Sleepless in Chicago

November 14, 2021 • 9:15 am

Posting may be lighter during the next several weeks as I struggle to overcome a case of chronic insomnia (or “semi-chronic insomnia”) that started a couple of months ago but has been exacerbated (as is intended) by therapy.  I’m not looking for sympathy here—insomnia isn’t nearly as bad as many maladies—but I’m trying to explain why posting may decline in frequency and in quality for a while. (It’s hard to think and write on four hours of sleep per night.)

Backstory: I’ve had bouts of insomnia twice in my life, both associated with stress. One was at the University of Maryland when I began my first job and was anxious to make good.  The stress took the form of me being unable to get to sleep. I went to a doctor who prescribed a change in behavior. “If you can’t get to sleep,” he told me, “Get out of bed and do pushups until you’re worn out with them. Then get back into bed. Repeat every 20 minutes until you sleep.”

I suppose the idea was that I would get so revolted by having to do pushups that my body would force me to sleep.

It didn’t work: I was still an insomniac, but with an impressive set of triceps. Eventually the insomnia went away.  It turns out, though, that getting out of bed if you can’t sleep is the basis for the kind of therapy I’m trying now, called CBT-I, or “cognitive behavioral therapy for insomnia.” Everyone says that it has a high success rate (about 70%), and it doesn’t involve drugs, which I don’t like to take. (My doc and I have tried to find a good sleep doctor who knows about medication for sleep, but so far without success. And I don’t know if those drugs would be efficacious—some of them have the side effect of making you get fatter!)

My current sleep issues began about two or three months ago.  The issue this time was not getting to sleep, as I always dozed off within ten minutes of turning off the lights, but waking up early in the morning and trying, unsuccessfully, to get back to sleep. Sometimes I’d wake up at 1:00 a.m. and and struggle for hours to get back to sleep. (I’m told that many people had sleep disruption during the pandemic.)

I pushed my bedtime back farther and farther, until 8:30 p.m. (which of course puts a crimp in your social life), but all that meant is that I’d wake up even earlier.  I was getting about 5-6 hours of sleep per night, and I know from experience that I need at least 6.5 hours to function decently and 7-8 to be in top form. (And you supposedly need more sleep as you get older.)

As for the cause of this bout of insomnia, I have no idea. I’m not particularly stressed over anything, though when I (and many people) wake up in the middle of the night, worries and dark thoughts sometimes run through the head.  Eventually I trained myself to dispel this midnight anxiety by simply pushing the thoughts out of my head. But that didn’t help my sleep, either. I’d lie in bed awake thinking of nothing in particular, the hours would turtle by, and eventually I’d give up and get up for the day.

Finally, my doctor referred me to a psychologist who specialized in CBT-I, a method you can read about here. I’m told that the regimen will take 5-7 weeks, though it could be longer or shorter, and the rate of
“clinically significant improvement” in sleep (I’m not sure what that means) is about 70%.  Right now I’m starting with “sleep restriction”, which is BRUTAL. Here’s what the link says about it:

This method sets strict limits on the time you spend in bed. The initial limit used is the same as the amount of sleep you tend to get on a nightly basis. For example, you may only get five hours of sleep even though you spend seven hours in bed at night. Two hours in bed are spent trying to fall asleep or go back to sleep after waking up. In this case, your initial limit would be set so that you spend only five hours in bed at night. This means that you are likely to get less than five hours of sleep.

This sleep loss will make you even more tired at first. However, it will also help you fall asleep faster and wake up fewer times in the night. This will allow a solid period of sleep and a more stable sleep pattern. As your sleep improves, the limit on your time in bed is slowly increased. The goal is to reach the point where you get the amount of sleep you need without reducing the quality of your sleep.

For two weeks I kept a sleep log, recording bedtimes, waking-up times in the night (you can’t look at a clock, so you have to estimate), and what time I finally get out of bed, as well as how I feel the next day and whether I napped the previous day. Under the regimen above, NO NAPS ARE ALLOWED! That’s the toughest part—aside from feeling half-dead. Oh, and I need to exercise regularly as part of “sleep hygiene.” I’m taking very fast walks for several hours each week, but it’s not easy when you’re dopey.

