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sleep hygiene: seeking practical tactics


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Atypical depressive here, awake @ 1:30am-ish and I work @ 6.

my love affair with sleep is getting me in trouble with my health. the problem is that my life sucks so hard that sleep is easier and seductive.

I can't be hurt by the world if I sleep though it. I only wake for work and play. I don't have cable or dish so there's no other reason for me to be awake, right?

well, I know that's not right. it's just that sleeping is preferable to life for me right now.

**not suicidal**

I'd just rather sleep.

so. any ideas? tricks? tactics to improve sleep hygiene?

drowsy...

tg

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As a recovering insomniac, the only way I could beat the sleep thing was to make rules for myself. I do all the classic things---pick a bed-time, do dull stuff for an hour before to make me sleepy, do all the routine things like brushing my teeth, taking night meds, etc.....all at the same time every night.

I hate alarm clocks, so I asked my husband to wake me up every day at the same time. I've been doing this a long time, so it works now. I go up at 11, I'm asleep before 11:30, and I wake up every day at 6:45. Sounds boring, but it worked for me.

And no naps. I took one last night and broke my rule, but I went to bed at my usual time and still fell asleep.

I don't have cable or satellite, either. Read a boring book---maybe that will help. Or read some of the boring threads on CB. heh Or read the blogs---that will really put you to sleep.

no naps!

olga

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For me and for a lot of people I know, it's been best to stay on a steady schedule. Shift work does me in, if it's rotating, and especially if they rotate me the wrong way.

There's no "right" amount of sleep that's universal. Some people are 5h sleepers, some are 12h sleepers, most are in that 6-8h range. The problem either starts (or becomes evident) when there's a big shift one way or another.

For the manic-depressive among us, sudden shifts in sleep pattern are both a cause and a symptom of changes.

I know that if I let myself be seduced by the hypersomnolence of depression, I can get very grim and very bleak very fast. I have to maintain that 7-8h schedule. Maybe up to an hour of naps total, but even that's marginal.

If I'm manic, you can't get me to sleep with a crowbar (or 25 mg of Zyprexa), but I can at least hang on to that regular waking time so that I have a semblance of circadian normalcy.

So if I were a 12h sleeper by nature, and I always got out of bed at 3 pm, then I'd try to stick with that (and not go to being a 18h sleeper who gets out of bed at 8 pm on the days off.) If I were a 7h sleeper while euthymic, then I'd try to force myself into that 7-8h schedule.

Rhythmicity seems to be really important.

I hesitate to even get into discussions of bright-light therapy here, because I have a good solid wariness of bright-lights - I've seen too many people get manic on them (they are no more benign than an AD) - but we can go there if you want...

For me, at least, sleeping through the depression is no less destructive than intoxicating my way through it with whatever. YMMV.

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Another strategy that works for me is: don't take naps! Or at least, taking naps (unless I'm physically very sick) kills my ability to fall asleep at night.

You're also not supposed do sleep-unrelated stuff in your bedroom--which may be hard to do if you, say, live in a tiny studio apartment. I guess in that situation, it may help to try to avoid your bed unil you're ready to sleep...

Most people say that if you don't fall asleep right away, you're supposed to get up and go do other (though not too exciting) stuff for a while. I call bullshit on that. Or at least it's not something that works for me. It's "normal" for me to require an hour to two hours to fall asleep. If I take my super-calming orange-flavored sublingual melatonin, that amount of time may be reduced to 30-60 minutes. Under "normal" circumstances, if I get up too soon, I'll never get to sleep--until I eventually nearly collapse from exhaustion. (And as soon as I recover from said exhaustion via an OK night's sleep, I start requiring 1-2 hrs to fall asleep again.)

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Okay, here are a few more practical tips:

1) If you're having a martini, do it at cocktail hour. Drinking close to your bedtime will disturb your sleep pattern and make it harder to get into that deep REM sleep that we all need.

2) Ditto with food. Eat at least 3 hours BEFORE you want to go to bed. If you enjoy carbs, dinnertime is when you should eat them because they will make you sleepy.

3) Physical exercise helps, but again, early in the evening. Maybe a stroll after dinner?

4) Sex.

olga

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I have a dawn/sunset simulator. It's sort of useless for me at the moment since the good ol' drugs put me in a coma-esque state for 12 hours a day, and I'm lucky if three separate alarms can wake me up. I'm not bitter, really.

Anyway, the contraption helped me fall asleep and wake up in the days where I could fall asleep and wake up in a more natural manner.

I've also found that yoga is OK to do before sleeping, if you don't do anything to invigorating.

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While I was out of work on temporary disability last summer, I started to get up at 8am every morning before I went back to work (even if I took a nap later). I started going to bed at a regular time--about 10pm & an hour of reading before I turned off the light.

When I went back to work, continuing to now, I get up between 5:45am (1st alarm/clock radio) and 6pm (cell phone alarm) on the weekdays. I immediately brush my teeth and get dressed for work. (I have to shower in the afternoon because it just doesn't happen in the morning anymore.) Then I get a healthy breakfast and cup of coffee ready, take my meds, and sit in front of a therapeutic light lamp for about 20-30 minutes (about 10-15 minutes now that it is not winter). Read my daily affirmation books (OA & AA). Eat & drink my coffee. Then make my sandwich for lunch and go to work.

On the weekends, I get up between 6:45am and 7am (same double alarm system) and do the same routine except get dressed for work unless I'm heading out early (which I'm usually not because it seems I put all my energy into showing up for work & then I stay home).

But on the weekends or weekdays if I take a day off, I DO go back to bed around noon to read until I fall asleep. I take an hour to 2 hour nap. I am SO lucky, because it doesn't affect my night sleep and I LOVE my reading & naps. Obviously, this is not recommended for most people.

I go to bed everynight between 9:30pm and 10:30pm and read for 30 to 60 minutes depending on how tired I am.

At the same time I started doing this, I also stopped eating sugar and white flour and eating regular, healthy meals based on a suggestion out of the Take Charge of Bipolar Disorder book (I found this book very motivating in making some lifestyle changes to help my moods). This is suppose to help eliminate smaller moodswings based on fluctuating blood sugar levels. I don't know if this has helped, too.

This routine has saved my life and allowed me to show up regularly at work.

Good luck,

Oreo ;)

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It sounds like you could use an AD that is stimulating. I was told I had atypical depression all my life, and I was always exhausted, even with the meds. Finally a doc suggested a sleep study and I found out I have Narcolepsy. My whole life now makes sense.

If you have tried every AD in the book and none helped with the sleep issues, I'd suggest a sleep study. You may have a sleep disorder like sleep anpea or Narcolepsy that needs to be addressed. Just my two cents because I've been there and done that.

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Okay, here are a few more practical tips:

1) If you're having a martini, do it at cocktail hour. Drinking close to your bedtime will disturb your sleep pattern and make it harder to get into that deep REM sleep that we all need.

2) Ditto with food. Eat at least 3 hours BEFORE you want to go to bed. If you enjoy carbs, dinnertime is when you should eat them because they will make you sleepy.

3) Physical exercise helps, but again, early in the evening. Maybe a stroll after dinner?

4) Sex.

olga

well as far as #4 goes, I'm currently unattached - so i'm holding my own.

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