Sleep Answers

Aloha and thank you for asking your question.   I can see how that scenario can be pretty stressful and I'm sorry that this is happening.  Stress often does impact our sleep and almost everything else.  I can understand how job stress can be a big one since that is very closely related to our financial state and how we meet our other needs in life by using that income. If your area offers unemployment benefits, it may be worth your time to apply for that since you have been laid off.  If may be time to consider other employment as well to regain steady income. As far as managing the stress, it takes a systemic approach to put a foundation of wellness in place that keeps us balanced and health and more able to withstand whatever comes our way. This includes physical, emotional, spiritual, and other aspects of wellness.   I am a fan of the "Eight dimensions of wellness"  as listed by SAMHSA, which you can search the internet for to gain more info about.  This very well rounded approach grounds us in a solid foundation of full wellness.  This will include things like getting a regular amount of physical activity and fine tuning our sleep and many other things.  How we eat and sleep impacts our mood so that is an areas to look at as well. You mentioned having your sleep impacted recently, which is likely the result of the stress, more specifically what sounds like anxiety, or worry, and for good reason as I read your scenario.  It helps to put relaxation techniques in place that are intentional and routine so you can build the habit and make it more effective for you.  Many find "focused deep breathing" as one of the simpler ones to start since you are essentially just focused on breathing deep and slow.  This helps us shift out of the "fight or flight" and into the more relaxing portions of our nervous system.  I have witnessed others feel this benefit in as little as 60 seconds of effort.   I would recommend doing this just before bed to make sure we settle into a relaxed state of mind and make our sleep more likely and make our sleep more restful when we have it.   As far as appetite, it is quite common to have fluctuations there when we have stress but anxiety can mimic stimulants to a degree and make us have less desire to eat in the same ways that say caffeine can do.     All these items and more can be addressed with the help of a counselor so I encourage you to work with someone if you have not already, who can help take this journey with you and provide accountability to help you get through it.   I wish you the very best and hope you have a great rest of your week.

Hi there, Thank you so much for your question and reaching out; I feel that this will be a question that comes up for a lot of people, as anxiety and worry before we fall asleep can be really common, and is really normal from time to time. I know that I also have these challenges every now and then, particularly if I am stressed myself. Though it will be different for everyone.  It sounds like the last two months have been really difficult when trying to go to sleep. You've noticed that your thoughts start to go to what you did in the day, and worrying about what seems like silly things. Your body is also reacting with your heart pounding, which can be really normal when we feel anxious, worried or stressed. I wonder how long this goes on for before you get to sleep? Or if it wakes you up in the night too? Mostly however, I am wondering how you have been managing this and working through this for the last two months if this has been going on? I hear that you say nothing should worry you - and it might be that rationally there is not anything really, however your body is trying to tell you something is going on, and, in the best way it knows how, is trying to keep you safe by thinking about what has happened (sometimes I like to say it's like an overly helpful friend, who may not actually be helpful in the way that we would like!). In essence, when we ruminate and think about different situations our mind is thinking if we think back to what has happened and learn from what went on, we are less likely to do this again in the future. One thing that can really help people when they are trying to go to sleep is doing some form of grounding exercises or focusing on your breath; now this doesn't work for everyone so it can be something to have a go at for a little while and see if this helps. It works by calming your neurological system, which is where the constantly thinking about little things throughout the day is based. I really like to bring to mind a place that feels calm and relaxing, which could be any place whatsoever, real or imagined. And then begin to think about the different senses while I am bringing it to mind. So, thinking about what I can see around me, what I can hear, what I can smell, taste and feel. Engaging our senses like this can be really helpful to bring us back to the present moment and engage us fully in what we are doing (and as such, calms the mind that is worrying about the past).  There are lots of other techniques that you could try, and I would say that a therapist could talk this through with you and see what works best for you - as everyone is different. I do hope that is helpful and can give you some much needed respite from the challenges you've been having when going to sleep. Best wishes, Nikki 

Hi Nat,  Thank you so much for reaching out with this question. Sleep is one of the most important activities we can implement in order to manage mental and physical well being. Studies have shown that having a full night’s rest will cleanse the toxins from the folds in our brain which will create a clarity and emotional balance in our bodies. What you are experiencing when you sleep is an interruption of your sleep which creates just the opposite of clarity and emotional balance; more like you experience disruption, imbalance and increase in your stress. The challenge of creating a healthy sleep routine is interrupted by your body's lack of ability to fall and stay asleep. Your illustration of your sleep struggles indicates that you may have a condition that needs to be assessed by a medical professional or a sleep specialist. Your best option is to look into a Cognitive Behavioral Therapy for Insomnia (CBTI) program in your area. In CBTI you will be assessed for disordered sleeping and receive non-medicated treatment. There are five components to CBTI: sleep consolidation, stimulus control, cognitive restructuring, sleep hygiene, and relaxation techniques.  If worry is keeping you from falling asleep, one technique you can try is a worry box or a worry notebook. Find a box (you can get creative and invent your own box to give it a personal flare) or get a notebook. Place this item by your bed. Before you climb into bed, write down all of your worry thoughts, not in detail, only as a statement. An example could be: “I am worried about my presentation tomorrow”. Take that piece of paper with your worry thought and place it in your worry box, or keep it in your worry notebook. If you find yourself beginning to attach to your worry again, simply remind yourself that the worry box or notebook is already taking care of your worry thoughts; therefore you have no right to take it back.  But again, I believe CBTI is going to be your best approach for creating a healthy sleep routine and give you the relief you need from your current struggle. Don’t stop seeking a solution to creating a healthy sleep pattern. There will be no healthier activity for self-care than rejuvenating cleansing sleep. All the best to you; do not stop seeking how to be the healthiest you that you can be. 

