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Insomnia

I had some sleep problems that started about five years ago after a very frightening personal experience. The effect was that, as soon as I closed my eyes or relaxed my concentration during daytime tasks, I started mentally replaying the event over and over. The surge of adrenalin and sudden sinking feeling in my stomach would instantly jolt me awake. If I did manage to fall asleep anyway, I would often wake with nightmares.

My doctor prescribed a short regimen of Ambien to help induce sleep. While that did indeed work, the short half-life meant that I invariably awoke two hours later, and then remained sleepless throughout the rest of the night.

I hesitate to use the word "flashback" or make comparisons to PTSD, but I suppose that the net result to me is the same with or without an official diagnosis. Stuff happens sometimes, and one must learn to live with it -- but no one who hasn't gone through the jaw-clenching tension of reliving a traumatic memory over and over and over can possibly understand how hard it is to "just get over it." It's more than a matter of will-power. Time, patience, and a determination to heal are required.

What worked for me was retraining my brain to relax when it got caught in one of those horrid loops. Instead of escalating toward panic, I learned to ease my mind into alternate pathways. I used doubling at first -- calculating the natural powers of two, up and up, and up, until I lost track -- I often found that I had no room to think of the dreaded event. This was as helpful for sleep induction as the Ambien had been. It did not, however, prove sufficient to quell the nightmares.

I went from there to memorizing Shakespeare. I found that, with enough repetition, my waking brain would happily move from reenacting the trauma to acting out a soliloquy. I would wander through Hamlet or Merchant playing the parts of various characters until I fell back asleep.

Over time, the trauma has lessened significantly. I still use Ambien or my Jedi mind control tricks every now and then, usually on anniversaries or when a similar tragedy happens to someone I know. The triggers can be significantly less obvious than those, however: sometimes just hearing the name of one of those who didn't survive the event is enough. But at long length, I've learned to identify the beginning of the perseveration, even if it's just browsing the news about something seemingly unrelated. If I can catch the first thought going the wrong direction, I can almost always head off the episode with distraction. Once I found myself sitting up in bed, firmly saying, "No, that's enough!" over and over.

The thing is, some wounds never heal completely. You build up scar tissue and become accustomed to it. You never have again what you had, but what you have is something new, and that can be okay, too.
 
I think of calming things.

If I can remember a previous dream, it really puts me in a dreamy, sleepy state.

I have literally tried counting sheep jumping over a fence.
 
I'd be grateful for a link to further information on this topic, particularly for anything I could give an initial try on my own.

First, the usual terms & conditions:- I am not a doctor or sleep specialist, just someone who has had my share of problems sleeping and learned what helps me to get a good sleep. If your problem relates to an underlying chronic medical condition, or to drugs (legal or otherwise) I don't know if my experience is relevant.

All I'm saying is that so long as the head is full of mental noise, not much else will help you sleep, except physical exhaustion.
As for a link, as usual start at Wikipedia and work outward- http://en.wikipedia.org/wiki/Relaxation_technique Any method that helps you relax can help you sleep. Try anything that appeals to you.

All I can tell you is what I did myself, which was a mix of stuff I picked up in exercise classes , karate and Aikido stuff, a bit of yoga and simple introspection- actually monitoring carefully what actually happens in my conscious mind as I try to get to sleep.

Start with deliberate relaxation- work your fingers, hands, wrists, all the way through the body, tensing every muscle group you can, holding for a second or so, then relaxing. If you can do a half hour of serious stretching-This sort of thing, http://books.google.co.uk/books/about/The_Whartons_Stretch_Book.html?id=RkOE938TlkYC before bed, very much the better. That particular book is aimed at athletic training and many of the exercises in it benefit from a partner, but really, any non violent, non cardio vascular exercise will help. Don't get your heartrate up, don't get out of breath. Yoga, Tai Chi, systematic stretching, anything you enjoy. Don't pick something difficult. Pick something you enjoy. The idea is partly to relax the body , but also to get the mind off whatever thought pattern it was in beforehand and on to concentrating on something simple and physical and internal.

The mental part seems to come easily to some folk, harder for others, but it boils down to this:- You have to stop thinking. It's a process of damping down conscious brain activity.
Now, I'm a verbal thinker. What goes around in my head is a stream of words . Very often I'd find myself rehearsing "what I should have said" to the smartarse/ boss/ whoever that really upset me today. That got my blood pressure up and kept me wide awake.
I trained myself to kill that process.
If you are a visual thinker, ie you "see" internal imagery, I assume you can also shut this down.
How?
Well , in my case, by listening to myself and deliberately interrupting.

