Arggghhh

February 22, 2013 4:21 PM

What are your best insomnia remedies?

A swing shift work schedule, an over abundance of circumstantial stress, along with what seems to be a genetic predisposition toward earlier and earlier AM waking with age is really screwing with my sleep. Its tough to use all my healthiest strategies, given the aforementioned stressful circumstances, but i do meditate at least three days a week and exercise regularly. I have issues on all ends of the sleep cycle, with difficulty falling asleep, frequent waking, and then early morning waking without being able to go back to sleep. Often I'm laying there obsessing, but sometimes it just feels physical and the main thing I'm stressed about is not being able to sleep.

In general I'm a morning person and also have a kid i have to take to school in the mornings, and I've been working the 3 to 11:30 PM shift about 3 days a week.

Any suggestions, including lifestyle modification and specific strategies for getting back to sleep, welcome and appreciated.

posted by latkes to health & fitness (41 answers total)

I like using a guided relaxation meditation as a way to get to sleep (and stay asleep) when I'm really stressed. I play white noise (rain) in the background so it's not so jarring when the meditation stops.
posted by PorcineWithMe at 4:23 PM on February 22 [1 favorite]

3mg of melatonin does it for me.
posted by griphus at 4:25 PM on February 22 [3 favorites]

I used to go through really insane bouts of insomnia back in college (stress mostly, I guess). I think I didn't sleep for about two weeks once. It was the worst. Anyway, after trying every common insomnia remedy under the sun a friend suggested something to me that worked like a charm, and I haven't had trouble sleeping since.

The trick is this: lay down in bed and tell yourself you're just going to have a little 5 minute nap. For whatever reason, this works for me like you wouldn't believe. Maybe it has something to do with taking the pressure off or whatever. Anyway, good luck.
posted by Pecinpah at 4:28 PM on February 22 [2 favorites]

Read Gayle Greene's Insomniac. There are many, many reasons people are bad sleepers and most of them are biological, not behavioral. For me, the only thing that works is prescription medication. I put off going to the doctor for years and years, but it was one of the best things I have ever done for myself, admitting that I'm just not a normal sleeper and never will be and that I'm not doing something wrong to make it that way.
posted by something something at 4:32 PM on February 22 [2 favorites]

If I'm really having trouble getting back to sleep, I get up and start cleaning out the fridge. Always makes me feel like getting back to bed and going to sleep - plus the fridge is a bit cleaner!
posted by AnnaRat at 4:33 PM on February 22 [2 favorites]

I would have not believed this would work but my wife was given a CD by Bellaruth Naperstak that somehow has the power to now put us to sleep in about 10 minutes into the meditation.

I have also found melatonin is amazing, but not to be relied upon. You can get used to the dosage, and higher dosages can cause problems.
posted by furnace.heart at 4:35 PM on February 22

White noise. It lulls me to sleep and stops me from hearing house/cat/other people's noises in the night.
posted by cooker girl at 4:41 PM on February 22

Thanks for the answers so far. A couple more specific questions:

How fast does melatonin work? If I take it when I wake up at 4 in the morning, will I be likely to be drowsy in the morning?

Also, if you have more specific recommendations of guided meditations etc, like the one mentioned above, that would be great.
posted by latkes at 4:45 PM on February 22

3mg of melatonin and Erik Satie.
posted by luriete at 4:46 PM on February 22

Reading Feynman's book Q. E. D. Always puts me to sleep.
posted by jeffamaphone at 4:52 PM on February 22

I started having terrible insomnia when I was a child. My mind would race and I just couldn't stop *thinking* and obsessing about things (I'm not the kind of person who's capable of meditation...or even just sitting and listening to music). Then it would suddenly be time to get up and go to school.

My cure was basically what everyone says insomniacs should NEVER-EVER do, which was reading in bed. But I didn't read anything new. I read my favorite book over and over and over again. I read that particular book hundreds of times when I was a kid. It basically became my nighttime routine, and my body learned that this book = time for sleep. Since I knew it inside and out, I wasn't overstimulated and looking forward to finding out what's going to happen next, but my mind was mildly preoccupied enough to let all those anxious thoughts and feelings go.

