A Patient’s Guide to Insomnia

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By Elaine K. Howley

If you’ve ever lain awake at night wishing for sleep, then you’ve likely experienced some form of insomnia. For those who struggle with this common sleep disorder regularly, the feeling of missing out on sleep can be excruciating. And the paradox of it is that the more you try to sleep the further away the sweet embrace of slumber seems to slide.

As awful as sleeplessness might feel, if there is strength in numbers, then you can take some small comfort in the fact that you’re far from alone. “The data shows that between 20 and 30 percent of people will be affected with insomnia during the course of their lives,” says Dr. Alex Dimitriu, a sleep medicine specialist who’s double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine in California.

Although we know that sleep is critical to maintaining health and wellness for all of us, in some people, the drive to sleep is weaker than in others. “Not everyone has the same propensity to go to sleep,” says Dr. Jerald H. Simmons, a neurologist who’s triple board-certified in neurology, epilepsy and sleep medicine and founder of Comprehensive Sleep Medicine Associates, a clinical practice with offices in Houston and Austin. This so-called sleep drive can vary, as does each individual person’s sleep rhythm. This is why some people are night owls while others are morning people. And in some people, a weaker sleep drive is easily disrupted by any number of factors, which can lead to the development of insomnia.

Insomnia is the most common sleep disorder, but not all cases of insomnia are the same. Generally speaking, there are two major categories of insomnia – difficulty falling asleep initially and difficulty staying asleep throughout the night. And the two may be quite different in how they’re addressed. “Don’t confuse going to sleep with staying asleep,” Simmons says. “You can’t lump them all into one category and say, ‘This is the medicine I use for insomnia patients.'” Rather, many people struggling with insomnia are going to need a treatment approach tailored to their specific problem.

Insomnia – More General Information

Sleep Disorders and Chronic Pain
Cognitive Behavior Therapy for Insomnia
Sleep Deprived? You’re Not Alone
Best Doctor for Sleep Problems?
How Sleep Disorders Affect Us – and How to Lay Them to Rest
How to Fall Asleep – and Stay Asleep – the Natural Way

“In most people who have insomnia, it’s caused by something,” says Dr. Jesse Mindel, assistant professor of medicine and neurology at The Ohio State University Wexner Medical Center. And there are many factors that can cause both short-term and chronic insomnia including:

  • Changes to your work or travel schedule. Jet lag and frequent changes to your work schedule, as can happen with shift work, can induce insomnia in some people.
  • Concerns over work, school or health issues. There’s a reason why the saying “to lose sleep over it” exists. Concerns about any number of aspects of your life can lead to disrupted or poor sleep.
  • Concerns about not sleeping enough. Simmons says some people “develop performance anxiety” about sleep and their insomnia is exacerbated by that anxiety. “They’re so worried they can’t fall asleep that they can’t fall asleep,” and it becomes a self-perpetuating problem.
  • Poor sleeping habits. Engaging in stimulating activities in bed or being inconsistent in your sleep-wake pattern can lead to insomnia.
  • Food and drink. How much, what and when you eat can also disrupt the quality of your sleep. Substances such as caffeine, nicotine and alcohol can have an outsized impact on your sleep quality, especially if you’re using them in the evening or just before bed.
  • Age. Some people tend to have more trouble sleeping as they age, and many post-menopausal women report experiencing insomnia or a shift in sleeping patterns that’s related to changes in their hormone levels.
  • Medical conditions. Some medical conditions, such as sleep apnea – a breathing issue that wakes you up multiple times a night – can disrupt your sleep and lead to insomnia. Restless leg syndrome is another condition that can turn you into an insomniac.
  • Mental health disorders. Anxiety and depression can both greatly impact the quality of your sleep and your ability to fall or stay asleep.
  • Medications. Some medications, particularly certain anti-depressants, steroid medications used for asthma, allergy medications, weight loss drugs and some blood pressure medications can cause insomnia as a side effect.

For many people, insomnia is a consequence of modern life. “A lot of insomnia is related to just being forced into a schedule that’s not natural,” Dimitriu says. Busy, stressful lives filled with electric lights and electronic devices that are constantly demanding attention and shedding blue light that disrupts the body’s natural signals to sleep are all implicated in our collective inability to just get some sleep. “LED lights produce a blue light that suppresses melatonin,” a hormone that governs when we feel sleepy, and this can impact your ability to both fall asleep and stay asleep. “There’s evidence that (after exposure to LED light) melatonin is suppressed through the whole night, so late-night phone play messes up the quality of the sleep for the whole night.”

