sleep medications

This post covers the lifestyle changes I used to overcome my insomnia and ditch the sleep medicines. I discussed the first five months of my personal struggle with insomnia in “My Insomnia Experience: Part 1, Sleep Medications.” During those early months, I was desperate and turned to sleep medications like many people. However, as a registered nurse, I was all too familiar with the long term dangers and side effects of sleep medications and I knew I had to find a more permanent, “drug-free” solution.

But what, exactly, was that “solution?” The entire reason I was taking sleep drugs was because quick fixes had already failed. Over-the-counter supplements such as valerian root, chamomile tea, melatonin and various herbal supplement formulations failed miserably. Another $20 for a supplement, another night waking up around midnight and staying awake most of the night.

Soft music, YouTube meditations, and podcast meditations also had failed. I even practiced mindfulness meditation and exercised routinely, and yet, I had full blown insomnia. I began to believe “something” was wrong with me. Maybe there was something wrong with the parts of my brain that regulated sleep. Maybe I would never sleep normally without sleep medications again.

The answer to my sleep problems as it turned out, was not in finding “the right” herbal supplement or podcast series or YouTube meditations. The answer certainly was not going to be long term dependency on sleep medications–I couldn’t accept that. Turns out, the answer was not one but many mindset and lifestyle changes over time that, combined, would restore my ability to sleep again naturally through the night.

Insomnia: Rule out medical causes

NOTE: Insomnia and frequent awakening can be a sign of an easily treated condition such as sleep apnea. (I had a sleep study years before due to snoring and had ruled out sleep apnea in my case). It can also be a complication of a host of acute and chronic illnesses or due to side effects from medications. This post is NOT a substitute for coordination with a licensed health care provider.

All medication and supplement decisions need to be coordinated with a qualified health care provider. While the following items helped me, everyone’s case is unique. This post is strictly for informational purposes.

Insomnia recovery step 1: A new mindset

Reclaiming my life from insomnia required a total lifestyle overhaul. Everyone that suffers from insomnia feels anxious about it. Further, everyone suffering from insomnia wishes they could sleep “normally” or without problems.

However, wishing, feeling anxious, complaining, going onto forums and social media–all these things are WORTHLESS unless this energy is used to fuel and motivate serious lifestyle changes. YOU may not be “broken,” but there’s a good chance your lifestyle is. The first resource that provided me with information leading to real improvements in my insomnia was the book by Sasha Stephens, “The Effortless Sleep Method.” I drew heavily on this book, applying principles progressively as I learned them. A copy of this book can be ordered here.

What’s so great about the book? Stephens (2010) really tackles the flawed mindset and harmful adaptations so many people suffering with insomnia unconsciously adopt. According to Stephens (2010) insomnia sufferers need to:

• Stop thinking your problem is “special,” “unique,” or that you are somehow “different,” that your brain’s sleep mechanisms are broken, stop thinking your problem cannot be improved!!
• Stop arguing about how right you are, how different you are, why changes won’t work for you
• HONESTLY evaluate your habits and lifestyle as you learn about necessary lifestyle changes, start making real changes AND STICK TO THOSE CHANGES…many of these changes have to be practiced consistently over time as their positive effects begin to take hold
• Regaining healthy sleep is not so much about adding MORE things to your life as it is about removing unhealthy habits that have accumulated and are finally taking their toll
• Replace old, harmful habits with new habits that promote overall health and sleep
• Stop letting insomnia dictate your life–“I will start exercising when I sleep better, I will start eating healthy when I sleep better, I will be active and productive during the day when I sleep better”–WRONG! Stephens (2010) emphasizes doing those things that benefit your life now-–do not let insomnia dictate your life and life goals during the day
• Stop letting insomnia dictate your schedule–“I leave work early or call off, or sleep in late or throughout the day because of my insomnia”–WRONG! Stephens (2010) emphasizes that you live your life according to your scheduling needs regardless of your insomnia. The insomnia does not dictate your schedule–you dictate your schedule (note: there may be exceptions, such as performing highly dangerous tasks that require total focus, I am simply sharing my experience in exercising principles from the book as applied in my personal situation)

Insomnia recovery step 2: Taking charge of my life and schedule

Applying the lessons I was learning from Stephens’ (2010) book ” The Effortless Sleep Method” during my summer of sleep medication dependency, an early change I made was taking charge of my schedule. I worked full time, I was actively taking graduate courses for a masters degree in nursing, I strength trained and walked on my treadmill while reading class material to meet my fitness needs. Insomnia was throwing a major wrench into all of this, but following Stephens’ (2010) principles, I couldn’t let insomnia dictate my life or my schedule.