Currently, I do the other thing that insomniacs are NEVER-EVER supposed to do, which is watching TV in bed. But not any TV--only very familiar overplayed episodes of lighthearted shows that I've seen a million times. It's basically the same thing as the book setup but in a different form.
posted by dede at 4:54 PM on February 22

Sleeping tablets were the worst thing ever for mine. Was on them for a week: bliss. Then off them - body clock destroyed and nights of hell. Never again am I taking meds for insomnia.

But hopefully I won't have to, as meditation is working for me, in many paths of life. Turn off all electronic devices for the night. Turn off any digital lights. Meditate - some MeFites came up with some useful suggestions for when I was struggling to focus. Then go to bed with a good book (the traditional mind distraction), read until sleep, turn off light, sleep.
posted by Wordshore at 4:54 PM on February 22

Melatonin usually kicks in about 15-20 mins after I take it. But it's a hormone supplement, not a sleeping pill (so it isn't habit-forming and doesn't have withdrawal effects like Benadryl, which is what OTC sleeping pills are) so generally you don't really realize it's doing anything until you actually try to go to sleep. It's supposed to make it easier to get to sleep and stay asleep, so you take it right before you plan to go to sleep, and it if it works, you won't be waking up at 4 A.M. to take it. I have no idea what happens if you take it at 4 A.M. though.

Also, I've been taking it for 5+ years at the same dosage (actually I went down from 9mg to 3mg) and haven't had any issues with dependency or efficacy. Without it, I can't get to sleep easily, but that's status quo since I was 9. YMMV, obviously.
posted by griphus at 4:55 PM on February 22

This is kind of silly but I occasionally wake up in the middle of the night with racing thoughts and this is what helps me (sort of my own guided meditation): I go through the alphabet and try to come up with at least one tree for every letter (e.g. Aspen, Apple, Birch, Beech, etc.). Sometimes I do flowers. This gives my overly active mind something to focus on but it's not so mentally engaging that it stimulates my brain any more than it already is. Plus, flowers and trees--such pleasant and lovely things to think about and visualize! Obviously if you're not into that stuff you could think of something else of pleasant and lovely but the idea works for me--I often make it to Zzzzs before I make it to "Z" (ha-ha, could not resist).

Another thing I do when I'm doing this little mental activity is force myself to lie flat on my back. I am a side-sleeper so this is always a little uncomfortable at first but I find that it actually enables my body to relax a bit more. If the tree thing above is not working, I try to focus on relaxing my body parts one by one, e.g. repeating in my head "My left foot is extreeeemely heavy" and try to imagine my left foot sinking through the mattress. It's like it sort of wills your body to relax and focuses your mind at the same time.
posted by lovableiago at 5:00 PM on February 22 [1 favorite]

Ambien.
posted by oceanjesse at 5:22 PM on February 22

I use melatonin most nights and I think it helps me settle down without noticeable side effects. However, I would not use it if I had to wake up in, say, four hours or less.

On nights when the melatonin seems inadequate for one reason or another, I fall back on Sonata (Zaleplon). One of the advantages of Sonata is that it can be taken as late as four hours before your intended waking time, whereas most sleep aids are intended to be taken only at the start of a full night of sleep. So, Sonata can be an option for getting back to sleep if you wake up in the middle of the night.

I suggest that you discuss your sleep problems with your doctor. The Z-drugs may be a good fit for you. They do not interfere with sleep architecture the way benzos and the antihistamines in over-the-counter sleep aids (Doxylamine and Diphenhydramine) do.
posted by LBS at 5:29 PM on February 22 [1 favorite]

My trick: Ambien, white noise and a soft comfortable sleeping mask.
posted by lois1950 at 5:35 PM on February 22

Yeah, benzos as a sleep aid is bad news bears if you want to get to sleep without them ever again.
posted by griphus at 5:35 PM on February 22

I can't remember where I learned any of these, so take them with a grain of salt.

The first is based on the idea that your brain processes the events of the day during REM sleep. If you're fixated on something that happened during the day, you should think about it while closing your eyes and moving them back and forth, mimicking the motion of REM sleep. Theoretically, you're tricking your brain into thinking you've already processed it and it's easier to not dwell on it. I've been trying to google this to see where I found it and I can't, though I did find a page that suggested it's easier to fall asleep when your eyes are tired, so maybe that's it.