Hi Lily bee, Sleep-Trich or sleep related trichotillomania can be body-focused repetitive behaviour from when you're awake. From your question, if it's just sleep focused hair pulling, it can occur during different sleep stages. Such as when your brain pattern slows, which is thought to be associated with an alert, but daydreaming mind. Showing that when your neurological wakefulness changes it can relate to hair pulling. Of course, this is my opinion of what some research has made me believe.   In terms of trauma from your past life being a cause it can be, which tells us that it would be a response behaviour from your past trauma. It could also be from more frequent stressors such as low self-esteem, for both the hair pulling act can be a release from anxiety and tension for you. It can be a bit of a vicious cycle with the hair pulling in turn becoming a source of repeat anxiety. It can be a type of addiction in giving you that release and can be difficult to stop.   An added obsession of what today's hair perfection culture wants us to feel can make it difficult to stop and the cycle begins again. New traumas can increase the need of release and it can start to feel isolating as people around us don't understand.   Cognitive behavioural therapy has been seen to be the most effective intervention of working with trichotillomania as it works with the underlying thoughts and emotions around the trauma rather than just the behaviour itself. Some negative symptoms you may be experiencing are shame, guilt, anxiety, embarrassment, depression, low self-esteem, isolation or even social withdrawal.   Some things that might be worth considering are a diary to help you understand any patterns that may appear, for example certain days of the week, after certain events or alcohol/sugars. This could help you understand what you may need to avoid or what may increase the frequency for you, your triggers. This could link to your past trauma and what triggers you have around that, therapy could really help with this as it could be a safer environment for you to explore with someone.   I do hope this helps you understand it a little clearer.

Hi, thank you for your question, which is a common question many ask. How to improve your sleeping routine? So many factors contribute to why your sleep may be disrupted, and there are fundamental things you can begin doing to eliminate habits that might be disrupting your sleep. You also mentioned struggling to communicate, which is something I will help you to understand as well. I am sorry that you have felt the need to isolate yourself and feel alone because you cannot communicate your feelings in ways others understand. A lack of sleep can impact your ability to focus, process thoughts, and concentrate.  First, anxiety and stress can harm your sleep schedule. Poor habits and stressful environments can make falling asleep and staying asleep difficult. Check your environments, such as lighting, room temperature, and noises, and reduce blue lighting. The blue light shifts your circadian rhythms when you use your phone or tablet later in the night. REM cycles start later, and we are less likely to reach extended REM sleep cycles. As a result of a disrupted sleep schedule, you may find that you're sleeping more than usual and still feeling exhausted. Or, you may find that you struggle to sleep at night. Either way, you may end up feeling tired and not having the energy you need to make other improvements in your life. Another factor is to consider your actual sleep schedule. What time do you sleep each night? Try to have a daily and nightly routine so that your body knows when it is time to rest. Go to bed around the same time each night, assess your environment and try to create and be consistent with the same daily routine. Another factor that may impact your sleep is ruminating at night when it is time to sleep. Rumination is when you replay different experiences and situations that have happened, and you fixate on them. You are playing out conversations and thinking about the things that have occurred, often with guilt, shame, judgment, and resentment. It's a fixation on things that happened, and doing this at night, adds anxiety and can leave you feeling restless. When we ruminate, our minds are repeatedly caught thinking about the negatives. If we think about the situation in a new way, we can sometimes stop the ruminative cycle. One way to challenge rumination is using cognitive reappraisal. Cognitive reappraisal involves recognizing your thoughts' negative pattern and changing that pattern to one that is more effective. Instead of playing out this unpleasant, seemingly automatic cycle, take a moment to consider another perspective (reappraisal) you might have in this situation. In other words, am I seeing the worst-case scenario and all of the negatives, or am I acting impulsively with my feelings and drawing conclusions without all the evidence? What is another way to see this situation? So shifting your perspective to see if there is another possible outcome. You mentioned wanting to improve your communication and express yourself so that you are understood by those you care about. To communicate effectively, you have to first know what your needs are. Your emotions will tell you what you need. For example, if you feel rejected, your feelings tell you that you want to feel accepted. Take time to reflect on your feelings, recognize the need, and know your goal. By communicating what is your goal and expected outcome for the message you are trying to convey? These are questions to ask yourself before expressing your needs. Asking questions and learning is a good way to improve personal development and interpersonal relationships. Thank you for your question, and I wish you well on your well-being journey. 

