Lack of sleep, stress can lead to symptoms resembling concussion
news.osu.edu
news.osu.edu
"Mindfulness, stoicism, exercise help, but nothing helps as much as a good night sleep"
So those are very connected. If you practice mindfulness and work out in a healthy way. And be conscious when and how you go to sleep ... things will improve.
Which sometimes lead to the strange situation of going to bed earlier on weekends.
I was incapacitated by this, which exacerbated my situation.
I eventually noticed that I could fall asleep if I sat with my daughters while they watched TV. This evolved to me falling asleep with the TV on. ...but the light, noise, and discomfort of the couch made this poor quality sleep.
Which then evolved to me falling asleep in bed with earphones on just listening to old tv, not watching. But I noticed that as soon as the tv show stopped, I would have nightmares again.
This evolved into me selecting 8 hours of movies that, on low volume, keep me asleep all night and I've essentially solved my sleep problem - despite this stressful situation persists.
My colleagues has instead started taking prescription sleeping pills.
I have found that selection of audio is important. It cannot be interesting or novel. It cannot be sound only - there must be speech. It must be content you enjoy, but have seen multiple times before. ...and it must have peaceful audio without screaming, shooting, abrupt sounds.
Interestingly, I no longer dream at all. The audio has essentially supplanted dreaming. I know this because on the occasions that the audio fails, my dreams return and are a notable experience.
I have been doing this for over 6 months now. 8 solid hours of sleep per night on the same programming all night. No ill effects noted. It has been instrumental in coping.
Food for thought. It seems stress caused insomnia can be cured without drugs, and dreams are optional for humans.
Also, teenagers, adults and elderly people have different sleep schedules that would allow for a tribe to have constant fire watch.
I can attest to it being very effective at inducing sleepiness. Here's a representative type that seems to work very well at making me fall asleep: [1]
As a sibling comment mentions, the old Joy of Painting videos by Bob Ross were early forms of this. He's kind of the unofficial godfather of ASMR
It has "Narration Only" versions of all episodes and it is very interesting, so if you can't sleep you can listen to it but it will not have harsh noises.
Also Philosophize This has the same properties (very old episodes have some loud music).
Let me know if you know similar podcasts.
Recently I've also started to listen to luetin09's Warhammer 40k lore videos. They are in similar vein that they could also be podcasts. Skeptoid is another one I've used.
I am neither a shrink nor your shrink but I think it's probably safe to say that whatever is affecting your sleep is probably affecting other parts of your life too, and while you mentioned a very difficult time - our bodies and brains don't by default react in most helpful says (eg - keeping you up with nightmares isn't helping anything)
In my experience what helps is a real way to "look within" to understand what's really going on. Ideally, this is done with the help of a real psychiatrist - someone willing to do real deep work of therapy and analysis, not just boredly write a prescription.
The other thing is developing self insight techniques yourself. For me, a diligent yoga practice and yoga study into the meditative aspects has been immensely helpful. But even on the purely physical practice level, learning to "look within" to understand why a pose is hard or painful teaches you the same process that I am talking about.
This all may sound wishy washy but if you are a software person you can relate to this - it's often easy to fix problems once you understand them. It's impossible to fix problems until you do, at best you can manage symptoms.
Unless the internal changes fundamentally change how you view the world ( i.e. the source of stress no longer causes stress, which is the kind of change you'll very rarely see in adults ) it will only be a paliative measure.
Being better able to cope with crap is useful, but I don't think it can be considered solving the root of the problem ( due to lack of neuroplasticity in adults ).
One example - people's natural emotional reaction to work deadlines is something like "I'll die if I don't make it" which is almost never literally true, but your body and mind torment you as if it was. Everyone can learn to reframe it to something more healthy like "I am a hard-working processional and I am driving myself to achieve this deadline as a matter of achievement and pride". Then you can engage with it fully and then still go to sleep at night.
Here's the key thing: whether you are able to change how you react depends on whether you try, and whether you try depends on whether you believe that you can. So at the start, you must believe that introspection will empower you to make changes, or you are doomed to be stuck forever.