Another idea I remember reading about a long time ago was to tense up parts of your body in order, like to start at your feet and work up so as to feel like tiredness is washing over you like a wave. Personally, I'll just try tensing up all the muscles in my body at the same time for a few seconds. Then you can just feel tired.

My fiancee pointed out to me that if I'm bothered by something, I'll lay on my back and just think about it until I get so frustrated with not being able to sleep or get over it that I'll just get up. But the thing is that I sleep on my side. So if I get into the sleeping position, close my eyes and just try to clear my head, that also works.

Spooning. I usually can't sleep while spooning my fiancee but I find the act of doing it to be relaxing, so I'll just try to lay like that for 5-10 minutes and settle down, then roll over and try again to fall asleep.

Or, like another person said above that reading is their trigger that it's time to fall asleep, I have dry hands so I always put lotion on them before I go to sleep. I think it's also possible that it helps convince my body it's time for sleep.
posted by cali59 at 5:56 PM on February 22 [3 favorites]

N-thing melatonin. Valerian is supposed to work as well, but I find that my dreams are a lot more vivid and cinematic. This may be a bug or a feature, depending. Light reading. If I wake up in the middle of the night, I start counting by prime numbers.

If everything fails, I'll just get up and putz around on the laptop or ipad for 15-20 minutes. When I'm in hotels for business travel, I've had a lot of luck with the SimplyNoise app - white/pink/brown noise as a choice, plus you can choose to make it oscillate and sound like ocean waves.
posted by jquinby at 6:10 PM on February 22

I have the problem that the same thing never works for long, so I have to have many strategies. They include:

1/2 cup of cottage cheese (something about the dairy and protein helps)
listening to a favored movie
playing mahjong on my phone in a sleeping position
rubbing one out
listening to Bach or The Nutcracker
taking a very small dose of Xanax (.25mg) or Ativan (.5mg) - I can only do this once in a while
systematically tensing all my muscles, group by group and working my way up to my head.

Melatonin never worked for me, neither does warm milk, booze, or hot baths/showers.

Good luck!
posted by ApathyGirl at 6:10 PM on February 22 [1 favorite]

"My feet are relaxing. My feet are relaxing. My feet are relaxed... My ankles are relaxing. My ankles are relaxing. My ankles are relaxed..."

My intention is always to work my way to the top of my head, naming and relaxing as many parts as I can. The repetitive thinking keeps my brain from the cyclic, panicked I'm not asleep! I'm still not asleep! feeling I'm prone to. It takes a level of discipline I'm not yet expert at in order to stay focused on the matter at hand, but it helps more often than not.

There are apps that will walk you through similar techniques, if listening to something is an option. I've talked about the ones I downloaded from Andrew Johnson before.
posted by juliplease at 6:16 PM on February 22

I've suffered from insomnia since I was in middle school. The only thing that has ever truly worked for me is sleep restriction therapy. Basically, you restrict your time in bed to only the amount you are sleeping. If you think you are sleeping only four hours a night, and you wake up at seven every day, then you'll go to bed at three. Each night, you increase this by 30 minutes, until you are at 7-9 hours. Sleep restriction therapy forces your body to recognize that the bed is for sleeping (and sex!) and that the only sleep you will get is when you are in bed. It's hell, but it works.

Sleep restriction therapy got my sleeping back on track for about three years. It's only recently gotten really bad again due to stress and anxiety. Until I am able to repeat the therapy, I try to use the theory behind it to help me sleep. When I find myself lying in bed for too long, I try to change the situation. Usually, I flip the pillows to the other side, but I've also slept on the couch...and once the floor. I try to do this before I get to anxious about sleep. This way, my body doesn't associate my bed with anxiety.

Insomnia is an anxiety. Just like someone who has a bad experience on a plane continues to have bad experiences flying because he is anxious, someone who has a bad experience sleeping will continue to have bad experiences sleeping. If your insomnia isn't due to caffeine or other physical issues, it's probably due to anxiety, and sleep restriction therapy can really help :). Just don't do it when you need to be extraordinarily functional!
posted by obviousresistance at 6:44 PM on February 22 [1 favorite]

The meditation podcast (that's the name!), episode 14, "deep sleep" or something like that. I'm exhausted and about to start listening to it myself...


