Improving sleep

Biggest improvement to sleep quality I had was giving up caffeine, which isn't mentioned in this article.

I'm inclined to bet, most people in the west who self report suffering form poor sleep, can narrow it down to caffeine over-consumption, since it leads you slowly to this march of death burning the candle at both ends where you drink coffee to compensate for poor sleep and you sleep poorly because of too much caffeine.

Four things that doing six months of CBT-i (Cognitive Behavioral Therapy for Insomnia) taught me are:

- Routine is EXTREMELY important (I.e. getting in bed and waking up at the same time, every day, even weekends)

- The best way to associate the bed with sleep (and, thereby, falling asleep more quickly) is to ONLY use the bed for sleep and sex,

- You're gonna have bad nights, but the key to preventing the insomnia from spiraling out of control is to remember that "you WILL go back to sleep; it's natural," and

- Sleep drugs (zzzquil, trazodone, seraquel, ambien, etc.) used daily are a bad deal for most people

Two visits with a bona fide sleep doctor taught me is:

- it's probably sleep apnea, and - lots of people have it!

I used to have a really hard time falling and staying asleep. My sleep patterns looked something like OPs, with lots of time asleep but even more time in bed.

CBT-i fixed that.

I needed to do it with a therapist to get the most out of it, but there is a free app in the App Store (CBTi Coach) that guides you through it.

I have no issues falling asleep now, and my total time in bed (TTIB) is very close to my total time asleep (I.e. my sleep efficiency is very high).

I still struggle with maintenance insomnia (staying asleep). As far as I understand it, this kind of insomnia is usually invoked as a protection mechanism against something that one's body perceives as a threat.

I am (finally!) getting a sleep study done to verify whether it's sleep apnea or something behavioral.

In addition to what you mention:

- If you have sleep apnea that might explain why you wake up in the middle of the night, and there are treatments you could try.

- Wearing ear plugs (the ones that look like a screw) has helped me a lot, but I have to cut them to be able to sleep with them, since they do protrude from the ear and are uncomfortable.

- There's a simple trick to fall sleep again in the middle of the night: Set a specific time in the morning to write down the thoughts that worried you the most, with possible solutions. When you wake up in the night, think that you will attend your thoughts only the morning at the time you have specified, with some time you will see how you can fall sleep easier. (This is part of the solutions to attend the rumination thoughts)

- I highly recommend you watching this podcast with Matthew Walker, which is one of the most important scientist in this matter: https://youtu.be/gbQFSMayJxk

- As I have suffered insomnia for 20 years, but have improved a lot in the latest years, this thread is based in my own research: https://twitter.com/JuanPabloSarmi/status/168856844920991744...

Nice list. I second having better sleep with white/brown noise. Be careful with in ears though. Don't wanna catch an infection. Also rolling over one ear piece may wake you up again, sabotaging the sleep.

I may add, as it's not mentioned in the article: co2. My 55m^2 flat barely stays below critical co2 levels without ventilation for a 7 hour sleep. So keeping all doors open is crucial and/or a window slightly open on the other side of the apartment. Closing the bedroom door - which I sometimes did when as I wasn't aware of this yet - was a recipe for a headaches and bad recovery.

For waking up, having natural light or other sources of light turn on before the actual alarm clock rings is nice to feel better in the morning.

> It's just a bit hard to book a night at a clinic 3 mo in the future when I don't know in which country I'll be then.

That might be the most first-world problem I've ever come across. Maybe frequent travel impacts sleep?

My main takeaway from this was not actually from the posted article, but from this person's technique of publishing (unfinished?) draft articles on their blog [0] with a prefix of "[draft]".

For someone who struggles to finish blog articles, this seems to be a stroke of genius. I might have to try it. I can't help thinking that once you've published something, the impetus to complete or polish it may be higher too.

[0] https://vincelwt.com

there is interesting historical research, which pops up from time to time, showing that people in many cultures before the advent of electric lighting commonly slept in two phases -- about 4 hours, a couple hours awake, and about 4 hours.

i think it gets too strong when people claim that this is "natural" or "better" or something. but the historical evidence suggests it's at least "okay", and if you sometimes wake up at 3am maybe just embrace this, get up, do something tedious, and go back to bed.

I don't use any of them, but I've heard firsthand from some like the author complaining about inaccurate data from devices like the Apple Watch and Oura, some getting rid of them due to this.

