Ask HN: I need help sleeping, any suggestions?

I used to get terrible dreams at night for a while, and it significantly hindered my productivity and energy during the day because I was not getting good sleep at night. For me, I needed more aerobic exercise during the week and I now take a melatonin most nights, about 30 minutes before I want to fall asleep.

As far as dealing with you pains as they kick in, try listening to a meditative podcast. I get migraines sometimes, and over-the-counter pain meds can't really help. This one meditation podcast I listen to helps me focus past the feelings of pain I'm experience at that moment and get some sleep. Here's a good, iTunes downloadable resource: http://www.meditationoasis.com/

However, I'm a firm believer that everybody's body is different. What worked for me might not work for you. It's really important that you talk to a doctor you trust, and you should experiment with a few of their suggestions. If this counselor you are seeing doesn't make you feel like he understands and wants to help you, then find someone who does. Even if they are giving the right advice, clearly you don't feel comfortable with them or how they are communicating with you. Don't feel like you don't have options, and don't spend any more time suffering than you have to.

Hope this helps; best of luck!

I wonder if sleeping in a comfortable chair (recliner-like, or just large and soft), or a couch with high and comfortable arms to put your head on, would be less likely to trigger the pains and anxiety. Maybe being horizontal has come to be associated with your pains (mental). Or maybe being horizontal changes blood flow or breathing (physical). Worth trying anyway.

I used to use melatonin, worked pretty well. That was for shift work and daytime sleeping.

One experiment OP could try is sleeping in a room other than the bedroom. Kind of goes along with the recliner idea, but maybe there's an association with the bedroom and the and the anxiety.

Does the problem persist on travel in hotels or anything?

If your Counselor is a psychiatrist or another provider with a license to prescribe I'd encourage you to talk to them about your problem sleeping. There are drugs that you can use for short periods of time without developing a physical dependency; sometimes sleep begets sleep (i.e.: being tired can keep you from sleeping, ask any parent w/ a very young child).

If your counselor isn't licensed to prescribe go to your Primary Care Provider (PCP; Physician, Nurse Practitioner, Physician's Assistant) to discuss treatment. Just because it's a "chemical" doesn't make it bad (remember: water is a chemical). Furthermore your primary care provider really does have your best interests in mind, and they love seeing patients who trust them. Don't waltz in demanding something in particular, chances are they've seen 4 other people today with similar problems and have a favored set of treatments and interventions. Also, always give your PCP time to solve something; a lot of medications and treatments like physical therapy and exercise take several weeks to start working.

Sources: my whole family are insomniacs, my wife is an NP.

How is your diet and exercise? Cut out any sugar and caffeine, avoid high processed foods (especially white bread and soda) and try to exercise at least 30 minutes daily. Do you take vitamin supplements? It is possible you could be vitamin deficient. There are blood test for that. Vitamin B-3 (niacin), vitamin C and vitamin D-3 are especially important.

Assuming those basis are covered, how is your breathing/posture? Programmers especially can develop bad posture because of sitting all day. Make sure you don't slouch when you sit. Here is something to try - when you feel anxiety coming, immediately stand still, straighten your back, slow down your breathing taking normal size breaths (don't deep breath, just breath normally) and clear your mind for 30 seconds.

How is your sleep, do you snore loudly and don't feel rested? You might want to check if you have sleep apnea.

That's all I can think of for now. There are also drugs, both non-prescription and prescription that can help. Personally I'd only use them as a last resort.

There are many other avenues to explore; however, I'll mention one quick fix. A single dose of St. John's Wort can take enough of the edge off to enable me to fall asleep.

Quality varies widely. Look for one that is standardized against hyperforin in addition to the usual standardization against hypericin. Eclectic Institute is one quality brand that offers this.

St. John's Wort is generally considered quite safe (NB: I am not a doctor!). However, it does interact with / influence the rate of absorption and/or potency/effectiveness of some other medications and supplements, one example being birth control pills whose effectiveness it lessens.

P.S. I see further now that you are describing "pains". If these are actually physical, that's another mattter. I was speaking more to anxiety and... "busy" thoughts.

As you point out, having panic over getting no sleep is often a self-fulfilling prophecy.

So give yourself permission to not sleep. If your brain thinks that staying awake and thinking-through problems is more important than sleep, that's ok. Let it happen.

When you have a pain you need to do the CBT stuff - stop the thoughts; examine the hot thought and emotions and evidence, and then reassess. It's disappointing that your therapist isn't helping with that.

You can also do CBT for sleep problems. So, uh, try that too.

(http://www.nhs.uk/Livewell/insomnia/Pages/myquestforsleep.as...)

> Dr Chris Idzikowski, of the Edinburgh Sleep Centre, says that people with insomnia often worry about their sleep. "They worry about the consequences of not falling asleep," he says. "This worrying turns into a vicious circle: the more you worry, the less you sleep."

> Dr Idzikowski says that breaking this cycle of anxiety about sleep is an important part of treating insomnia. "I tell my patients to focus on letting go of being awake rather than focusing on falling sleep," he says.

You might need extra help. "Sleep hygiene" is useful, but it's mostly about setting up a routine and sticking to it. Do you think a calming routine would help you unwind, and go to bed un-anxious?