From the sleep log, the psychologist determined that I was getting about six hours of sleep per night, including naps. Ergo, the prescription: go to bed at 8:30 and get up for the day at, yes, 2:30 a.m.  If you wake up in the night and can’t get back to sleep in 20 minutes, go into another room and read a book for five minutes. Then go back to bed. Lather, rinse, and repeat.  If you don’t get to sleep doing this, you still have to get up at 2:30 a.m.

Oh, and you aren’t supposed to be in bed for any purpose other than sleeping. That’s tough for me, as I always read in bed, write a lot of this site in bed, and am often horizontal when I’m home, even when awake. Now I don’t go near the bedroom until it’s time to sack out for the night.

You may have wondered how I know when it’s 2:30 if I’m not allowed to look at a watch or clock. I set my phone with an alarm. I’ve always hated alarms, and never used them since I always woke up at the same time. They’re intrusive!

They weren’t kidding when they used the phrase above: “this sleep loss will make you even more tired at first”.  The first day I got about 4 hours of sleep. And getting up at 2:30 a.m. is no picnic, let me tell you. There’s nothing on t.v., so I read or simply go to work. The second night I was so tired that I almost passed out, and slept the entire 6 hours without awakening. That was very encouraging, but last night was another 4-hour rest again. I’m not sure how long I can keep this up, but I’m determined to follow the regimen because it’s been shown to have a high success rate.

Well, all that is by way of explanation, but I also find the experience interesting though debilitating. But I know that lack of sleep can injure your health, so I’m worried about that, too.  The upshot is that trying to work or think or write often seem like insuperable tasks when you’re this tired, but I’m soldiering on.

Again, I’m not writing this to solicit pity (or prayers!), but to explain what’s going on.  I’ve found that just writing this down made me feel better—though not less tired.

Readers may wish to weigh in with their own tales of insomnia. (Please don’t prescribe things for me to do or swallow, though, as I want to stick with the plan we’ve settled on.) The disorder is said to be quite common.

NO LOOKING AT THE CLOCK!

104 thoughts on “Sleepless in Chicago

  1. I moved all computing equipment out of my bedroom. There seems to be something to it.

    Phone diet – something to it.

    Melatonin – seems to be something to it. Always consult with doc.

    Have the docs do a sleep study – see if there’s a struggle for air while asleep – causing stress.

    Hope that helps.

    1. Wanted to add to my Official Advice from Pseudonymous Users on the Internet :

      Diet – unavoidably, it is related to circadian rhythm. In particular : Soluble fiber – where is it coming from?

      I found they have soluble fiber gummies. There seems to be something to them : to keep the gut in a rhythm, I think – but do not know – giving the gut at least soluble fiber can help, ultimately, sleep. It will help digestion of course, and that of course is a slow process that can unfold while the body is sleeping – and, if irregular, could make the body wake up.

  2. You need to get back to teaching. There’s nothing like a pile of ungraded papers for putting you to sleep.

    When I have trouble sleeping, I get onto my computer and do something really boring. After a while, I can’t stay awake.

    1. “I get onto my computer …..After a while, I can’t stay awake.”

      I’ve decided that I must be fiction ‘other abled’, as maybe they say, since struggling through ‘Anna Karenina’ has been doing the same for me recently.

    1. Same for me, the more exercise, particularly strenuous, the better I sleep. Not right before bedtime though. Doing pushups in the middle of the night probably gets your body keyed up instead of sleepy.

    2. I think that’s the same for me—
      but only at night-time:
      For decades, driving back an hour after doing a nordic ski race, I’d need to be especially careful. That (higher than any other I do level of aerobic effort) would keep dropping my alertness till I was very sleepy in the middle of the day. So, a little voice would insist: ‘Pull over, you idiot, put your feet up on the dash, sleep for 5 minutes and you’ll then be safe and alert’. Maybe it’s that hour gap, rather than the time of day/night.

  3. The “don’t do anything in bed except sleep” protocol makes me wonder if this works prophylactically. Does this habit prevent insomnia among those who have never (yet) suffered it?