The pit that many people fall into is that they take themselves very seriously and believe that how they feel about something is an objective representation of the severity of that thing. My example with deadlines above is one example. Another simple one is social anxiety. Someone can really believe and feel that "if I go to drinks with coworkers, they will judge and laugh at me and I will make an ass out of myself somehow" - that feels super real to them but objectively it's not real at all. So they spend hours of torment and lots of sleepless nights fearing and dreading and avoiding something that objectively is nothing. If they can reframe it (over the course of years, with a lot of help and work) the whole thing reduces to "it's just drinks who cares.". Same situation, but the person turner a stressor into a neutral or maybe even positive.
Don't be stuck where you are, and don't think you can't change or feel differently unless the world does. And then expect the change to be hard work but worth it.
Paycheck to paycheck drastically increases stress level, yet so many won’t get away from it.
When I ran an Airbnb, it was shocking to see how cheap other cultures would eat. Every meal home made. Despite no kitchen access label on listing.
When someone says they are under a lot of stress, I take it as they work 70 hours weeks, or they found out they'll be a cripple or people they love are dying, or the chance that you'll be stabbed when going to work is quite high.
Never crossed my mind that enough people are under heavy stress by the examples you gave.
We are also dealing with the source of my/our stress, and it should be resolved one way or another in the next few months. It's a 24x7 crisis for us that's complex and we're all working on it. This isn't routine work stress.
I have also used some stoic phrases and slow breathing to help me during the day. https://iamthemaninthedarkroom.com/
My above comment is strictly about this one technique that I stumbled upon.
Anyways, thanks for the link, I bookmarked it. Might also make a local version of it and set it as my homepage.
I turns out that the only time when I was not doing something that occupied my mind was when I was trying to sleep. Eg, I'm either working, consuming media such as Netflix or podcasts, talking with people, etc. I'd even listen to podcasts while taking walks. So when trying to sleep, I'd be stressing out over my problems, and trying to work through them.
For me the solution was to find a better time to remove distractions and think about my problems. Eg, taking walks without podcasts, driving without the radio on.
My experience has been that most of the psychological issues can be resolved to a great extent by employing the "redundancy of potential command a.k.a Self-Organization"(See McCulloch). Meditation does this by asking you to bring back the wandering mind again and again. But you can also do this voluntarily by repeatedly observing the stress inducing conditions such as nightmare(in your case), which can help your brain better adjust and detect patterns.
In my case, we're facing a crisis - so we know the source, and that it's temporary (one way or another).
I used to fall asleep listening to audio books. I eventually found audio books that are barely interesting, with certain narration styles to put me to sleep faster.
I now have a series of audio books, mostly gumshoe detective novels, that I use to sleep on nights when I'm dealing with stress. I set the sleep timer for 6 hours, and invariably get a good night of sleep.
My thoughts on the book series aside, it's long, and I find the narrator rather soothing.
I'd absolutely check out samples first though. One person's soothing narrator is another person's grating narrator.
- panic attacks
- waking up into a panic attack; imagine sleeping, then waking hyperventilating, shivering, and for lack of a better word "freaking out"
- sleep disturbances
- periodic severe emotional disturbance
- inability to remove the stressors, and critically, I had to increase the stressors involved as it was time critical
I was able to take two weeks off from work, and I took escitalopram.
I didn't find escitalopram to be ... a game changer, but it did allow me to "decide" how I was going to feel, and if I felt I was going to have a panic attack, I could head that off through feedback and self aware thinking.
The key for me is that the background sound must contain speech. Podcasts don't work either because their is no visual component. I need to be able to imagine the visual, even if I'm not watching it. Somehow, that's important. Maybe it stimulates that part of my brain to prevent it from creating visual dreams. I suppose there's a general rule in the brain that when you're listening and watching something, that part of your brain goes into input-mode rather than compute-mode.
There are two important takeaways here.
1. I've (for myself) obviated the need for sleeping pills (the solution my colleagues have taken).
2. There are seemingly no ill effects to preventing my brain from dreaming naturally for over six months.
If you really think about that 2nd point, this means that it would be possible to create sleep specific programming. One could use it to incorporate messages to ones self.