The ubiquity of these screens and their ability to become a detriment to our sleep cycle is a growing problem for many people, especially those who are prone to insomnia. “We’re living in a very tech-heavy world with clocks and other built-in hard stops” to our natural rhythms. “We’re not adjusting to that,” and the evidence of that disconnect between the demands of the waking day and the inadequacy of sleep to meet those demands becomes vastly obvious when you look at the length of the line at your local coffee shop each morning, Dimitriu says.

Most people who have insomnia are well aware of the difficulties they’re having sleeping. Common symptoms include:

  • Difficulty falling asleep.
  • Waking up during the night and having difficulty returning to sleep.
  • Waking too early in the morning.
  • Not feeling refreshed after sleeping.
  • Grogginess or tiredness during the day.
  • Depression, anxiety and irritability.
  • Cognitive issues such as difficulty focusing or concentrating on tasks.
  • Making lots of mistakes in your work or noticing an increase in accidents or clumsiness.
  • Anxiety about not getting enough sleep.

If you’re experiencing symptoms of sleeplessness, it might be time to visit your doctor for an evaluation. There can be a lot of factors contributing to your specific experience of insomnia, and your doctor will likely perform a physical exam and take a medical and sleep history to understand what’s going on.

You may also be administered a sleep test, which sometimes can be done at home but in other cases may need to be conducted in a sleep lab. These tests typically involve sleeping with sensors attached to your body to monitor your vital signs and look for other indications of physical disruption, such as changes in breathing or heart rate that could be causing you to wake up throughout the night. These tests monitor what you do in your sleep and are often helpful in diagnosing obstructive sleep apnea, restless leg syndrome and other conditions that can disrupt sleep.

Ruling out underlying medical conditions should be a primary goal of any visit you make to a sleep specialist. “First and foremost, I want to rule out any other causes that could be feeding into the insomnia,” Dimitriu says. These other conditions may include:

  • Depression.
  • Anxiety.
  • Restless leg syndrome.
  • Sleep apnea.
  • Thyroid problems.
  • Use of substances such as alcohol or drugs.
  • Other medical conditions.

“As a physician, first I need to eliminate all treatable medical issues. Then I look at substances” and other extenuating circumstances such as living too close to a source of late night noise or light. “Once you’ve eliminated those variables, you discover some people just have pure insomnia. This may be schedule-related or circadian rhythm related. Once we’ve eliminated all the scary stuff that could be treated medically, using a little medication or behavioral intervention can get people sleeping again,” Dimitriu says.

Treating insomnia and making sure that you’re getting enough sleep is an important aspect of overall health and wellness. While there are many things you can do to help ease yourself to sleep, one of the most important things is habituating your body to sleep and the ritual of sleep. “Rhythmicity is key, so having a regular bedtime and wake time and not deviating from that at all,” says Dimitriu. That, alas means “no sleeping in on the weekend, and no napping during the day.” The idea is that by forcing your body to stay awake during the day and adhering to a strict bedtime and wake time regardless of what else is going on, you can retrain your body to accept sleep when it’s most appropriate.

Simmons says many people who deal with insomnia have “poor sleep hygiene,” which means “they’re doing all the wrong things. They’re drinking caffeine in the evening. They’re taking naps in the middle of the day if they have the opportunity to,” and so on. Those sorts of actions “throw their biologic rhythm off. Those individuals need to wake up at a regular time in the morning. They shouldn’t sleep in and they need to get bright light exposure that will lower melatonin levels.” You want to increase the naturally occurring levels of melatonin in your brain at bedtime, and then help them drop in the morning when it’s time to get up and get going.

Other elements of good sleep hygiene include winding down from the day and creating a ritual around bedtime that helps your brain get ready to sleep. Switch off the television and step away from any other screens. Keep your bedroom cool, dark and quiet.

Simmons also recommends taking a hot bath shortly before bedtime to help you relax and get ready for sleep. “As we get drowsy our body temperature drops, and you’re going to sleep better in a cool room. So, if you take a hot bath before bed, that enhances that change in body temperature.” Just be sure to make it the last thing you do before bed. “That window of opportunity where the cooling will help is only 45 minutes to an hour,” he says.

If you’re still having trouble sleeping, it might be time to see a sleep specialist for further testing or more specific treatment. Simmons says that for some people, particularly those who engage in shift work, a consultation with a sleep specialist might help them develop a good strategy for dealing with or avoiding insomnia. “Seek out a consultation with a psychologist or physician who is well versed in sleep disorders to work on a unique plan that’s tailored to your needs,” he says.