Since the OP continues to use them, am I to understand there is no better alternative that is comparable on the comfort/ease-of-use/cost-effectiveness axis with these devices?

The idea of making health decisions based on bad data makes me queasy, but do people who continue to use these devices despite knowing their inaccuracy still recommend their use because one shouldn't let "the perfect be the enemy of the good"?

I like the table of trying things.

Personally, I’ve found the majority of my sleep issues come from one problem and only one problem: stress. It’s almost the most easily correlated thing I can find for my sleep quality. I’m a light sleeper naturally but I am lighter the more stress I have. Outside of that, I found when I am particularly upset, I will wake up at very early hours and just be way more wide awake than I want to be. I can go to bed at 2am and wake up at 4:30am feeling quite awake but obviously very tired.

If I am able to lower my stress then I find sleep gets much better and so does everything else.

At the current moment, I am actually finding my body is getting progressively more sore everyday because I’m unable to get enough rest to recover from my workouts! Due to poor sleep, my lifts are incredibly unpredictable. One day I can do about four sets of ten then the other day I can only do two sets of 7. Sleep is hugely impactful for getting enough volume when in the gym. I can feel when my muscles just won’t respond to the signals I’m sending - or that my body won’t send the signals I’m asking for - whichever it is.

Highly recommend making sure your stress is low because that has always been the biggest by far contributor to sleep for me. Everything else seems worthless in comparison.

Also, and this might be obvious, turn off some time before going to bed. I am in the habbit of 'trying one more thing the fix this bug' before bed which makes me sleep simply terrible.

Eating old cheese also helps for me but can make me feel groggy in the morning.

How do you sleep with Airpods Pro's in? (wouldn't it be uncomfy, especially if sleeping on one's side?)

My tactic for falling asleep just about anywhere is over-ear headphones (QC35) and a sleeping mask.

Sleeping slightly on your side is no problem with QC35 and if the noise around you is low enough you don't even need white noise. The battery lasts a couple of nights too (esp with no white noise on).

I've tried doing the same with Sonys over-ear but they make a loud noise when I move my head so they don't work for me at all. AirPods Pro work in a pinch but the battery runs out and my ears start hurting.

Another thing which I find mildy helpful which wasn't mentioned here is Valerian. If my lack of sleep is stress-related Valerian works sometimes for calming. If my lack of sleep is due to bad routine / off schedule Melatonin works very well but if I'm stressed it does not work at all and leaves me groggy in the morning.

OP briefly touched upon sleep apnea. Getting an early diagnosis for sleep apnea can be life changing and life saving. If you wake up exhausted, suffer from daytime sleepiness (especially if you're falling asleep at the wheel and stuff like that), or if you've had bed partners complaining about choking/gasping/snoring/dying, you'll want to get that looked at.

No amount of supplements or yoga is going to make you feel better when you're waking up 20+ times an hour because you've stopped breathing.

And I didn't see this mentioned anywhere, but a consistent sleep schedule/routine is also great. I'm better on a consistent 24:00-06:00 sleep schedule than I am on 23:00-07:00 one night, 24:00-08:00 the next night, etc.

~ My average sleep efficiency (time asleep vs time in bed) according to Apple Watch & Oura is ~85%, meaning to get my 7h30 of sleep to feel rested I will stay more than 10h in bed. That sucks!

85% of 10h is 8.5h :) To get 7.5h with 85% you need ~8.8h in bed.

I don't want to give up caffeine, but I have my two shots before 7 or 8am and that's it for caffeine. You didn't mention alcohol, maybe you aren't a drinker? Giving up alcohol for ~4 days definitely improves my sleep - no 2am wakeups, more dreams - but then it's the weekend again, whoops. If I can't fall back asleep after around 15-30 minutes, I get up and read for an hour; that always works. I try to think in terms of sleep cycles - did I get enough? can I get one more? I'm surprised a sleep mask doesn't improve sleep onset. I am addicted to my scarf eye cover's total darkness.

Is there a sleep tracker (or general fitness tracker) which doesn't store my data in cloud services or require an account?

Scanning through the comments, I was really surprised not to see the one thing that was ultimately the cure for bad sleep for me (in addition to the basics of "caffeine hygiene" and getting some exercise):

1) Get up at the same time every day. 2) don't nap

That's it.