Many in this sub-thread are thinking they can use it to learn new things - typical HN! ...but since novel content wakes your mind, I think it would be more valuable to program motivational content. Content that reinforces your core principles and might help you focus yourself in the subsequent day. It might even be possible to have a small portfolio of programming if you're expecting/planning a different type of day.
Obviously, I'm going through a temporary crisis, so I cannot pursue this, but someone should.
Another book "Why We Sleep" by Matthew Walker also goes into how important various stages of sleep are for learning and good health: https://en.wikipedia.org/wiki/Why_We_Sleep
So, while you have found something that seems to work for you to prevent regular dreams, I wonder if it could leave you stuck somewhere emotionally with a trauma or otherwise may also interfere with other healing and learning aspects of good sleep? On the other hand, maybe your approach help keeps you call enough at night, and so you are dreaming OK but don't remember your dreams (which is fine), and so you do have dreams and do process memories through them, and so your approach is a breakthrough in that sense? Anyway, there remain a lot of unknowns about sleep and dreams...
"Sleeping pills" in general are bad news for healthy sleep (as Matthew Walker explains in depth), so good to avoid them. This is because they interfere with normal sleep (as do many other things like alcohol late at night).
It can’t be a new one or else I’ll get too interested in it.
It's a little tricky to choose the right length (i.e. not being awake enough to notice when it ends, but also not too long so it reads to me for hours).
I'm not sure if this is healthy... It works for me as a source of entertainment, but I can fall asleep without this too. I've heard that bringing a computer into the bedroom is definitely something not recommended for anyone seeking work-life balance.
[1] https://docs.google.com/document/d/1mApa60zJA8rgEm6T6GF0yIem...
I have tried several sleep aids in heavy dosages, meditation, breathing exercises, visualization/journey exercises and pre-recorded journeys ... but none create such a powerful relaxation response.
Weird, I know! It took me a while to notice how deep and regular my breathing was without effort, and how a deep calm always settled over me when I fell asleep listening to audio such as from The West Wing. Eventually I bought a sleep mask with built-in wireless earbuds, and began experimenting with different kinds of human speech as background for sleep.
Just as @koheripbal discovered, I found the selection of just the right audio is important.
In Chinese, it's a single, uhm, guess you could call it a word: 報復性熬夜
See also:
https://www.scmp.com/yp/discover/advice/living/article/31130...
This is easy to recognize from outside but at the time I did not really understand the problem, I thought it was just my capability/identity and the inherent difficulty of the work.
Worst case in college, you submit the later assignment, settle for a D, and vow to study hard for the final. In the real world, you manager calls you to his office, asks you why you're weeks behind, it's going down now in your evaluation. Maybe you're in a start up, you loose that crucial client, now you're wondering how to pay your expenses as well. You have a family, kids, the stress compounds, pretty soon you're a mess at home and at work.
And, I've got 12 years of higher education under my belt. When I made the final push for my PhD thesis corrections, I stayed up 4 days straight right before the deadline dotting my 'i's and crossing my 't's. 6 years into the "real world", I often look back on that time as the good ole days.
Do we just live in the different real worlds? Because in my real world, deadlines are almost always arbitrary and fungible so long as the right kind of communication is made -- the only times I've seen that not be the case for me/folks in my network is 1) when they're working on something that's actually time critical (rare but does happen) and 2) when they're working in a dysfunctional, top-down environment (far more common).
I can't help but raise an eyebrow at the idea that you might lose a client by missing a deadline by 2-3 weeks (rather than not selling them well enough). Is this a hypothetical situation you're talking about? Sometimes, 2-3 weeks is as fast as they'll get back to you with a single hop of communication. The other example of engineers get down-evaluated for ending up jumping on the grenade of a task that gets significantly longer (sometimes by months) -- I do see that happen from time to time but whether the manager down-evaluates is often inversely correlated with that manager/management chain's capability. The good managers understand that scope creep and an unforeseen gotchas happen; they don't want to take those instances as failures but rather .
> When I made the final push for my PhD thesis corrections, I stayed up 4 days straight right before the deadline dotting my 'i's and crossing my 't's. 6 years into the "real world", I often look back on that time as the good ole days.