Sleep medicine was only recognized as a specialty field of medicine in 2007. Although the science is still young it is expanding, and today there are a growing number of specialists who can help you with sleep problems with a variety of techniques. Simmons says some sleep specialists are now using cognitive behavioral therapy, an approach common in treating mental health problems that can retrain the brain to sleep properly.

Another technique called neurofeedback is a form of “biofeedback using brainwave activity (to) train someone to put themselves into a state conducive to falling asleep,” Simmons says. Using this approach, patients “learn how to relax and we train the brain through this feedback process on how to wind down and go to sleep without medication.” It’s a process that’s similar to meditation. In fact, Simmons says “I jokingly refer to it as meditation on steroids.”

Dimitriu uses similar CBT and meditation techniques to help patients retrain their bodies and brains to accept sleep. The challenge with some of these approaches is that they take time and practice. But tired people aren’t generally well known for being the most patient among us, especially when it comes to sleeping more. “A lot of people say, ‘I slept well last night, why am I still tired?’ The answer is sleep debt takes time to replenish – on the order of about one to two weeks.” That’s why it’s important to keep at it and not give up if you don’t seem to have solved your insomnia problem after just a few nights. Think of it like dieting – it takes a while for your efforts to add up to results, but if you stick with it, you’ll likely see an improvement.

That’s why Dimitriu says it’s important to keep practicing and trying to sleep without the assistance of medication as much as possible, especially when the stakes are low. “It’s easier to practice driving in the parking lot than to practice driving on the highway. By the time you have a big meeting the next day and you can’t fall asleep, meditation can help, but you’d better be good at it by then.” Therefore, he says it’s best to “practice when it’s easy” and you don’t have that pressure of getting to sleep immediately.

There’s a multitude of meditation and sleep-inducing apps and programs available online these days, or a sleep specialist can design a program specific to your needs. And remember to be patient. “If you can learn to meditate, you’re pretty likely to solve your insomnia problem, but that takes time and effort,” Dimitriu says.

If You Can’t Fall Asleep In Under 20 Minutes, It Could Be A Sign Of These 9 Health Issues

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Some nights it’s easier to fall asleep than others. But for certain people, needing over 20 minutes to fall asleep every night is a given — and sometimes others have to wait hours more. The causes of insomnia can be due to all sorts of physical and medical health conditions, so it’s important to examine all of the factors that may be creating your difficulty falling asleep.

Falling asleep can say a lot more about what’s going on with your body than just how tired you are. “The amount of time it takes to fall asleep is known as ‘sleep latency,'” Conor Heneghan, lead research scientist at Fitbit, tells Bustle. “A normal amount of sleep latency is approximately 15-25 minutes, which is considered the ‘sweet spot’ for your body to drift into light sleep stages. However, sleep latency is impacted by [a variety of] factors.” These factors can be anything from what you’ve eaten that day, or whether you’ve altered your bedtime routine, to a more serious underlying medical condition that’s making it difficult for your body to rest at night.

And while having trouble falling asleep can be caused by a myriad of health issues, falling behind on sleep can cause sleep debt and add to these problems. So if you realize you’re taking more than 20 minutes to fall asleep every night, asking your doctor about this problem may get you some relief.

Here are nine health issues that not being able to fall asleep in 20 minutes could be a sign of, according to experts.

1GERD

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GERD, or gastroesophageal reflux disease, can cause symptoms that aren’t quite apparent until you lie down to try to fall asleep.

“When lying down, it’s easier for stomach acids to flow up your esophagus, causing heartburn,” Terry Cralle, RN, clinical sleep educator and sleep consultant for Saatva, tells Bustle. “Heartburn, in turn, can disrupt falling and staying asleep. That’s why many people with GERD experience an increase in symptoms at nighttime and may have trouble finding a comfortable position for sleeping.” Avoiding GERD trigger foods like spicy food, coffee, and alcohol, in the hours before bed, may provide some relief.

2Anxiety

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Anxiety doesn’t exist solely in the mind. If you’ve been dealing with feelings of stress and nervousness in your daily life, it may be building up and causing it to be difficult for you to fall asleep.

“Those who experience anxiety have a complex relationship with sleep,” Dr. Sujay KansagraMattress Firm’s sleep health expert, tells Bustle. “Anxiety can not only prevent someone from falling asleep but it can also be worsened once a person experiences the effects of sleep deprivation.” Dr. Kansagra recommends talking to your doctor if stress or anxiety may be affecting your ability to fall asleep.

3Asthma

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If falling asleep regularly takes more than 20 minutes for you, and you also experience respiratory symptoms, this could be caused by asthma.

