When you have insomnia there is nothing that sounds sweeter than the promise of a guaranteed good sleep. The temptation of the pill that lulls you into sleep carries the weight of knowing that you don’t have an “Ambien deficiency” and it’s not truly healing your sleep. The only true relief is when you know that you, on your own, are capable of falling asleep and staying asleep.
Day in and day out, I see my new patients walking through my door, complaining of suffering from relentless insomnia.
I see the mom whose kids are now sleeping through the night, yet she is up in the middle of the night. Sometimes she wakes up in the wee hours of the morning, making everything look darker than ever. Then, as a cruel joke, she may finally feel like falling asleep just minutes before the alarm goes off.
I see the perimenopausal woman whose body is resisting the amount of work she has on her plate, who is approaching menopause faster than her mind is ready for.
I see the postmenopausal woman who’s gone through it, hot flashes and all. But even now, she cannot sleep deeply.
I see the wonder woman who has done everything that one can possibly do. Dairy free, gluten free, exercise more, exercise less, no alcohol, no caffeine, and a slew of therapies, including perhaps the famous edible pot.
Sleep is complex to treat and so precious to have. Here is what I have learned from the women with insomnia I have worked with that can help you:
Insomnia is more than anxiety and depression
Traditionally, insomnia was seen as a byproduct of anxiety and its close sister, depression. There are many different reasons why one has insomnia, with some insomnia stemming from anxiety indeed, but more often insomnia is rooted in other imbalances such as your circadian clock or hormonal or neurotransmitter disorders. Quite often, I see that the fact that you are not sleeping leads to anxiety and the sleep deprivation itself to depression. So be assured, it’s not all in your head.
Winding down works
We can never underestimate the power of winding down in the evening. For most of us, regardless if we suffer from insomnia or not, 45 minutes to an hour is ideal to wind down. If even the slightest stimulation shoots your cortisol through the roof, then you need to slow down all activities 2, 3 hours before bedtime. You can look at the rule of 12/12: 12 hours are active, while during the other 12 hours we should make a point to slow down. We are in bed anywhere from 6 to 9 hours; that leaves us with least 3 hours to honor times of quietness, less stimulation, more inward energy. The first couple of hours might consist of dimming lights, slowing down mentally, giving yourself a break from all worries. The last hour before bed is the best time to read a paper book, take a shower, stretch, listen to a podcast. Once your sleep heals, the duration of your winding-down time may shorten significantly.
Gratitude lists work, especially when you get to worry first
I am a fan of writing down things that you are grateful for. However, decongesting the mind of worries first helps you let go and relax. Either right as I leave my office or while I get dinner ready, I carry a piece of paper with me and write down all the things that I didn’t do, forgot to do, should do, have to do tomorrow, all worries that linger in my mind. I write them down as a way of saying, tomorrow morning is another day and that’s when I’ll pick them up and work on them. Now that I’ve given myself permission, I can relax a little more, and later I may actually be in the perfect mood to write what I am grateful for, and really mean it.
Our bodies are made for naps
I have seen naps help numerous women turn their sleep around. If it absolutely can’t fit in your schedule, simply forget it. However, if you can possibly find 30 minutes to spare, between noon and 3pm, then give this some thought. You don’t even have to fall asleep, but simply rest lying down. Some women tell me that they never even considered naps; that is because when you live in a constant fight or flight mode, your body cannot relax to even consider some rest; it has to be up and watch out for whatever “danger” might come your way. When you are more relaxed and in sync with your body, you feel the natural small release of melatonin that happens around 1 or 2pm every day. It takes tremendous energy for our brain to initiate and maintain sleep so the nap or rest will give it enough recharge, so it’s easier to sleep at night. If you have kids, you know that when they miss their nap, they tend to have a harder time falling asleep at night.
Resetting the circadian rhythm through light
Some of my late-riser patients who never see the early-morning sun manage to reset their internal clock simply by waking up at the same time each day and going out for a walk immediately. Exposure to the morning light, especially on a sunny morning, stops melatonin production. In the winter you can use a light-therapy device. When done consistently, your nighttime sleep gets more efficient.
Eat protein within 30 to 45 minutes of waking up
Cortisol irregularities are very common in women with insomnia. There are a number of things that can be done to support the adrenal glands, but one that’s easy and simple for you to do is making sure you eat a breakfast that is rich in protein to trigger a surge of cortisol as large as possible, so then hopefully, by the time you go to bed, your level is nice and low. If you decide to give this a try, do it consistently for 30 days in order to see results.
The caffeine story
The first thing I do when I wake up is drink 1 to 2 cups of room-temperature water. Many of my patients who tried drinking water right after waking up reported that once they do this they feel as energized as having a cup of coffee. Truth is, we lose up to 1 liter of water a night, so we are mostly likely dehydrated and groggy and the caffeine will only dehydrate you further. The general sleep hygiene rules state that we should not be drinking any caffeine after 2pm, or at least 6 hours before sleep. Truth is, some people are affected even after having caffeine at 7am as they are slow metabolizers, and some of us have a defective gene that can make us feel wired for two days straight after consuming caffeine. It is different for everyone, so I ask most of my patients to come off caffeine, or at least choose green tea, and once they sleep better after completing my program, then they can try it and they will see that night if it affects them or not. Caffeine may not the problem, but just be a mild contributor, so I want to make sure we do all we can to heal the sleep, with different therapies and sleep-hygiene habits.
Small bugs for big sleep
Gut health is crucial for sleep health. 70 to 90% of serotonin production happens in the gut. Serotonin is greatly needed for sleep and mood and many of the drugs used to treat insomnia, anxiety, and depression work with this hormone. Furthermore, serotonin is a precursor to melatonin. In my practice I always make sure that the gut is well taken care off and also advise my patients to cultivate their gut biome with probiotics supplements, but especially through eating various fermented foods.
We are all unique. Each type of insomnia is as unique as the individual. That’s why when I work with my patients there is no cookie-cutter approach; I am able to pinpoint where we are going. I do my part with acupuncture and together we find out which changes in your daily life are doable and can actually make a huge difference. Insomnia is not something to be taken lightly. We all have the best intentions, but after a bad night’s sleep, nothing makes sense anymore. That is my most important job, to help you pull through perhaps a few more weeks or even months of gradual healing, but a healing that will stay with you for hopefully the rest of your life.
These thoughts I shared with you are only a small dent in the complexity of insomnia. Sometimes, insomnia is associated with sleep apnea, an anxiety disorder, restless leg syndrome, or nightmares. So if you have questions, please feel free to book a free consult with me, or simply make an appointment for an initial session.