Help me plan my sleep itinerary?
January 10, 2016 12:15 AM   Subscribe

I am on a 10am-4pm sleep schedule. Have to get to ~1 am to 9 am. 2 am to 10 am would also be great. I would like to do this over the weekend. How should I plan my wake/sleep times over the next 3-4 days?

I have chronic insomnia that's gotten out of control over the past month. (I've written about it before, but that was about general approaches, not specific times, and I wasn't as far gone as this :/)

I tried to do a "reset" this week by staying up all night, twice. I sucked at that. Failed to stay up the second day, got only a few hours of sleep at weird (and inconsistent) times - middle of the day; 11pm-2am - made things worse, very scary.

Immediately before the failed resets, and now, was/am on a 10am-4pm sleep schedule (sleeping at 10am, waking at 4pm).

I was hoping to get this done over the weekend. Last night was another bust (my fault, 100% my fault*). Some help in planning the next three days/nights would be great. How should I plan my wake/sleep times?

I finally filled out a prescription for a benzodiazepine I've been sitting on (prescribed for general anxiety about sleep, and a more specific hypnophobia related to fear of losing consciousness - this doesn't matter for the answers, just explaining why I have the scrip). I'm very reluctantly willing to use it for a couple of days, if it will help. My doctor would have me take the med about an hour before my target sleep time (1am, according to them), but experience tells me that since I've only been up for ~10 or so hours, the med will likely not be strong enough to put me down, and I'll only get frustrated, stay up later, etc. And I can't shift this as gradually as would be ideal per the literature (i.e. by half an hour per day).

I was thinking of treating this like I'm travelling. I've travelled a fair bit, but not in a few years. I'm either 7 hours west of where I need to be, or 17 hours east. Travelling west is said to be easier, but my memory is that jet lag is way worse coming back from Europe than it is going there (from ~North America). Not sure about this approach, though, because of how badly my reset attempts have worked out; I'm afraid to make things worse.

SO again, my question is: what time should I try to sleep? And what time should I try to wake? For a) tonight, b) tomorrow, and c) Monday.

*I am crap at sleep hygiene. I know what it is and will comply, though - just need help with the timing.

NB: I have a difficult time conceptualizing time, and working with time metaphors if they are spatial ("forward"/"backward"/"ahead"/"behind"). I don't know why that is, and it's embarrassing. But I would be grateful if answerers could try to spell things out (e.g. "stay up later by this amount of hours). All of this is embarrassing, really :/

TIA
posted by cotton dress sock to Health & Fitness (17 answers total) 4 users marked this as a favorite
 
A few questions!

You need to be asleep from 10am to 4pm - correct? Do you work the the night shift? Is your sleeping room dark during daylight hours in this case?

My bedroom has one giant window. I used construction foam insulation sheets to make a "window plug" to block noise. Very expensive thick curtains cover the window - it's aesthetically very attractive! When the "plug" is in place no sound or light enters the room. A ceiling fan keeps air moving when we want that. The curtains (drapes?) hide anything ugly. Looks great, works better!

I take L-Glutamine amino acid powder to help me stay asleep. I take Trader Joe's chewable Melatonin tablets to make me feel sleepy 30 minutes before I'm ready to get into bed.

I have insomnia. This combination works. I also take Magnesium with the Melatonin to help me relax. Vitamin D in the "morning" to help keep sleep and waking regular.

The insomnia thing is fraught! Scripts are OK short term, usually supplements work better. I take Valerian (an herb) in a pinch, but honestly, the vitamins work better for natural feeling sleep.

I've struggled for years. Research led me to this solution. YMMV. MeMail me if you want to delve deeper into my experiments and research. I've worked weird hours for many many years - and I have nervous system issues that get me racing sometimes when it should be bedtime. I'm happy to discuss. You don't have to exist with this hardship. Sometimes solutions are easier than they seem. I'm happy to share because I've been here. Oh, boy! Have I been here!