“Asthma symptoms often worsen at night, [including symptoms of] nighttime coughing, chest tightness, wheezing and breathlessness: a condition referred to as ‘nocturnal asthma,'” Cralle says. Check in with your doctor if you realize that these sorts of symptoms tend to come along at night.

4“Social Jetlag”

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Keeping a completely different sleep schedule on weekdays and weekends can make falling asleep more difficult in general.

“Another major factor that may contribute to longer sleep latency is ‘social jetlag,’ brought on by the shift in sleep schedules that many experience on days off compared to workdays,” Heneghan says. This issue with your circadian rhythm can be addressed by keeping a more consistent bedtime and wake up time throughout the week.

5Arthritis

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If you have general aches and pains, and they worsen at night enough to make it difficult for you to fall asleep — you may have undiagnosed arthritis. And arthritis doesn’t only affect older people.

“It is estimated that as many as 80 percent of people with arthritis have difficulty sleeping,” Cralle says. “Pain makes it hard to get comfortable and to fall — and stay — asleep. Since sleep deprivation makes pain worse, it’s critical that arthritis sufferers get enough quality sleep.” So talking with your doctor both about your pain and your sleep problems can be a step in the right direction.

6Menopause

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Like arthritis, menopause is associated with aging but can show up in young peopleas well. Since you may not realize this is possible, you may not be connecting the dots between potential gynecological issues and lack of sleep.

“Women are twice as likely to suffer from insomnia than men, according to the National Sleep Foundation, and their sleepless nights have been linked with hormonal changes —especially during menopause, when hormone levels are erratic,” Dr. Kent Smith, founding director of Sleep Dallas, tells Bustle. Making sure you regularly see an OB/GYN, and always tell your doctors about changes to your health, can help you stay on top of these potential issues.

7Restless Leg Syndrome

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Tossing and turning doesn’t have to be something that you ignore. Health issues like restless leg syndrome could be seriously impacting your ability to fall and stay asleep.

“Approximately one in 10 adult Americans suffer from Restless Leg Syndrome, according to the National Sleep Foundation,” Dr. Smith says. “This sleep-related movement disorder causes overwhelming and often unpleasant urges to move the legs while at rest, often making it difficult for sufferers to drift off to sleep.” If you find it particularly hard to lie still at night, it may be best to get in touch with a doctor.

8Sleep Apnea

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While sleep apnea is known to cause disruptions during sleep, it can cause difficulties during the process of falling asleep as well. And since sleep apnea can be difficult to diagnose, you might not connect the dots on this sleep disorder immediately.

“Sleep apnea, a condition in which a person ceases to breathe multiple times per hour when they sleep, can inhibit a person’s ability to fall asleep,” Dr. Smith says. “The brain detects that it is receiving less oxygen during sleep, so, in a life-preserving attempt, it actively prevents the sufferer from falling asleep.” If you have difficulty falling asleep, plus other signs of sleep apnea, then it’s important to see a sleep specialist and seek treatment.

9Vitamin Deficiency

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Sometimes, the root cause of your difficulty falling asleep can be hard to pinpoint but relatively straightforward to treat. One of the examples of this is vitamin deficiency.

“Several common vitamin deficiencies can lead to sleep disturbance,” Arielle Levitan, M.D., co-founder of Vous Vitamin LLC, tells Bustle. “[…] Determining which vitamins to take and in which safe and proper doses is important.” Particular deficiencies like magnesium and iron can cause difficulty falling asleep, Levitan says. To find out if this is a problem, the first step is to speak with your doctor and potentially have them perform blood tests to check for deficiencies.

In order to protect your physical and mental health, it’s important not to normalize your difficulty falling asleep. Taking note of why you may be struggling to fall asleep within 20 minutes or so, and how you feel the next day, may provide you some of the data you need to discuss this issue with your doctor — and find a treatment that works for you.

How Can I Get on a Better Sleep Schedule?

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Sleep schedules vary a lot from person to person. Some are naturally “larks”—early to bed and early to rise—while others are “night owls.” Schedules shift with development, too, with babies typically being larks compared to older children; adolescents in particular often are on a later schedule, which can make it difficult to accommodate early classes.

Thankfully even night owls generally can align their schedules with the rest of the world. However, at times they may find themselves stuck in a cycle of late to bed, late to rise that’s hard to get out of.  For example, college students may go to bed and wake up later and later during winter break, and need to shift their schedule to one that’s compatible with academics as the new semester approaches.

If you find yourself in this situation, here are some recommendations for effectively getting on an earlier schedule.

1. Start in the morning.

Most people who try to change their sleep habits start by trying to go to bed earlier. Since sleep has a beginning and an end, it makes sense intuitively that we should adjust the start time. Unfortunately this approach is very likely to fail.