Why? That sounds like unproductive, unhealthy self-martyrship. It's the complete opposite of how a competent professional works through things. Do you simply like to suffer? There's a reason people don't work like that in the "real world" and it's because there are actual real dollars on the line and competent organizations understand that such behavior purely results in expensive unforced errors.
How does a person go through university and not learn this lesson? Should we teach them the better way? How?
Edit: I remembered a potential clue- my coworker was able to transition from work to sleep rather easily, where I require a substantial wind-down period. Perhaps this shifted the equation.
I once made the mistake of absorbing lots of accountability for things under the misguided instinct of “protecting” people. My role changed quickly as a result of a crisis and the world seemed to change. The reality was that it was really a type of selfishness and pride. After a few weeks I got to a point where I thought I had a physical problem — I basically had no short term memory.
Took me a bit for my thick skull to grasp, but once it clicked it ended up being fairly easy to fix.
When you increase your levels of magnesium, suddenly it's easier to be present, meditate, mental endurance increases, you can endure much more mental stress.
If you're deficient, it can lead to a bad, downward spiral.
Magnesium Status and Stress: The Vicious Circle Concept Revisited
https://www.mdpi.com/2072-6643/12/12/3672/htm
"The idea of a bidirectional relationship between magnesium and stress was first introduced by Galland and Seelig, in the early 1990s [9,10] and then referred to as the vicious circle. This vicious circle implies that stress can increase magnesium loss, causing a deficiency; in turn, magnesium deficiency can enhance the body’s susceptibility to stress"
...so of course a lot of tech companies absolutely wreck their employees' sleep habits with crunch times, oncall requirements, notifications around the clock, etc.
I bet some Zen master would reprimand me for this being the wrong approach, but I found it quite difficult to get into the habit of doing, say, a single 30-60 minute session per day. Now I can consistently drop into the meditation session with no urge for procrastination and have also successfully experimented with longer ones.
[1] refers to the method of increasing your pull-up capability by installing a pull-up bar in your office / bedroom doorway and doing a set every time you pass through the doorway
Hey, that's what I do too! I've never read anything meditation-related and consequently do not know any of those approaches but I once realized that lying in bed/on the couch/on the floor for a few minutes while freeing my head of all thoughts really helps with mental fog (I have ADHD and fog tends to build up even with meds). I tend to jokingly refer to the process as 'clearing my cache'.
Happy to see this concept references here!! I've started thinking about a lot more things in my life in terms of greasing the groove, IE: how can I make the healthy things convenient and the unhealthy things inconvenient? I want to be lazy with my willpower when I can.
I often employ it in work too, picking one of the most minor thing I have on the to-do while having morning coffee and three hours later realize I have been grinding away non-stop.
Regulators need to recognize that continuous tracking devices are a new tool for establishing a health baseline and they should not be expected to match the performance of single-test medical devices. Apple, Garmin, and Fitbit need to build standards to share this baseline data with medical professionals and offer analytics to determine when changes occur.
Questionnaire based medicine seems backwards given the digital tools available.
Putting more and more of our data, especially health data, in the hands of others is the wrong direction to be moving IMO.
Found it though: https://github.com/fluxtream
I don't know how representative you folks are. I know a few people who invest time, money, and effort into tracking and measuring every aspect of their health. It looks like neuroticism to me. Especially when they look for explainations of every blip on every chart.
I have light sleep apnea, but a CPAP didn't help either. I'm old (60) so I'm considering trying melatonin to replace what I'm no longer producing, but I'm also wondering if I'm missing some other potential "staying asleep" lifestyle factors. Anyone here successfully dealt with the "stay asleep"issue other than with the variables I listed?
https://www.scientificamerican.com/article/the-messy-facts-a...
https://www.acsh.org/news/2019/05/05/closer-look-anti-inflam...
A book I just read (Fast Asleep by Michael Mosely) recommended that kind of diet, but said apparently some studies showed that being even a bit overweight can reduce or even eliminate the improvement, so that is one thing to tackle first if that’s an issue. Other ones were a big emphasis on managing stress, and suggestion to try intermittent fasting (even just limiting all eating to 12 hours apparently can help, but some people limit all food to 8 hours and then fast for 16).
