I slowly open my eyes to reveal the starry nights sky suspended over my head. As each new star slowly comes into focus as the last disappears. Sweat is dripping down my legs and over my chest as I slowly rotate my head to right, hoping, begging, for a moment of rest and respite. I just need some fucking sleep. It shouldn't be this hard.
As my cheek hits the pillow, I'm rudely greeted by the glowing red strobe of my alarm clock. It's numbers pulse with the rhythm of my heart beat, mocking me as it exclaims 3:43 repeatedly and aggressively. I close my eyes hoping for a different response than what I've been greeted with the past 5 hours.
After what seems like an eternity, I open my eyes again, my body drenching my sheets in sweat, only to be taunted by the alarm clock that reads 3:46. I fight the urge to throw it out the window. It's a nice clock. An aesthetically pleasing orb that promises to wake me up with a soft glow that simulates the sun rise. It's done nothing wrong. Instead, I lift my covers and climb out of bed where I'm greeted by the frigid air of my bedroom. I drudge to the bathroom, my legs feeling as if I've just spent 4 hours on a treadmill. I make my way there, groggy despite my complete lack of sleep, and pull my towel down from the curtain rod.
As I wipe the salty, unearned sweat from my body, I stare into the mirror wondering what exactly I've done to deserve with fate. I didn't drink any caffeine. I stayed away from alcohol, TV, and my phone. Yet here I find myself. Again.
Emily and I are heading to the airport in a few hours for our first trip together. Cancun. A destination that would likely be derided by the travel bloggers I have to read to do my job at Tortuga. But it's OUR destination. OUR trip. I just want to be able to enjoy it without behaving like the sleep deprived asshole that I'm now virtually guaranteed to become. Again.
This was me 3.5 years ago. A lifelong insomniac just hoping, praying for one decent night's sleep. Something I'd, to my knowledge, never really had. That was then. Today, things are different. Where before I rarely slept more than 3 hours a night, today I regularly sleep 6-7. While that may not sound like a lot to you, for me, it's been life changing. Here's how I did it.
Sleep Doctors: Thousands of Dollars and Few Results
I trust doctors. I trust science. I believe both can help me and they have. So, after years of thinking it was ridiculous to go to the doctor to be able to sleep, I decided to schedule an appointment because I was desperate and lucky enough to be able to afford it. Based on my experience, this was not worth the time or money for two reasons.
First, my doctors were obsessed with generalized solutions. They wanted me to adhere to whichever treatment that was optimized for their specialty to make more money. A psychologist was obsessed with one specific type of therapy with questionable evidence. He refused to consider alternatives despite the lack of progress over multiple months. I just had to keep coming back, he said.
Countless physicians asserted that the cause must be sleep apnea because the sleep test that they required me to take showed that I often stopped breathing at night. The doctors ignored me when I told them that I was actually awake during most of these events. My breathing wasn't stopping because of flaws in my physiology. It was stopping because I was deep in thought and, sometimes, when that happens I stop breathing. It happens all of the time. It's probably happened multiple times as I've been writing this.
More than anything, these doctors pushed expensive medical devices and drugs on me. This was at a time that, due to substantial weight loss, my sleep apnea was going away. After multiple panic attacks from wearing a CPAP machine and wasting thousands of dollars on a mouthguard that did more harm than good, it was clear that this wasn't the solution. My doctors ignored this evidence. I just had to keep paying my monthly CPAP subscription, they said.
Frustratingly, when a drug actually showed promise, my doctors wouldn't prescribe it because it wasn't covered by my insurance. I checked the list price and, despite the fact that I could easily afford it and begged them to prescribe it anyway, they wouldn't. If that was the case, why did they give me the damn samples in the first place? I just needed some damn sleep.
Second, everything useful they told me could be found in a 5 minute google search. Unfortunately, that information isn't presented in an easy to understand or useful manner. Let's change that. Hopefully we can save you some time, money, any agony along the way.
