bright light bulbs. Avoid bright lights before bed, use low-wattage bulbs instead.
When it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical displays, use heavy curtains or shades to block light from windows, or try a sleep mask to cover your eyes.
Use a flashlight to go to the bathroom at night. If you wake up during the night to use the bathroom—as long as it’s safe to do so—keep the light to a minimum so it will be easier to go back to sleep.
Create a relaxing bedtime routine
If you make a consistent effort to relax and unwind before bed, you will sleep easier and more deeply. A peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses.
Make your bedroom more sleep friendly
Keep noise down. If you can’t avoid or eliminate noise from barking dogs, loud neighbors, city traffic, or other people in your household, try masking it with a fan, recordings of soothing sounds, or white noise. You can buy a special sound machine or generate your own white noise by setting your radio between stations. Earplugs may also help.
Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.
Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more or less support.
Reserve your bed for sleeping and sex
If you associate your bed with events like work or errands, it will be harder to wind down at night. Use your bed only for sleep and sex. That way, when you go to bed, your body gets a powerful cue: it’s time to either nod off or be romantic.
Relaxing bedtime rituals to try
Read a book or magazine by a soft light
Take a warm bath
Listen to soft music
Do some easy stretches
Wind down with a favorite hobby
Listen to books on tape
Make simple preparations for the next day
Eat right and get regular exercise
Your daytime eating and exercise habits play a role in how well you sleep. It’s particularly important to watch what you put in your body in the hours leading up to your bedtime.
Stay away from big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Fatty foods take a lot of work for your stomach to digest and may keep you up. Also be cautious when it comes to spicy or acidic foods in the evening, as they can cause stomach trouble and heartburn.
Avoid alcohol before bed. Many people think that a nightcap before bed will help them sleep, but it's counterintuitive. While it may make you fall asleep faster, alcohol reduces your sleep quality, waking you up later in the night. To avoid this effect, stay away from alcohol in the hours before bed.
Cut down on caffeine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Consider eliminating caffeine after lunch or cutting back your overall intake.
Avoid drinking too many liquids in the evening. Drinking lots of water, juice, tea, or other fluids may result in frequent bathroom trips throughout the night. Caffeinated drinks, which act as diuretics, only make things worse.
Quit smoking. Smoking causes sleep troubles in numerous ways. Nicotine is a stimulant, which disrupts sleep, plus smokers experience nicotine withdrawal as the night progresses, making it hard to sleep.
If you’re hungry at bedtime
For some people, a light snack before bed can help promote sleep. When you pair tryptophan-containing foods with carbohydrates, it may help calm the brain and allow you to sleep better. For others, eating before bed can lead to indigestion and make sleeping more difficult. Experiment with your food habits to determine your optimum evening meals and snacks.
If you need a bedtime snack, try:
Half a turkey sandwich
A small bowl of whole-grain, low-sugar cereal
Granola with low-fat milk or yogurt
A banana
You’ll also sleep more deeply if you exercise regularly. You don’t have to be a star athlete to reap the benefits—as little as 20 to 30 minutes of daily activity helps. And you don’t need to do all 30 minutes in one session. You can break it up into five minutes here, 10 minutes there, and still get the benefits. Try a brisk walk, a bicycle ride, or even gardening or housework.
Some people prefer to schedule exercise in the morning or early afternoon as exercising too late in the day can stimulate the body, raising its temperature. Even if you prefer not to exercise vigorously at night, don’t feel glued to the couch, though. Relaxing exercises such as yoga or gentle stretching can help promote sleep.
Get anxiety and stress in check
Do you find yourself unable to sleep or waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. When you wake up or can’t get to sleep, take note of what seems to be the recurring theme. That will help you figure out what you need to do to get your stress and anger under control during the day.
If you can’t stop yourself from worrying, especially about things outside your control, you need to learn how to manage your thoughts. For example, you can learn to evaluate your worries to see if they’re truly realistic and replace irrational fears with more productive thoughts. Even counting sheep is more productive than worrying at bedtime.
If the stress of managing work, family, or school is keeping you awake, you may need help with stress management. By learning how to manage your time effectively, handle stress in a productive way, and maintain a calm, positive outlook, you’ll be able to sleep better at night.
Relaxation techniques for better sleep
Relaxation is beneficial for everyone, but especially for those struggling with sleep. Practicing relaxation techniques before bed is a great way to wind down, calm the mind, and prepare for sleep. Some simple relaxation techniques include:
Deep breathing. Close your eyes, and try taking deep, slow breaths, making each breath even deeper than the last.
Progressive muscle relaxation. Starting with your toes, tense all the muscles as tightly as you can, then completely relax. Work your way up from your feet to the top of your head.
Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.
Ways to get back to sleep
It’s normal to wake briefly during the night. In fact, a good sleeper won’t even remember it. But if you’re waking up during the night and having trouble falling back asleep, the following tips may help.
Stay out of your head. The key to getting back to sleep is continuing to cue your body for sleep, so remain in bed in a relaxed position. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake. A good way to stay out of your head is to focus on the feelings and sensations in your body.
Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.
Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, try getting out of bed and doing a quiet, non-stimulating activity, such as reading a book. Keep the lights dim so as not to cue your body clock that it’s time to wake up. Also avoid screens of any kind—computers, TV, cell phones, iPads—as the type of light they emit is stimulating to the brain. A light snack or herbal tea might help relax you, but be careful not to eat so much that your body begins to expect a meal at that time of the day.
Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when you are fresh and it will be easier to resolve. Similarly, if a brainstorm or great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive and creative after a good night’s rest.
Make sleep a priority at the weekends or on your nonworking days so you can pay off your sleep debt.
Written by Larry M. Barber, LPC-S, CT author of the grief survival guide “Love Never Dies: Embracing Grief with Hope and Promise” available online at Amazon, Barnes & Noble or Christianbook.com.
The grief survival guide is also available in Spanish as “El Amor Nunica Muere: Aceptando el Dolor con Esperanza y Promesa” on Amazon.com.
FOR INFORMATION ON SCHEDULING COUNSELING SERVICES WITH LARRY BARBER https://taylorcounselinggroup.com/larry-barber .