Better Than Chamomile Tea: A Psychiatrist’s Sleep Advice

If you’re struggling to fall asleep on a regular basis, you’re not alone.

I’ve recently talked to a psychiatrist about something that has been plaguing my life since I was a little kid: sleep (or really, a lack of it). I’ve dealt with insomnia for years, and it seems like, at this point, I’ve tried everything: a warm bath, eye mask, drinking chamomile tea, meditation, bedtime podcasts, sleep aid meds (ie melatonin)… the list goes on. And yes, many have worked in the short term, but most lose their effectiveness as time goes on (ie sleep aid meds), or, is simply not feasible on a regular basis (do ANY of us have the time to take a bubble bath every day?). Some just never worked for me at all (ie. those bedtime podcasts…). Some feel just way too weird (ie putting your phone away, meditations). At this point, I’ve almost given up. I cannot sleep until 12 am, no matter what time I go to bed! But I gotta get up at 7 the next morning… and so the vicious cycle of fatigue ensues.

Here is how the psychiatrist describes it:

1. Cutting your sleep short leads to a multitude of problems, ie. moodiness, trouble concentrating, weakened immunity
2. Teens need an average of 9 hours of sleep per day.
   • This number will fluctuate from person to person, but MOST teens do require that amount of rest for optimal growth and functioning
   •  This means if you have to wake up at 7 for school in the morning, you would need to fall asleep at 10 pm the night before.
3. This seems unrealistic for most of us because we don’t even feel sleepy at 10 pm.
   • This is because in many cases (especially in teens) our biological clocks (and thus our sleep cycles) run later naturally. Meaning, our brains are wired to not want to fall asleep until midnight. If we let our brains get the rest they wanted every night, we would naturally wake up later in the day. This can happen on the weekends, however…
4. However, for school or work, you need to wake up earlier. This is when a late sleep cycle becomes problematic: You are consistently cutting your sleep short on the weekdays, but then reinforcing the late sleep cycle on the weekends.
5. So… you NEED SLEEP! But how can you force yourself when you really don’t want to (or can’t)? What if my sleep cycle is just later?

Answer: You need to develop good sleep hygiene, and move your biological clock forward.

Developing good sleep cycle and hygiene is a bit like training for a marathon. You have to want it bad enough, and be willing to put in the time (time for yourself to rest!), dedication, and consistency. You must develop good habits, and work toward your goal in increments.

Here is the psychiatrist’s advice for me, and after years of hearing sleep advice, this is the most tangible advice I’ve ever heard:

1. You need a strong association between sleep + bed, and you need to train your brain to do this. If your brain associates bed with something other than sleep, going to bed is not going to make you fall asleep
   • Don’t stay in bed if you can’t fall asleep
     • Many of us try to tough it out and lie in bed awake and frustrated when we can’t sleep. This is EXTREMELY counterproductive. When this happens, your brain is learning that bed is a place to stay awake, which is the opposite of what you want! So, if you find yourself unable to fall asleep after 30 minutes, don’t just stay there and hope for the best. Get up, go downstairs, read at your desk, or walk around for a while until you feel tired again, and try again. This might seem like it’s making things worse at the moment, but sticking with it will pay off.
   • Don’t do anything else in bed except sleep
     • Many of us have a tendency to read our phones, watch Netflix, work, or study in bed. Of course, it’s comfy, but it’s detrimental to your ability to fall asleep in bed because it’s making an association between working + bed, or active + bed. So, when you climb into your bed ready to sleep, your brain is thinking “It’s time to work/read/study!” and you are not going to want to sleep. Instead, if you have the urge to read, or watch TV when it’s bedtime, do it in the living room, or at your desk, and save the bed for sleeping only.
2. Don’t push yourself to fall asleep at a certain bedtime if you are not sleepy. At least, not for now.
   • Start by going to bed about 30 minutes before you would normally fall asleep, even if that time is later than what you would like right now.
     • Let’s say your goal is to be asleep by 10:30 pm each night. If you are used to falling asleep after midnight, your brain’s is not going to adjust to an earlier sleep time right away. If you suddenly try going to bed at 10:00 pm, you’ll likely end up lying awake for hours, frustrated that you can’t sleep. This is why many people who try to go to bed at an earlier time do not succeed in changing their sleep patterns. To re-adjust your sleep cycle to an earlier time, start small: if you usually fall asleep (note: fall asleep, not go to bed!) at around 12:00 am (even if you are usually in bed by 10:30 pm), try reading (or doing something relaxing) somewhere else until 11:30pm, and actually going to bed then. Although this will seem like a late bedtime, you will likely find that you are falling asleep more quickly than you normally would, spending less time awake in bed. This is the association that you want your brain to develop between bedtime and sleeping.
   • Once you’ve established a bedtime at which you can reliably fall asleep in a reasonable time (about 30 minutes), try pushing the bedtime forward by 30 minutes. For example, if you’ve established that you are able to fall asleep by 12:00 am consistently with a bedtime of 11:30 pm, try now to change your bedtime to 11:00 pm (to fall asleep at 11:30 pm). Keep up the new bedtime for a week, and once it’s comfortable move it forward again, to 10:30 pm. Keep at it until you are falling asleep at the time that you would like.
     • This will require LOTS of dedication, and slip-ups will happen. Don’t let a slip turn into a slide.
3. On weekends, your schedule may change. You’ll likely wake up later, and go to bed later also. However, do your best to keep it consistent. Two out of seven days is not going to hurt you in the long run, but during the adjustment-to-new-clock phase, it will be easy to let one late night ripple into the rest of the week. Do your best to keep on track!
4. No caffeine after 3 pm!
5. Relaxing activities (ie. baths) are good for calming yourself down before bedtime
6. No screens 15 minutes before bedtime (I find this one hardest to follow)

I’m hoping, with this advice, to finally get enough sleep on weeknights. It’s been working so far for me, hope it can work for others too!

Anyone else has any other sleep hygiene tips?