I am obsessed with sleep. I love to check my Fitbit sleep stats in the morning to see how much REM versus deep and light sleep occurred during the night. It amazes me how many times I wake up during the night without realizing it. Sleep is one of the first things I assess when a patient comes to see me for therapy. Decreased or poor nights of sleep can increase anxiety and depression symptoms. It can even cause physical illnesses. A person between the ages of 18 and 64 years old needs 7 to 9 hours of sleep a night. This is sleep time, not time in your bed as we experience many periods of wakefulness during the night. Tracking your sleep with a Fitbit or an Apple Watch is a good idea to really see how much and what quality of sleep you are getting nightly.
I talk to my patients about good sleep hygiene, which includes keeping a consistent sleep schedule, using the bed only for sleep and sex, avoiding alcohol and caffeinated drinks at least 4 hours before bedtime, and no bright lights 30 minutes before bed. Bright lights consist of cellphones and computer screens.
However, if sleep is not your friend and is hard to achieve then here are some strategies to try.
If you go to be and are not asleep after 20 minutes get up and move to a chair with a dim light to do something pleasant but not absorbing. Read a textbook or a boring book, crossword puzzle, or a word search. Or listen to soothing music or nature sounds. When you feel sleepy, return to bed.
Always get up at the same time even if you are still tired and didn’t get enough sleep. You will be sleepy earlier that night. This helps regulate our circadian clock.
Most importantly we need to recognize if we are telling ourselves negative sleep thoughts. Do you find yourself says “I will never get to sleep” or “I can’t sleep”? Do you find yourself worrying about getting enough sleep, which then causes you to stay awake instead of falling sleeping? If so, then we need to reframe these thoughts (CBT theory) to reduce the anxiety that the negative thoughts are causing. Instead say - “I’m having a tough time falling asleep, but I will eventually go to sleep”. Or “I always fall asleep, I will be asleep soon”.
A technique to distract your thoughts is paradoxical intention. Focus on a spot on the ceiling. The goal is to stay awake and not to let your eyes close. You need to stay focused on the spot. While you are doing things, notice how your eyelids are getting heavy. Resisting sleep gets hard and then you drift off to sleep. This is actually clearing your mind to focus on one thing, which is actually tiring.
Another technique to try is called progressive muscle relaxation. You can either start at your toes and go up or start at the top of your head and go down. Tense each muscle part and then relax it. You go one muscle/body part at a time. You will be asleep be for you reach the opposite end of your body.
If you still need further sleep coaching, please reach out to me. Happy sleeping!!
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