(But you need to use headphones, because in addition to the guided relaxation it's got binaural beats going on. Those are tones to each ear which are slightly out of phase that are supposed to put your brain in a more sleepy state. Probably totally woo but I don't think it hurts...)
posted by wyzewoman at 6:48 PM on February 22 [3 favorites]

Something that works for me is to read while listening to talk radio. I think it's just a cross-sensory barrage where the brain just gets tired from parsing language from both the ears and eyes BEEP sleep occurs.
posted by rhizome at 6:51 PM on February 22

don't use benzos, you'll just get addicted and then you'll have much bigger problems than insomnia. melatonin is good, as is very vigorous exercise earlier in the day (finish that at least a few hrs before bed.) try not to go to sleep with a very full stomach.
posted by zdravo at 7:24 PM on February 22

I have a space heater right next to my bed (which is on the floor). No matter how awake I feel, after the temperature passes a certain level, sleep becomes irresistible and I unplug the heater with my last bit of wakefulness.
posted by slidell at 7:26 PM on February 22

I f I have brain spin, I will play a simple repetitive computer game, like bejeweled or whatever. It occupies my brain enough to allow me to relax and get to sleep.
posted by annsunny at 7:28 PM on February 22 [1 favorite]

you restrict your time in bed to only the amount you are sleeping. If you think you are sleeping only four hours a night, and you wake up at seven every day, then you'll go to bed at three. Each night, you increase this by 30 minutes

This and remember that your preparation for sleep begins when you wake up. Cast off the old bedtime and throw as much energy as you can into the day. If you can exercise, do it early, do it hard and try to sustain a high level of attention to things throughout the day. Take breaks, but go hard.
If you can exercise not closer than three hours before you go to bed, like at lunchtime, do it.

It sometimes works for me. I typically have to work out until I'm exhausted to have 1/2 a chance at a decent night.
posted by Smedleyman at 7:29 PM on February 22

iPhone Tetris.
posted by whitewall at 10:01 PM on February 22

I have had some epic struggles with insomnia at different times in my life. Some different things that have worked for me at different times:

-wearing socks to bed. If my feet are cold, it's harder to fall/stay asleep. It can easy to miss having slightly cold feet, but be just enough uncomfortable to distract your brain from sleeping.

- If my mind is racing about something, I will write it down on a pad of paper I keep on my nightstand. If I can get it down on paper, I can mentally let go of it. (Sometimes.)

- I have a big book of sudoku puzzles. It's on paper so there is no screen, no time pressure, and at a certain point hunting around to figure out where to fit the 7 lets me drop off.

- If I am desperate for a good night's sleep, or know I am likely to be woken up (i.e., mr. ambrosia returning home late after I've gone to sleep) then I will take Benadryl before 9pm, but never two nights in a row.

- I have sought the assistance of acupuncture. The day of the session I always slept great, but only that one day. She did give me some stinky herbs to help me sleep, but I have no idea whether they really did anything or whether it was just a placebo effect.
posted by ambrosia at 10:11 PM on February 22

Plenty of people take benzodiazepines without becoming addicted or building up tolerance. For me, the magic combination was klonopin and trazodone after years of suffering. I've been on the same dose for years, I go off and on depending on the season and the stress level. It's one of the best things I ever did in my life. Try different things - just because one pill doesn't work doesn't mean another won't. Ambien and Lunesta were horrible for me, Ativan was okay but not great. Melatonin worked for like two days. Good luck - insomnia sucks.
posted by walla at 11:07 PM on February 22

I lie quietly in the dark and listen to calm, soothing podcasts or audiobooks. British accents work best for some reason. At worst, my mind is mildly occupied and I am distracted from my worrying and anxiety about not being asleep. At best, I drop off to sleep before finishing the podcast/getting very far in the book. I can set my iPod to turn off at 15 minutes, 30 minutes, or 60 minutes. I set it to 30 and am almost always asleep before it turns off.
posted by hurdy gurdy girl at 1:28 AM on February 23

Seconding "Hurdy girl", audio books via earphones. Something nice and comforting.
I love The Hobbit so I listen to it, from the beginning, every night. Its narrated by Englishman Rob Inglis and he is the best. Usually, around the time of Bilbo's 111st birthday party I'm sound asleep.
posted by Tullyogallaghan at 6:20 AM on February 23

White noise after a hot bath, and (if you wake up in the middle of the night) a little reading. Never off your computer, its display's too bright, just a book with a single incandescent lamp for illumination.