I believe I originally read about it here: https://www.theguardian.com/news/2018/sep/14/finally-a-cure-..., and implemented shortly after, so has been working for me for about 5 years.

This is something I never think "anyone else is going through" and find out I'm completely wrong. It's all the things I experiment with in my head and keep to myself and here he's taken them all out and tabulated the data.

I would like to add to his findings that alcohol (any amount at all) changes sleep quality for me very consistently (not staying asleep/lack of morning after "rested" feeling). Strange to me that it's not an item on his list but maybe he doesn't drink to begin with.

Keep in mind that everyone is different, and there may come a point where you have to accept things as "good enough", but from my time seeing a sleep specialist, these are the best ways to improve your sleep quality:

1. Get up at the same time every day. Try not to push it more than an hour later on the weekends, or two hours on vacation.

2. The old adage about getting 8 hours of sleep isn't right. Many people don't actually need that much.

3. Don't go to bed until you're falling asleep (do your nighttime routine of brushing your teeth and such before this).

4. If you can't fall asleep after 15 minutes, get out of bed and do something until you feel like you're ready to fall asleep.

5. Your bed is for sleeping (and maybe sex). Nothing else.

6. Your room should be as dark as possible.

Regarding #2, a compressed sleep schedule may help you. That is, if you're going to get up at 6am every day, try to aim for an 11pm bedtime. If you still have trouble, try 11:30, and then midnight. In some cases, it's necessary to go for extreme sleep compression - as little as 4 hours a night, but this is usually done as an in-patient program, and generally shows results within a couple of weeks.

Caffeine, alcohol, and sugar can have a major effect on people, although everyone processes these at different rates. Cutting back or stopping consumption earlier in the day can make a big difference.

Consistency is key, and if you're doing a lot of traveling, it's going to be much harder.

I also have a light sleep. In my case, light sleep means that I wake up very easily to almost any sound or movement. I most of the time fall asleep very quickly but sometimes not.

I tried most of the things shared in the article, and indeed, for most of them, it is hard to say if they improved or not over the long run.

Here is one thing that worked for me:

1. I am doing 20 to 30 minutes of what I call light sports every day.

2. I take magnesium l-theonate and apigenin 1-2 hours before sleep.

3. I lost about 10kg, from 100kg to about 90kg.

4. I eat something light around 6 PM.

What do I mean by light sport? For me it measn zone 2 running or I adapted some HIIT training to tone down a bit the intensity or walking a lot (when I am in vacation).

Why 20 minutes to 30 minutes? I only have time for that. It may be better to do more, but that is the amount that I am sure I can commit every day.

Why every day? For me, the effects of this started to kick in after 1 week or more. The first week of doing sport every day I slept well, but I also felt tired the next day. But after 1-2 weeks, I noticed that the tiredness during the day started to disappear.

This is not a scientific study, so I am unsure if magnesium and apigenin have any effect or if it is just a placebo. I plan in the next period to not use them at all for 2-3 weeks and see the effects.

I noticed that if I do this every day, my average sleep gets very good: I wake up less times during the night, the sleep is deeper. I fall asleep around 09:00 PM and wake up at 05:00 AM, fully energized.

Something I've started doing that's had a very marked impact on my sleep is going for a walk each morning. I've always been very active at night (with terrible trouble falling asleep), and always been a zombie in the morning; but this seems to have shifted my wake cycle in such a way that I'm alert and productive during the day and tired at night instead. Hell of a thing.

Biggest improvement in sleep quality happened to me, when I returned to intermittent fasting.

For more than a year, I stopped doing it (along with the diet) and indulged myself in junk food, tasty things like ice creams, bakery et cetera.

All that carbs and sugar overload made me stay awake overnight with no added value really. Eventually, I calculated the sleep stats — around 5,5 hours of sleep per night. Needless to say, I felt lousy and self-loathing a lot of mornings. Neither coffees, nor cold showers helped me to really wake up properly.

Once, I cut off junk food again, returned back to 18/6 fasting cycle, I sleep like a baby. I shut down by 10.30 PM and awake by 7 AM or little bit earlier. Before the alarm goes off!

Garmin watch reports, that I have good to excellent sleep quality with no wake ups: at least 2 hrs of deep sleep and 2+ hrs of REM.

