Welcome back to Wellness Wednesday. This week I’m talking about the very contentious topic of sleep, and sharing 5 things I learned that had a major positive impact on my routine.
Sleep is one of those topics that everyone seems to agree on in the worst way. Almost anyone you meet could wallow with you in your sleep woes, and it’s almost a guarantee that there will be lamenting and competing over who gets less.
Don’t get me wrong, sometimes it’s nice to connect with someone over something you both think sucks. I spent many years as the person that knew they slept less than anyone else around them, without a doubt. I went years without sleeping through an entire night without interruption. But the reality is that I probably was sleeping more than lots of those people. People have kids, work overnight shifts, care for sick loved ones, are on call 24-7 – there are lots of people out there sleeping less than I was.
Even still, my sleep was pretty awful. As a kid I remember being up in the middle of the night all the time, but I was a kid with no adult responsibilities so it didn’t really matter. I have distinctly happy memories of waking up in my room with the sun coming in my window, listening to turtle doves, waking up rested and ready for the day. So although my sleep has not always been great, it didn’t impact me in a big way until I was an adult.
About 10 years ago I started taking medications for two chronic conditions. Once I started, I noticed that my sleep grew dramatically worse – I was not just waking up in the middle of the night, but I was wide the fuck awake like it was broad daylight, when in fact it was usually around 2am. Soon, I found myself back in my doctor’s office discussing how poor my sleep had become. We tried adjusting my medication and doses, but to no avail.
The best answer at that point in time was to keep my other meds as-is and start taking sleep medication. I happily obliged because I was exhausted and desperate to sleep the night through. I started on a small 2.5mg dose of Ambien nightly.
That shit was awesome, magic, like a dream come true. My Ambien was like my new best friend. After a while, I had to increase my dose (which was to be expected, my doctor warned me of this in advance). I was on 5mg for a while, then 7.5mg, then 10, then 12.5, then 12.5 controlled release. This all happened over the course of 7-8 years, and I got to the point where I could not sleep without my ambien.
Things got even worse when I realized I could not sleep with my Ambien either. Once I got up to a 12.5mg controlled release dose, I knew it was not wise to go much higher. Ambien is a great sleep drug, but it has some crazy side effects too. The worst I ever experienced was online shopping; I knew exactly what I was doing, but the Ambien brought me to a swirly, happy, sleepy, trippy place where it seemed totally OK to order a bowl specifically made for chopped salad making, or any other outrageous thing that Ambien Hilary was convinced she needed. I’m lucky that I never experienced any of the more serious or weird side effects that have been reported.
In January of 2019 I knew it was time to try and get off Ambien, but I knew I wouldn’t be able to just quit cold turkey. It took 4 months (!), but I was finally able to get an appointment with the Center for Sleep Disorders at George Washington University Hospital. The doctor agreed that I absolutely needed to get off the Ambien, and gave me a plan to taper off my dosage over the next 2 months. He also gave me some tips about sleep hygiene, and recommended that I improve my sleep habits.
When I went back for my 3-month follow up, I was fired. My sleep problems had disappeared!
Even I had a hard time believing it. Not only was I off the Ambien, but I was sleeping healthily for probably the first time in my life. I wasn’t getting up in the middle of the night, and was waking up feeling rested and ready for the day.
Quitting the Ambien was great, but I know the thing that made the biggest difference for me was following the 5 sleep hygiene rules that he gave me. So here I am, ready to share all this great info with you all!
Only go to sleep when you’re actually tired.
I had been taking sleep medication for so long that I wasn’t sure what feeling tired naturally felt like. I actually googled ‘what does being tired feel like?’ at one point so I would know what to expect (heavy eyelids!).
Here’s the thing my doctor explained to me – the brain is extremely powerful, and we have to work very hard to go against what it says the body wants. In this case, my brain wanted to stay awake, but I knew I needed to sleep. The process of waiting until I was actually tired before going to bed was particularly awful. It meant there were several nights where I was up until 2, 3, or later just waiting to feel tired, when I had work the next day. But this process was necessary to nudge my brain and body rhythms to reset in the right direction.
