The Evidence Points to a Better Way to Fight Insomnia

Am at the SLEEP conference in Seattle. Two exhibitors in this space: http://www.clevelandclinicwellness.com/Programs/Pages/Sleep.... http://sleepio.com

One that is recommended is "mood gym" - an Australian site.

https://moodgym.anu.edu.au/welcome

A book that is recommended is "Mind Over Mood".

There's probably space in the market for more and better apps and websites.

The English body that assesses efficacy and cost-effectiveness (NICE) have reviews of computer guided CBT here: http://www.nice.org.uk/guidance/ta97

The article points to http://www.cbtforinsomnia.com but it's not an app. I'm likely to give it to my partner to try.

I share that frustration. Also the assumption that increasing sleep time by 10% would be helpful - 10% of zero is still zero. My last marathon of chronic insomnia was 96 hours without sleep. Not being restless in bed, but just not sleeping at all. I'm about to start CBT for this but I'm skeptical, given that it's related to a medical problem for which I'm still awaiting treatment.

I spent two weeks in the hospital from my chronic insomnia once, anybody who tells me I just need to relax or stop reading in bed is about as helpful as someone who tells somebody with chronic depression to cheer up.

Not everything is in your head, and no amount of positive thinking will change that.

By and large it is a psychological issue. When it comes to physical problems, doctors focus on treating that instead of secondary symptoms like insomnia, so that's why when you present complaining just about insomnia, doctors initially assume a psychological cause.

Seen quite a few mentions of doctors using calming, relaxation stimulus before operations to reduce perceived stress and pain. That anticipation if I may say so is a strange thing.

McGonigal has this really elegant and captivating way of presenting the importance of maintaining a healthy perspective on stress. Recently she presented a similar talk (or the same one? I haven't watched the full TED talk yet.) at the 99u Conference in NYC, in which she made the point: "You can use that stress not as a signal that there’s something wrong with you...but to actually use that same stress as a sign that something you care about is at stake. Take that stress as an opportunity to think about what you care about, to view the situation as an opportunity to learn and grow, to trust you can handle the challenge."

Indeed. Most of us suffer from work-related stress issues, which in turn lead to sleep problems, particularly after one crosses the mid-30s.

What has worked for me is a gym routine in the evening, avoiding browsing the iPad in bed at night, firing up a long podcast to listen to (something without music, loud noises etc). But meditation has been another big factor. Though I must caution you: meditation rarely has a quick payoff. So be patient and don't get anxious about results and keep working at it.

The second half of the article answers the question of how CBT addresses sleep problems.

Not terribly, I've found. I've just come off a pretty terrible stretch of insomnia (being unable to sleep for two or three days in a row every week for months), and what I've found helpful is taking a bunch of Vitamin D3, 8000 IUs a day for me. I'm 260 lbs, so you may want to adjust downward if you're not similarly large and male, because it is a fat-soluble vitamin.

Taking four gelcaps in the morning has made all the difference in the world to my mood, and I actually sleep now, which is a huge improvement.

https://www.vitamindcouncil.org/blog/why-does-the-vitamin-d-...

I take melatonin as a sleeping pill whenever I need to get to sleep, it knocks me right out with less grogginess the next day compared to over-the-counter stuff. My doctor later said it was hit or miss with different people, which is why you probably hear very mixed results about it. Still, I try to avoid taking it unless I really need to get to sleep on time - despite relative safety, no clue what weird longer-term effects may get reported in the future.

Side note: I visited a sleep specialist/neurologist a while back, who said the proper way to use melatonin was to take it in the middle of the day and stay awake until your regular bedtime. I haven't been using it like that, but thought I'd recommend looking into it first if someone is going to consider taking it. He was the expert, after all.

Yes, but only for occasional short-term use. You get used to it pretty quick, so for chronic insomnia it loses effectiveness.

I didn't have insomnia as bad as some on the thread and with the caveat that every case of insomnia seems to be different enough that there isn't a single fix for it:

I found melatonin helped to get me started on a sleep schedule, but, in the long run, not as much as using f.lux and making my room as dark as possible at night. Got rid of my TV and listened to audiobooks instead.

I weaned myself off the melatonin supplements over a few months.

For the last two years I've been able to get a full night's sleep without much problem.

It's helped me a lot - a lot more than prescriptions, anyway. I have been taking it for a very long time, so I'm pretty dependent on it, unfortunately. Going to try and taper down soon-ish, but I haven't noticed many bad side-effects. YMMV though.

Definitely!

I have tried Puritan's Pride products and they helped me a lot to get over those ugly sleepless nights without the nasty and horrible effects of those sleep aid meds.

Melatonin is sold as a supplement, so it's subject to much less regulation than other medication.

Some consumer organisations have tested the pills being sold and found wide variation in the quantity of melatonin in the pills.

In the UK melatonin is a prescription only medication.

Personally: I found it useful. I strongly prefer zopiclone. That preference might be connected to how insomnia affects me.

Gwern's authoritative writeup/analysis, http://www.gwern.net/Melatonin

I found I had to up the dose to ~15mg to make a large difference. I went from sleep problems 1/4 nights to <1/10.