Why Can’t I Sleep?

Notably usually absent or poorly followed: - waking up early, at the exact same time, every day. - as SOON as you get up, you need to eat a heavy breakfast of fats and protiens with as few carbs as possible. Some people think they are special snowflakes who "have never been able to eat in the morning", you need to practice it and get in the habit then you will be able to. - ACTUAL psychological separation of bed, and screen areas. - not sleeping in the same bed as someone else to those it applies to - keeping your room around 20 degrees, if you cant decide, colder is the preference for sleep as we did not evolve with masses of blankets and insulation. - understanding and handling rumination, more complex but if you handle tasks in a way that leaves you with unresolved threads all the time, you will ponder on them endlessly. This must be handled sensibly.

Sleep duration is just a single metric; apnea, REM+NREM3 duration etc. all matter. You may be getting as much REM+NREM3 in 6.5 as someone gets in 8... and if you don't have apnea, you might get WAY more actual sleep than most people.

I went through a period where I believed my body would only accommodate a certain amount of sleep. Once I stopped caring about sleep duration... that duration slowly increased to eventually revert to 'normal'.

The key is to just _stop_caring_ about it. Do everything right, and let your body/mind handle the rest. It doesn't happen overnight.

I did this for years. Felt great for a while, then starting having noticeable impacts on my ability to focus, my mood, and my physical health.

The same old advice took close to 6 months to really start helping me. It was an absolute grind to stick to a wake + bedtime routine. The discipline it takes is absolutely insane (weekends were the hardest). I stopped and started over and over and over again, but eventually stuck to it.

Low/medium dose ambien once or twice a week was the the thing that really got me into the habit/routine. Medication is not a long term fix (especially this stuff), but this was enough to get me through the fitful nights for a few months--it stopped me from getting out bed and breaking the routine.

Anecdote, so as usual, ymmv.

Try the benzos or a mild andidepressent (discuss with your doctor of course). Do not take more than the prescribed dose (maybe even start with half of it). The important thing is to use it along with a solid bedtime routine. Same time, lights out, no TV, etc. I had a bad experience with it when trying to use it as a replacement for a bedtime routine, but its been wonderful in addition to a routine when I needed the help.

GPs & sleep medicine physicians are worthless for insomnia issues. You need to see a psychiatrist. Sleep issues are a huge component to mental health treatment, so they have much better insights. And since you've correctly identified that anxiety is related to sleep loss, psychiatric help is doubly useful.

Talk to a psychiatrist about low dose trazodone, mirtazapine or seroquel. They have relatively good safety profiles and are not habit forming like benzodiazepines. They also act like a safety blanket; I know that if I'm having trouble sleeping they will knock me out and right the ship. That is super helpful at releasing the anxiety around 'I can't sleep'.

And of course, if you have other stressful things in your life, you need to focus on working them out. Stress doesn't just 'release itself' because we are going to bed. Having a high base level of stress throughout the day makes sleep difficult for _everyone_.