Early on, my boss was compassionate and allowed me to take a few half days after particularly bad nights, but I knew this could not last. We even discussed a leave of absence. However, Stephens’ (2010) principles motivated me to take a different path!!

Stephens (2010) warns that you can end up feeding the insomnia monster by subconsciously rewarding it, unintentionally using insomnia as a means to avoid other difficult challenges or stressors in your life. These stressors are often necessary for success and health (such as exercise, hard work, healthy diet, making changes within your life). Insomnia can become a way to excuse yourself from making or facing these changes. You do NOT want to reward your insomnia, even subconsciously–you do not want to feed your insomnia monster. So don’t…don’t even chance it.

My schedule: Insomnia be damned!

What did I need to do to succeed in work and life in terms of my goals?

• Sleep requirements scheduled: I needed 7 to 8 hours of sleep (even though that was not currently happening without meds)–this is what I wanted, so I was going to create this schedule whether the sleep actually happened or not
• Morning cardio and reading: I wanted to get my half hour of morning cardio plus some class reading accomplished before work (I read my college text requirements on my ipad while walking on the treadmill)
• Getting to work on time in spite of the morning cardio: To get to work on time, I would need to get up at 5:30 am most days and some days at 4:30 am. As such, this was my wake up time, NO MATTER WHAT. NO MATTER WHAT!!! If I was up all night, or hung over from sleep medications, it didn’t matter, this was the time I was getting up. (Days off were the only exception: I did not set my alarm on my days off, but frequently was up at this time anyway on those days)
• Strength training: I was going to strength train (and read college text in-between sets on my ipad) 3-4 days per week, regardless of how terrible I slept, and regardless of how hungover I was on sleep medications. Was this a struggle? Absolutely. Did I have some lousy workouts? Obviously. But what really surprised me was in spite of my condition, I managed to set new personal records that summer. I followed the “Texas Method” training program outlined in here–the long rests between sets actually were great for keeping up with my college reading assignments:
• Choosing a bed time, and sticking to it: With my early waking times, I would need to go to bed around 9:00 pm plus or minus a half hour approximately in order to get 8 hours of sleep, so this is the time I went to bed. This created conflict with my family due to working and college demands interfering with family time–they wanted me to stay up later–however, I knew for long term health I was going to need a schedule that could be maintained and support health. Changes, such as plant-based diets, exercise programs, sleep regimens, etc., are not always understood or supported by family members. That’s ok, you are in charge of your own health. Own it.
• My work day: My work shift requires 9 to 10 hours of work 5 days a week, plus a small number of hours from home on the weekends. I was going to work this schedule regardless of sleep medication hangovers, and when weaning from sleep drugs, even if I was up most of the night. Clearly, the occasional vacation day used to make a three day weekend or even four day weekend when possible offered some relief from pressures of working and doing school with sleep deprivation, but those were scattered and only occasional.
• Cutting off caffeine after 1:00 pm: Coffee is one of the great pleasures in life in my opinion!! I could drink it all day. However, that does not serve my long term goals of a healthy wake and sleep schedule. No matter how tired I was, I eliminated caffeinated coffee and caffeinated tea after 1:00 pm. Dark chocolate also has caffeine though, and I’ll be honest, I still sometimes have some of that around 4:00 or 5:00 pm.

I implemented this schedule during the summer months when my insomnia was at its worse. It proved to be a major step, setting the foundation for recovery. This recovery was not immediate, but I held fast to this schedule regardless. A healthy schedule would prove to be AN ESSENTIAL part of the journey to overcoming my insomnia.

Insomnia recovery step 3: Dealing with the hours spent awake at night

As I mentioned above, I refused to take my sleep medications on nights before a day off, despite having college projects and heavy workout goals which I wanted to accomplish on my days off from work. So that’s great, but I found myself awake most of the night. If I was to permanently get off the sleep medications, I needed to learn how to better deal with the sleep issues that plagued me when I did not take the medications.

