{"id":2072,"date":"2020-02-08T20:52:34","date_gmt":"2020-02-08T20:52:34","guid":{"rendered":"https:\/\/donovancarper.com\/?p=2072"},"modified":"2020-10-25T06:45:57","modified_gmt":"2020-10-25T15:45:57","slug":"my-insomnia-experience-part-3-sleeping-naturally-at-last","status":"publish","type":"post","link":"https:\/\/www.donovancarper.com\/index.php\/2020\/02\/08\/my-insomnia-experience-part-3-sleeping-naturally-at-last\/","title":{"rendered":"My Insomnia Experience: Part 3, Sleeping Naturally at Last"},"content":{"rendered":"\n
\"\"
(Image credit: Pixabay<\/a> at Pexels)<\/figcaption><\/figure>\n\n\n\n

This post closes out a series that shares lessons I learned during a horrendous bout of insomnia. I will discuss the final set of interventions I discovered that actually worked to help me sleep naturally again. No supplements needed, no sleep drugs\u2013just healthy, natural sleep!! <\/p>\n\n\n\n

A brief review<\/h3>\n\n\n\n

My Insomnia Experience: Part 1, Sleep Medications:<\/a> In Part 1 of the series, I discussed the onset of my insomnia along with my experience using sleep drugs while I scrambled to adapt to my frightening experience. The health risks of insomnia along with the dangers of sleep medications are discussed. During the early days of my insomnia, I was desperate. I knew insomnia could wreck my health, and I knew sleep medications could do the same. However, insomnia was new to me and at the time, I did not know what else to do! I share tips I used to reduce the risk of developing tolerance and dependency on the sleep drugs. <\/p>\n\n\n\n

My Insomnia Experience: Part 2, Taking My Life Back<\/a>: Part 2 of the series lays the foundation for recovery. The post describes the methods I used to take my life back from insomnia. My insomnia was not resolved at that time, but based on principles found in the book \u201cThe Effortless Sleep Method\u201d (Stephens, 2010), I created a healthy schedule that would prove essential to my recovery. I also share how I overcame my reliance on sleep drugs in part 2 of the series!<\/p>\n\n\n\n

The tools of recovery: Lifestyle overhaul<\/h3>\n\n\n\n

Imagine my surprise when I woke up in the morning, fully rested, in the fall of 2019\u2013realizing I had not awoken once throughout the night? For many people, such an experience would be quite mundane, but after a year and a half of struggling with insomnia, I found it pleasantly remarkable. Imagine now how thrilled I was when this experience repeated itself night after night over the next several weeks?? No medications, no supplements. This restoration of sleep is now my norm again\u2013restful, healthy sleep. <\/p>\n\n\n\n

When you are in the midst of your insomnia experience, you read about recovery experiences with skepticism<\/strong>. You think \u201cok, that\u2019s you\u2026I tried a lot of what you are describing, my case is different, I\u2019m different\u2026I don\u2019t know if I\u2019ll ever beat this\u2026nothing works for me\u2026\u201d I know this, because I was there, thinking those thoughts. Recovery is possible, but the truth is, recovery requires A LOT on your part. <\/p>\n\n\n\n

\"\"
Sleeping till dawn is possible, but may require a total lifestyle overhaul if you want to succeed (Image credit: Jonathan Petersson<\/a> at Pexels)<\/figcaption><\/figure><\/div>\n\n\n\n

Recovery involved an entire lifestyle overhaul in my case. I had to have faith in the process, that the research-backed, recommended changes would help\u2013 <\/strong>even if the results were not immediate. <\/strong> Recovering from insomnia was far more about creation of a new life, a process over time, than any quick fix. However, the process worked. Perhaps if I had not doubted so much, perhaps if I had adopted many of the recommended changes sooner, my restoration of sleep could have occurred much more quickly. <\/strong> <\/p>\n\n\n\n

A necessary disclaimer: Coordinate with your provider<\/h4>\n\n\n\n

If you are suffering from insomnia, it is essential to coordinate with a healthcare provider. I discussed this in my previous posts, but it bears repeating. Untreated health conditions will unnecessarily plague your recovery efforts.<\/p>\n\n\n\n