As soon as I start thinking something, I consciously interrupt the thought with a burst of random noise. An imaginary hiss, whistle, "shush". This is purely internal. If you were sitting beside me, you would hear nothing. It's just an interrupt- breaking the cycle before it gets momentum.
After doing that, I may get 5 or 10 seconds of mental silence, before I catch myself thinking again. Repeat the process. The gaps get longer , the reflex faster and easier. Eventually it ceases to be conscious. At that point, you are well on the way to going over.
There comes a point when I become aware that I am inside my own mind watching myself, silently. That realisation is itself a conscious thought. I dismiss it. And I keep doing this till I feel my mind start to slide. Even that can register as a conscious awareness and be enough to reawaken me.
Then it gets so I "know" at some level that I'm still on guard, but I'm no longer consciously aware of doing it.

This takes practice. Don't expect to get it right in a night. Could take weeks or months, but I'd expect to see some result (if a bit hit and miss) in after a few nights. Some people seem to "get it" very fast - a night or two.

I found after a while that the sudden realisations of where I was and what I was doing became briefer and further apart. It's like balancing a scale by keeping a fingertip on each side- after a time, you scarcely move either finger ; you even lose the sensation of touch. You have damped the oscillation of the system totally.

I read a book on lucid dreaming in which the writer seemed to use very similar methods to start lucid dreaming. That has never worked for me. I've had a few LDs, but never at will.

This all sounds a bit woo. But it's just a matter of monitoring and suppressing your own conscious neural activity. I realise this may be harder, even impossible, for people with some medical conditions, but it works for me..

If you think visually, some sort of neutral image may be what you need- a blank screen, for want of a better term. (I find it hard to believe people can think in pictures. I can't do so at all). You find yourself developing mental shorthand and shortcuts- you suddenly become aware of a thought, but find you have suppressed it so fast it didn't hit short term memory. You literally can't remember what you just started to think about.
Sometime about this stage, I'm gone.

A friend says she uses the mental chanting of a meaningless mantra to get to sleep. If it works for her, it may do for others. Me it would wake up, because I'd start thinking about the word, then thinking about my thoughts about the word and then...chaos. I need to damp verbal activity, not swamp it, but I don't pretend my way will work for everyone.

One thing to absolutely avoid is any external stimuli that can get your conscious attention. This is why the snorer is so dreadful, because he hits you again and again. It's not the noise, it's the periodicity. You are consciously listening for the next snore. I can sleep like a log with machinery running a few feet away. (I may wake if it stops), but gods save me from snorers.

In-ear foam earplugs can be a godsend, by the way. Do try them. You can buy them from Health & safety suppliers for a few dollars for hundreds. Chuck 'em away every morning to avoid the chance of ear infection.

One thing I tried years ago was a "Mindlab", a gadget that featured LED- equipped glasses and earphones linked to a tape cassette. Flashing lights and odd patterned sound were claimed to have all manner of beneficial effects, from enhancing the IQ to straightening your teeth. Dunno about all that stuff, but I do know it put me out like a baseball bat between the eyes.

Anyway, that's my 2 cents worth. I could pad it into a 200 page self help manual , but it boils down to-
Learn to relax physically.
Shut out external stimuli.
Teach yourself to damp your own thinking.
 
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I sympathize with you. I used to suffer from severe insomnia. Some days it was so bad I had trouble functioning. I was taking OTC sleeping pills on a regular basis, and even melatonin, but the effects wore off after a while. My life at that time wasn't particularly stressful.

Eventually I figured out that the main reason I couldn't sleep was due to light sensitivity(from TVs, computers, fluorescent lights), due to blue light in particular. So I looked for glasses that would block out blue light while not making it too dark. I eventually found these orange glasses. Wearing them a few hours before bed time helped me go to sleep early since they block out 100% of blue light. I can even watch TV or use my computer at night while wearing them and not worry about the light stimulating me.

Instead of going to bed at 3 AM like I used to do, I was going to bed at 11:30 PM, and waking up early and refreshed(6 to 7 AM). Even on days off from work I wake up very early, instead of at noon like I did before. The glasses make me feel sleepy very early, since they block out the type of light that suppresses melatonin, the body's natural sleep hormone. This seems to work for some other people I know, but it doesn't necessarily work for everyone. The older a person is, the less effective they are, since as we age, we tend to produce less melatonin.