Trying to ensure that you get a bit of outdoor light exposure, and as early as possible is apparently good too, and I think it’s helping me. I just wake up and sit by the window for 20 minutes.
I’m also interested in trying doing a 72 hour fast (just drinking plenty of water taking a bit of electrolyte supplement) three or four times a year which apparently is good for gut bacteria, immune moderation etc. but people should have a chat to a doctor about doing it safely. I’m specifically interested in autoimmune disease because I have psoriatic arthritis, which is almost 100% managed by immunosuppressant but I’m interested in seeing if I can reduce my dose (working with the rheumatologist, not by myself!) but I’ve always been terrible at sleep and am trying to improve that as well (since that can help manage my condition too).
I think my gut bacteria is pretty good. I'm a nut for fermented stuff, make my own yoghurt, kimchi, saurkraut, kombucha - and eat it all the time. It has been really fantastic for digestion, which had been a problem (pain, irregularity) and now is great. Since starting yoghurt every single day I have a freakin' Iron Stomach. I have zero autoimmunity issues fortunately (knock on wood).
I'll consider the inflammation stuff. I've been trying to cut out down on sugar anyway.
Anecdata: I cut out all caffeine during quarantine and I've never slept better. But I was drinking ~12oz a day prior to that. And I also cut out all the other drugs in my life too. And the commute due to WFH. Honestly, trying to say it was one thing that made my sleep better isn't really possible, it's all entangled. But the SO says that caffeine was the major culprit.
Just this morning, I think I finally diagnosed my central sleep apnea. I was laying there and just as I fell asleep I started awake because I wasn't breathing. My diary has notes about this happening all the way back to last March. This happened to me after my first sleep.
To add to that, I've become hyper-sensitive to caffeine. It causes palpitations (started in late 2019).
I don't snore, but I have been using Breathe Right strips to make sure I have adequate air flow, and so I'm really sure I don't snore. Curiously, I haven't used them for a couple of weeks (long story).
EDIT: if you want to contact me, my info is in my profile
Uncanny. Me too. Also tried every airflow device I could find (breathe right, nose baffles, chin strap, and many more) to no avail.
CPAP was a total fail because if the pressure is turned up high enough to defeat my resistance, it just fills my stomach with air (called aerophagia, a common CPAP problem). I'm starting to think the only solution is one of those implanted breathing pacemakers but that freaks me out.
Btw, I also had palpitations! I'd wake up with them really bad, probably from not breathing. Going off caffeine doesn't help though. A beta-blocker (6 years now) works wonders. HOWEVER! I just saw a study yesterday that people can have insomnia from beta blockers, and that 2.5mg melatonin helps counteract it. Round and round!
I’ve struggled for years, and I still do with waking up like you do. Some nights are perfect though. What has helped the most is:
- Sleep study. Awful but it landed a CPAP. Also awful but it works now that I’m used to it.
- Quality bedding
- No pets and no computers in the bedroom. Everything is off
- exercise. Until exhaustion if possible
By the way, a friend of mine is doing a Master's thesis in work psychology at the University of Turin on this subject.
I am a bit ignorant about this topic since I have a business background + work in tech-startups. But I am genuinely passionate about this kind of thing.
The gist of the thesis is that all these dynamic and interdependent aspects (e.g. lack of sleep, stress, social pressures, even for athletes before, after and during a race, even if we think about the influence on self-perception in relation to other people and related expectations on personal performance) can lead to somatization which can come in the form of concussion, but also to burnout or multiple injuries (as my friend is researching on the thesis) and as it happened to me too, in my life.
Practicing yoga or simply going for a walk daily, helped me a lot along that path... and helped many friends of mine as well. But some people can argue that it is the natural outcome of a "placebo effect".
All of these are very interesting talking points and the inherent dynamics behind vicious cycles (echoing @raghuveerdotnet's comment) is still not crystal clear and needs further research and experimentation.
What are your thoughts?
What would a placebo effect even be when talking about lack of sleep, stress, etc.?