And for me (and I realize there's a lot of medical advice to the contrary) a snack before retiring is mandatory -- sleeping with an empty, growling stomache is impossible.
posted by Rash at 8:35 AM on February 23

Does 'swing shift' mean you work earlier shifts on other days? If you can, try to aim for a consistent sleep/wake schedule on all days of the week, as sleep hygiene principles recommend. (I've never been able to be religious about them, but when I can, things are better. I do follow the suggestion to get out of bed if I'm lying there, wide-eyed, for longer than 30 minutes. I get out of bed, do something boring, and lay where I fall.)

I have also somewhat reduced my anxiety around sleep onset by avoiding looking at clocks (turning their faces away helps), and saying this to myself: "You know what, big deal, maybe you'll be on three hours of sleep tomorrow. It's not the worst thing in the world. Soldiers and ER people and new moms do it all the time and survive." Best case scenario: I 'naturally' accrue enough sleep debt over the week to just tire out somewhere near a normal hour by the end of it. Worst case, it doesn't actually help with sleeping, but the whole experience is slightly less aversive.

Careful timing of exposure to light is meant to help; I remember one of these tools suggesting the best times, depending on your patterns.

I use a dawn-simulating alarm clock, backed up by two other clocks (one at the other end of the room).

(This news freaked me out about prescription sleep meds, and in general I try to stay away from sleep aids, because of the compensatory response that accompanies so many drugs. But when I'm out-of-my-mind desperate, I take an OTC antihistamine for a couple of days to bring me back to a reasonable schedule.)

Yeah, it's always a work in progress for me. Hope you can get it worked out.
posted by nelljie at 11:14 AM on February 23

This is what I do to stop myself from obsessing or letting my mind race:

I listen to something that is only talking. Starting with my eyes open, I listen for a word that has the letter 'J' in it. Once I hear a J-word, I close my eyes and I HAVE TO keep them closed until I hear another J-word. Then, I open them and HAVE TO keep them open until I hear another J-word, and so on.

Having to keep my eyes open gets harder and harder each time, and when another J-word finally happens and I can shut my eyes it's incredible and I fall right asleep, usually within three rounds. J is a good letter, too, because it is just common enough, but not too rare, like Q or Z.

It keeps my mind focused and away from racing thoughts, but it also keeps my mind from engaging in the audio topic itself because I have to keep listening for the next J-word. It seems to turn off the obsessing part of my brain, almost like flipping a switch.

I think this technique is especially good for those 4am wake-up times.
posted by Brody's chum at 9:55 PM on February 23 [2 favorites]

nelljie, the Swing shift is between 4PM and midnight. Midnight to 8AM is the Grave shift (or midnight or third shift if you're squeamish) and you can guess the hours of Day shift.
posted by Rash at 10:11 AM on February 24

How fast does melatonin work? If I take it when I wake up at 4 in the morning, will I be likely to be drowsy in the morning?

This is probably not a great idea. Melatonin is useful if you have circadian rhythm problems [e.g. it's good for jetlag], it's not a 'put me to sleep drug'. If your internal melatonin/serotonin cycle isn't well aligned with your bedtime, taking melatonin will help. If that isn't your problem, it won't help. And you probably don't want to be aligning your internal clock to a 4am bedtime.
posted by HiroProtagonist at 8:00 PM on February 24

I take one Unisom and that usually does it. I feel fine the next morning - no hangover, no weird dreams.

I used to use melatonin but it quit working after a while.
posted by deborah at 12:09 AM on February 25

Hi folks,

I've been having good results from taking melatonin about an hour before bed on nights before I work. Also from some of these resources for guided relaxation for getting back to sleep. Fortunately, I also got off the swing shift and am mostly working days now. Phew!

I'm not really inclined to take sleeping pills.

Thanks all, this thread really turned around a worsening cycle of problems for me.
posted by latkes at 8:27 PM on April 20 [1 favorite]