Before we get started here a few basics that might help you get more sleep. You may know these, but it's necessary to repeat them to make sure we share a foundational understanding of how to get more and better sleep.
Here are some basic tips for better sleep:
Avoid caffeine, especially after lunch.
Avoid alcohol all of the time.
Use your bed only for sleep and sex. No reading. No working. Sleep and sex. That's it.
Avoid physically, mentally or emotionally strenuous activities for a few hours before bed.
Maintain healthy eating habits and exercise regularly.
Avoid eating a few hours before bed.
Do not take naps. Ever. If you fall asleep accidentally fine. Otherwise, just don't do it no matter how tired you might be.
If you can't fall asleep after 30 minutes of trying, get out of bed, do something boring for 10 minutes, then try again. Repeat until you fall asleep. Think of this as hitting the reset button.
Most of us know what a healthy lifestyle looks like. If you're having trouble getting enough sleep, a good step to take is to make your lifestyle healthier. I promise, it will help a lot. However, it's unlikely to be a complete solution.
One thing that you'll notice is missing from my list is to avoid watching TV. As a general rule, that's a good idea. The blue light from TV makes our bodies think it's daytime. That's not good. TV can also engage our minds in unhelpful ways, keeping our attention heightened preventing us from falling asleep. I, however, do not avoid TV at night. I'll explain why in a bit.
Train Yourself to Sleep
Before I continue, I must acknowledge that I was able to make this discovery due to a lot of privilege. I had a great job that let me set my own schedule. I had great insurance that let me explore potential solutions. I could afford to invest time, money, and energy to help me solve my problem. Most do not have these luxuries. This is my attempt to help you get better sleep even if you do not have the privileges, though, even then, following this path may be impossible for many who are less lucky than I was and in many ways continue to be. Moving on.
Many of my friends have small children. As a result, the idea of training a newborn to sleep is a regular topic of conversation. I won't get into the pros and cons of sleep training a baby. Like anything involving parenting this is an emotional and fraught topic that I am not qualified to discuss. I can tell you that sleep training is a great idea for adults that struggle to get enough sleep. Here's how to do it.
Step 01: Document your nights
To learn how to sleep better, we must first learn what makes the nights you sleep well better than the nights you sleep poorly. Or, in my case, the nights I slept for a few hours versus the nights I didn't sleep at all.
To do that, keep a sleep diary. In your sleep diary you should include the following information. The format for this doesn't matter. Do it in a way that is easy for you to read and understand. I tracked each night on a loose leaf sheet of printer paper, but it doesn't matter how you do it. Though, the loose pages made Step 02 much easier.
First, document what you did in the hours before you tried to fall asleep. Next, document when you got in bed, when you got out of bed in the morning. From there, we need to know what actually happened during that time. When did you fall asleep? How long did you stay asleep? What, if anything did you do when you woke up? How long were you awake? When did you fall back asleep? For how long?
I think you get the picture. Document everything you do for a few hours before bed until you get out of bed in the morning to start your day. Make sure you include the total number of hours you slept each night. This is the key number for Step 02.
Our goal here is to figure out what works for you. My doctor encouraged me to try to set some ground rules and a schedule, much in the same way a parent does when the are sleep training a child. That didn't work for me. Instead, I had to start from scratch to learn what worked and what did not.
To do so, I tried a range of things before bed. I went to bed at different times, and got out of bed a different times. This won't help you get good sleep while you're testing, but it might help you figure out what works and what does not.
You probably need to do this for about 30 days. I had to do it for closer to 60 because in 30 days I didn't have enough decent nights of sleep to proceed to step 02. You probably want to document about 10 nights of decent sleep before you move to Step 02.
Step 02: Identify Patterns
Now that you have this collection of data, you need to analyze it. You could probably use some advanced statistical analysis if you want, but I used a shortcut. I flipped through my diary and picked out the 10 or so nights where I slept the best.
