Drugs, Lifestyle, and Insomenia (July 10, 2018)
Yes, I know it's spelled -- and pronounced -- "insomnia". But it was invariably referred to as "insomenia" by a favorite professor of mine, who originally hailed from Taiwan. I cannot help but treasure the memory. Besides, if you ever get it badly enough, you might end up mispronouncing it yourself.
Insomnia is more common than usual this time of year. That is not simply because people are more uncomfortable when it's too hot to sleep. Temperature, specifically a drop in temperature, is a trigger your body uses to enter the sleep state. So it’s too hot, you’ll have trouble falling asleep. That’s one of the items on the Fix Insomnia Checklist at the end of this newsletter.
Ok, let’s stop here for a second. Did you bridle at hearing that there’s a Fix Insomnia Checklist in here? Then I am going to make two assumptions about you, and here they are. (1) You have trouble sleeping, at least occasionally. And (2) you don’t have the slightest intention of really doing anything about it.
Of all the disorders that can be remedied with lifestyle fixes, insomnia stands out as the one that your basic sufferer is LEAST likely to fix with a lifestyle change -- not because said changes don't work, but because said sufferer just won't be bothered. It is a picnic getting someone to take a daily walk, for example, versus getting them off the computer two hours before bedtime.
A typical insomniac will shamelessly tell you TO YOUR FACE that that thing you just told them to do? The thing that will help them to sleep better? Well, they are not going to do it, because -- well, they just aren't. They CAN'T, or something. Then they look at you smugly to see you try to figure out how to fix their problem anyway. Well, guess what? Acupuncturists aren't hairdressers. You don’t get to do any darn thing you want and come in here and get the mess you made fixed up. Physiology doesn't work that way.
I have been in the wellness biz longer than I like to think about, and probably the biggest problem with it is what practitioners call “patient compliance”. This is not just a problem in wellness care, of course; conventional medicos deal with it too. But in their case, “compliance” usually is talking someone into submitting themselves to the knife. In OUR case, “compliance” usually means either starting to do something you don’t really want to do (exercise) or quit doing something you like (eating sugar). Getting someone to agree to being cut open is a whole heckuva lot easier to do than getting them to stop drinking diet soda, trust me.
People do things in a certain way because they LIKE doing them that way, and that is the reason that pill popping and surgery – quick, easy fixes – will always be the favored form of American health care. I know this, and I accept it. But when someone thinks that “alternative medicine” just means that they can trade in their Ambien for calcium, or that some essential oils are going to change a physiology that took billions of years to develop just because they feel like playing Fortnite Battle Royale four hours a night, well, sorry.
No, I’m not sorry. There’s no substitute for taking proper care of yourself. When your body makes you uncomfortable or otherwise seems to turn on you, the only REAL solution is to give it what it needs. Do anything else and you are heading for trouble down the road. Lack of discipline eventually is its own punishment.
Ok, thanks for listening to all that. Back to insomnia. “Too much stimulation, too late in the day” is the fundamental theme underlying the different sleep disruptors. Correcting that is the key to getting more and better sleep. With that in mind, here are a few things you can do to sleep better, if you want to be bothered.
THE FIX-INSOMNIA CHECKLIST
1) Go to bed and get up at the same time every day, even on weekends. Your body likes regularity, and giving it the same bedtime and awakening time every day helps it figure out what it needs to do at what time. (And make sure that you are allowing enough time in bed to actually get sufficient sleep. There’s nothing praiseworthy about sleeping less than you need to.)
2) Eliminate caffeine and alcohol for at least the last few hours before bedtime. (Alcohol may help you get to sleep, but it will also cause you to wake up several hours later). You may need to stop earlier in the day. If you eliminate them both completely for a week and that fixes your sleep issues, then you can start playing with the timing.
3) Get some regular exercise (although not vigorous exercise late in the day). That decreases muscle tension (and not just at bedtime).
4) Make a point of "winding down" at the end of the evening. If the hour or so before your bedtime is boringly peaceful and relaxing, you're probably on the right track. You won’t sleep if you aren’t calm.
5) No computer time (or maybe any screen time at all) at least two hours before bedtime. Light at night disrupts the normal melatonin cycle, which is why you can use melatonin to help with sleeping issues. It is also why any artificial light, but particularly the wavelengths emitted by computer screens, makes sleeping difficult. Cut the screens off at least the last couple of hours before bedtime
There is some evidence that blue light-blocking orange goggles filter out enough of the overstimulating blue light that underpins the light of computer screens that some people can simply put them on around 6 PM and spend the rest of the evening on the computer. Just sayin'.
6) If you tend to wake up at night, you need something to occupy your mind with when you do wake up besides tomorrrow’s to-do list. I heartily recommend the 4-7-8 breathing technique for this:
I know that Dr. Weil is kind of annoying. But this is a great little technique. Trust me.
7) Keep the bedroom cool enough. People sleep the best at 60-67 degrees fahrenheit. If your bedroom temperature is typically over 75, try dropping it a few degrees.
If you’re doing all the right things and still can’t sleep, try seeing an acupuncturist. Acupuncture is GREAT for insomnia. And insomenia too.
And if you won’t do what you need to fix the underlying issue, go see your doctor. S/he has lots of great prescription options to choose from. Of course they might also lead to you eating entire frozen pizzas without realizing what you are doing, cleaning your shotgun in your sleep, or hallucinating that you are talking to historical figures while driving in traffic. But then, no one said life would be a walk in the park -- or that it might be something you did while unconscious.
Anyway -- sleep tight, you all!
--dr. diane holmes
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