I drink around 2 regular mugs of coffee per day (around 20oz) and at least 1 liter of green tea. The rest is still water, so 2,6 quarts each day.

Weightlifting and better nutrition really improved my sleep. I almost hibernate every night now, it's like a miracle.

Wow that graph… I’m jealous!

As a non-24 the graph looks more like this: https://photos.app.goo.gl/pdsZmimGqKmKm4wE9

It has improved over the years since, thanks to melatonin (285 micrograms), sleep masks, and if all else fails, Xanax.

Using an IR camera for (more) accurate data is a very smart strategy. Bravo.

My insomnia-related anecdata: Spine surgery fixed my sleep hygiene.

Most of my feelings of anxiety were being triggered by impingement of nerves in my spine. That physical sensation brought on my mental state. Which may explain why none of the pharmacological treatments worked for me.

When I (finally) got surgery, most of my anxiousness was just gone.

I share this because a) resolving insomnia is hard b) having a difficult to diagnose and treat dis-ease doesn't mean you're crazy and c) exactly no one any where suggested anything like what I experienced.

I had all sorts of tests. I tried all sorts of drugs. I actually got the spine surgery to resolve a totally different problem.

So. Whatever you're experiencing, never accept "no" or "i don't know". Someone, somewhere has the answer(s) you need. Keep looking.

High CBD cannabis flower, usually marketed as hemp, is not as helpful as full-spectrum 1:1 (CBD:THC) flower. I'm discovering that I'm reacting differently to each cannabis strain, some producing far longer hangover effects than others. It may be a case of personalized medicine, or maybe there actually are terpene profiles that lend to zero, if not low, hangover effects. There are strains marketed for daytime use, usually of the sativa variety, where as there are strains for night-time use, of the indica variety. Yet, I've found that 5 vape puffs of certain sativa-dominant strains yielding 8 hours of deep sleep with minimal hangover. Short-term memory, however, always seems to be affected regardless of what kind of flower is consumed.

I used to think weed was the best sleep aid ever, but quitting coffee, alcohol and weed, and having a (organic) valerian root tea at ~6pm not only ensures I go to sleep but even if I wake in the night I will go right back to sleep.

I'd like to see some deeper explanation around the following:

> My average sleep efficiency (time asleep vs time in bed) according to Apple Watch & Oura is ~85%, meaning to get my 7h30 of sleep to feel rested I will stay more than 10h in bed. That sucks!

1. Where does the 10h figure here come from? It seems to me that 85% SE would reach 7h30 sleep hours at 8h50m bed hours (7.5/0.85).

2. What is an expected healthy sleep efficiency? Does 85% fall outside the normal range?

3. Where does the 7h30 target come from? If this is based on the standard adult recommendation of 7-8 hours, are we sure that this recommendation assumes 100% SE? If it doesn't, we're mixing different units.

Nasal strips are worth a shot too, if nasal airflow is a problem (eg nasal valve collapse or deviated septum).

For sleep apnea, I think there was a post on HN recently that recommended trying a mandibular advancement device before trying sleep masks.

If you listen to Humberman Labs podcasts[1] at all, you'll know he is a big advocate for going outside and getting some direct sunlight in the mornings (including no sunglasses).

Recently saw a sleep specialist who also gave this advice (amongst other things). It wont have an immediate impact, but give it a few weeks.

[1] https://hubermanlab.com/toolkit-for-sleep/

Also, if you think you might have sleep apnea, and frequently waking up during the night is indicative, then do try and get a sleep study done.

Using emoticons with different colors would make this more readable, ie: https://emojipedia.org/large-green-circle and https://emojipedia.org/red-triangle-pointed-down

Things to consider: CO2, timing of exercise, timing of eating (What does "Eating < 7pm" mean?), bed cooling (ie, 8sleep, ooler etc)

I will share what the changes that I did in my life to have a better sleep:

- 7-8 hours of sleep;

- Try to go to the bed at the same time everyday (for me around 22:00);

- Go to the gym (weightlifting) 4 times a week;

- Not have dinner after 19:30;

- Not drink anything with caffeine;

For about a year already, I use ASMR audio/visuals when I go to bed (strange, not even mentioned in the referenced post). I found they help me falling asleep (though, probably, not staying asleep). Also, not just any ASMR stuff does the job, there is a lot of ASMR junk out there. Plus, ASMR triggers differ in efficiency from one person to another, so I preliminarily assess if a particular recording might be good for me. Most of all, I like educational ASMR about history/culture/languages/etc.