Hi Ethel! Thank you so much for asking this vital question! I can tell that you are feeling curious and are interested in discovering some tips, perhaps some new ideas, as well as guidance, on how to manage insomnia. I can certainly relate to your concern that you have been experiencing trouble sleeping throughout the night. What is your current evening routine? It sounds like you are having trouble staying asleep. Are you also having trouble falling asleep, as well? I know that you mentioned in your question that you have recently been experiencing insomnia. How long have you been experiencing insomnia? These are some of the important questions that you may want to address with your therapist or primary care doctor. The first thing that comes to mind for me when it comes to managing insomnia is to establish a sleep routine. Take some time to identify the patterns of sleep that you notice that you are experiencing. Start by simply observing your sleep patterns and begin to make changes as you go. I recommend keeping a sleep diary, if that is at all possible. The BetterHelp platform offers a worksheet on sleep hygiene as well as an example of a sleep diary that may be helpful for you. In addition to starting a sleep diary, I recommend utilizing aromatherapy techniques. This strategy may help you to feel more relaxed and calm in the evenings. For example, you may want to purchase a scented pillow, a body or room spray, or a scented eye mask. I believe that lavender is a popular scent for people to use to stay asleep. It may be a good idea to test a few different scents out and see which one appeals to you and which one brings you the feeling of relaxation. Perhaps vanilla or jasmine might be other scents that you could try. If you are waking up in the middle of the night, you can utilize aromatherapy in order to focus on falling back to sleep. I am not sure if you were doing this already, but it would be a good idea to shut off all electronics and screens an hour or two before bed. Turning off your cell phone, the TV and any other blue light device, such as a laptop or computer, will likely be beneficial for you and your sleep cycle. Sleep education is going to be key so do what you can to learn about the various stages of sleep. It would be great if you could read a book or a magazine as a means to relax before bed. Keep a consistent schedule, such as adhering to the same bedtime and wake time every day. These ideas will hopefully be beneficial for you! In addition to the aforementioned strategies, I recommend relaxation strategies. Relaxation techniques include mindfulness meditation, progressive muscle relaxation, deep breathing, and guided visualization. These are just some examples of relaxation techniques that you can try any time, from the comfort of your home. Listening to audio clips on the topic of mindfulness might be a great idea for you! Here is a resource to a website that I recommend: https://wellness.mcmaster.ca/your-health/mindfulness-and-relaxation/ It may be a good idea to practice these techniques while you are awake and during the day in order to feel more comfortable with implementing these strategies in the moment when you are awakening at night. One thing that I tell my clients is that if you are awake, laying in bed and can not sleep for more than thirty minutes, take about twenty minutes to get out of bed and do a different task, such as an epsom salt foot bath, listening to music or reading a story. The idea is that it is best to leave the bed and the room you are sleeping in, refocus your energy on something else and return to the bed feeling refreshed and ready to try to sleep again. You can certainly learn more about these strategies and techniques in individual therapy sessions. You may want to try some holistic modalities, as well. This may include massage therapy, acupuncture, art therapy, herbal supplements and more! It is up to you what you decide to try and be patient with yourself in the process! Thank you for giving me more information about what you have been worried about. I think it makes sense that you are worried about your son. It can be difficult, as a parent, to stop worrying about a child, no matter what age they are at. In order to combat your feelings of worry, I recommend making a worry chest. You can design a container to your liking and use sticky notes or scrap pieces of paper to write your worries on and fold them up and place them in the container. Know that your worries are safe in a place that you have made for them. Allow the worries to exist and give yourself the time you need to rest. You can always revisit your worries again in the morning. I can tell that you are feeling lonely. What is it like for you to live alone? I can only imagine what it must be like for you to be a widow for fifteen years. What has that experience been like for you? I think that it is a great goal to try to meet someone new and go on a few dates. That seems like it would be helpful for you! I recommend utilizing a positive affirmation in the evening as a means to comfort yourself and wind down before you go to sleep. An example of a positive affirmation for sleep could be: "I will get a good night sleep tonight. I give myself permission to rest. I know that when I feel tired, that it is time to relax my mind and body and get some sleep." It sounds like a positive aspect of your life is taking classes at the local YMCA and spending a good amount of time with your friends. I encourage you to keep doing that! Thank you again, Ethel, for your time in asking this important question related to insomnia!

