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Insomnia: Part II – Solutions to Help You Sleep

Your own experience should be your best guide to combating insomnia. If napping seems to enhance your waking hours, it’s probably a good choice. If it leaves you feeling lethargic, or seems to interfere with your nighttime sleep, then it’s probably not for you.

Beyond Habits: Intervention

OK, so you do your best to keep a regular sleep schedule, you exercise, learn relaxation and meditation techniques, and have made an informed decision about napping.

And you’re still having trouble. What else can help?

Foods That Promote Sleep

Whether through chemistry or cultural association, some foods can help bring on restful sleep, starting with that old standby – the glass of warm milk (unless of course you are like 85% of people on earth who are lactose intolerant). You can probably chalk this up to cultural or infantile sensory association, and perhaps also to milk sugars. A meal or snack of mostly carbohydrates seems to send us off to dreamland (this, rather than tryptophan, is now believed to be the reason for the post-holiday-feast crash). As usual, non-sugary, complex carbs are best, such as those found in bananas, sweet potatoes, oatmeal, and whole-wheat bread. In all these cases, just taking a moment to prepare and enjoy a simple treat after the labors of the day may be as helpful as any food chemistry in promoting a good night’s sleep. Of course, to avoid sleep-destroying reflux (heartburn), avoid chocolate and peppermint as bedtime approaches, and don’t eat too much too late.

A Few Tricks in Bed

A crash course in yoga – a yoga aid to crashing Savasana (accent on the second syllable) is a position for relaxation that is a part of virtually every yoga session. It is one yoga pose not recommended for meditation precisely because its total body relaxation promotes drowsiness! As part of yogic practice, there are very particular procedures for entering and leaving savasana; for our purposes, the essence of it is lying on your back with arms and legs slightly outspread, palms up (or in their most comfortably relaxed position). Breathe deeply, evenly, and naturally. Move mentally through your body: checking for muscle tension, lift and stretch each body part that needs to relax.

Traditionally this is done downward from the top of the head; some yogis advise that if your purpose is sleep rather than a state of relaxed wakefulness, you may want to do your relaxation from the toes upward. If you are avoiding sleeping on your back because of sleep apnea, roll onto your side as you feel sleep stealing over you.

Unclench That Jaw
One of the commonly held tensions that interferes with sleep is the clenched jaw. Whether as part of a whole-body inventory or a shorter checklist, checking your jaw for tension can make all the difference in when and whether you fall asleep. If you habitually hold tension in your jaw, you may not even be aware of it. To check, open your mouth as wide as you comfortably can. Now move your jaw forward (away from your chest) till it stops. Relax: release all tension in your facial muscles, leaving yourself “slack-jawed”. Now slowly bring your still gently-extended jaw upward. As your mouth closes, the hinge of your jaw should drop comfortably into a relaxed position. Once you learn this technique, you can apply it smoothly and in an instant. One more roadblock to sleep has been cleared.

Can’t sleep? Then get up!

You really do not want to stay in bed tossing and turning. You don’t want your brain and your body to react to your bed as a place of torment. Get up. Stretch. Check for muscle tension and try to release it. Sit and read, or knit, or step outside to gaze at the stars. Maybe do that simple task you’ve put more energy into avoiding than you need to accomplish it. You may be surprised at how stealthily sleepiness comes over you. Ride out your wakefulness until you feel sleepy again. And remember, your anxiety over “losing” hours of sleep can be lessened if you’ve made at least a contingency plan for daytime napping as needed.

Additional Interventions: Herbs, a Hormone Supplement, Needles

For herbs and supplements, all the usual disclaimers apply:

  • Carefully research and try to minimize adverse reactions and interactions with anything else you put into your body, including prescription drugs, other herbs and supplements, and even food.
  • Choose suppliers who can provide accurate identification (common and scientific names), scientifically supported dosage, and possible adverse effects of any herbal preparation.
  • Know how to tell a promotional website from a valid source of replicable scientific data.
  • Avoid a scattershot or kitchen-sink approach.
  • Do not overmedicate.
  • If something doesn’t work, stop using it.
  • If something makes you sick (break out, throw up, worry, panic, spend too much time in the bathroom or outhouse) stop using it and seek medical advice.

Herbs

  • German regulators have approved valerian root, hops, and lemon balm as sleep aids.
  • Chamomile tea has long been used to calm the stomach and the nerves, and to prepare for a good night’s rest.
  • Catnip, as much of an excitant as it may be to cats, seems to have a sedative effect on people when brewed as a tea.
  • Skullcap and passionflower are also thought to be helpful in promoting sleep.
  • Some of these herbal teas along with others my work in part by providing a moment of restful ritual and relaxed enjoyment.

Melatonin

As mentioned earlier, melatonin is a hormone known to play a critical role in circadian rhythms including the sleep-wake cycle, and specifically in how the brain responds to light and darkness. Research shows it to be as effective as several commercial prescription drugs. Since it acts differently from standard “hypnotic” drugs, its effectiveness may vary according to the specific sleep disorder for which it is tried. Short-term adverse effects and safety are not significantly different from those of placebo. Research on long-term effects is incomplete. The biggest caution is the general one against long-term hormone supplementation, which can have wide-ranging systemic effects.

Acupuncture

Traditional Chinese medicine treats insomnia with acupuncture. Some research is promising, indicating elevated levels of melatonin as a possible effect, and reported improved quality of sleep. Overall, however, research is spotty, and studies listed on the web more often lead to practitioner organizations than to sites specializing in science-based evaluation of health information. It looks like another case where all the data is not in, and prospective patients need to do their homework.

Special Risks and Considerations: Obstructive Sleep Apnea

If you have run through the gamut of these tips and techniques already, you may want to consider reconnecting to the grid long enough to have a sleep study done. These are especially useful in cases of suspected—potentially fatal—obstructive sleep apnea, in which one stops breathing periodically throughout the night. The study usually consists of two parts, including a period of sleep attached to some two-dozen monitoring electrodes (talk about being hooked up to the grid!) If sleep apnea is detected, the second phase will test the efficacy of a Continuous Positive Airway Pressure (CPAP) device, a kind of mask attached to a pump that keeps air flowing through the night.

There may be a waiting list for a study. Any primary care medical practitioner should be able to ask you the half-dozen or so questions (e.g., Do you snore? Are you tired throughout the day? Have you ever fallen asleep while driving?) that will tell you whether such a study is relevant to your problem.

Sleep apnea is one area where Western medicine does not rush to drugs as a fix. Recent research suggests that an older, less expensive, less technological device—the Thornton Adjustable Positioner (TAP) that fits in the mouth and adjusts the position of the jaw to ensure continuous airflow—can be just as effective as CPAP. The frequent (by no means universal) association of sleep apnea with overweight has been known for some time; relatively recent research shows that weight loss provides effective relief for many sufferers.

Insomnia doesn’t have to take over your life. Its debilitating effects can be mitigated through one or more of the alternative therapies listed here. Clarity of mind is important in any emergency off-grid situation that you may find yourself.

Your very survival may depend on it.

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