From there, I looked for patterns. Was there anything I did regularly before I went to sleep on the nights I slept well? What time did I get in bed? When did I actually fall asleep? For how long? When did I wake up in the morning? What other common factors might have helped me sleep well?
Next, I reviewed my 10 worst nights of sleep. Here, I did the exact same thing, but this time I was looking for common factors in the nights I didn't sleep well. Here I learned that if I stayed up past 2:00 AM, I didn't sleep well. I also didn't sleep well if I tried to go to bed before 11:00 PM.
Here's what I found. On the nights I slept well, I fell asleep on the couch before I fell asleep in bed. I fell asleep laying down, not sitting up. I fell asleep with a very specific type of TV show playing. It was something that was evenly paced with few large changes in volume. It was something I had seen before. It was something that had pretty interesting(to me) storylines and dialogue, but not a thriller. Shows like West Wing and Newsroom were at the top of the list.
On my best nights, I started the process of falling asleep somewhere between 10:30 PM and 11:30 PM. That doesn't mean I was trying to sleep at that time. Instead, I was preparing to wind down. I was setting the stage for a good night's sleep. I'd go to the bathroom, brush my teeth, maybe eat one last snack, pick the right episode, and lay down on the couch. I wasn't trying to sleep. I was just relaxing. This was the key. Trying to sleep made sleeping impossible. I could only sleep well if I fell asleep accidentally.
I typically fell asleep about an hour later after laying down. I woke up after dozing off for about 30 minutes, then went to the bathroom, but not to brush my teeth, and immediately to bed. If everything went well, I'd sleep 6-7 hours total. I got out of bed around 8:00 AM. I got out of bed when I woke up naturally after anything longer than 5 hours. Not a lot, but significantly better than the 2-4 hours of sleep I had been getting previously. I woke up after less than 5 hours of sleep, I could generally fall back to sleep. Any more, and I just got frustrated because I couldn't sleep and, somehow, I actually felt more tired throughout the day.
That's what I thought worked for me based on the evidence. This became my hypothesis to test in Step 03. Inevitably, your hypothesis will be different than mine. I can't tell you what it will be, that's why we kept a diary.
Step 03: Set and test a Routine
So, now we have some idea of what works. Next, we have to set routine so we can test our hypothesis. The science of sleep indicates that, like a baby, we should have a very specific routine. We should do exactly the same things at the same times every night before we go to bed. Then, we should do the exact same thing every morning when we wake up.
I don't think this is realistic for most adults, but it's a good place to start.
Using your previous analysis, create a plan for how you will prepare for and go to sleep every night. If your data contained mixed signals, pick the option you feel most confident about. You might be wrong, but that's OK. Our goal here is to create and test a plan. If our plan fails, we can just try something else.
As you set your plan, be specific. This should be a step by step process where each activity has a specific time designated to it. If you brush your teeth before you get in bed, what time do you do it? How long will it take? This plan should be exactly the same for all 7 nights of the week. Changing your schedule on the weekends will really fuck things up if you're struggling to sleep. I speak from experience. I used to dread Sunday nights.
Now that we have our plan, we've got to test it. Try, as closely as is reasonable, to follow your plan for 4 weeks. Why 4 weeks? That seems to be the magic number for developing new habits that you actually stick to.
Over this time, you should continue your diary. We want to understand what is working and what is not. If there is variation in our routine, we need to understand the impact it has.
It's important not to put pressure on yourself to fall asleep. If you do, you will make it less likely to get a good night's rest. You also shouldn't expect perfection right away. Just like with a baby, what we're doing here is training our body and minds to associate these behaviors with sleep. The goal is to get yourself to fall asleep by convincing your body that's what it's supposed to be doing anyway.
Over time, you may find the need to adjust your plan. You may find that you actually need 7 hours of sleep a night not 8. If you're still getting consistently less than 6 hours of sleep, you have more work to do. That's OK.
You also shouldn't expect to sleep well every night even if you follow your routine perfectly. I still have some bad nights, but, overall, I sleep better than I ever have. I hope you'll teach yourself to do the same.