In my case, I have an anxiety disorder that escalated and erupted into insomnia. Treating the anxiety disorder by itself did NOT resolve my insomnia (my insomnia continued for more than a year after starting Lexapro for my anxiety), but did reduce the intensity of it. It is my belief that had I not received treatment for my anxiety disorder, the other recovery efforts I put into place would not have worked the way they have. <\/p>\n\n\n\n

On a side note, there is some question that Lexapro (generic name: escitalopram) can cause hypnic jerks and other sleep disturbances (Sathe, Karia, Desousa, & Shah, 2015). My personal experience is that I sleep better if I take my Lexapro in the am.<\/strong> A coworker had a similar experience. Such hardly serves as scientific evidence, but is worth consideration at the least for those taking the medication and having sleep disruptions. <\/p>\n\n\n\n

The final set of interventions that helped me sleep naturally again<\/h3>\n\n\n\n

The following interventions are the ones I adopted after first creating the foundation for recovery <\/strong>as covered in my previous post<\/a>. A major resource for many of the following interventions comes from the book by Shawn Stevenson, \u201cSleep Smarter.\u201d You can purchase your own copy here<\/a>.<\/p>\n\n\n\n

Establish a bedtime routine: And stick to it<\/h3>\n\n\n\n

In my prior post, I discuss the importance of taking charge of your schedule and not allowing insomnia to dictate how you live your day. Part of that schedule needs to include establishing a health promoting, consistent bedtime routine. Research is mounting that variable bed times (such as staying up 2 hours or more later on weekends or days off) contributes to sleep-cycle disruptions, insulin resistance and higher body mass indexes (Taylor et al., 2016). <\/p>\n\n\n\n

These findings held up even if sleep duration was similar between those that maintained a regular sleep schedule and those who significantly altered their sleep cycles on weekends (Taylor et al., 2016). The authors speculated that those staying up late on weekends altered their natural circadian rhythms through a variety of means, including increased late evening \/ night light exposure. Altered circadian rhythms in turn lead to disruptions of a wide variety of hormonal and physiological processes essential for long term health (Fisk, Tam, Brown, Vyazovskiy, Bannerman, & Peirson, 2018).<\/p>\n\n\n\n

It must be emphasized that family (and friends) may not support you in sticking to such a routine. Stevenson (2016) emphasizes the necessity of taking your insomnia serious enough to make real changes in your life. This includes doing such in the face of resistance. <\/p>\n\n\n\n

\"\"
Establish a bedtime, and stick to it (Image credit: Krivec Ales<\/a> at Pexels)<\/figcaption><\/figure><\/div>\n\n\n\n

For me, my wife and kids were irritated and repeatedly protested that my bedtime routine involved going to bed at 9pm. Eventually they accepted such, but it took a while. My early bedtime was necessitated by my work schedule and fitness goals. This may not be the bedtime you choose, but whatever you choose, make sure it serves your health, fitness and life goals and that you stick to it, even on days off. Or ignore this, and enjoy the roller-coaster ride of circadian cycle disruption! <\/p>\n\n\n\n

Embrace the dark! In your bedroom and evening routine that is\u2026<\/h3>\n\n\n\n

Circadian rhythm cycles over a 24 hour period are a basic part of biological life. These rhythms have been identified in lifeforms as simple as bacteria through complex mammals (Fisk et al., 2018). Light is a MAJOR regulator for these cycles. Sleep cycles, metabolism, brain function, behavior, and hormone rhythms (including melatonin) are all influenced by your circadian rhythm. As such, maintaining a healthy circadian rhythm is essential for promoting general health and healthy sleep (Fisk et al., 2018). <\/p>\n\n\n\n

Light is itself a stimulus, and blue light in particular has demonstrated sleep disrupting effects (Fisk et al., 2018). Chances are, you already read about the importance of minimizing evening time light exposure. If you are like me when I first read such information, you may not yet have made all the necessary changes despite this information. I wish I would have acted on the following advice sooner, it definitely has been part of my sleep recovery success.<\/p>\n\n\n\n