The problem is that you won’t have been up for enough hours in order to fall asleep easily, and so you’re likely to lie in bed for hours; the next morning you’ll probably stick to your typical wake time. There’s also a good chance you’ll get stressed out about not sleeping, which can lead to insomnia as your bed becomes associated with anxiety.

The better method is to think of being awake as having a start and an end, and adjusting when you start being awake. In other words, start by getting up earlier.

Ideally you can make this change gradually, so it’s not too difficult. For example, if you’ve been getting up at noon, start by setting an alarm for 11:30 AM. Gradually shift your wakeup time 15-30 minutes earlier as your body adjusts.

2. Get natural light early in the day.

One of the most effective ways to shift your 24-hour internal clock (or circadian rhythm) is to have exposure to bright light at the right time of day. For moving to an earlier schedule, that means getting natural light early in the day—preferably as soon as you wake up.

It doesn’t have to be for a long time (even 15 minutes helps), and you don’t need the Florida sun—being outside on an overcast day or sitting near a south-facing window can be enough. The light will signal to your brain that it’s time to be awake, and will suppress the production of melatonin, the hormone that tells your body and brain when to expect sleep.

On the flip side, avoid bright lights late in the day, like the glow of your tablet or phone, which can turn off melatonin production right when you need it.

3. Avoid caffeine later in the day.

If you’re getting up earlier, chances are you’re going to be sleepy at times during the day. The temptation to use caffeine to cope can be strong, especially around the mid-afternoon slump. However, it’s likely to keep you awake at bedtime, pushing your wakeup time later and delaying your ability to change your schedule.

What’s “later in the day”? A safe rule of thumb for most people is to avoid caffeine after lunchtime. If you’re sensitive to caffeine, it may need to be even earlier. (Of course, if your sleepiness is a safety concern—like while driving—do what you need to do.)

Instead of caffeine, try something like going for a brisk walk or doing calisthenics. If you’re able to go without it after lunch, you’re more likely to be ready for sleep come bedtime.

4. Be careful about naps.

Napping can have a similar effect to caffeine, making it harder to fall asleep when you’d like to. Our drive for sleep depends on how long we’ve been awake, and naps reduce that drive.

As with caffeine, the time of the nap is important; a 7:00 PM nap is going to be a bigger problem than one at 2:00 PM. If you do nap, aim to keep it short—no more than 20-30 minutes. And again, nap for safety reasons when needed.

5. Go to bed when sleepy.

Finally, be careful not to go to bed too early. It’s best if you feel like you could fall asleep relatively quickly once you lie down, to avoid spending a long period of time trying to wrestle your brain to sleep (see the first point, above).

On the other hand, you may be able to go to bed earlier than you think. Many people find that they get a “second wind” if they stay up past a certain hour, even if they were ready for bed earlier in the night. So take care not to push though sleepiness at night. By going to bed when your body is ready, you’ll have a better chance of getting up when your alarm goes off.

Some individuals on a late sleep schedule could have a condition like a Delayed Sleep Phase Circadian Rhythm Sleep-Wake Disorder that may require consultation with a professional. As always, consult a qualified medical professional before making major changes to your sleep. 

Earlier in my life, I didn’t have difficulties with falling asleep. However, with age, I’ve noticed that it’s harder to go straight to bed when you still, for instance, have so much on your mind. After I got married, together with my husband, we noticed that there are things we do each and every day, […]

via 5 Tips For a Better Sleep — simple Ula

Struggling To Sleep? Share Your Experiences

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Woman in bed with illustrated sheep drawn above her head
 Counting sheep has been suggested for those who struggle to sleep. Photograph: Garo/Phanie/Getty Images/Passage

The Guardian is planning a new video project about sleep.

According to a study by health insurers, two thirds (67%) of UK adults suffer from disrupted sleep, and around 16 million say they have insomnia.

We’re hoping to understand more about how people are affected by sleep problems and would like readers to tell us how they navigate sleepless nights.

How to take part:

We want to include first-person video testimony from our readers. If you’re interested in getting involved, or would like to find out more about the project, please fill in your details below – and let us know a little bit about how sleep disruption affects you. We’ll contact you with instructions about how to submit your video contribution.

*author article has sign up page!

8 Bizarre Sleep Habits From Around The World

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Would you sleep on the job?

Are your sleep habits ruining your daily life? It might be worth taking a nap on the job!

To celebrate World Sleep Day on March 15, Brother UK has taken an in-depth look at the most bizarre sleep habits from countries around the world to see if they could have an impact on productivity.