        1. Dear Prof.
          Sam Harris has a very interesting talk,
          Apologies if this is already mentioned.

          Now, Making Sense, episode 267
          New Podcast Episode
          The Kingdom of Sleep
          A Conversation with Matthew Walker
          In this episode of the podcast, Sam speaks with Matthew Walker about the nature and importance of sleep. They discuss sleep and consciousness, the stages of sleep, sleep regularity, light and temperature, the evolutionary origins of sleep, reducing sleep, the connection between poor sleep and all-cause mortality (as well as Alzheimer’s disease, diabetes, obesity, and heart disease), sleep across species, learning and memory, mental health, dreams as therapy, lucid dreaming, heart-rate variability, REM-sleep behavior disorder and parasomnias, meditation and sleep, sleep hygiene, different types of insomnia, caffeine and alcohol, sleep efficiency, bedtime restriction, cognitive-behavioral therapy, napping, sleep tracking.

  4. Sounds like a lot of work! My suggestion is to read until you get sleepy. But if you can’t sleep don’t lay there for too long; turn the light on and read again. Repeat. If you don’t get a lot of sleep limit yourself to a not-too-long nap the next day.

  5. I’ve been struggling with obstructive sleep apnea (OSA) for roughly 10 years, which at times also disrupted my circadian rhythm, leading to early awakenings and vicious cycles of sleeplessness. I think many people underappreciate the importance of truly disciplined sleep hygiene (perhaps because the name is a bit lame), but I suggest severely limiting your bright light exposure in the evening, do not eat within 3-4 hours of bedtime (try to be as consistent as possible with daily mealtimes) and try cooling your body temperature significantly both before and during sleep (this will drop your HR and make it easier to fall and stay asleep), and absolutely stay away from alcohol consumption until you normalize your sleep.

    I sleep with a mattress cooling device and have my AC set to 68 in my bedroom, and I monitor my HR and sleep with an Oura Ring (the sleep stages may not be all that accurate but watching your HR evolve throughout the night is useful). The only daytime activity that I have found to be effective in clearing brain fog and also helping sleep is vigorous exercise (running 4 miles per day). While I agree with avoiding pharmaceuticals/supplements, low dose melatonin (1 mg) 2 hours before bedtime can be useful. I hope this helps.

    1. I also have OSA, and that is greatly helped by faithful use of a cpap machine. I very much dislike it, but wow does it work. I wake up bright and alert. Much better (and healthier) than the dragged down tired feeling that I used to have.

        1. A sleep study is the prerequisite for these devices – I’d like to just highlight that connection… while also noting that CPAP machines have a stigma that developed along with the devices themselves, such that patients who can benefit from them will readily assume it isn’t for them because, well… reasons… shall we say…

      1. I love my CPAP machine. My doctor is always amazed when I say that. It has never disturbed me (since day one) and really helps me sleep. Especially if I have cold symptoms (my mask is a Philips that only places pressure on my nostrils, effectively inflating my nasal passages and keeping my nasal airway open, even with a cold.

        1. Weren’t those Philips CPAP machines recalled? Or was that some other manufacturer? I seem to remember a report on this some months ago.

        2. My Phillips one got recalled after only about 6 months. They said I might get a new one in a year😖(great service) So I bought a Resmed, which works fine. I have several friends who refuse to use them, despite being diagnosed with apnea. They are quite easy to get used to, and as James says, there’s no problem even with a stuffy nose. I was worried that my very scaredy cat might be scared of the hose, but no problemo.

  6. I added to the post above to ask readers NOT to tell me what I should be doing, though I appreciate hearing what worked for them. I am trying to stick to my regimen, which involves other stuff (no computers before bedtime, etc). Oh, and I don’t have sleep apnea nor do I snore (according to reports).

    Thanks!

    1. You mentioned your sleep log. Are you logging non-sleep-related data? Has anything else changed? The amount and content you post here? Diet? Shifting diets and information overload both seem to lead to short-term insomnia for me.

    2. My writing tends to lean away from “I did this” into generalizing which sounds like “You should do this” which I know that is bad, so I wrote above “Have the docs do a …” – in my mind this feels like simply troubleshooting without addressing one person in particular. Apologies for this bug in my system.