How dark should your room be?<\/strong> Darker than you likely have it currently!<\/h4>\n\n\n\n

Stevenson (2016) advocates that when the lights are out in your bedroom, it should be so dark that you can not see your hand held in front of your face.<\/strong> Is your room this dark? Is it really? Mine wasn\u2019t! <\/p>\n\n\n\n

Even with the lights out, my digital alarm cast a green glow, so I covered it up with a t-shirt and socks! My computer cord and screen had lights showing that they were plugged-in, even when in sleep mode. I unplugged them at night. <\/p>\n\n\n\n

Our bathroom light night? It was a bright white light. I changed it to red-toned nightlights and cracked the door so that it is barely open. My phone, turned it face down so the random alerts would not light up the screen (I have to have it on in case of calls from my work). Our curtains? Thin material that let a neighbor\u2019s porch light into the room\u2013we replaced them with light-blocking curtains. Only after ALL of these changes was my bedroom dark enough that I could not see my own hand in front of my face. <\/strong><\/p>\n\n\n\n

\"\"
Want to sleep better? Get rid of artificial light in your bedroom!! (Image credit: Francesco Ungaro<\/a> at Pexels)<\/figcaption><\/figure><\/div>\n\n\n\n

Note: all the lights I mentioned above are artificial, and for most of human history did not exist. Is it any wonder sleep issues are becoming more common globally? (Jaiswal, Owens, & Malhotra, 2017). The concern of artificial light and sleep disruption is further reinforced by research noting that populations that live in regions of greater artificial light intensity were more likely to experience sleep disruptions and sleep duration averaging less than 6 hours per night ( Ohayon, & Milesi, 2016). If you have insomnia and your bedroom is bright enough to see your hand at night due to ARTIFICIAL light, take action\u2013you can\u2019t beat your biology\u2013accept and honor it instead. <\/strong> <\/p>\n\n\n\n

Light in the evening-time from tablets, phones, computers: it disturbs your circadian rhythm<\/h4>\n\n\n\n

Research has shown use of electronic devices that emit light in the evening negatively impacted sleep quality <\/strong>for participants compared to when these participants used printed reading material (Chinoy, Duffy, & Czeisler, 2018). On evenings when participants in a study used light emitting electronic devices, onset of sleep was delayed, melatonin release was delayed, subsequent levels of melatonin levels were suppressed, and participants felt more sleepy in the morning (Chinoy et al., 2018). In fact, a growing body of research has repeatedly demonstrated these negative impacts from electronic devices at night on sleep and general well being<\/strong> (Chinoy et al., 2018). <\/p>\n\n\n\n

These study findings have held true in a variety of population groups and settings when people use light emitting electronic devices in the evening before bed (Chinoy et al., 2018). This is not surprising, considering the \u201cmaster-clock\u201d in the brain, the hypothalamus, directly receives signals from light receptors in the eyes. This \u201cmaster-clock\u201d also helps regulate immune system activity (Chinoy et al., 2018). <\/p>\n\n\n\n

\"\"
Goodbye\u2026Phones and screens at night give off too much light! (Image credit: Tyler Lastovich<\/a> at Pexels)<\/figcaption><\/figure><\/div>\n\n\n\n

With so much at stake biologically speaking, its important we have a healthy respect for our bodies, enabling them to function as they are designed. Stevenson (2016) suggests that we avoid screen usage approximately 90 minutes before bed time. For myself, I generally avoid using my phone (even on \u201cnight mode\u201d) one hour before bed (with rare exceptions to glimpse the time or initiate a white noise app emitting gentle rain sounds when I go to bed). <\/p>\n\n\n\n

Absence<\/strong> of blue light before bed is optimal (van der Meijden, et al., 2018). Instead of using my phone or a computer one hour before bed, I read actual physical books (\u2013with paper and everything!). I found books that offer serious escapes from reality without being overly creepy tend to work best for me at night. <\/p>\n\n\n\n