After about a week of this, my brain began to adjust, and I started to feel tired closer to the appropriate time. The few late nights were a small price to pay for the circadian reset I received.
If you wake up in the middle of the night for more than 5 minutes, get out of bed, go sit in another room with no light or distractions until you naturally feel tired again.
Have you ever woken in the middle of the night and sat in the dark quiet living room for an hour, waiting to feel tired again? Well I have and it’s pretty strange.
The only way for me to get through that was to repeatedly tell myself that it was going to work, that I would feel tired soon and get back in bed. The hardest part was ignoring my very curious cat who wondered why I was up at such an odd hour (rule from the doc was that no cat entertaining was allowed during these times).
The idea behind this is to not associate your bed with being a place that you’re struggling to sleep. Being awake and in bed and frustrated for hours about sleeping makes the bed a place of adversity – you versus sleep. In actuality, your bed should be a place of peace, comfort, and calm, which leads directly into my next point.
The bedroom is for sleep and sex only.
I was previously very guilty of doing lots of chores in the bedroom. Folding laundry, taking phone calls, getting some extra work done in a quiet place, all was happening in the bedroom in addition to normal nighttime activities. My apartment isn’t huge, and it was easy to use the bedroom as an extra place to get things done.
My doctor said that this all had to stop. Bedroom is for sleep and sex only. It should not be a place that you associate with doing anything unpleasant. So I immediately moved all my chores that I would complete in the bedroom into the living room. No more folding laundry (even though it was so convenient, the dressers are right there), no sitting in bed with my laptop, and no sitting in bed to take phone calls. All that stuff needs to happen in the living room now.
No falling asleep to the TV.
This was the worst sleep hygiene rule of all, because not only did I firmly believe that TV helped me sleep better, but I had a nostalgic relationship with falling asleep to TV since I’d been doing it my whole life.
I had a giant TV in my bedroom! But doctor’s orders, it went back into the box in the closet. Essentially, if I was following rule #1, don’t go to sleep until you’re tired, it shouldn’t matter whether the TV was there or not, because I would be falling asleep right as I got into bed anyway.
Once I got the hang of rule #1, I didn’t miss the TV in my room so much. And I must say that I’ve gone back on this one a little bit. I still don’t go to bed until I’m actually tired, and the TV is still in the closet, but I do put on Forensic Files on my phone when I get in bed because the narrator’s voice lulls me to sleep. I usually don’t make it past the first few minutes.
Right behind no TV in the bedroom, this was the rule I despised the most. I really loved taking naps. I looked forward to the weekend just because I would have time for naps! Naps are the shit!
But I realized that the more I napped, the shittier I slept at night. It made sense – if my body got used to napping, it wouldn’t need as much sleep at night, which contributed to me waking up and not being able to fall back asleep. I did stop napping (although I still nap for special occasions), and it had a positive impact on my overall sleep.
I made some other changes that improved my sleep life too. I got blackout curtains for my bedroom to diminish the amount of light coming in at sunrise. I cleaned out a lot of the clutter and junk that was stored in the bedroom to make it feel more more open and light. I try to make a point of keeping the space as clutter-free as possible, and spend as little time in there as I can outside of going to bed.
I am a happy sleeper now. I am no longer the person that competes with someone else over who got the least sleep. I genuinely feel terrible for them, and for the old me – sleep is powerful and important for so many of the body’s functions.
In the past, I could push through my day on little to no sleep and feel like a champion. Now if I don’t get enough sleep, I am like a sad sloth. Not a good look.
If you struggle with sleep, I urge you to take a look at your sleep behaviors and see what’s not working for you. Then commit to change! You should also see a doctor for chronic sleep problems, as these issues can be symptomatic of a larger medical condition.
Thanks for reading and see you next week.