  7. Good luck with the BCT-I! I sometimes wake in the night and have trouble getting back to sleep. I find that listening to an educational podcast with a sleep timer set for 15 or 30 minutes often puts me back to sleep. It seems to focus my mind, and I find a male voice very soothing for some reason. Lately I’ve been listening to This Week In Virology which is very interesting if I happen to stay awake. Regards.

  8. Following, as I think we say about posts. I too wake anywhere from 2:30 to 4:00 a.m. The time change didn’t help.

  9. Thanks Jerry! Your podcast on the subject is timely for me as I have been having problems sleeping for many months. Please keep writing about insomnia and what eventually works for you.

  10. I hope the therapy solves the problem. My wife has had periodic problems with insomnia and has had therapy for it. I can’t say that it was very helpful, but she wanted to do *something.*

    I, too, have had periods when I would toss and turn and ruminate. Usually the problem eased over time (days or weeks) without even noticing. I try to take the attitude that “it’s just sleep.” This doesn’t mean that sleep isn’t important or that I’m minimizing the anguish, but I try to actively avoid focusing on the problem and worrying about it. This is much easier said than done—and my sleep problems are only occasional—but I do find that focusing on the problem makes it worse.

    I do know that focusing on the woke among us makes sleep more elusive. (Just kidding.)

  11. I have found trazodone to be helpful. It is non-habit-forming and doesn’t affect memory (unlike ambien and valium). It is a first generation anti-depressant that was unsuccessful as an antidepressant because…it put people to sleep. It has been around a very long time and so its effects have been well studied. It has pretty much no side effects. I was an insomniac until I discovered it.

    1. Agreed – my doctor prescribed it for me a year or so ago, and what a difference it has made.
      I still wake up in the wee hours sometimes but find that half a tablet, plus getting out of bed and reading for half an hour or so, generally sends me back off to the Land of Nod.

  12. How about
    “The stress took the form of ME being unable to get to sleep.”
    vs.
    “The stress took the form of MY being unable to get to sleep.” ?

    I occasionally have similar insomnia but often it is accompanied by panic and/or despair upon awakening. But it has happened often enough that I know that i eventually calm down even if i don’t get back to sleep for some time.

    1. Both are correct, but the emphasis is different. In the first case, “being” is an adjective (present participle), while in the second it is a gerund (a verb used as a noun).

      He saw me running across the street: the emphasis is that he saw ME, and I happened to be running across the street.

      He saw my running across the street: the emphasis is that he saw how well I could run and, being a scout for the Olympic team, offered to pay for my training.

      I heard him singing in the shower, so I knew that he was home.

      I heard his singing in the shower, and realized what a good voice he had.

      (Not: with a female, the accusative and genitive forms are the same: I heard her singing in the shower, so the difference is noticeable from context only.)

      1. I don’t know, while I agree with your structural characterisation (present participal vs gerund), the two first sentences sound pretty much the same in meaning and emphasis to me. I think it’s different when the clause is the object of a preposition than when it’s the object of a verb.

  13. Sleep, and the need for sleep is such a strange thing!
    I remember talking to my son when he as about 4 or 5 years old about all the weird things about our biology. Our primary teeth falling out, to be replaced by new ones. That sort of thing. After much thought he just exclaimed “Why are we made this way?!”

  14. I suffer from waking up early also. I have read somewhere that it is referred to as terminal insomnia because it happens at the terminus of the sleep cycle, but man that sounds dire! I know my condition is at least partially caused by stress and it gets worse whenever I feel like I am behind at work or having some work related issue. Too much coffee is also a large factor for me. I never drink coffee past noon but I generally drink about 32 ounces in the morning. Just cutting back to 24 is helping. I should probably cut back even more, but I love my coffee.

  15. Thanks for sharing the information about CBT-i. I hadn’t heard about it. I have similar problems: I fall asleep fine, but wake up in the middle of the night and cannot get back to sleep.

    And I also feel anxiety when I wake up, so my mind tries to figure out what I could possibly be anxious about; of course, it succeeds in coming up with an extensive list…

    I find reading engaging fiction when I am up gives me something else to think about when I do try to go back to sleep.

    For supplements: magnesium, melatonin, and valerian have been somewhat helpful for me (though the valerian does seem to make my dreams more intense).