In medicine the size of the placebo effect seems to depend on the procedure. A placebo surgery is more effective than a placebo injection, which is more effective than a placebo pill. So if you want to test if an injection is better than a placebo you compare it to a placebo injection like saline water, something where there's no way it can have a medical effect beyond the psychological effect. But that would mean that to evaluate meditation you would have to compare it to some kind of fake meditation, maybe breathing exercises that have no viable way to be effective beyond the placebo effect. But we don't know nearly enough about neuroscience to come up with such a thing.
For my schizophrenic sibling one of the most troubling aspects of his condition is bad irregular sleep. Sometimes he can't sleep all night and then he sleeps the whole next day. But it's never enough sleep, nothing but constant drowsiness and lack of energy. Psychosis sure does resemble dreaming while awake, you accept weird ideas, things just happen etc, same as in a dream. And once medication kicks in, seems like slowly waking up and dream fades out.
Somehow it's all connected and whoever figures out the puzzle of sleep will make the world a much happier place.
One sign, which I observed in a few other sleep-deprived people as well, is the inability to form a coherent sentence - or even say a single word sometimes.
Funny thing was, I had some of the symptoms to a lesser degree before the blow. So was it brain damage, or did the blow merely worsen my visual and vestibular systems and cause more fatigue? I’ll never know.
But a key thing is that in the two years prior to the blow I had some burnout, seasonal cashflow issues in my business (thankfully resolved), and worse sleep. I fixed those and I have my old energy back. But for months leading up to the blow I hardly felt able to go to the gym, and old tasks felt tiring. Fatigue, some headaches, etc
In the last couple years I’ve come to realize how idiotic that position is; just because I don’t immediately collapse from exhaustion every time I get insufficient sleep doesn’t mean that my body doesn’t need it, and that it won’t have long term effects if I push it off too much.
For the last couple years, and even more since COVID, I’ve been making a point of getting regular exercise, and trying to get at least 7 hours of sleep a night (usually 8 or 9). I feel healthier, and I do think it has helped a lot with my depression.
Personal anecdote, when I’m getting more stressed I start getting a heart spike at sleep. I’ve tried ignoring it and it turns into anxiousness and stress.
These are the symptoms one would experience after anything happened to them that involved their brain, be it a little lost sleep or getting knocked out by a 300 lbs linebacker.
Given this, the headline seems a little exaggerative and reductive to the point of being meaningless. I mean, spinning around in an office chair a dozen times will cause a few of these symptoms, but that's not anywhere near the level of harm caused by getting concussed.
Also, I should learn to touch-type the digits. It's funny that I've been touch-typing Dvorak for 20 years, but still haven't picked up the digits.
That being said, if you can't remember 6 digits, just imagine how the rest of your work suffers at that point. Everyone is better served by you taking a nap first
As a former sender of six digit codes, I worked hard to make them visually (and auditorially) appear to be two three digit codes; we thought that would make it easier for people to process. If you make a habit of processing the codes as two three digit codes, it might help when you're over tired.
I take Lexapro daily, have a low-dose benzo for situational anxiety that I try never to take except it true emergencies, practice mindfulness / meditation, see a therapist off and on. You get better at managing it but it's a problem that never truly goes away.
- Do not eat or drink anything but water at least 3 hours before when you are going to bed.
- Do not have screens in the bedroom.
- No screens 1 hour before before bed.
(That last one I utterly fail at, but I am mainly doing textual things not from an attention-economy leach on the screen so, and it works out. Either the other 3 is enough or that screen time is sufficiently less stimulating.)
I've figured lately that working "hard" at chores at home can replace some of it, the point is to not be too lazy.
Good quality sports cloth are not that expensive anymore and make winter outside exercising possible and pleasant. Really, buy merino shirt and sport pants.
The other option is fast wall outside, but that have to be longer to amount to exercise.
Third option is to have a look at bodyweight exercising. Most of it you can do at home with zero equipment and don't require much space. Some of it requires stomping, so you may have to skip those is someone lives under you.