I am so sorry to hear that you are struggling with your sleep and the negative symptoms that is causing.  It will be important to recognize when your feelings have a purpose versus when they do not.  We of course want positive feelings in our lives, but sometimes negative feelings are there for a reason and we need to live out that purpose in order for it to get better.  If we do not live out the purpose of our feelings, it likely leads us to feel worse.  For example, something as simple as having anxiety about needing to get the chores done has the purpose of getting us motivated to get the chores done.  Therefore, if we do not live out that purpose and the chores remain undone, that can lead to more bad feelings, such as, “I am lazy” or “I am worthless.”  This is a simple example of how if we do not pay attention to our feelings and live out the purpose, they can become much, much worse.  So, I would encourage you to try and separate out the thoughts that have a purpose from the thoughts that do not have a purpose and are more intrusive.    For the ones that do have a purpose, it can be helpful to allow yourself to think through the anxious thoughts because anxiety has a nasty way of going to the worst possible scenario.  If you can wrap your head around that scenario, it can make it less scary.  For example, I had a client that was very anxious daily about being single for the rest of his life.  Thinking to that extreme is clearly anxiety and it just lingers there.  So, then he was able to think through that scenario and come up with a plan to make it less scary.  He then came up with that if he really is going to be single the rest of his life, which is highly unlikely, he is going to work towards being able to live close to the ocean since that is a dream of his.  Thinking about it now does not make him as scared because he recognizes he could be happy with that. So, try to think through specific things you are anxious about that have a purpose and make sure you have a specific plan on how to improve those things. For example, having a specific plan for how to address specific anxieties you have before bed time or during the night.   Intrusive thoughts tend to not have a purpose and it can be really helpful to try and overpower those before they are accepted as truths.   We can have power over our thoughts and I want to help you not engage in these thoughts that make you so upset.  The easiest example of this that I can think of is if I went skydiving.  If I went skydiving I would have some obvious, rational, anxious thoughts.  If I really have a desire to skydive though I will need to not engage in those thoughts.  I might have thoughts such as, "My parachute could fail, I will hit the ground, I am going to pass out, etc."  However, since I really want to follow through with skydiving, I would want to stop those thoughts in their tracks with, "I know this is going to be really fun, they inspect the parachutes ahead of time, people hardly ever get hurt doing this, etc."  By focusing on those thoughts and not engaging in the others, I would be able to follow through with skydiving. Try to sort through any thoughts that get you down about yourself and that you can’t handle all of this and try to overpower those.  These types of thoughts are very common when dealing with this kind of lack of rest.      As you do those processes it can be helpful to validate yourself as someone of worth and that has been able to get through challenges in your past.  Something that could be helpful for you is what I like to call centering thoughts.  These are thoughts that are predetermined and unique to you for you to turn to in low moments.  They need to be powerful enough to bring you back to your center.  It is important that these thoughts are accessible for you to look at when you need to.  Some clients prefer to read and re-read them and some prefer to write and re-write them until they feel better.  I have clients that write these somewhere they will see daily such as their bathroom mirror or phone background, while others simply have them in their phone to pull out when they need to.  An example of a centering thought would be from a client I had that related to nautical themed things and her thought was, "I will not let this sink me."  Another example is from an Olympic skier that actually had difficulties with negative thinking getting in the way of her performance so she went to therapy.  She mentioned that she learned about centering thoughts to battle all of the people telling her she “should be” or “should do.”  To battle those thoughts, she uses the simple centering thought of, “I am.”  She can then remind herself that she is good enough, that she is confident, and that she does want to still compete, which really affirms her own feelings and not others.  Hopefully you can come up with something that helps validate your worth and abilities to move forward.       I hope that some of this is helpful and that you can apply it to your circumstances.  I hope that you can lean on some family and/or friends through this.  Doing so can help take weight off of your shoulders as well as hopefully get some valuable advice from them. Try to take the healing one day at a time and adding one positive thing back into your life each day. I wish you all the best and I hope that you are staying safe.

Hi there, thank you for your question and the follow up information. I'd like to give you some basic background information before diving into your question on sleep, which you may or may not already be familiar with.   Basically, there are different cycles of sleep, including the rapid eye movement, or REM cycle. Dreaming occurs in different parts of the cycles of sleep, and how clearly you remember your dreams also depends on your level of consciousness.   Some thing I would particularly like to explore is how clearly you remember these dreams, basically, are they pretty vivid, or more fuzzy around the edges? I'm guessing from your details you provided in the question that they are more vivid, as you said sometimes you get confused or lose touch with reality because of the dreams.   One thing I encourage you to do outside of exploring this through therapy is seeing a primary care doctor or a possible sleep specialist to make sure there is nothing physical going on at this time. They may even recommend a sleep study, which can sometimes be done in your own home nowadays with the technology that has been developed.   Another important aspect of what is going on is the contents and or details of the dreams. Since you used the word dreams, and not nightmares, I'm hoping that the content is not too disturbing for you. If the content is disturbing, I also encourage you to talk to a primary care doctor or psychiatrist about medication options for nightmares.   There are non-medical ways of dealing with the dreams, such as writing out what you remember and completing the dream in a way that you wish it would've been in your sleep. Basically, rewriting the dream to have the outcome that you would like.   I also think it's important to examine how often you are sleeping, because if you are constantly dreaming when you are sleeping you may not be going deep enough into the different cycles to get enough rest. I encourage you to keep a sleep diary, and also try to practice good sleep hygiene. This involves things that you have likely heard before come out like falling asleep and getting up at the same time every day, keeping napping and caffeine to a minimum, and getting regular exercise if it all possible.    Thank you for your time and your question, good luck and take care.