Research via the National Sleep Foundation (NSF) suggests that lack of sleep can have a negative impact on emotion. Could naps of 20-30 minutes make for a more productive workforce, and have a positive impact on mood, concentration and attention?

Struggling to sleep? READ: How to sleep better – simple ways to get a good night’s rest

Sleep habits

1. China – Bring your bedroom to work

In factories and offices across China, the lines between bedroom and workspace are becoming increasingly blurred. Due to longer working hours, many employers now advocate a short nap after lunchtime to increase concentration. Certain offices have even installed temporary or permanent sleeping and washing facilities in their office spaces to encourage employees to stay round the clock.

2. Japan – Inemuri

Taking a nap at work could well be perceived as a sign of laziness, but not in Japan. The hectic lifestyle of Japan’s city dwellers has led to the wide-scale uptake of “inemuri”, or “sleeping whilst present”. Thanks to inemuri, Japanese workers can nap on public transport, at their desk or even during meetings – and it’s commonly seen as a sign of hard work.

Sleep habits

3. Spain – Siesta

Originating in Spain and parts of Latin America, the siesta is perhaps one of the most well-known daytime snoozing traditions across the globe. This practice might be under threat, however, with new business laws introduced in 2016 limiting how late employees can work, and effectively reducing the time they have to squeeze in an afternoon nap.

4. Italy – Riposo

Where the Spanish have a siesta, the Italians have “riposo”. Commonly taking place after lunch, riposo can last anywhere from 2-4 hours. Get us to Italy now! Frustratingly for tourists, this means that many attractions are closed throughout the day.

5. Norway – Napping outside

Take a stroll through Oslo, Helsinki or another Nordic town, and you might well see some infants taking a nap in temperatures as low as -5 degrees Celsius. Don’t worry – they haven’t been abandoned; sleeping outdoors in the daytime is actually believed to be very good for their health.

Sleep habits

6. Indonesia – Fear sleep

Stresses of work getting you down? The ominously named ‘fear sleep’ might be the solution. Locally referred to as “todoet poeles” – the practice of fear sleep enables people to nod off instantly to avoid feelings of excessive anxiety and stress. Nodding off when your boss walks in might not be the best solution, but regular naps could well help avoid work-related worry.

7. Botswana – Sleeping on your own schedule

You should sleep when it’s dark, correct? Not quite. At least, not in Botswana. The country’s native Kung hunter-gatherer tribe are well known for sleeping only when tired, regardless of the time of day. With an increased uptake of flexi-time, rise in self-chosen hours and growth of contract-based work, could businesses be embracing the way of the Kung sooner than we think?

Sleep habits

8. USA – Silicon Valley sleepers

Though it’s not a national custom just yet, sleeping on the job is widely being embraced by some of the USA’s biggest employers. Technology and software companies are leading the napping revolution, with firms like Google going so far as to have purpose-built sleeping pods installed in their offices to help employees rest and refresh.

How to Calm Your Racing Mind so You Can Sleep

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You long for sleep. You may even feel tired before going to bed. But as soon as your head hits the pillow, it happens again. You’re wide awake. You can’t stop thinking. It’s the worst.

I regularly speak to groups about the necessity of sleep for the prevention of burnoutmanagement of stress, improvement of mood, and a host of other benefits. Almost every time I do, someone comes up to me and says:

     “I know I need more sleep. But what do I do if I can’t fall asleep? I get into bed early enough to get eight hours, but then I just lie there with my mind racing.”

I also frequently hear this from coaching clients and patients. When I do, I start asking questions. And usually find the answer.

Here are the questions, for you to ask yourself:

1. Do you take your phone to bed?

First of all, the light from the phone is stimulating to the brain and can suppress melatonin release (melatonin helps you sleep). The best solution is to not look at your phone after 9 p.m. (or an hour or two before bed), but lots of people aren’t ready to give up that habit. If that’s you, use a blue light-blocking mode, like “Night Shift” on iPhones, and turn your screen brightness down as far as it can go.

2. What are you reading, or doing in bed, before you go to sleep?

This is my second point about the phone. I once heard a sleep expert at Harvard say that texting at bedtime is a bad idea. The thought processes that you use are too stimulating to your brain. Obviously, checking work emails (or any email) at bedtime is a really bad idea, especially if you come across something stressful. You may not even want to read the news, in case there’s a headline that stimulates thoughts or concerns.