* have an early dinner. I eat at 4 or 5 pm. This is extreme, but earlier will probably help if possible. No snacks after dinner
* Get light exposure as early as possible after waking. A morning walk is good
* Exercise close to waking. In practice I do a 7 min workout, eat and walk
* blue light blocking glasses help
* A sleep mask can help. I use a manta mask + their glasses. I don’t actually sleep with the mask as I side sleep, but I wear it for 10 min or so while laying in bed and I fall asleep, then shift to my side to continue. (For whatever reason I can’t sleep on my back)
* Fewer household lights in evening. Lamps are good.
* Decide to get ready for bed even if you’re not sleepy. If you start a wind down routine by dimming lights, brushing teeth, reading, whatever you do before bed, you’ll start to get sleepier. It sounds dumb, but if you are, say, staring at your phone for three hours waiting to get tired you won’t get tired.
* Keep a log. You may identify changes or factors specific to you that help improve things
Thank you for reminding me of this.
Two years ago I had a sleeping revolution and I had success with a barrage of efforts I did, most notably giving up caffeine and having this routine, and ensuring 100% darkness. But I have to recognize that I lost the routine now.
But yeah simply deciding to start each night is the stupidest yet most effective thing. I think it’s easy to forget this as sleep sort of feels like a non activity vs. say working out or reading etc where deciding to do the thing is obviously the first step.
Avoid caffeine. If not entirely, at least don't have any after noon. Everytime I have a really hard time falling asleep it'a because I had a (delicious) coffee or cola after lunch. Enough times that I've almost learned my lesson. ;)
Go to bed quickly if you're feeling drowsy in the evening, even if it's before your preferred time. I often feel sleepy just before 21; and if I get into bed then, I usually sleep through the night and wakeup rested; but if I push through it, for whatever reason, I'm no longer drowsy in 30 minutes, and I will have a hard time sleeping until much later.
My work put us on call at night 1 week out of 3 to monitor an ailing server and my productivity fell precipitously almost immediately. That was the last straw, so even though I thought I had the discipline to handle it, my body thought otherwise and I started crashing (falling asleep at my desk, having so much brain fog that I struggled with basic chores, etc). I miss that job often, but the writing was on the wall at least a year before that when I noticed that nobody listened to my expertise, they just wanted output. That's the surest route to burnout that I know of so far.
I did have a lot of concussions in elementary school, but all I remember is the nausea and laying in bed for days. Severe burnout/depression feels similar in that one loses their executive function. To me, burnout felt like what I imagine having a stroke might feel like. My problem-solving faculties shut down, so it was like my mental muscle memory of everything I had learned was no longer there so I was consciously aware of every single step I had to perform (which left me frequently overwhelmed). It also felt like maybe the left and right sides of my brain weren't talking. When I thought about doing any task at all, no matter how minor, I felt low grade pain over my entire body like the feeling you get as you walk slowly into a cold body of water. Where there used to be excitement at the anticipation of doing things I enjoyed, there was now only a void of apprehension and dread. Everything felt like work, even recreation.
I had to start from the beginning and relearn how to write todo lists, journal about what I wanted out of life, address all of the physical issues I could, etc etc etc. The self-help stuff is all true. The only part they are missing is that IMHO as much as 80% of our mood is derived from physical sources. The science of vegetarianism isn't quite there yet. So for example, I was eating more beans (legumes) and nightshades each day than most people probably eat all week. The anti-nutrients had lowered my absorption of iron, zinc and I'm pretty sure iodine, not to mention that I wasn't taking enough of the basics like B vitamins. Each time I reintroduced traditional foods like bacon, I received outsized returns because of things like tryptophan turning into serotonin. Nutrition is huge.
Anyway, when it's all said and done, the best treatment for me was to slow down and emphasize things like how priceless consciousness is (dignity), and deemphasize artificial human constructs like worth/productivity (materialism). Also I learned that habits take about 2 weeks to form, so it was helpful to list 1 or 2 things I was struggling with, then perform them manually and dispassionately until the habit stuck. Negative self-talk is huge too. I adopted a continuous mindfulness as a set of rules so that whenever my inner monologue is critical, I note it and file it away without engaging. Over time, the positive thoughts grew as my inner child learned that positive reinforcement works.
I'll stop there since I could talk about this literally forever, but I highly recommend talking to someone and seeing a doctor or nutritionist and trying some integrative and holistic approaches. Don't lose years like I did.