Hi Pony,   I am sorry to hear that you are struggling the way that you are.  It is not at all uncommon to experience anxiety and depression together.  Finding some new self-care strategies might benefit you along with improving your sleep hygiene.  For example, what are some of the things you do prior to bedtime to prepare your mind and body to settle down?  Having a consistent practice of washing your face, brushing your teeth, etc. is one way to help the brain to know it is time to quiet down however there are additional strategies that are sometimes overlooked.  This includes having the temperature set at a comfortable level, avoiding any screen time at least 30 minutes before bedtime, and also avoiding naps during the day. You also want to use your bed just for sleeping and sexual activity.  So for example, if you are one that tends to do other activities in bed such as eating, reading or watching television, your brain may then correlate the bed to more stimulating activity making it difficult to fall or stay asleep.    I would also be curious to know what sort of thoughts you are waking with since you mention such a feeling of dread.  Cognitive-Behavioral Therapy (CBT) involves paying attention to how our thoughts, feelings and behavior are all connected.  Often times, unhealthy or unhelpful behaviors are the result of unhealthy/unhelpful thoughts, and gaining insight into this could be quite helpful for you.    I have listed some additional general self-help tips below, some of which I commonly share with my clients and in my responses. o   Talking to a professional or reading some literature may be helpful for you.  The book Self Compassion: The Proven Power of Being Kind to Yourself by Kristen Neff is one that comes to mind, and some reputable online sources I would recommend when it comes to finding additional tips on sleep include Healthline, WebMD, and Psychology Today. o   Having a consistent self-care practice as well as self-esteem practice is critical.  What do you do for your self-care?  Consider having short mindful moments throughout the day, seeking out some creature comforts and pampering, or finding what you truly enjoy and getting lost in it. And physical activity can help reduce stress and anxiety as it releases endorphins and enhances chemicals in our brains that help us to feel better, like serotonin and dopamine.  When done on a regular basis, it can help to lower your overall level of anxiety. o   Practice relaxation skills.  I know I am repeating myself when I say self-care is so key! Try such calming and meditative exercises as deep-breathing, imagery of a relaxing scene, and guided meditations.  Sometimes it can be helpful to repeat a calming word or mantra you create for yourself such as “I can get through this… I am at peace.”  Journaling thoughts and feelings can also be useful.  And if sign up for BetterHelp, there is a journal feature that would be available to you, which can include daily prompts if you want.   I hope you find some of this helpful.  There are a number of qualified mental health professionals on this platform who I am confident would be able to help you further.  I wish you all the best for the rest of your 2022!  Think about what was helpful and harmful for you this past year and incorporate more of what can help so that it can be a great year for you.  Good luck and be well!   -Alicia

Hi Max!  I'm a therapist here on BetterHelp.  Sounds like you are experiencing two problems that are often related to one another: anxiety and poor sleep!   It's a vicious cycle, feeling stressed out and anxious makes it difficult to sleep, and then the lack of sleep can make the anxiety worse!  Online therapy can help you with both sides of the problem.  It can teach you how to prevent and manage panic attacks, and it can also help you learn to to manage your daily work stress much better by teaching you anti-anxiety coping skills and strategies, as well as new was of thinking and communicating that will generate a calmer state of being.  Through therapy, you can also learn how to apply problem-solving skills to the situations in your life that are causing the most stress. Therapy can also help you overcome insomnia and other sleep difficulties too, even nightmares.  There are also many self-help books on the topics of anxiety management too, if you cannot therapy at this time.  I'm going to share some good sleep tips with you, to help you get started right away on improving this very important aspect of self-care! Really optimizing your sleep is the main key to feeling better emotionally and getting your life in order. Great sleep also helps immensely with physical health issues, chronic pain, weight management, and disease prevention. But great sleep isn't just about how many hours of sleep you get per night, it's also about how deeply you sleep!… Deep sleep is what keeps us healthy and happy! To assure that your brain experiences an optimal amount of deep sleep per night Max,  make sure to get some indirect sunlight to your eyes every morning. Go out to your porch and sit for a bit or take a walk, first thing in the morning. Avoid looking directly into the sun of course, but do look up at the sky! If that's not possible, use a Nature Bright light to get the same 'sunlight effect.' That sunlight to the eyes will help your body release a hormone that will help you fall asleep faster and sleep deeper each night, and it will help correct night-time wakefulness as well. Also, be sure to avoid 'blue light' after the sun goes down. Blue light is emitted from TV screens, phone screens, and computers/laptops. It's even emitted from most types of indoor lighting. Blue light tricks your brain into thinking the sun is still out! And that ruins the quality of sleep you're getting each night. That's a big reason so many people don't feel calm, content, and energized, even though they may be getting 8 or more hours of solid sleep at night. Many people who are aware of this 'blue night at night' problem think that if they rely on the "night-time" light setting on their electronic devices, that will protect the quality of their sleep. Unfortunately though, that doesn't solve the problem, because it doesn't block the blue light adequately. It's much better to stay off all electronics after dark, and switch all household lighting to incandescent bulbs, or using candle light. Or if you like watching TV in the evening and being on your phone or computer after dark, simply wear 'Blue-blocker' amber glasses once the sun goes down. Beware that some of the blue-blocker glasses being sold are sold are a rip off... they do not block very much blue light!... plus they really make it hard to see clearly. So I recommend Spectra brand amber glasses… they are reasonably priced.  Remember... if you don't optimize your sleep, it will be harder to gain control of your anxiety and panic attacks.  Deep sleep is one of your very best life improvement tools! If you can't fall asleep due to over-thinking (rumination or dwelling)  , therapy can assist you with that!  Some people all have good luck with meditation apps.   Establish a pre-bedtime routine that's calming, soothing, and pleasant. Here's just a few ideas for low-key activities you may wish to incorporate into your pre-bedtime routine: ~ Reading (be sure to use sleep-safe lighting only, or wear your amber glasses) ~ Gratitude Journaling ~ Listen to calming music ~ Herbal Teas (the sleep-inducing ones are great!) ~ Guided Meditations ~ Sleep-inducing Aromatherapy ~ Watch a light and positive TV show, or nature/wildlife/sea-life documentary (wear your amber glasses, though!) ~ Soothing music or candlelight ~ Prepare for the next day For best mental health, make every effort to get to bed by 10:30 pm at latest. Ideally, you will wake up just naturally, before your alarm clock goes off. If your alarm clock is waking you from a sound sleep, that is a sign that you need to get to bed earlier. If you need or want to take a naps during the day, keep them before 12 noon, that way it will not wreck havoc with the quality of your night-time sleep. Avoid night-time shift-work if at all possible!   Make sure to get daily exercise. Avoid alcohol and other recreational drugs.  Avoid caffeine after the noon hour, too. Persistent anxiety issues definitely indicate that therapy would be a good idea.  And if your sleep problems persist,  a visit to your physician may be a wise idea too. Hope this helps!  Maya 