If you like to read to wind down, choose a book (the printed kind). Ideally, that book should not be too thought-provoking or stimulating. It shouldn’t be disturbing. It also probably shouldn’t be so incredibly captivating that you can’t put it down…

3. What do you do with your evenings?

If you have trouble winding down to sleep, take care not to wind yourself up over the course of the evening. Good rules of thumb:

  • Avoid challenging conversations with your spouse in the evenings if possible. Definitely avoid starting a difficult conversation close to bedtime.
  • If you must work in the evening (i.e., answering emails), try to do so earlier versus later, so you have time to wind down your mind before bed.
  • Working out in the evening makes it harder to wind down and fall asleep. Do it earlier in the day.
  • If you go out on a work night, plan to get home at a reasonable hour so that you have time to wind down and still get into bed on time.

Notice what “winds you up” in the evenings. Either avoid it, or schedule it much earlier.

4. What lighting do you use at night?

This is another key to winding down. People used to sleep an average of nine hours a night before the advent of widespread electricity. The lights we have on at night in our homes are stimulating and can also suppress melatonin secretion.

Feel the difference between two late evening scenarios:

A) All the lights are on. The TV is blaring. You’re sitting at a table catching up on emails, while simultaneously conducting a logistical discussion with your spouse. You feel stressed and don’t even want to go to bed. You’ll need at least an hour of Netflix to wind down from this (not a good idea, because of the screen involved, and also if it’s a really well-written show, it will be hard to turn off in time for bed).

B) All the lights are off, except a warm yellow lamp in the corner of the room. Soft music is playing. You and your spouse are quietly reading. As you read, the inevitable happens. Your eyelids start to droop. Your head bobs as you fall asleep for a split second. Even though it’s earlier than you’d planned, you get up and head over to the bathroom to start getting ready for bed.

5. Is there something specific you’re worried about?

Perhaps there’s a stressful situation you can’t stop worrying about that’s keeping you awake. In this case, I’d recommend a variety of approaches:

  • If it’s serious, get professional counseling support to help you problem-solve the situation and/or your response to it.
  • Journal before going to bed to get your worries out of your head and onto the page.
  • Learn a relaxation practice, such as a simple relaxation breathing meditation, to quiet your mind and body before bed. If I can’t fall asleep, I focus on a three-line scripture about peace as I breathe slowly in and out; it almost always works. One of my coaching clients, a former figure skater, skates in her mind until she falls asleep.

6. How are you using your bed?

Leverage the strategy of “stimulus control.” If you do lots of different things in bed (e.g., watch movies, answer emails, take phone calls, etc.), your body and mind get confused about the purpose of bed. If you have insomnia, it’s best to only use your bed for sleep. For the same reason, if you can’t fall asleep, get out of bed, and go do something quiet and relaxing until you start to feel sleepy, and then head back to bed.

7. How much caffeine are you drinking?

The sleep expert I mentioned earlier also said that if you struggle with insomnia, you should eliminate caffeine (and any other stimulants) completely and see if that helps. If that feels impossible, start by eliminating caffeine in the late afternoon or evening. Sources of caffeine include coffee, non-herbal teas, chocolate, and some supplements.

Elena Rostunova/Shutterstock
Source: Elena Rostunova/Shutterstock

Note: Some people who can’t sleep have a bigger issue, such as Generalized AnxietyBipolar Disorder, or other medical concerns. If your sleeplessness is extreme or doesn’t respond to simple interventions, it’s important to talk to your doctor about it.

Copyright 2019 Dr. Susan Biali Haas

Night Owls May Experience ‘Jet Lag’ On A Daily Basis

Author Article

Some people declare themselves to be morning larks, or early risers, and they effortlessly wake up at the crack of dawn and fall asleep earlier in the evening.

Others, however, are night owls, or evening people, who stay up until the early hours of the morning and wake up later in the day, if left to their own devices.

Previous research has shown that the night owls face some health risks due to their daily rhythms. These include a tendency towards poorer dietary habits, which, in turn, can increase the risk of metabolic conditions, such as diabetes.

Now, a study led by investigators from the University of Birmingham in the United Kingdom has found out how activity patterns in the brains of night owls are different from those of morning people. The study also highlights how these differences can impact their lives and levels of productivity in a world that typically favors early risers.

“A huge number of people struggle to deliver their best performance during work or school hours they are not naturally suited to,” notes lead researcher Dr. Elise Facer-Childs, previously of Birmingham University and now based at the Monash Institute for Cognitive and Clinical Neurosciences in Melbourne, Australia.

“There is a critical need to increase our understanding of these issues in order to minimize health risks in society, as well as maximize productivity,” she emphasizes.

The researchers have now published their findings in a study paper featured in the journal SLEEP.

Brain activity in night owls

For this study, the research team recruited 38 healthy participants. They divided the volunteers into two groups, putting 16 early risers into one group and 22 late sleepers into the second.