For the last several years, I wake up almost every morning after only 4-5 hours of sleep. Then I don't feel right during the day unless I am able to go back to sleep.

It makes me think that theory of pre-industrial dual sleep periods may be true.

It's also possible that I'm just older and have to urinate. Or the reflux issues that interfere with my breathing somewhat need to be cleared out.

As far as falling asleep, I have found that Vitamin D3 can help quite a bit, if taken in an adequate dose.

They mention getting tested for sleep apnea and the difficulty of doing the study. It need not be difficult. I did an at home sleep study and got my results in a few days. It was easy and made a huge improvement on my sleep. Instead of getting up multiple times a night to pee, eat, or whatever, I generally stay asleep the whole time.

On a side note, you can kind of do your own sleep study with a wellue/viatom o2 ring or checkme o2 max. It will give you a good idea of whether you should go down the sleep study path.

I'm happy the author was so thorough on the physical attempts at reducing their insomnia! Since they seemed to have a lot of the physical figured out, my curiosity immediately goes to the mental. What is the quality of their minds when they wake up in the middle of the night? Do they have racing thoughts or perseverate on things?

Also, this is a classic Vata disorder in ayurveda. An ayurvedic practitioner should be able help narrow down options without all the trial and error.

Linking this here as it's still the best sleep supplement I've found:

https://www.reddit.com/r/Nootropics/comments/15ceths/timerel...

In the past I had problems both with falling asleep and staying asleep, but these days it's mostly the latter. I've tried pretty much everything, too, to no avail. What works best is melatonin, but it's still spotty and I suffer diminishing returns after 3-4 days of consecutive use. I wish you good luck.

My first reaction is, if I'd worry that much about my sleep I would sleep bad, too.

Then again I don't think the OP has a very unusual sleep pattern. But if it bothers the OP, go get checked up. I would make it possible to be in the country where I have a doctor's appointment in three months if it is important to me.

Drink one cup of coffee less per day, and stop it completely after 3PM. This was one of the many small things that helped me sleep better. There were more sinister things I discovered to be the true reason for my poor sleep. Something to do with poor mental health, but I’ll write about those some other time.

Things which improve my sleep tremendously:

- be active (Walking, Running) for at least 20 min a day

- do not drink coffee after noon

What worked for me:

1. Cut alcohol even the smallest amounts 2. Exercise 3. Stop overthinking stuff. Remember. When you're in bed, there's no use thinking about work/school as you're not there.. 4. Find a happy place in your mind

I don’t see any mention of cold showers / ice baths. That seems trendy now and people suggest sleep improvements. I notice my restless leg has a lot to do with sleep quality.

I don't sleep enough. I don't usually have a problem with falling asleep as much as I do staying asleep. I've found Magnesium Glycinate extremely helpful with sleeping longer.

For white/brown noise nothing beats the Bose Sleepbuds. They are the only earbuds I've tried where I can actually sleep on the side with my ear against the pillow.

What worked for me, when I had bad sleep due to too many thoughts: Vitamine B1, 300mg

Already the first pill had an tremendous effect.

Could you try sleeping with a weighted blanket and give us your feedback? It works very well for me.

Under Compounds D3 is missing. Magnesium, D3 and Glycine fixed all my issues.

also: Huberman says get light in your eyes in the morning and evening. This anchors your circadian rhythm.

And if you take melatonin you only need 300 micro grams. Life extension brand sells these.

There's one thing I didn't see mentioned: have your significant other remind you of some chores you promised to do.

Sounds like a boomer joke, but there's an explanation why this works: our hunter-gatherer brains aren't equipped to deal with tasks without a clear survival-related reward, so they produce a feeling of tiredness/sleepiness instead to prevent us from wasting energy.

I've been using this for years now. You need new types of tasks on a regular basis though, because the effect wears off with usage.

One additional thing I can think of is cold, fresh air - or simply more oxygen per unit volume of air.

Some say earthing improves sleep as well.

Pretty sure OP has apnea

What about disabling wifi and phone completely + using grounding mat? Anyone tried?

I think the biggest detriment to the quality of sleep is to start trying to improve sleep. It should not be a performance with self monitoring and evaluation.