Hi Kels, This is a great question that you raise.  A few things that are coming to mind for me are:  How long have you noticed this pattern? How many hours of sleep do you generally get? One of the main reasons why we may sleep late could be related to other symptoms that we are experiencing so I'm always curious to know if you are dealing with any depressive symptoms that could potentially contribute to this.  I also want to make sure you know that I'm not making any assumption that you're dealing with depression but again, this could be one of the reasons why you're experiencing this.  I'd also like to know if, when you wake up, do you feel rested or do you often wake up feeling extremely tired?  Some of these factors can definitely impact sleep. Additionally, what does your sleep hygiene look like?  Sleep hygiene is the term used to describe good sleep habits. Considerable research has gone into developing a set of guidelines and tips which are designed to enhance good sleeping, and there is much evidence to suggest that these strategies can provide long-term solutions to sleep difficulties.  What are your routines before you go to bed?  Develop rituals to remind your body that it is time to sleep, like relaxing stretches or breathing exercises for 15 minutes before bed.   It's also important to be as consistent as possible.  Avoid taking naps during the day. If you can’t make it through the day without a nap, make sure it is for less than an hour and before 3pm. Also, is your daytime routine the same?  Even if you have a bad night sleep it is important that you try to keep your daytime activities the same as you had planned. That is, don’t avoid activities because you feel tired. This can reinforce the insomnia. I want to acknowledge that these can be things that you are already doing and if that is the case, we can further discuss what may be getting in the way for you. I'm very curious to know what you feel has changed from the time that you did have a normal/consistent routine to now.  Have you made any significant life changes or changes in schedule that could be contributing to this. Let's not forget, daylight savings has also been a difficult transition for most folks! 

Worry is a natural part of everyday life for a lot of us that can’t be avoided.  Worry is an emotion that has several reactions in the body.  While these reactions in the body differ from person to person, one common reaction is increased blood pressure.  One simple reason for this is that we tend to increase our heart rate when we are worried.  For example, if I am worried about a job interview that is really important to me, I might naturally feel a fast heart rate and maybe could even hear my heart rate so fast.  Higher heart rates are naturally associated with higher blood pressure.  Another symptom of worry that is really common and can cause a rise in blood pressure is a disruption to sleep.  Some people suffer from restless sleep after falling asleep, others suffer from not falling asleep, and some suffer from both.  Whatever the case may be, a lack of sleep is closely connected with your body’s overall health. Therefore, if you are losing sleep because of being worried, that can easily increase your blood pressure.  This is especially true if this goes unaddressed and you continue to lose more and more sleep.  When we get worried, it is really common to struggle with our eating habits.  Some people react to worry by eating less, and some react to worry by eating more.  When people react to worry by eating more, they tend to make poorer choices about the foods that they are eating.  Poorer food choices, such as foods higher in fat content, higher in sugar content, and higher in sodium content, can cause an increase in your blood pressure. On that same note, when people are worried, they sometimes drink alcohol and/or smoke more.  People that do not drink alcohol might even drink more drinks that are higher in sugar content.  All of these optioThesease someone’s blood pressure over time if they are not consuming them in moderation.