Hope this helps:)
posted by jbenben at 1:02 AM on January 10, 2016 [1 favorite]


Best answer: I think OP is moving from 10a - 4p to 1a - 9a. I would break it up incrementally and try going to bed three hours earlier each night:

Tonight: 7a - 1p
Tomorrow: 4a - Noon
Monday: 1a - 9a

To do this, I would use every trapping for a good night's sleep: comfy PJs, fresh clean sheets, close your blinds, etc. Consider using tried-and-true methods to help you get to sleep, whether that's a warm bath, a mug of chamomile tea, lavender balm, etc. Not to get you started on wine, but wine and carbs conk me out pretty much immediately (I used to combine these on overnight flights to help bring on sleep.)

Remember to stay away from computer and TV screens for several hours before sleep. Drop or limit caffeine all weekend. If you don't fall asleep immediately, just focus on resting and getting up when your alarm goes off.
posted by mochapickle at 1:22 AM on January 10, 2016 [5 favorites]


mochapickle is on point and I agree with their suggestion. As another one that would be supplementary to fixing your time schedule, f.lux as a free app is something that i would consider to be on a 'a very good friend of mine' level, and there are custom lighting and time settings!
posted by yueliang at 1:28 AM on January 10, 2016 [1 favorite]


Response by poster: Sorry that was hard to make sense of, guys. Mochapickle, kudos to you for understanding what I meant in all that, and for your excellent advice and plan :)

Minor correction (among many needed) that I think will not change things - I'm actually either 7 hours "east" of sleep onset target 1, so would be going "west", that way, and 17 "west" of sleep onset target 2, so would be going "east" to go there. The question I was muddling towards there was around directionality, i.e. whether it would be less painful to stay up later or go to bed earlier. But obviously, staying up later isn't working so well.

I like your approach, mochapickle. Thanks so much, again.

Thanks for the tips, jbenben and yueliang :)
posted by cotton dress sock at 1:59 AM on January 10, 2016


I am a natural night person and I have chronic insomnia, so it's not rare for me to be awake until sunrise and wake up way too late. But a few years back I got a job on a rotating shift. A few days per week I'd be working until 6 AM, then other days I'd be waking up at 5 AM. It was rough, but I surprised myself by not going crazy or dying or something.

When I first needed to make the switch to waking up before dawn, it was really intimidating. I did it by taking OTC sleeping pills and going to bed at 10 PM to wake up at 5. I think I got about 4 hours of sleep, but I forced myself to get up and go to work. My system adjusted surprisingly quickly. Going to bed at 10 felt unnatural and some mornings waking up at 5 just hurt, but I was pretty used to it within just a few days. It was a hard job for me physically, and the exhaustion helped me fall asleep too. Insomnia wasn't really a problem when I had that job. (All the constant switch between the day and night shift nearly killed us all. Humans aren't meant to live like that.)

It may be that you'd have luck with a hard reboot like that, just setting your alarm for 9 AM and knowing that no matter how little sleep you get you WILL get up at 9. You might have a day or two of being really sleepy, but you'll get through that. Try exercising when you're short of sleep, and that night you might surprise yourself and conk out without needing any drugs!

You don't talk about trying OTC sleep meds, and if you haven't I'd say try some good ol' Sominex before any prescription stuff. It's always worked better for me than Ambien, but I built up a tolerance and had to give it up.

Good luck, and remember that the transition will be over soon. And even if it kind of sucks, it probably won't suck as much as you're worried about.
posted by Ursula Hitler at 4:48 AM on January 10, 2016 [1 favorite]


Best answer: I think Mochapickle has a good plan -- one thing I would say is that you should adhere VERY FIRMLY to the wake-up times in that plan. So even if you don't drop right off to sleep at 7am on the first day, FORCE yourself to get out of bed at 1pm. You don't get to "make up" any time that you weren't sleeping before (e.g., "Oh but I didn't really fall asleep until 9am so I will let myself sleep until 3pm"). Even though this may result in some fatigue for the first few days, that will ultimately help you to fall asleep earlier, which is after all your ultimate goal. This strategy is very consistent with empirically supported methods for treating insomnia.
posted by Bebo at 6:20 AM on January 10, 2016 [2 favorites]


I'm very reluctantly willing to use it for a couple of days, if it will help.