  16. PCC. You might be interested in a very recent podcast Sam Harris just did with sleep expert Matthew Walker. Four hours long (maybe there’s a transcript) but I’ve only listened to 1h.

      1. I can’t recall…it all seems like a bad dream.😉 Nice irony.
        “Hey did you listen to my 4h podcast on insomnia?”
        “I started it but fell asleep halfway through.”
        “Another satisfied customer!”

        1. Joking aside, I do play podcasts to try and help me fall asleep. I choose ones I am interested in with speakers who have calm, soothing, almost monotonous voices. I think it helps me somewhat.

  17. The other thing I do when I wake up exceptionally early is get up, go to my easy chair in the living room with a blanket and listen to continuous rain sounds on YouTube through my ear buds. The white noise of the rain sounds plus the inability to toss and turn like I do in bed seems to help me fall to sleep. I can get an extra two hours or so that I would have missed had I stayed in bed.

  18. Ugh. Sorry to hear this. When I was in my early 20s, I often had trouble falling asleep as I worried about things (school, job, girls). Of course, you can get yourself in a rut, because as you lay there not sleeping, you also begin to fret about the not sleeping. I finally learned to tell myself that, whatever the problem was, I wasn’t going to be able to do anything about it at midnight. In general, that seems to have worked over the years (not having to worry about school or girls might have helped, too). I hope this gets better for you.

  19. I hope that the CBT-i helps – my eldest daughter suffers from insomnia fairly often so it might be something for her to try. Meanwhile, Wokeness is obviously spreading…

  20. I have an illness that results in chronic fatigue. I need a lot of sleep and even then I’m exhausted upon waking. I have had similar bouts of insomnia lately and I’m completely crippled by it as it adds to all the other painful symptoms of this condition. Since I look normal and have to mask it anyway I’m pretty much just considered a liar.

    1. My sympathies, and I can relate as I have a chronic condition too. It does drain your energy and spirit to constantly deal with varying levels of pain.

      Such conditions are fairly common unfortunately. JFK suffered from something similar to what I have, and was at times in considerable pain, which he masked most of the time. I’m fortunate to have better treatment options than he had.

  21. Whenever I find I can’t sleep, I get up or read in bed. I find that I eventually get tired and can sleep. I think it is most important to avoid worrying about not sleeping as it can become a vicious cycle. Still, I have never suffered from serious insomnia so perhaps my opinion should be taken with a grain of salt. On the other hand, I’ve never suffered from serious insomnia so my remedy works! Ok, I’ll stop now.

  22. Odd how everyone wants to be a doctor when these issues come up. All I know is this is a serious illness and you are right to get professional help for it. If they totally understood the reasons for this we might have a cure. I do suspect that stress is not all there is to it. Most of us are under the most stress when working for a living – I know I was. Yet I slept better then than I do now. All I can say is I hope you find a way out and back to sleeping normally. The only thing I know about getting older as we have, is you do have to get up more often in the night to go. When we were young this was not happening.

  23. I have been an insomniac all my life. Even as a baby I wouldn’t sleep properly (there is an expression, having 40 winks to mean having a sleep. My long dead uncle nicknamed me “tiddlywinks” because of my inability to sleep as a baby).

    I find it impossible to get my brain to switch off, it just keeps on going. I envy those who can sleep anytime, anywhere.

    This treatment sounds interesting and I’ll give it a go.

  24. If we were fully conscious at birth and got a briefing:
    “Congratulations on your new life.”
    “Thanks, I’m looking forward to it.”

    You will be unconscious for one third of your life.”
    “Wait, what?”

    That’s the part you’ll most look forward to.”
    ” “

  25. There is a typo in a couple places in this article. This treatment is called CBT-I, not BCT-I. It’s the recommended initial treatment for insomnia, since it works well without the the long-term side effects of most sleep medications. Wanted to point that out so people can research more if they are curious.

      1. While you’re fixing things, Jerry, you might want to correct the fact about sleep requirements with aging. Nearly all of us need less sleep as we get older, and a common issue for the elderly is to go to bed at the same time as has been their lifelong habit, and then find they can’t sleep until their usual wake-up time.

  26. I’ve been dealing with this for years. I’ve always assumed that evolution has bred me to be a sentry around the campfire.