There are exercises around "mindfulness" that might be helpful. Classes of meditation are helpful for this, but I'd be interested to see if there's any decent online meditation guides.

You might want to look on YouTube for ASMR videos. These are odd, in that they feature people whispering and using objects to make odd sounds. Some people feel the ASMR "tingle". I don't, but some of the videos are calming, and they're strange enough to distract me.

I liked Zopiclone as a short term intervention. I take it for a few days to kick me back into a sleep routine. It might not be a good choice for anxiety!

(http://www.nhs.uk/Livewell/insomnia/Pages/treatment.aspx)

Obviously this is not medical advice and I'm not a doctor and I have no experience or training etc.

For the ASMR there is also the curated site http://www.soothetube.com/

I also like to listen to rain/thunderstorms which I find relaxing. Hope that helps.

Well you are most likely really anxious to fall asleep. Hypnosis can help. Depending on your hypnotic susceptibility it can be more or less effective. But, I suggest you give it a try. The video down below is about lucid dreaming, however, that's not the point. If you are highly susceptible to hypnosis it'll relax you very very deeply. Then, naturally you'll fall asleep. Here's the link: http://www.youtube.com/watch?v=Uk6VTM_ZiYA I hope it works for you.

First, let me just tell you, you are not the only one. When I had my first panic attack, I got very scared and everything just hit me like a train. Anxiety, worry, strange pains and the worse, sleepless nights. I panicked about not being able to sleep and therefore I wasn't able to sleep. I know exactly how you are feeling, after a few weeks of almost no sleep, I thought I had lost it and I was in too deep and that it would never end. Let me just assure you that this isn't permanent and that you can change a lot but you have to put your mind to it.

Let me tell you what helped me: Questioning and Thinking, I will explain. Because of the panic/anxiety I had especially when I was laying in bed, trying to fall asleep, I also had a phobia of my bedroom and sleeping (this of course made it worse). I would lay in bed feeling miserable and not understand why my body wasn't letting me rest and why this was happening to me. I would lay there scared and all I thought about was that it would never end and this was permanent. But with the help of counseling and just experiencing the symptoms enough, something in my thoughts changed and I started questioning: "what's the worst that can happen? This can't kill me. If I don't fall asleep, I may not feel great but nothing bad can really happen." And with that, I slowly started to get more and more comfortable and having better sleep. Some nights are better than others and when they aren't great, it's not permanent. Get your head out of thinking in patterns, if you can't fall asleep, get up and read a book, get away from your bed, do something and tell yourself that you will fall asleep but if you don't, it's not a big deal.

Although I did use medication, try to go the natural route first. And try distraction as well, as others have mentioned, there is some great meditation and other kinds of music you can listen to to help you sleep. Just Tell yourself that it doesn't matter if you fall asleep or not. Understand that your body and mind know what to do and that they will do what is right. When you get the pains, once again, tell yourself that it may be uncomfortable but it is not permanent, it can't kill you and it doesn't have to keep you from sleeping.

Stay positive and remember that everything will be great. My email is in my profile and I would love to answer any more questions you have.

Try varying lots of things, maybe one at a time.

Do you eat within 1-2 hrs before bedtime? Maybe you shouldn't. Or if you don't, maybe you should. Healthy stuff, either way, of course.

Do you do fairly strong aerobic exercise regularly? (25+ min, 3-4x/ week, work up to ~80% max hr, which is 220-age, roughly).

I beat bedtime anxiety by listening to religious audio casts on arcane topics, despite not believing in them. I find it soothing and I fall asleep within the first 10 minutes.

Take a Motrin PM right before going to bed, once a week, this will give you a good night of sleep without any side effect. You can buy them at your local Walgreens/CVS.

This is a temporary fix. The long term fix would be a drastic change in lifetime. Maybe living in Paris, working 32 hours a week, 2 hour lunch break might set you on the path to recovery.

Cheers!

snark: Watch Fight Club.

question: Do you have trouble going to sleep, or is the trouble actually in the waking up?

advice: As someone who has trouble sleeping sometimes due to the racing mind, Sonata has worked well as a medication. It's a hypnotic, so it just helps you get to sleep - it doesn't keep you asleep. But if you can't sleep because your brain won't settle down (for whatever reason), it might be a good thing to investigate. I wind up using on a weekly to semi-weekly basis, one to three nights, until my rhythm returns.

secret: I sleep a lot better next to my spouse.

Thank you for asking this. I haven't slept properly in over a month now and it's starting to really effect my startup (and me of course)

http://www.vipassanaforum.net/forum/index.php

You could be reacting to something biological. Try cleaning up your sleep space. Wash all bedding, dust, declutter, etc.

The Prophet Mohammed (PBUH) used to sleep on his right side and place his right hand under his cheek.

It works PERFECTLY for me

1. exercise 2. no more caffiene 3. justgetflux.com

I would try something non-habit forming like valerian root or melatonin first before going to prescription drugs.

Also, at bedtime try to keep the TV and/or reading to something that's not too interesting or too boring(shopping channels/business TV helps me).

The main thing is to distract yourself away from thinking about sleep while trying to fall asleep. A hot shower or a peaceful walk may also help.

Try to maintain proper sleep hygiene.

http://www.sleepfoundation.org/article/ask-the-expert/sleep-...