There is a company that specializes in orange tinted glasses to help you sleep - Lowbluelights. Unlike the glasses I linked to before, these are very expensive. The other glasses I linked to do the same exact thing(although they are not advertized as "sleep" glasses), based on my testing and experimentation as the Lowbluelights glasses. I hope it is appropriate to post this, I am not advertizing for them or the other company I linked to. I have no link with either company. There are also the very cheap orange glasses($8.20), the Uvex S1933X Skyper Safety Eyewear, Black Frame, SCT-Orange UV Extreme Anti-Fog Lens that they sell on Amazon that seem to do the same thing as the Noir glasses, however I find them uncomfortable because of how close the lens is to the eyes, and they are kind of flimsy and not fit-overs.

It's not necessary to wear the glasses while sleeping, but make sure your bedroom is as dark as possible for sleep. It may also help if you get yellow or orange colored bulbs for your bedroom and bathroom, to minimize problematic light. The effects are too strong and consistent for me to believe it's a placebo, although it could be. Some scientific studies do exist demonstrating these glasses work and that blue light is problematic. Again, it is not guaranteed to work for everyone, since insomnia can have multiple causes. It may also help if you are exposed to bright light early in the morning to help reset your clock better and eliminate grogginess. I also wear ear-plugs when I sleep and avoid eating large meals too late at night. It also helps to cool the body before bedtime(sometimes I use an icebag if I feel hot before bedtime), especially the head at night, since heat can be stimulating just like light. Too cold though can be just as bad, so don't try to freeze yourself.
 
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Doctors advice is: "Try to get more sleep." I agree that would be a good cure for insomnia, but a bit more practical advice on implementation would be nice.

In fairness to the Doctor (and in the interest of full disclosure), she did offer to write a prescription. Don't know if that would have helped as I didn't take it. Psychoactive drugs scare me.
 
Was just reading an article in a recent Time magazine about nightmares and insomnia. For insomnia: Avoid caffeine, don't take naps more than absolutely necessary, wear ear plugs to sleep. I had insomnia for years and for me none of that worked, though all of it helped. Ambien worked best but it was addictive and my doctor would never prescribe more than 5 or 10 at a time, which was probably wise but not very helpful for a problem that was near constant. Benadryl worked but it made me cranky and foggy the next day. Alcohol worked to get me to sleep but I would always wake up in the middle of the night and be unable to go back to sleep. Seizure meds worked better than anything else for me, with the unexpected side effect of getting rid of both insomnia and nightmares, but I realize that's not useful to anyone without seizures.

I did think it was interesting that they linked nightmares to breathing difficulties like sleep apnea, or even just something called upper airway resistance.

They also recommended a medication called prazosin which was a blood pressure med that turned out not to be too effective at lowering blood pressure but highly effective at reducing the frequency of nightmares in soldiers and others with PTSD or just frequent nightmare sufferers.

Third was imagery rehearsal therapy where you mentally rehearse a dream you would like to have, write it down and think about it daily. Evidently this from a paper published in JAMA showing a dramtic reduction in nightmares for PTSD sufferers from 6 a week to 2.
 
I used to not have trouble sleeping, then I put my house on the market. Very stressful. My mind would race through all the things that could go wrong. I found Ambien to be extremely helpful. I believe it's habit forming though.

Also, I tried an abbreviated self-hypnosis routine. I didn't stick with it, but I've found that if I wake up in the middle of the night and can't get back to sleep, if I do breathing exercises (clear mind of everything and just focus on center of breathing), this often allows me to drift off to sleep.

Don't know if it's been mentioned, but sleeping through the night is a pretty new innovation. It used to be common to sleep for four hours, wake up for an hour or so to read, relax, have sex, etc, and then get four more hours. Getting up for an hour has helped me sometime too.
 
I understand. I don't drink alcohol (liver issues) but suspect there is something out there that will have the same calming effect on my brain.

This is almost certainly about quieting down the brain during stressful periods.

Marijuana? ;)
 
I am a doctor, but not a sleep specialist (well, unless you're having a surgical procedue ;) ).

Best quick advice:

(1) Go to bed early and get in a pattern. Proper sleep hygiene is key.
(2) Lie in a quiet, dark room that is cool.
(3) Don't read or watch TV in bed - very bad habit.
(4) Do not nap during the day.
(5) Do not drink any caffeinated products after 2:00 PM.
(6) Exercise regularly.
(7) If you are overweight or your significant other tells you that you snore, check to see if you have sleep apnea by talking to a qualified general doctor and/or scheduling a formal inpatient sleep study.
(8) Self-meditate (not in the TM sense) by focusing on a point in your mind of emptiness and, if you start to have racing thoughts, go back to focusing on that point. Continually re-direct your mind to that point of emptiness.
(9) Avoid alcohol. This does not promote good sleep.
(10) If you continually wake-up early in the morning and can't get back to sleep, get an evaluation for occult depression. Do not self-treat with OTC meds or prescription sleep inducers (e.g., benzodiazepines, eszoplicone, zolpidem, etc.) for this type of sleep pattern.

