Insomnia SOS

The concise no frills guide to resolving insomnia

This website sprung from my own frustrating experience attempting to navigate the web for relevant, effective information on overcoming insomnia. I would stumble upon what largely amounted to fluff: thinly-veiled product advertisements with boilerplate text, inconsistent and limited suggestions for sleep hygiene. I have culled some information from research papers which hopefully will prove useful to others. I have attempted to cite thoroughly, though omitted sources to some claims to avoid redundancy and clutter. I encourage everyone to review the research. Reclaiming sleep may take vigilance, but it is within our means. It ought not be a privilege.


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Rise at the same time every day. A consistent wake time will help anchor your circadian rhythm. Adherence to a fixed advanced sleep/wake schedule can result in significant circadian phase shifts for adults with delayed sleep phase disorderSee Effects of an advanced sleep schedule and morning short wavelength light exposure on circadian phase in young adults with late sleep schedules. This will allow you to effectively build the sleep drive necessary to fall asleep at an appropriate time, usually 7.5-8 hours ahead for adults. Delayed circadian rhythm is a common antagonist for onset insomnia, often exacerbated by sleeping in late or staying up late regularly.

Limit your total time in bed. Spending excessive amounts of time in bed can lead to both onset and maintenance insomnia issuesSee Treatment of Chronic Insomnia by Restriction of Time in Bed. Conversely, restricting time in bed may aid in consolidating sleep. This is the reasoning behind restriction therapy, a component of CBTi.

Employ CBT principles. Consider exploring CBTi, Cognitive Behavioral Therapy for Insomnia, either through self-administration or with a therapist. It comprises two components, being CBT and sleep restriction therapy. The former is a means, in part, to train yourself to recognize and reject fatalist thinking. Anxiety is a strong driver of insomnia and certain cognitive trappings can exacerbate it. Negative thoughts for example may be variations on "I must sleep well tonight to manage my work day tomorrow", or "sleep is just impossible for me". Realistically, even if you have a bad night you will survive the next day, and natural sleep can be reclaimed. We tend to also underestimate the amount of sleep we actually get, and catastrophize over what will happen with insufficient sleep. Seek out further reading. I recommend Overcoming Insomnia: A Cognitive-Behavioral Therapy Approach Therapist Guide by Edinger and Carney. This CBT guide may also be helpful. CBTi is demonstratively effective at improving sleep quality in most people, even onlineSee Efficacy of internet-delivered cognitive-behavioral therapy for insomnia – A systematic review and meta-analysis of randomized controlled trials.

Employ a wind-down routine. Ritual can be powerful. It breeds a familiarity and comfort. Take advantage of this by employing some light, relaxing activities in the hour before bed, generally away from electronics and blue-light emitting screens. Some suggestions are outlined in the relaxation section.

Exercise. Exercise provides a host of benefits, among which is boosting serotonin levels and improving sleep processesSee Exercise and sleep in aging: Emphasis on serotonin, as well as modulating adult neurogenesis and relieving depressive symptomsSee Neural Mechanisms of Exercise: Anti-Depression, Neurogenesis, and Serotonin Signaling . There is a caveat here, that most strenuous exercise will raise cortisol levels in the short-run, which then fall over the course of a few hours. For this reason exercising too close to bedtime is to be avoided. The cardinal rule is not to exercise within 3 hours of sleep. Err on the side of caution and schedule your workouts earlier. Relaxing movement such as a low-intensity yoga session however is appropriate.

Mind the temperature. Ambient temperature has an influence on sleep quality and duration. Cool temperatures in the range of 65-68F are purported to be ideal. This, however, is relatively common knowledge. Just as important is bedding microclimate.

The comfortable range of surface-skin-temperature in bed is relatively warm, suggesting an optimal bed microclimate temperature approximately 33 degrees CelsiusSee Skin deep: enhanced sleep depth by cutaneous temperature manipulation . Dilating the blood vessels on the skin surface allows us to expel heat, most of which is lost through distal areas like our head, hands and feet. This is why warming feet prior to bed helps us fall asleep fasterSee Skin Temperature and Sleep-Onset Latency: Changes With Age and Insomnia . Warming skin at the hands and feet helps lower core temperature, thus advancing one’s temperature minimum, and additionally, release melatonin, both of which increase sleep propensity. This can be a boon, as insomniacs are more likely to have greater difficulty regulating temperature at nightSee Do chronic primary insomniacs have impaired heat loss when attempting sleep?. Depression may also increase nocturnal temperatureSee Nocturnal sweating and temperature in depression. Please review the Tips section for notes on bedding.

Sleep initiation likely occurs during the maximum rate of core temperature decline, with sleep propensity increasing near the temperature minimum circadian phaseSee Effects of Temperature on Sleep: Manipulating Body Temperatureto Improve Sleep Quality, Onset, and Arousal. Prior to this phase is the wake maintenance circadian zone, in which sleep attainment is most difficult. Those with sleep onset insomnia typically exhibit delayed circadian phases. Consequently, their temperature minimum is reached later.