I've said this before but the funny thing about benzos is that anxious people are afraid to take them. That said, I agree that they are maybe not the thing for you in this case and what you need are just sleeping pills to get this sorted and get yourself to stop anxiously thinking about it and then you can move to the sleep hygeine stuff which is basically 202 level stuff from where you are now. The fasting thing is useful. The "removing stimulus" stuff is useful (for me, so no lit up screens an hour before your set bedtime, the idea is to sort of bore yourself to sleep). Some people find mindfulness and doing meditation helpful. For me the only thing to do--for example when I am traveling and need to sleep and basically can't because I am all wound up-- is just pills, temporary, only-take-when-traveling pills because then I know there is just an oversized knock out drop plan for the evening and I don't worry about it at all during the day and sleep passably at night. Best of luck. Honestly if staying up all night is not resetting your clock you really need to call in the big guns because you have an anxiety spiral that is not going to be improved by over-controlling the issue. Good luck!
posted by jessamyn at 6:25 AM on January 10, 2016 [1 favorite]


Melatonin is often used specifically to help with shifting sleep schedules, and available over the counter. The schedule mochapickle outlined seems reasonable; you could try taking melatonin 30 mins-1 hour before your planned bedtime each night. It may not knock you out right away, but it mimics your body's natural night-time melatonin surge (the main signal that tells your brain it's bedtime). Over the counter diphenhydramine (benadryl) is NOT a good long-term sleep medication, but is probably okay for 2-3 days (again, 30 mins - 1 hour before bedtime) to help get you drowsy, especially since you're aiming for a short reset period. Anecdotally, if you're someone prone to muscle aches or physical pains keeping you awake, increasing dietary potassium and magnesium may also help.

Limit light (especially blue light from computer/phone/TV screens) in the few hours leading up to bedtime. Conversely, when you're supposed to wake up, try to flood yourself with as much light as possible - light acts as an entraining signal that helps shift circadian rhythms. There are wake-up lights that you can set to simulate sunrise - starting at a set time, the light gradually increases until it reaches full strength at your desired waking time.

Also recommend regular exercise; afternoon exercise may be best for promoting sleep. You could calculate when "afternoon" would be for each of the bedtimes on mochapickle's schedule (maybe 5-6 hours before?). As others have said, optimizing a comfortable, regular bedtime routine is key; and avoid caffeine especially over this reset period.

Finally, you may already be aware, but insomnia-focused CBT (CBT-I) is an evidence-based thing that exists, and may be helpful for you in the longer term. Good luck, and sleep well!
posted by staraling at 7:53 AM on January 10, 2016 [1 favorite]


This happened to me and using the benzodiazepines for just 3 days totally worked. I never used them again, no concerns about addiction at all. Sleeping pills like Ambien did not work for me, and the key was the potent anti-anxiety effect, which you do not get from sleeping pills. A few years later I did an online CBT-I course for insomnia that totally changed my life - best $35 I ever spent!
posted by yarly at 8:12 AM on January 10, 2016 [1 favorite]


What helped me getting out of a reverse sleep schedule was committing to three to five days straight of activities outside my house I absolutely could not cancel on. After that my schedule normalized, but you know what? I hated being awake during the day. I felt my depression, more than being awake at night.

Now I'm awake during the day, and while it was an adjustment, it is now scary for me when I wake up late, like 11am. It makes me feel the non functional side of my depression is back, as opposed to the functional side.
posted by charlielxxv at 8:18 AM on January 10, 2016 [1 favorite]


If you don't want to take the benzos but need something to help you sleep at the appointed time; Z-quil is good for that. It's just re-branded benedryl. I take it all the time when my sleep gets messed up. All it does is help you sleep, no nasty side effects, and no hit-or-miss like melatonin.
posted by bleep at 11:43 AM on January 10, 2016 [1 favorite]


Response by poster: Thanks guys :) Appreciate all your strategies and support.

@charlieixxv, yeah that's exactly how I feel about this. It's scary. I don't like it. Going out for long periods is something I've been staying away from for a bit, because of this hilariousness. (I was determined to not use pain meds - not NSAIDs, because they can compromise healing, and I did not want to have a chronic problem with sitting down, and not anything oxy-related because just no, I used to teach people with chronic pain who had to rely on that to get through the day (for more than one reason, in some cases), and although I'm not prone to addiction (nicotine and internet excepted), just, no thanks. So for the past while, I've been using pain as a limiter of activity, and it was pretty limiting. Have probably been babying myself too much, though, lately - that pain is much, much better than it was, and I can probably comfortably e.g. sit at a coffee shop for ~ 40 mins at a time, now, could break that up with walking.)