Stephen’s (2010) book “The Effortless Sleep Method” helped here as well. There are many principles in the book, I trialed various interventions suggested and stuck with what seemed to help me the most. Interventions I took (inspired by the book) to get through restless nights included the following:

• Covering up the face of the alarm clock, taking off the watch and putting it face down or away from my bed. Obsessing over how much or little you are sleeping, obsessing over how close it is till the alarm goes off does NOT promote sleep. Since adopting a set schedule as recommended by Stephens (2010), it did not MATTER what time it was for me…it was not going to change what time I got up, and it was not going to change how I ran my day.
• Preserving the sanctity of the bedroom for sleep and sex. If you don’t want to associate your bedroom with tossing and turning and overnight anxiety, then get up and leave your bedroom if you can’t sleep after what feels like 20 minutes of laying awake (remember, you are not looking at your clock anymore, so when it feels like 20 minutes or so have passed, get up and leave the bedroom).
• Finding a new sanctuary for when I can’t sleep in bed: for me, if it felt like 20 minutes had passed and I had not fallen back to sleep, I left my bedroom and went down into the basement, taking my pillow with me (there were blankets already available in the basement). Our basement is finished, and has a recliner with a table and lamp next to it. I would end up spending many nights here over the following year and a half!
• Creating a sense of peace in the night in my alternate sleep location: after giving up on sleeping in bed, I would go to the basement as mentioned. If I felt wide awake, I just turned on the lamp next to the recliner, set my iphone to the Pandora station “Sleep Sounds of Nature, Relaxing Mindfulness Meditation Relaxation Station”–(Hey, I didn’t name this station, just happened to find it when typing “sleep” into the Pandora search bar). I set the volume on my phone to where it was barely audible. Honestly, I did my best to ignore the clock on the iphone. There was a little Bible on the side table and I would read that till I thought I felt tired, focusing on scriptures of hope, healing, forgiveness, salvation, etc. to encourage a more positive frame of mind. If I felt somewhat tired, I would turn out the light, set the alarm on my iphone, and try to rest or sleep.
• Managing my thoughts when attempting to fall asleep, or when waking up initially: Even in this peaceful environment I created for myself in the basement, where I was free to turn on the light or turn it off as I needed, where I could toss and turn, and where I could read or not, the insomnia fueled anxiety. I needed a way to manage my thoughts. Prayer only helped if kept brief, as for me, it soon became anxious prayers about worries, concerns, requests, etc. All fine, but not conducive to sleep. Instead, I adopted a technique inspired by Stephens’ (2010) book “The Effortless Sleep Method” as follows:
• The count back technique: Nothing fancy here, and Stephens suggests various options. This is the one that worked best for me. Upon waking in the middle of the night, or when trying to fall asleep, I would start counting backwards from 99. To slow it down a little (I was anxious, so the count would go a little too fast!), I added “Lord Jesus” to the count. May sound corny, but I didn’t care how I sounded, I wanted to sleep. I would count back “99 Lord Jesus, 98 Lord Jesus” etc., counting backwards from 99. Every time my thoughts went racing away, I would start the count over again. Over and over. I usually did not make it past 90 till I would have to restart again because of my mind wandering (or racing). Sometimes I made it down to the 30’s before having to start again. Over time, this count back tool has become a MAJOR help, one I still use regularly. Regular practice of the technique starts to strengthen the technique in terms of overcoming racing or distracting thoughts–essentially it is a form of focus meditation.
• When nothing worked: Over time, along with other life style changes I continued to make (and will cover in the next post), the count back technique really started to help get me through the night with blocks of sleep…wake up, do the count back…sleep another block of time…repeat numerous cycles through the night. However, early on, I still spent a large portion of the night awake. I would alternate reading the scriptures for a while, turning off the lights, listening to the iphone radio on very low volume, and practice my count back technique…repeating the cycle until it was time to get up. I did journal a little bit during the overnight hours, (such is recommended by Stephens with specific recommendations regarding what the journal should focus on), but such never became a major component of my recovery. For me, it was soft music, scriptures, then darkness, toss and turn, count back technique alternating between these items through the entire night, catching sleep here and there through it all at times.

Insomnia recovery step 4: Weaning off the sleep medications…going “al natural”

Stephens (2010) strongly advises against using sleep medications and even supplements in her book. Her philosophy was consistent with mine, and reinforced my desire to get off the sleep medications. However, I opted to try one more supplement when weaning off the sleep medications. I stumbled across this supplement when exploring blogs on the health and fitness website Legionathletics.com. Turns out, this supplement would actually help my efforts in getting off the drugs, though its role was definitely limited.

The supplement is called “Lunar,” (NOT LUNA!!) and is available at Legionathletics.com (current link is here). Note, I am not in any way affiliated with this company, I receive nothing in terms of commissions from them–I am simply sharing what I personally used and my experience with such. It contains specific doses and formulations of melatonin, lemon balm and a lesser known herb, rutaecarpine.