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Dietary considerations. Dietary consumption has an impact on sleep quality. Notwithstanding the ambiguity of research in the domain of nutrition, experimenting with such metrics can lead to worthwhile gains in sleep quality. Some possible antagonists and protagonists are highlighted as follows.

Take care also to limit very spicy and hard to digest meals in the evening. These can raise body temperature at onsetSee Spicy meal disturbs sleep: an effect of thermoregulation?. This could lead to more discomfort and difficulty falling asleep, as would eating dinner very late. Spicy foods may carry health benefits but are best consumed earlier in the day.

Light exposure. Sunlight has the benefit of both improving mood and regularing your circadian rhythm. Modern living is such that most adults are lacking, and consequently deficient in vitamin D. Supplememtation of vitamin D3 with vitamin K, and even exposure to light-therapy lamps (aka SAD lights) can be of aid. Beware that very high doses of D3 supplementation may lead to high calcium levelsSee Vitamin D toxicity resulting from overzealous correction of vitamin D deficiency and other side effects. Consult a physician.

Light can also be a hinderance. Exposure to blue light emitted from electronics in the period leading to onset suppresses melatonin production, sometimes exceeding 50% in studiesSee Light emitting diodes can be used to phase delay the melatonin rhythm. Light may also raise cortisol, and core body temperature, another impediment to sleep onsetSee Effect of a single 3-hour exposure to bright light on core body temperature and sleep in humans. If you opt to use a device later in the evening, consider a blue-light filter, e.g. software such as flux. Bright light can rouse you from slumber, so do well to keep your bedroom dark. Blackout curtains may be a good investent here.

Restrict pornography consumption. Excess consumption of pornography may lead to insomnia. High consumption is associated with psychological distressSee sample list of references. It may also lead to dopamine receptor depletion as with other addictionsSee Neuroscience research fails to support claims that excessive pornography consumption causes brain damage. This is currently inconclusive, though it is possible that dopamine receptor depletion is antagonistic since dopamine, along with serotonin, is a sleep regulator.

Ditch the pills. Medication is not a sustainable long-term solution to insomnia. It may be useful as a means to bridge to recovery. Sedative agents may have toxicities and side-effects, and some have addictive potential. CBTi avoids these pitfalls and may yield superior results to drug therapies See Treating insomnia with medications.

Active learning and cerebral hobbies. The process of learning and forming new memories as well as challenging cerebral tasks may improve sleep quality See Intensive language learning and increases in rapid eye movement sleep: evidence of a performance factor See Posttraining increases in REM sleep intensity implicate REM sleep in memory processing and provide a biological marker of learning potential .

Unobstructed breathing. Rule out the possibility of sleep apnea or other difficulties with a professional if you suspect it. These afflictions can decimate sleep quality and restfulness. Also take care to allow some level of air circulation in the bedroom. A closed door in a small space, with you in it, can accumulate higher CO2 levels. This may impair sleep qualitySee I’m living in a carbon bubble. Literally. .

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The following leans more on the anecdotal side of things.

Experiment with bedding. Bedding microclimate is at once more manipulatable than ambient temperature, and highly impactful. For some, particularly while undergoing bouts of chronic insomnia, it can be difficult to configure a lastingly comfortable sleeping environment that won't rouse one hot or cold. Chronic insomniacs tend to have more difficulty with temperature regulation, and recognizing the most comfortable thermal environment conducive to sleepSee Sleep, vigilance, and thermosensitivity. With ambient temperature accounted for somewhere in the range of 65-67F, take stock of bedding. As explained in the essentials section, we are at our most comfortable with a bedding microclimate within a range that allows warming of the skin and lowering of core temperature. Some suggestions on this task:

In general we can withstand somewhat more heat on our lower body than upper body in terms of sleep comfort. Be cognizant of your level of comfort and make adjustments where necessary.

I'm not falling asleep, what now? End the sheet dance. Should you find yourself feeling alert or throwing sheets on and off in discomfort, running hot and cold, sit up in bed for a few minutes until the point at which you yawn again. This should allow some sensation of sleep pressure to return.

Otherwise, one useful gambit in the event you're tossing around in vain is to switch your position to a half-military crawl. There are reference pictures online. The advantage it provides is two-fold: it prevents you from moving much, and warms your stomach and upper thighs against the mattress allowing your back to cool. This can provide the temporary relief necessary to fall asleep.

Relaxation Methods. It's unnecessary to say much about these individually. Capitalize on a wind-down routine with activities that relax you. It does well to stay away from excessively stimulating sources in the hour before bed. Some examples are as follows:

  • yoga
  • meditation
  • reading before bed
  • progressive muscle relaxation
  • 4-7-8 breathing
  • warm shower / bath
  • sex

Sex and masturbation can reduce stress. I would only caution that excess consumption of pornography, a dopamine-seeking behavior, may lead to insomnia. More on this in the Extra Mile section.

For further reading, these opinionated resources may be of interest as accounts of self-edification for sleep.

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Stating the Obvious