Red light spectrum appears safe for sleep <\/h4>\n\n\n\n

But what about the red nightlights I mentioned earlier? Research has shown that the absence of the blue light (short-wave) light spectrum leads to improved sleep while exposure to light waves in the red light spectrum does NOT negatively impact sleep (van der Meijden, et al., 2018). For anyone that has fallen asleep by fire light, there is something soothing about the red orange glow of embers as a fire slows itself when you drift off to sleep. The red light tolerance is also interesting in that the colors of sunset are on the orange and red light spectrum as evening turns to night. I found red nightlights cheap and readily available online. The set I use in my bathroom can be purchased here<\/a>. <\/p>\n\n\n\n

A hot bath in the evening cools you down at night and can enhance sleep quality<\/h3>\n\n\n\n

Stevenson (2016) advocates for a hot bath as part of your evening ritual if possible. I managed to squeeze this in to my routine, even when I was working on my master\u2019s degree on top of exercise and full time work. I kept it to 20 minutes and combined the bath time with meditation (multitasking!). Research supports taking a hot bath approximately 90 minutes before bed to improve sleep quality (Fischer, 2019). <\/p>\n\n\n\n

Why 90 minutes before bed and not, say, immediately before bed? A hot bath brings blood to the skin. When you get out of the bath, this blood is cooled by the ambient temperature and gently falls to lower, cooler temperatures than if you had not taken the bath (Fischer, 2019). This in turn mirrors how the body itself cools overnight and helps promotes release of melatonin. In terms of general room temperature, Stevenson (2016) suggests a cool room with a generally warm bed. I have found the same works for me generally speaking. Maintaining cool but comfortable temperature levels seems to help me the best\u2013waking up cold is no better to me than waking up too warm. <\/p>\n\n\n\n

Guided meditation during the 20-minute bath<\/h3>\n\n\n\n

Mindfulness meditation is a recommendation Stevenson (2016) suggests based on research he cites in his book. I had done mindfulness meditation for approximately 20 minutes a day most days of the week for nearly a year or so prior to the onset of my insomnia, and found that despite research findings, mindfulness meditation did not necessarily improve my sleep quality. This is despite trying mindfulness meditation in the morning or at night, and despite having practiced it now off and on for several years. I find mindfulness meditation relaxing, but it does not appear to impact my sleep for better or worse in my personal case. <\/p>\n\n\n\n

I also experimented with MANY guided meditations on YouTube. One I consistently come back too seems for me personally to work the best. It seems to put me in a proper frame of mind during my bath and before bedtime. What do I like about it?<\/p>\n\n\n\n

The guided meditation I found that works best for me starts of with a guided imagery session that it useful for getting my mind off of work and whatever other preoccupying thoughts I may have. It next follows with a segment on thinking about positive events from the day and giving gratitude for the even the smallest positives in your life. It continues by encouraging you to let go of the past, envision a positive tomorrow, and finishes with a segment for prayer as you desire. <\/p>\n\n\n\n

\"\"
A hot 20 minute bath with meditation, 90 minutes or so before bed, is a great for sleep (Image credit: Pixabay<\/a> at Pexels)<\/figcaption><\/figure><\/div>\n\n\n\n

A positive bias, attitude of gratitude, and practice of faith are all components of resilience against the negative effects of stress (as covered in my post concerning the science and research findings for resilience against stress<\/a>). My natural disposition has tended towards anxiety and negativity. By practicing this meditation, it helps re-frame my thoughts. It is free, and titled \u201cGuided Evening Meditation \u2013 Gratitude, Forgiveness and Letting Go<\/a>\u201d by Suzanne Robichaud<\/a>.<\/p>\n\n\n\n

Going (mostly) plant-based: your diet can impact anxiety, depression, and sleep <\/h3>\n\n\n\n