According to Legionathletics.com, the herb rutaecarpine is used to reduce the effects of caffeine in the brain. Caffeine has a surprisingly long half-life in the body, taking anywhere from 1.5 to 9.5 hours (varies widely based on genetics and other factors) just to reduce a caffeine dose by half once inside the body (Institute of Medicine (US) Committee on Military Nutrition Research, 2001). The combination as formulated in the supplement Lunar seemed to help me. Here’s how I used it to get off the sleep medications:

• Using the supplement Lunar: According to the container for Lunar, you are only to use it three nights a week maximum, or else it loses its effect. I found that it worked best for me using it only 2 nights a week, and not on consecutive nights.
• Weaning off the sleep medications: I began weaning off the sleep medications first by replacing the medications 2 nights a week with Lunar instead. I work Monday-Friday, so I used my Ativan or Vistaril (discussed with risks and side effects in my previous post) on the nights of Sunday, Monday, and Wednesday, and then took the supplement the nights of Tuesdays and Thursdays. All these were my work nights. Friday night I had Saturday off, as well as Sunday, so I took neither supplements or medications on the nights before days off, choosing to go “al natural” even if I worried that I might be up most of those nights. I continued to practice all the above lifestyle changes and sleep techniques described in the previous sections above, and continued to read through the book “The Effortless Sleep Method” (Stephens, 2010).
• Weaning ALL THE WAY OFF the sleep medications: After cutting my sleep medications back to only three nights per week (using the supplement Lunar on the other two work nights), I grew a little more “daring.” I eliminated my Wednesday night dose, figuring I only had to plow through Thursday and Friday till I had a break from work. I continued using my supplement during this time on Tuesday nights and Thursday nights. I used the basement and count back techniques as described above when I ran into trouble. Next, I eliminated the Monday night dose of sleep medication. The last dose to go was the Sunday night dose, as I was anxious on Sunday nights with a full work week ahead of me. However, after becoming practiced in my night time and day time routines, I finally eliminated the Sunday night dose.
• Eliminating the supplement: Eliminating the sleep medications was a challenge. Knowing I could cope with not having the sleep medications (using the techniques described already above going down to the basement, sticking to my schedule), eliminating the supplement was easy. Occasionally I would take Lunar on a Sunday night before the work week began, but soon that dropped off entirely as well.
• The end of sleep medications, but not the end of my sleep problems: My sleep problems would persist at this time for another year, though progressively improving over time. I had not cured by insomnia or recovered from it at the time that I eliminated my sleep medications and supplements, but I found new natural ways to cope. It would take months more of learning, adapting additional new habits and lifestyle changes till I began sleeping maybe even 6-7 hours total overnight routinely. It would take another full year till I would sleep straight through the night again, multiple nights per week, free of medications. However, here in the fall of 2018, I had set the stage now for lifestyle changes to dominate my path to successful sleep. I had broken free of my dependence on medications!

Summary

The above methods created a solid foundation for which additional lifestyle interventions could build upon as I recovered from a very serious case of insomnia. My insomnia started in April 2018. I found the book “The Effortless Sleep Method” in the summer months, began reading it and implementing changes, such as adopting a set schedule in spite of the insomnia early in the summer. In the fall of 2018 I weaned myself off the sleep medications and supplements. Further, I had been on Lexapro at this point for a few months, so my anxiety overall was becoming better managed. In the next post, I will discuss additional habit changes that I discovered (or took more seriously) and implemented to further improve my sleep, progressing steadily over subsequent months to recovery a full year and a half after the initial onset.

Thanks for reading!! I hope you enjoyed this post!! Feel free to join my e-mail list to receive my latest posts on health, fitness, and research through a faith-based lens! Post a comment, and share with a friend if you’d like! Thanks again, Donovan

Related Posts

My Insomnia Experience: Part 1, Sleep Medications

My Insomnia Experience: Part 3, Sleeping Naturally at Last

References

Institute of Medicine (US) Committee on Military Nutrition Research. (2001). Pharmacology of Caffeine. Caffeine for the sustainment of mental task performance: formulations for military operations. Washington (DC): National Academies Press. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK223808/

Stephens, S. (2010). The effortless sleep method: the incredible new cure for insomnia and chronic sleep problems. Scotts Valley, CA: Createspace Independent Publishing Platform.