The researchers split the participants into these two groups based on their melatonin and cortisol circadian rhythms — the natural circulation of these two hormones affect sleep and waking cycles.

The researchers monitored the participants’ sleeping and waking patterns, and the volunteers filled in questionnaires about their rhythms. On average, late sleepers went to bed at 2:30 a.m. and woke up at 10:15 a.m.

To assess brain activity patterns, the investigators asked the volunteers to undergo MRI scans. The researchers also tested the participants’ performance on various tasks they undertook at different times throughout the day to see how sleep-wake cycles affected daily functioning.

The team noticed a difference in brain activity patterns between the two groups, namely that night owls had lower resting brain connectivity in brain areas that scientists primarily associate with maintaining a state of consciousness. They correlated this with shorter attention spans, as well as slower reactions and lower energy levels.

Early risers performed better and had faster reaction times during morning tasks. They also declared themselves as being much less sleepy at that time.

On the contrary, as expected, late sleepers performed best and experienced the fastest reaction times around 8:00 p.m. However, even at the time when they were at their peak performance, night owls did not do much better than their early rising peers.

This suggests that throughout the day — or from around 8:00 a.m. to 8:00 p.m. — resting-state brain connectivity is affected in late sleepers, adversely impacting their productivity.

Social expectations ‘could be more flexible’

Dr. Facer-Childs likens the night owls’ state throughout the day to a form of constant jet lag, emphasizing that this may have a significant effect on their well-being in the long run.

This mismatch between a person’s biological time and social time — which most of us have experienced in the form of jet lag — is a common issue for night owls trying to follow a normal working day.”

Dr. Elise Facer-Childs

“Our study is the first to show a potential intrinsic, neuronal mechanism behind why night owls may face cognitive disadvantages when being forced to fit into these constraints,” she adds.

For this reason, the researcher argues that societies need to take a long, hard look at their organizational structures, chiefly in terms of working hours and how to become more accommodating to people’s individuals needs. This flexibilty should mean that night owls can put their best foot forward while avoiding adverse health outcomes.

“To manage this [situation], we need to get better at taking an individual’s body clock into account — particularly in the world of work,” Dr. Facer-Childs argues.

“A typical day might last from 9:00 a.m.–5:00 p.m., but for a night owl, this could result in diminished performance during the morning, lower brain connectivity in regions linked to consciousness, and increased daytime sleepiness,” she warns.

She further advises that “If, as a society, we could be more flexible about how we manage time, we could go a long way toward maximizing productivity and minimizing health risks.”

The Dangers of Sleep Deprivation

Why Being A Night Owl Might Be Damaging Your Mental Health

Author Article

woman sleeping in bed

GETTY IMAGESCAIAIMAGE/PAUL BRADBURY

Not only is being a ‘night owl’ annoying when you have to get up for work the next day, it apparently affects more than just your body clock – it has a big impact on mental health, too.

According to a new study published in the journal Nature Communications, people who are naturally early risers are less likely to develop mental health problems than those who go to bed late and sleep in.

The large-scale genetics study, conducted at the University of Exeter, used data from 250,000 research participants signed up to the private genetics company 23andMe, and 450,000 people in the UK Biobank study. Participants were asked whether they were a “morning person” or an “evening person”, and their genomes were analysed, revealing certain genes people shared that appeared to influence sleep patterns.

Lead study author Samuel Jones, a research fellow studying the genetics of sleeping patterns at the University of Exeter, said:

“Part of the reason why some people are up with the lark while others are night owls is because of differences in both the way our brains react to external light signals and the normal functioning of our internal clocks.

“The large number of people in our study means we have provided the strongest evidence to date that ‘night owls’ are at higher risk of mental health problems, such as schizophrenia and lower mental wellbeing, although further studies are needed to fully understand this link.”

The results found uncovered an apparent causal link between being a night owl and being more prone to depression, anxiety and schizophrenia – with evening types 10% more likely to develop the latter condition.

However, they found no increased risk of obesity and diabetes among night owls, despite what some earlier studies have said.

Samuel Jones said the conclusion is that night owls are more likely to have to work against their natural body clock in school and the world of work, which may have negative consequences on their mindset.

So, how can you go about adjusting your sleep schedule? Hope Bastine, sleep psychologist for high-tech mattress maker Simba, says we need to identify our individual sleep needs first.

“Experiment with your productivity and your performance rate and adjusting your time schedule to that,” she told Cosmopolitan UK. “Find a rhythm, a schedule, a lifestyle that really suits you, and that makes you feel in harmony with yourself. Make sure your sleep schedule is as non-negotiable as possible.”

Putting sleep first? Done.

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