What to do when you can't sleep

I’ve never been a great sleeper. On average, I get somewhere between 3-6 hours a night. I try to sleep in on the weekends when I can, but that’s not always feasible. 

Generally, I can be a pretty high functioning person on that amount of sleep – when I’m taking care of myself and eating right and exercising etc etc. But if I’m recovering from an illness, learning new things, or just generally stressed out and sub-optimal, not being able to get enough sleep can be pretty detrimental. I often make the joke that I’m not a night owl and I’m not an early bird, rather, I’m some form of permanently exhausted pigeon. 

According to the Statistics Canada Health Report on the duration and quality of sleep among Canadians aged 18-79, I’m not alone. About one third of Canadians are getting less than the recommended 7 to 9 hours of sleep a night, and about 43% of men and 55% of women aged 18 to 64 reported having trouble going to sleep or staying asleep “sometimes/most of the time/all of the time”.

This is important because a lack of quality sleep impacts not only our mood, productivity, and mental health, but it also puts us at risk for health problems like heart disease, diabetes and obesity. 

So how can you get more of the good stuff? 

Knowing what’s causing your sleep troubles is step 1. Your doctor or nurse practitioner can run some tests to see if there’s anything underlying your sleep trouble. They may schedule you an appointment with a sleep clinic to try to figure out if you have an underlying sleep apnea problem or similar condition. 

Done all of that and you’re still having trouble? 

There are some other things you can try:

1.    Use blue light filters on your electronics, or cut them out entirely 2 hours before bed. The light emitted from electronics can disrupt melatonin production – the hormone that helps you fall asleep. Can’t do 2 hours? Cutting out electronic light even half an hour before bed will help. If you still feel like you need something to help you wind down from your day, try switching to a good, old-fashioned, paperback book for your evening entertainment. 

2.    Melatonin supplements can help if your problem is falling asleep, but in general they aren’t a good long-term solution as there haven’t been many studies done to evaluate their long-term risk. If you find that they do help you, you might have a general underlying hormone imbalance problem that your doctor might be able to help solve, so it might be worth scheduling an appointment just be to sure. 

3.    If you find that melatonin doesn’t help you at all, you might want to try booking a physical therapy appointment with an osteopath. Sometimes the culprit behind sleep problems is nerve compression in the neck, either at the base of the skull or along the path of the vagus nerve. Since this nerve is responsible for your ability to turn off your stress response, cervical compression can create over-stimulation of your sympathetic nervous system, leading to difficulties with both falling and staying asleep. If stress is your issue, you might find regular relaxation massage helpful. 

4.    Cognitive Behavioural Therapy (CBT) has been found to be more effective at treating chronic insomnia than prescription sleep medication. It can help you change the thoughts and behaviours around sleep that might be contributing to your sleep problems. 

5.    White noise machines or switching to a different mattress can help if you find that every little noise wakes you up or you’re having trouble getting comfortable enough to fall and stay asleep. 

6.    Have a bedtime ritual. Don’t knock the power of routine. Having a bedtime routine will help you body switch into ‘oh, it’s time for sleep’ mode. 

The other thing I find super helpful is keeping a sleep journal beside the bed. If there are things that are keeping me awake, I take a second and jot them down. This can be anything from a to-do list for the next day or coming week, feelings I might be having, things I wish I said or did better, etc etc. Whatever might be swirling around in your head, oftentimes having it down in physical form can relieve your mind of the burden of having to carry it for you. It’s also handy if you want to write down your dreams as soon as you wake up so that you’ll remember them better. If you sleep beside someone and don’t want to wake them up to scribble in a journal, you can get a small reading light at a bookstore or online that illuminates the page but not the room.

What about you? Any tips or tricks that help you sleep?

Is Your Sleep Problem Hormonal or Neuronal?

Waking up rested from a good night sleep is one of life's underrated pleasures. One of the things I get the most feedback on after treatments is how much better my patient’s sleep. They almost never bring up sleep issues unless I ask specific questions about it during their intake, but how much better they’ve been sleeping is consistently the thing people will bring up at their first follow-up appointment (that and how much better they’re pooping - I get soooo many emails from patients about their improved bowel movements. They don’t even wait for the follow-up appointment to let me know about that one…). 

Proper sleep is important for our health for so many reasons - it’s well known that chronic sleep deficits can contribute to many chronic health conditions; it’s important for proper brain functioning, emotional responses, as well as wound healing and tissue health. 

So how can you get more, better quality sleep? Well, first off, it helps to understand if you’re dealing with a hormonal problem, a neuronal issue, or just bad behavioural habits that can impair sleep. How can you tell which is which? Does taking melatonin help? If yes, you’re likely looking at a hormonal or behavioural problem. If it does nothing for you, you’re likely dealing with a neuronal issue - for instance, an anterior C1, your first cervical vertebrae, that might be placing strain on your brainstem, or perhaps you have jaw problems and that’s placing stress on your temporal bone (the T in the TMJ), which is impacting your occipitomastoid suture, irritating your vagus nerve, which is responsible for your ability to switch out of flight or fight mode, etc.. A trip to your local, friendly osteopath will likely help you out. If it’s hormonal, seeing your doctor and naturopath can help you to get your endocrine system function optimally. If it’s behavioural, the tips below can help you get the restful sleep you need. 

1. Stay off electronic devices an hour before bed: Studies have shown that the blue light emitted from our electronic devices can prevent the release of melatonin, the hormone that makes us sleepy. So opting to read a paperback book before bed instead of watching tv or reading on an e-reader can help your body prepare for sleep. For those who just cannot turn off digital devices, you can try dimming the brightness of your devices or reversing the print so the page is dark and the text is light. There are also programs and devices that filter out short-wavelength light in the evening. 

2. Do relaxing activities to prepare your body for sleep: listen to calming music, take a warm bath before bed each night, try these relaxing stretches. It might take some trial and error, but find a night-time routine that tells your body ‘it’s time to sleep now’ and stick to it. The more you make it a routine, the more those activities will become associated with sleep and the better it will work. 

3. Avoid stimulants before bed: this should go without saying, but try to have your last cup of coffee at least 6 hours before you plan to go to sleep. Don’t drink a bunch of water before bed. Try not to eat a big heavy meal too close to bedtime, but don’t be too hungry either. Also avoiding nicotine and alcohol can be beneficial both for sleep as well as wound healing. 

4. Consistency pays off: Going to bed and waking up at the same time every day can help train your brain and body into ‘sleep time’ and ‘wake time’. The more consistent you can be with this routine - yes, even on weekends - the better your sleep will become.  

5. Delayed Sleep Phase Disorder (DSPD): A note about DSPD - this is a disorder where your natural sleep-wake cycle is off from the ‘social norm’. It’s consistently ‘shifted’ a few hours before or after what is typical for the rest of the general population. For instance, my ‘bed time’ has always been 2-3am until 8 or 9 am. Has been my entire life. Trying to go to bed at 11 pm for me would be like someone who normally goes to bed at 11 pm trying to fall asleep at 8 pm - it just doesn’t work out. I can make it manageable, the same way shift workers can train their bodies to their new sleep-wake cycle, but it’s never a great sleep. However, since becoming self-employed, I have the benefit of being able to work my schedule around it. I no longer require all of the melatonin sprays, sleeping pills, valerian teas, etc., that used to take up a lot of shelf space in my life. It can be worth a visit to a sleep clinic to diagnose so you can work your schedule around it.

6. Seek Professional Opinions: I always recommend talking to your doctor and/or seeing a sleep specialist to get to the root cause of sleep disturbances. Conditions like sleep apnea or DSPD can be helped once you know of their existence.