  27. As important as sleep, some psychologists say, is the intermediary state between sleeping and waking. This liminal condition is known as the “hypnagogic state,” a transitional mode of consciousness in which the imagination takes over from reason. Yung, Yeats, Poe and others have tried to induce this state of passive potency, a kind of calm alertness and observant receptivity, as an aid to creativity. Conversely, insomnia might well be an indirect means of avoiding such a state.

        1. If you start having hypnogogic hallucinations you may be either entertained or terrified. I’ve had a few of these after long bouts of migraines. I think I see someone standing over me or standing in the room & I scream. I’m a delight.

      1. “Sometimes I wake hearing my voice in my head narrating a story, it’s weird.”

        I can’t say I’ve ever had that happen to me. Isn’t that one of the claims as to how belief in gods started? When humans first started verbalizing, they couldn’t distinguish between thoughts and hearing voices?

  28. I also suffer from intermittent insomnia that sounds really similar to yours. I very much appreciate you sharing what you’re doing because nothing I’ve tried works for me so far. Best wishes! I hope this works for you!

  29. I wrote my take on the matter of sleep a few years ago. To wit:

    “I first understood that I was well suited to the academic life back in college when I attended my first academic seminar. It was a veritable epiphany: the room was warm, a speaker at the front was doing the equivalent of counting sheep for me, and then the lights went out for the first slide; I settled back comfortably in my chair, and knew no more until the lights came back on after the last slide. I realized then that I had discovered a true calling, like Paul on the road to Damascus.

    My career of sleeping through seminars continued in graduate school. One time, I was seated next to the Associate Director of our institute, a tough-talking biochemist who was reputed to have mob connections. Everyone referred to him as Big Al.

    Realizing that I was seated in a sensitive location, I fought to retain consciousness as the speaker droned on and on, and actually made it to the third slide before I retired to never-never land, slumping sideways at the same time so as to use Big Al for a pillow. When the seminar ended I awoke, refreshed as always, and looked blinkingly around. Turning to my left, I made eye contact with Big Al, who was fixing me in a stare that would freeze helium. “Ya feel bedduh now?” he growled.

    Fortunately, Big Al was not on my Ph.D. thesis committee, and in due course I earned that key of entry into the academic world. It has been a long and rewarding career since then. Several years ago, I underwent a medical procedure on one eye. I was told I must sleep sitting up for ten days or so. No problem. I had already had thirty-five years of practice. ”

    from: https://www.krabarchive.com/ralphmag/EO/brilliant-career.html

    1. Jon, that’s why my family will not take me to the movies. I’m asleep within 10 minutes and don’t wake until the credits flow.

    2. There have been many math stories similar to the following: Joe Internationally-Famous Mathematician falls asleep, very obviously, with snores even, soon after the seminar starts, stays that way almost all the way through—but then at the end is the only one in the room who realizes that somewhere in the middle, while J. I. M. was seemingly asleep, that poor post-doc has made a subtle error. Maybe J. I. Mathematician has already figured out how to fix it, so the post-doc’s main theorem is true, but with a slightly modified proof. It’s unclear whether that is better or worse for the latter, as fixing his/her own error might be better.

      My own Ph.D. supervisor was very famous, and fantastic for me I’ve always thought (he’s long dead). But he definitely nodded off a lot, and also didn’t hesitate to publicly be hard on ‘beginners’, seeming to take math mistakes by others almost personally sometimes.

      I actually benefitted from the 1st, the sleeping, only about 5 months after starting as a Masters grad student. The 2nd was inapplicable because I was trying to explain another’s very good just published work. But it had been unreasonable to assign me that so early. There were some fundamental things I could quote, but no way yet give known answers to many questions about them. But I managed to do that quoting in the middle of the talk while he did sleep soundly apparently. Then at the end, something, unwritten out by the original author, came up from him, something that I had been able to think about and he hadn’t. So it seemed to me from then on he treated me more like a junior colleague than just any old beginning grad student, despite the fact that he was without question overestimating me. Maybe I’d never even have finished the Ph.D. without that psychological encouragement early on.

    1. The guy referred to on Sam Harris’ podcast says THC is not good for good sleep because it is a drug that is spinning the brain up. Pr it just makes the brain a mush.