Alzheimer’s is a progressive brain disease that results in dementia symptoms. Alzheimer’s is responsible for the majority of dementia diagnoses given. While the condition is different for each person who experiences it, the disease tends to advance systematically. Scientists believe that the condition is caused by the buildup of proteins in the brain. These proteins are called plaques and tangles. The formations of plaques and tangles block brain cells from absorbing needed nutrients and interrupt their ability to communicate with one another. This results in the symptoms associated with Alzheimer’s disease, and brain cells eventually begin to die. Over time the disease results in atrophy or a loss of mass in the brain overall as cells continue to die. Alzheimer’s advances in particular stages. The earlier symptoms are memory and cognitive-related. Difficulty recalling words or names in the beginning, is common. In the middle stage, which may last for many years, memory issues become more severe. Wandering and becoming lost and difficulty remembering personal history and events and personal information like home address are common during this stage. In the later stage of Alzheimer’s, the loss of motor abilities like walking, swallowing, and talking are impacted by the damage to the brain’s cells. Sleep issues are common in the later stages of Alzheimer’s. The patient may begin to sleep at odd hours and more often. This occurs for a few reasons. The damage caused by the disease leads to an increase in exhaustion over time. This extreme tiredness causes the need to sleep. Some of the medications that may be used to treat mood issues that are often experienced with Alzheimer’s can cause sleepiness and increase sleep. Increased sleeping can signify that the disease is progressing, but if you notice any changes in your loved one with Alzheimer’s, talk with their medical provider for guidance. People in the later stages of Alzheimer’s disease are more prone to infection. They may struggle with communicating, so they may have trouble communicating pain or other symptoms to you or other care providers. This makes it important to talk with the doctor involved if there are any sudden changes in symptoms or behavior. If you have concerns about Alzheimer’s symptoms, talk with your doctor or your loved one’s doctor. You can also contact the Alzheimer’s Helpline at 1-800-272-3900.

Until a few years ago, doctors were not overly clear as to why people with Alzheimer’s needed to sleep so often. However, research does show a correlation between people that had a neurodegenerative disease and an increased need to sleep during the day could be at a higher risk of developing Alzheimer’s. In the past few years, new research has come out from the University of San Francisco, along with some other institutions, showing patients with Alzheimer’s have brain cell loss in the brain areas responsible for keeping us awake. According to the Alzheimer’s and Dementia Journal, a protein in the brain called tau can trigger these brain responses if too much is being released. These proteins can disrupt communication between the brain cells or neurons and affect cell health. [Retrieved from: https://www.medicalnewstoday.com/articles/326073.] When a person enters the later stage of dementia, they become weaker due to the excessive damage to their brain, and increased sleeping is a symptom of that. Daily tasks such as eating, talking, or engaging in what is going on around them are overwhelming and exhausting, so they will sleep more as their symptoms become more severe. Patients with Alzheimer’s usually take many different medications, and some of those could contribute to them feeling groggy or tired as well. If you feel the medication is causing these symptoms, it is important to discuss those concerns with the patient’s doctors. Alzheimer’s can impact everyone a little bit differently. For some, their sleep patterns can become reversed where they sleep all day and stay up all night, or others have a hard time distinguishing between night and day, or they wake in the middle of the night and cannot go back to sleep. Therefore they need to nap during the day. Most people that have Alzheimer’s may be sleeping anywhere from 10- 15 hours a day. However, it most likely is not a good sleep quality, as they do not get enough of the slow-wave sleep needed to help the body and brain recovery. [Retrieved from: https://www.alzheimers.org.uk/blog/is-it-typical-people-dementia-sleep-lot-during-day] There is still so much to learn about Alzheimer’s and its overall impact on the brain. There is a lot of new research and treatment options that can help improve the quality of life. It is always important to discuss these options with a doctor to know all of your treatment options.

Mindfulness is the practice of just being in the moment, embracing what is instead of what was or what will be.  There are various ways mindfulness can be implemented, including focusing on elements of experience within the body, outside of the body or a combination of both.  Popular methods that focus on internal perceptions and bodily sensations are typically breathwork and body scanning.  Breathwork involves focusing on the sensations of inhaling and exhaling, whereas body scanning is about slowly noticing feelings occurring in the body from head to toe.  Focusing on the body and breath is usually best suited for those most comfortable with being internally receptive or those who would benefit from enhanced awareness of bodily feelings (i.e., building awareness of hunger signals, connecting to the self, etc.).  Sometimes focusing inward allows for a sense of grounding or stability in situations or circumstances in which external aspects of the environment are too overwhelming or bring stress. Connecting to elements outside the body may be more helpful or appropriate for other people.  Practices here may include tuning into sounds, smells, sights, etc., bringing awareness to the external vs. internal environment.  Some people are not ready to confront feelings and emotions that can arise in focusing on the body, so putting the spotlight on the environment can be a helpful adaptation to being mindful.  Because there are so many things outside of us to pay attention to, the directions this technique can go in are endless.  For some, a combination of both can be used and/or effective in connecting to the present moment.  No matter what process is used to implement mindfulness, the person should feel safe (enough) to use it without feeling destabilized or panicked.  One of the great things about mindfulness is that you can adapt it in any way you choose—so if you are worried about what it may feel like, you can start by using it in small increments (around 1-2 minutes) to test the waters.   If it feels doable, you can continue to use it however it feels best.  If it feels unsafe or overwhelming, you can either modify how you use it or use a different technique altogether.  You always have the power to choose what fits your life best!