Nearly four months into my insomnia experience, my father-in-law was diagnosed with stage IV colon cancer and given months to live at best. He was only 57 years old. This traumatic experience for myself and my family caused me to research deeply the diet, cancer, and overall health connection<\/a>. I write about my experience<\/a> changing from a \u201ctypical American\u2019s\u201d idea of a healthy diet (high protein using animal sources such as lean meats and protein shakes) to a mostly plant-based diet following this experience. I can not say for sure how much this contributed to my sleep improvements. However\u2026<\/p>\n\n\n\n

Research on Mediterranean diets<\/a> has shown that adopting a majority plant-based diet containing whole foods, whole grains, fruits, vegetables, beans and lean proteins such as fish can have positive and protective effects on mood states such as anxiety and depression. Emerging research is also demonstrating positive impacts of Mediterranean diets on sleep duration and quality<\/strong> (St-Onge, Mikic, & Pietrolungo, 2016), though as the authors note, the research is still in early stages. As an aside, a fascinating video from the organization Physicians Committee for Responsible Medicine<\/a> notes that many of the researched benefits identified concerning the Mediterranean Diet were found primarily in the adherents that ate the least animal products and ate mostly plant-based foods (Barnard, 2019). <\/p>\n\n\n\n

Time restricted eating: Nothing after 6pm<\/h3>\n\n\n\n

Due to issues with gastric reflux, I stopped eating after 6:00pm most days. Often now, I avoid eating after 5:00 pm if I can. I found eliminating nighttime snacks and drinks substantially helped with reflux in my case. While reflux was not the primary factor causing my insomnia, eliminating it reduced one more factor that at times woke me up at night.<\/p>\n\n\n\n

Research concerning intermittent fasting (such as increasing the amount of time between the last meal of the day and the first meal of the next day to greater than 12 hours) has shown a number of fascinating health benefits such as reductions in inflammation and improvements in insulin sensitivity (Longo & Panda, 2016). The fasting state is a time when the body focuses on cellular repair and rejuvenation, activities that also occur with sleep (Longo & Panda, 2016). Research is beginning to show that nighttime feeding and narrow time windows (less than 12 hours) between the last meal of the day and first meal of the next day can disrupt circadian rhythms. <\/p>\n\n\n\n

My goal of eliminating nighttime snacking had little to do originally with my insomnia. However, by not eating anything after 6:00pm, such may be benefiting my sleep not only in reducing reflux but also in promoting a healthier, more natural circadian rhythm cycle. The research is still young in humans in terms of time restricted feeding, but appears promising (Longo & Panda, 2016). <\/p>\n\n\n\n

\"\"
A diet that is mostly plant based, such as the Mediterranean diet, appears to improve anxiety, depression and sleep! (Image credit: Ella Olsson<\/a> at Pexels)<\/figcaption><\/figure><\/div>\n\n\n\n

Pink noise: Nature sounds and sleep<\/h3>\n\n\n\n

An article from the Cleveland Clinic<\/a> (2018) describes pink noise as consisting of natural sounds, such as rainfall or thunderstorms. The article notes that research demonstrates a slowing of brain waves and enhancement of deep sleep cycles. Research has demonstrated through use of EEG monitoring of brainwaves and EKG monitoring of cardiac rhythms, deeper and more stable sleep for study participants both during naps and overnight when they were exposed to \u201cpink noise\u201d consisting of soft, steady natural sounds (Zhou, Liu, Li, Ma, Zhang, Fang, 2012).<\/p>\n\n\n\n

Both my wife and I enjoy playing at low volume the sounds of gentle rainfall while we sleep using my iPhone. I currently use an app called \u201cAbide\u201d and simply play the ambient noise setting available for the background noise. The Abide meditations are fine but did not seem to improve my sleep\u2013perhaps that\u2019s just me. <\/p>\n\n\n\n

\u201cEarthing\u201d or \u201cgrounding\u201d\u2013Whaaaaat?<\/h3>\n\n\n\n

\u201cEarthing\u201d or \u201cgrounding\u201d sounds a little like science fiction when you first read about it, but preliminary research published in the medical science literature<\/a> has shown some very interesting early findings. I became interested in grounding after first reading about it in the book \u201cSleep Smarter.\u201d These findings include:<\/p>\n\n\n\n