      Read his book or listen for his own words.

  30. We made the half caffeine/half decaf coffee switch (mentioned above) a couple of years ago, as my “terminal” insomnia has gradually worsened over the past 5-8? years (I’m 2 yrs younger than our host). Less caffeine has probably helped my wife more than me. I don’t think I can blame personal stress, at least not work (retired) or financial, although I’ve had some stressful medical events/diagnoses past 2 years (with which I’ll be dealing until actual terminus). And I’m chronically stressed by the state of the world and USA, way more than I was 10 years ago.
    So I wonder if it’s that, or just part of the aging process.
    I won’t offer advice, and things I try sometimes work better than other times, so I can’t say what’s best even for me. I will say I love my early afternoon naps (usually ~ 60 minutes, without an alarm), especially after a morning’s moderate (intensive is no longer allowed) bike ride. I don’t think my napping ruins my nocturnal sleep, as the latter can be bad even if I miss a nap. And even if I’m wrong about that, I’m always sleepy after my rides, regardless of the previous night’s outcome, so I plan to continue the naps.

  31. Sorry to read of your insomnia Jerry.

    I’ve always had a trouble relationship with sleep. Sleep is boring. I just don’t want to go to bed.
    Currently I’m waking up early too, no idea why but not enough sleep. However I do what I think is the opposite we are supposed to do: I just start surfing the internet on my phone. For whatever reason after about 20 minutes or 1/2 I seem to be able to get right back to sleep. All in all I seem to be doing ok, not really tired during the day.

    My wife’s side of the family – she and her dad – are super sleepers. They have never EVER had a moments trouble sleeping. They nod off almost immediately when their head hits the pillow.
    (My wife is a physician who still does overnight calls and obstetrics so her super power for sleeping is a blessing). I’ve always envied people who easily nod off to sleep.

    1. I’m a night owl forced into the world of the day. I find this a constant difficulty well. Like you I also don’t want to sleep. It’s boring. I could be doing something else. Yet I’m almost always tired.

  32. I undertook a CBT-I program a few years ago under the supervision of a psychologist. The first week was pretty awful. I was also told “no screens,” so my sleeping aid of choice is reading (always has been). CBT-I did eventually help, but I’ve had to do “refreshers” every time I get into another bout of insomnia. This involves reading on the couch in the living room until I get sleepy then climbing the 1.5 flights of stairs to my bedroom. I have to do this for many weeks, then cross my fingers that I can once again read in bed and fall asleep. I never developed much confidence in this method, even though I know there are data to support it! Now I’m using Lunesta every night and it helps although I know that I’m addicted because if I mess up my pills and don’t take it, there will be no sleep. And it’s probably not good in the long term to take it.

    1. I misread your “no screens” as “no screams” & thought, “wow, it really must be awful if screaming is common enough that they tell you not to do it”. 🤪

  33. Unfortunately I have insomnia. I worked with a sleep specialist who used CBT techniques. My problem is different than yours: not being able to fall asleep, tossing and turning, and then being exhausted in the morning. I found the CBT process very successful. I recall forcing myself out of bed and then, with little sleep, NO NAPS. It was painful. I, too love to read and work in bed. My bed is one of my favorite “rooms”, which is a very bad habit for those of us with insomnia. Well into the pandemic I was patting myself on the back for maintaining my hard-earned sleep behaviors. Then… back to staying up all night. I need a tune-up. I am going to apply the techniques she taught me. If I get stuck, I will return to her for coaching assistance. I wish the techniques solved the problem forever, but I am grateful to know what do when the Big Eye hits.

  34. Have not slept well for years. When combined with chronic pain (I now have a spinal cord stimulator) the combination has forced me to stop work. Have just done a polysomnography and am awaiting the results. I have always found that trying to stay in bed and get to sleep when you wake to be very counter productive. It was always best to get up and go and do something else until tiredness returned and only then go back to bed. It was only when the pain came along which on its own would keep me awake it became unbearable. The stimulator is a huge help but sleep is still a major problem. Hopefully the study will lead to improvement. Amusingly at one stage on the study they rang me when I awoke at 4.30am to tell me it was meant to be a sleep study. I said I would try again but didn’t think I would get any more sleep. An hour later they agreed and took the monitoring equipment off me.