Mindfulness is a great practice to bring you closer to your present experience through noticing emotions, thoughts, and sensations, nonjudgmentally.  Resources for mindfulness can be found on Youtube, mindfulness-based websites, and apps.  Because people gravitate to apps as a convenience, many apps have become available specifically for mindfulness practice. One of the most popular apps for mindfulness is called Calm.  Its free version provides the user with soundscapes, a few mindfulness-guided exercises, and breathing practices.  Its full version allows users to choose from many meditations, sleep stories, and music made for distinct settings or situations.  Having a variety of options can be beneficial as sometimes we need to focus on breathing, sometimes we want that calming background noise, and other times we need help falling asleep.  Calm also gives the user options to track their use and log moods before and after certain features. Headspace is another popular mindfulness app that has both free and paid versions.  It offers nearly the same features as Calm and movement-based techniques to recenter yourself or reduce anxiety.  As with the Calm app, there are many different options for meditation and mindfulness to choose from, including those focused on distinct emotions, situations, and goals for the day.  They have practices suited for people at different levels of meditation, making it an app that can provide for your individual needs. The great thing about apps is that you can usually set reminders to use their features.  This can help keep people on track with mindfulness goals and provides ease of access as the only thing you need is your phone.  Another benefit here is that if you don’t connect with one app, there are plenty more to choose from that may fit your needs better.   It may take some trial and error, but it only takes one to find the right fit! For some people, apps aren’t helpful, or premium versions are not affordable.  Other options include www.mindfulnessexercises.com, www.mindful.org, and other sites specific to the practice.  Finding what works for you is an important and necessary part of meeting your own needs!

Thank you for your question, reader. Losing sleep over your worries can certainly be disruptive and add to your overall worry. Hopefully, practicing the tips discussed here will help you feel like you have some tools at hand the next time you find yourself unable to sleep because your mind won’t turn off. One common mistake that people make when they can’t sleep is to keep laying in bed, willing your mind to turn off so that you can rest. In fact, one of the best things we can do for worry is to help your mind disrupt that process of worrying. It is recommended that you leave your bed, and even better, the room that you sleep in, and do something else for about 10-15 minutes. However, don’t distract yourself with screens, like on the phone, unless you have blue-light blockers. Light can be stimulating for your brain, making it harder to prepare for rest. You could try drinking some herbal tea or warm milk, reading a good book, listening to calm music, or completing a small chore. After that period of time, try laying back down to see if you are feeling any more tired. If you cannot fall asleep within 15 minutes or so, you should get back up again. Another tool that can be beneficial is to give yourself a set time to journal about what is on your mind, again about 10 to 15 minutes. At the end of that time, tell yourself to stop thinking about it until the morning. Tell yourself there is nothing productive that you can do about any of this worry until the daytime. Sometimes, the brain goes over and over things in an attempt to store them in memory; allowing yourself to make a record of the worry to keep until the morning can help. Another practice to help disrupt the worry process is to do a short mindfulness practice that helps to refocus your attention onto sleep or rest. There are many scripted exercises available on the Internet that you can close your eyes and listen to. I recommend searching for keywords like “mindfulness with deep breathing” or “mindfulness practice for sleep.” If you often find yourself suffering from insomnia, it could help you speak with a mental health professional about the uncontrollable worry you are having.

Thank-you for reaching out to better help for assistance. I look forward to assisting you. Sounds like you are saying you fall asleep but you wake up in the middle of the night and than you have trouble going back to sleep. Sounds like it becomes more difficult with your anxiety and depression.  I would suggest you get a good physical check up with your medical doctor, to make sure everything is okay physically and see what the medical doctor would suggest. I am sure this is frustrating that you wake up in the middle of the night and than can't get back to sleep. That is a horrible feeling to be lying in bed and not be able to go to sleep. I am sure this makes you more anxious and depressed. Are you taking any medication for your depression and anxiety. If you are, talk with your doctor about possible side effects for these medications. Also are you having dreams or nightmares at night, when you go to sleep. Nightmares and dreams could make it harder to back to sleep. Also you want to have a good sleep hygiene program. You can talk to a medical doctor about a good sleep hygiene program, google one and I will talk about it here some. For good sleep hygiene, you want to have a comfortable and relaxing place to go to sleep, no caffeine or eating after a certain time, prior to bed. You don't want to be looking at a computer screen alot prior to bed. The blue light can affect your sleep. You want to practice some good relaxation skills. Some good relaxation skills are deep breathing and progressive muscle relaxation. With deep breathing, just breath in deeply through your nose, hold for 4 seconds and blow out your mouth. This will get good oxygen to your brain. Oxygen is food for your brain. With progressive muscle relaxation you will get a good deep sleep. I would suggest trying this one. You can download a 15 minute progressive muscle relaxation video, on you tube, lie down on your bed or somewhere else, close your eyes and listen to the person talking your through the progressive muscle relaxation exercise. People say it puts them to sleep and it is a good deep sleep. It also takes away headaches. I would suggest you try both of these relaxation tips but really try the progressive muscle relaxation exercise. I wish you the best and look forward to hearing from you. Thank-you for allowing me to assist you with this problem.