Prior to the "resets", I'd been taking two extra strength Sleep-Eze D (100 mg diphenhydramine hydrochloride, total) for a few nights, no luck with that. Valerian root or L-theanine before that. Earlier this year, I tried melatonin + light + exercise (with 2 hour walks on waking), did that over three weeks - a lot of stress and hope and effort for a fragile result - it took going out once to mess it up. I'm not prepared to not ever go out, I need to go out.

My concern around BZs isn't really addiction, and I don't see anything particularly wrong with short term use on the moral or whatever front; it's the other risks that have been found that put me off :/ But if it's between a theoretical risk (with very short term use) and some kind of permanent sleep dysregulation problem like non-24-hour sleep-wake disorder, I mean... Sucking it up seems smart. (Hypnotics, though, I am flat out not going there again, hated those.)

Like, this is a lifelong thing. I was the baby that no one could get to sleep. Had terrible nightmares up to teens, developed bad habits early on, snowballed from there... It's usually manageable (if imperfectly) when I have a 40-hour/week, 9-5 type of life, but I don't right now (school + working from home + odd jobs), and that's not helping at all. That will change after April, though, I am hoping. I think I am basically not a person who can do without structure.

@yarly - thanks for the recommendation. A focused approach to that side of things would be helpful, agreed. Does this course address the fear of losing consciousness, specifically? I actively, compulsively fight that, every night. It's easier for me to lose (i.e. win) when I'm on a schedule; then, my body's optimally trained up for sleep, and I'm positioned to trick myself into nodding off via distraction (i.e. by reading or watching something boring and passing out).

Someone mentioned camping in my last sleep question. I have to say, the best sleep of my life was the time I worked on an apple farm. Fresh air, hard work, good food, a clear view of the night sky, and a pint of lager is probably my optimal solution, but my joints couldn't take that now, oh well :/

Thanks everyone :)
posted by cotton dress sock at 1:43 PM on January 10, 2016


I should have mentioned - for me the liquid z-quil works way better than the diphenhydramine pills. It's technically the same stuff, but my body tends to ignore it in pill form for some reason. The liquid always works.

Like you my sleep schedule goes all to hell as soon as I don't have anywhere to be in the morning; and even sometimes when I do. My brain just doesn't like shutting off. I was worried about how often I needed to resort to z-quil to get back on track so I asked two different doctors, they both said the same thing, which is that lots of people take Benedryl every day for their allergies. It's pretty mild as medications go. There's nothing wrong with taking it if you need it and it helps.
posted by bleep at 1:56 PM on January 10, 2016 [1 favorite]


Response by poster: Thanks, bleep! I'll look for the liquid stuff - hopefully, we have that in Canada.

My brain just doesn't like shutting off.

Argh, I know - what is it with that? Need to find good places to put that energy...
posted by cotton dress sock at 2:01 PM on January 10, 2016


In my personal experience dealing with jet lag (huge timezone changes), what works for me is to stay up as long as possible that first day of shifting. Just go as long as you can, doing active outdoor things especially near the end, which for me is about 28 hours. At that point, I have a large meal and then I can barely hold my head up, much less do anything requiring intelligence. Then take melatonin, which isn't so much to help you fall asleep but rather STAY asleep for a decent period. Without the melatonin, I wake up after ~4 hours and BING am wide awake. Everyone's different of course but melatonin really has worked for me. Sleeping pills don't work on me.
posted by intermod at 8:55 PM on January 10, 2016 [2 favorites]


Yeah melatonin is specifically really useful for jet-lag — I don't find it helpful for, e.g., sleep maintenance, but for changing a literal or metaphorical time zone, I find it hugely helpful. There's also some evidence that if you fast for 16h (!) then eat a big breakfast in the early AM, that this will help you adjust.
posted by en forme de poire at 7:41 PM on January 11, 2016 [1 favorite]


Response by poster: Checking in later than my original target day, but nevertheless at 9:01 a.m. EST :D

Thanks guys XD
posted by cotton dress sock at 6:02 AM on January 13, 2016 [3 favorites]


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