  35. For a couple of decades – in my 50s and 60s – I’d lay awake for hours each night ruminating on life’s failures.
    In desperation I sought something to listen to for night time distraction even if not for actually lulling me to sleep.
    I found a podcast called ‘Sleep With Me’. It’s an hour of so of meandering silliness (unfortunately with a couple of promos along the way) with no storyline so there’s no point in trying to follow where the speaker is taking you.
    It worked. I’d fall asleep fairly easily both at the start of the night and if I woke during the night (who needs an alarm clock when you’ve an elderly bladder?)
    Eventually I felt the need to move on from the podcast and now download free audiobooks from my local library.
    I’m picky. They must have a non-irritating narrator, content that’s only mildly engaging and no ‘must-read-the-next-chapter’ plots. I’ve resorted to borrowing the same book that ‘worked’ several times. It’s amusing and I know what’s coming. I don’t need to stay awake to find out what happens next.

  36. I guess I have the opposite problem in that I think I sleep too much. I do wake up several times a night to go to the bathroom, but I almost always fall right back to sleep. I usually go to sleep around 3 am, and get up in the early afternoon. Then I will almost always take an afternoon nap. I feel most refreshed and alert from about 6pm to midnight. Good thing I don’t have to work.

  37. When trying to meditate, I often find I get sleepy. So to facilitate getting back to sleep I use meditative techniques such as counting breaths (1-10, repeat) or heartbeats (1-30, repeat), or maintaining any other focus of concentration (e. g., a mantra) that competes with intrusive thoughts. I just come back to the focus of attention when I notice the thinking. That, and relaxing the body, e.g., the shoulders and neck. Getting enough exercise during the day helps to minimize tension, and all the standard sleep hygiene tips apply, except perhaps for the nap prohibition, imo.

    The interesting thing about sleep – the temporary suspension of waking consciousness – is of course that it can’t be directly consciously commanded since consciousness is trying to monitor success in its own cessation. Falling asleep can’t be under direct conscious control. So the approach has to be indirect, e.g., a conscious effort in service to competing with what’s blocking sleep, which is usually rumination and tension, by paying attention to alternative conscious contents.

    The prohibition of naps is cruel since a 20-40 minute nap not too late in the day needn’t jeopardize the prospects of sleep at one’s normal bedtime, in my experience. A nap can rescue a good deal of the day from the debilitation of sleep deprivation.

    Good luck all!

  38. I listen to the radio on a very low volume that makes it hard to follow, & used to have an audio book I know really really well.

    Most of all not worrying about it.

    Dementia can come from poor sleep! 😬🤭

  39. Here’s a first for me – hopefully offering levity :

    I dreamed I was reading the latest Hili Dialogue! A fuzzy recollection :

    “It’s [some comestible] Day. I used to eat the one my mother would make for us with [cream and apples ?]. My favorite way to eat this was with [toast? jam?] and milk biscuits, which look like this [picture of a small roll up with something good in it].”

    The last bit was exactly from the dream, including an in-line picture of a “milk biscuit”. I have no idea if “milk biscuits” are real.

    Enjoy! With jam! Cheers, PCC(E)!

  40. It looks like you drink wine every evening. Alcohol consumption results in a temporary suppression of brain activity, followed by a rebound increase in activity that can wake you up in the middle of the night. It also causes dehydration, which also can wake you up in the middle of the night.

    1. I know you mean well, but I asked readers not to give me advice. The fact is that I went off wine for about two weeks to see if that affected my insomnia, and it didn’t. I don’t drink that much anyway, and drink it several hours before bedtime. And I’ve already discussed it with both my doctor and the sleep therapist, who didn’t think it was a problem. And I don’t get dehydrated.

  41. I have struggled periodically with acute insomnia. I have been taking 50 mg of Seroquel nightly. It has helped. I am wondering if anyone else has or is taking this drug.

    I have considered CBTi for a while. I will probably try it.

    Wishing you all the best.

  42. During restless nights, I quiet my mind with Sudoku. It eases my anxiety and I usually can fall back asleep when my eyes get tired and the eyelids heavy. Also, I can’t have caffeine after noon without risking repercussions.

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