Forgetting to sleep? Try forgetting the day.
Have you had some trouble sleeping? Yes, I have had more of that in the past year than ever, I think. In addition to the whole precarious state of the world in 2020 and moving into 2021, our family has had some significant stressors in the past year. There have been nights when troubled thoughts kept me awake for sure, but that's actually pretty uncommon for me. I personally am really grateful for that, as many do not sleep that easily.
First, it may be a good idea to mention it to your primary care doctor. There are some medical conditions associated with poor sleep, such as obstructive sleep apnea, restless legs syndrome, or other painful conditions that awake you from sleep. Even if it is your sleep partner that snores loudly enough to keep you awake, s/he could benefit from medical evaluation, and you will benefit too. And if the answer is not evident, a polysomnogram may be recommended to make a diagnosis, which could involve an overnight stay in a sleep lab.
I am often asked about natural medicines for sleep. It's almost always OK to use melatonin 30 minutes before bedtime, considering a 1 mg timed release preparation. Magnesium supplements can be helpful, as well as B vitamin complexes, especially if anxiety accompanies poor sleep. There are a number of excellent herbal/botanical medicines to consider, but because they are not always safe when combined with medications or other medical conditions, I will only share those in the context of a complete consultation in my office. Botanical medicines are natural and usually safe, but must be chosen carefully.
Let's consider how to regulate thought and emotion around sleep. I have heard sleep expert Dr. Rubin Naiman say that it's less important to "take something to get to sleep," as it is to "let go of something to get to sleep." This makes perfect sense, as so much of the problem we have with sleep is letting thoughts of today, yesterday, and tomorrow, continue to occupy our minds. We worry, we fret, we rehearse things we said, what someone else said, what we might say tomorrow, what could go wrong, or maybe go right? But none of that helps us to do what needs to be done at that very moment, and that is to simply let go of all those thoughts, and then to trust the night, and trust our own bodies and minds to be unconscious for a while. We truly need a prolonged period of time every 24 hours to let go of wakefulness in order to be physically and mentally healthy. Can we trust that all those things we "need" to think about will be ready for us again in the morning? And that sometimes a good night of sleep brings mental clarity on things that we otherwise could not get straight?
Training a mind to be quiet is like training a new puppy: it takes consistent daily adherence to the same practices and rules. Minds like predictability, patterns, and ritual. So make sure to do the same quieting routine if your brain startles you awake in the night. Here are some of those practices and rules I recommend to everyone.
The transition from mental noise to regular sleep will be aided by giving your mind something else to focus on when you are in bed. Consider for example sleep audios such as the guided imagery found at Health Journeys.
We can also allow the brain to naturally produce melatonin at the right time by creating bedtime rituals that do not involve light from TV, computer, phone or tablet for 1 hour before bed. Use that time for other activities that are quiet, purposely letting go of the day. Some experts recommend using that time for journaling about the events of the day, making sure to write down on paper things you want to remember, tasks you need to pick up again in the morning, with the intent of bringing closure to those things, symbolically “closing the book” on today, knowing that the things you need to remember for tomorrow are written down.
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