~Dr. Imago
 
Some people seem to thrive on little sleep.
The bad part is not wanting to be awake when you are awake.
We should be writing a novel.
 
I sympathize with you. I used to suffer from severe insomnia. Some days it was so bad I had trouble functioning. I was taking OTC sleeping pills on a regular basis, and even melatonin, but the effects wore off after a while. My life at that time wasn't particularly stressful.

Eventually I figured out that the main reason I couldn't sleep was due to light sensitivity(from TVs, computers, fluorescent lights), due to blue light in particular. So I looked for glasses that would block out blue light while not making it too dark.

There is software called f.lux that makes the color of your computer's display adapt to the time of day, warm at night and like sunlight during the day.
 
I do indeed find dark helps, and now use a mask as well I've found this helps sleep onset and delays waking.
What I meant was to avoid bright light for some hours before trying to sleep, while you're still alert, functional, and presumably have things to do that aren't compatible with total blackout. Apologies for redundancy if you recognized that already.

The idea is to reduce optic nerve electrical activity that inhibits your body's own melatonin production. Apparently that was evolution's way of culling individuals who didn't use daylight hours for stuff harder to do at night. We technological hominids are both more shielded from the regular solar illumination and bombarded by more arbitrarily scheduled artificial illumination.
 
Many of the tips mentioned here are, in my experience, useful. I will add one other, which was already touched upon.

Self-hypnosis, though it doesn't replace sleep, is better than lying there with your eyes wide open wondering if you're ever going to get any sleep. Basically, self-hypnosis is a conscious decision to relax the body (think of going as limp as a wet dishrag) combined with a mental focus and feedback. One technique is to close one's eyes and just look at the colors. Of course, there AREN'T any actual colors, if you're in a darkened room with your eyes closed, but you might be able to see colors anyway: yellows, greens, purples, pinks. Sometimes you may see splotches, sometimes you may see patterns.

Think of a color, and then see if you can make it appear before you. With practice, you can actually SEE the color you want to see. This is the feedback part. When you see part of the color you want to see, you may find you may be able to make yourself see more of it, or see it more clearly. Then make it dissolve into a different color, or appear and disappear.

What often happens after a while is that distinct images appear. This is the start of dreaming. Unless the images are unpleasant, don't fight them; go with them.

This is sometimes a very useful technique for me, but it is less effective if I am very worried about something.
 
First, the usual terms & conditions:- I am not a doctor or sleep specialist, just someone who has had my share of problems sleeping and learned what helps me to get a good sleep. If your problem relates to an underlying chronic medical condition, or to drugs (legal or otherwise) I don't know if my experience is relevant.
Of course.

This takes practice. Don't expect to get it right in a night.
Thanks for the suggestions. It sounds like a road I've started down plenty of times, but I guess I just got frustrated and gave up too soon.

One thing to absolutely avoid is any external stimuli that can get your conscious attention. This is why the snorer is so dreadful, because he hits you again and again. It's not the noise, it's the periodicity. You are consciously listening for the next snore.
If you think regular periodic snoring is a deal breaker, try going to sleep next to an aperiodic snorer. Consciously listening for the next snore is bad enough. Knowing it might not arrive on cue adds to the suspense. When another comes just as you quit listening for the last, you're hooked again for another cycle. Remembering the state's attitude toward smothering somebody with a pillow only adds to the frustration. I've finally learned to address such external stimuli before too many cycles raise my frustration hackles; tweak the snorer's position, hide the snores behind earplugs or background noise, or take myself somewhere the snores can't reach.

I think it's internal stimuli that has made me give up just as I might have been approaching success. Too many times, I've used techniques similar to what you describe to get myself nearly to sleep... only to have some random thought grab my undivided attention when I let down my guard.
 
I've tried various herbal sleep remedies (no effect what-so-ever),
Alteril is non-scrip in the US and works for me. I take one every few nights, and it takes 30 min to kick in.

Sometimes a bit of am after-waking drowsiness, but usually not too bad.

L-trytophan, Glycine, Melatonin and GABA are the ingredients.
 

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