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Improving sleep

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Re: Improving sleep

#101

Post by nunez »

Four things that doing six months of CBT-i (Cognitive Behavioral Therapy for Insomnia) taught me are:

- Routine is EXTREMELY important (I.e. getting in bed and waking up at the same time, every day, even weekends)

- The best way to associate the bed with sleep (and, thereby, falling asleep more quickly) is to ONLY use the bed for sleep and sex,

- You're gonna have bad nights, but the key to preventing the insomnia from spiraling out of control is to remember that "you WILL go back to sleep; it's natural," and

- Sleep drugs (zzzquil, trazodone, seraquel, ambien, etc.) used daily are a bad deal for most people

Two visits with a bona fide sleep doctor taught me is:

- it's probably sleep apnea, and - lots of people have it!

I used to have a really hard time falling and staying asleep. My sleep patterns looked something like OPs, with lots of time asleep but even more time in bed.

CBT-i fixed that.

I needed to do it with a therapist to get the most out of it, but there is a free app in the App Store (CBTi Coach) that guides you through it.

I have no issues falling asleep now, and my total time in bed (TTIB) is very close to my total time asleep (I.e. my sleep efficiency is very high).

I still struggle with maintenance insomnia (staying asleep). As far as I understand it, this kind of insomnia is usually invoked as a protection mechanism against something that one's body perceives as a threat.

I am (finally!) getting a sleep study done to verify whether it's sleep apnea or something behavioral.

Re: Improving sleep

#102

Post by zingababba »

FirmwareBurner wrote: post #4

Biggest improvement to sleep quality I had was giving up caffeine, which isn't mentioned in this article. I'm inclined to bet, most people in the west who self report suffering form poor sleep, can narrow it down to caffeine over-consumption, since it leads you slowly to this march of death burning the candle at both ends where you drink coffee to compensate for poor sleep and you sleep poorly because of too much caf…

Same, quitting caffeine made a massive difference in my sleep. Daily consumer for 20 years, quitting suuucked and took me probably 20 tries but finally did it. My mind works so much better now.

Re: Improving sleep

#103

Post by nunez »

bookaway wrote: post #22

I don't use any of them, but I've heard firsthand from some like the author complaining about inaccurate data from devices like the Apple Watch and Oura, some getting rid of them due to this. Since the OP continues to use them, am I to understand there is no better alternative that is comparable on the comfort/ease-of-use/cost-effectiveness axis with these devices? The idea of making health decisions based on bad dat…

Outside of devices used for sleep studies, sleep tracking is notoriously inaccurate in general.

There is even a condition for people who develop insomnia from sleep tracker anxiety. It's called orthosomnia, and you can learn more about it here: https://www.sleepfoundation.org/orthosomnia

I used to use AutoSleep religiously. It told you how much "sleep debt" you've accumulated. I've definitely lost sleep over worrying that I wouldn't "pay down" the debt (a useless endeavor, since sleep quality is something that's mostly out of your control once you're asleep).

These days, I just use Apple's built-in sleep tracker, and I don't put too much stock into it.

Re: Improving sleep

#104

Post by zingababba »

necessary wrote: post #80
FirmwareBurner wrote: post #4

Biggest improvement to sleep quality I had was giving up caffeine, which isn't mentioned in this article. I'm inclined to bet, most people in the west who self report suffering form poor sleep, can narrow it down to caffeine over-consumption, since it leads you slowly to this march of death burning the candle at both ends where you drink coffee to compensate for poor sleep and you sleep poorly because of too much caf…

It has been incredibly hard for me to quit as the consumption of caffeine feels directly tied with work performance and mood for me. It also doesn’t help that I love the taste of coffee and the routine.

Exactly why I had such a hard time quitting. I kept rationalizing it by telling myself that abstaining was killing my productivity (it was in the short term.) But after /finally/ quitting it has absolutely been worth it and my productivity is back to where it was plus it's not in manic bursts like it was with caffeine use.

Re: Improving sleep

#105

Post by nunez »

tallanvor wrote: post #57

Keep in mind that everyone is different, and there may come a point where you have to accept things as "good enough", but from my time seeing a sleep specialist, these are the best ways to improve your sleep quality: 1. Get up at the same time every day. Try not to push it more than an hour later on the weekends, or two hours on vacation. 2. The old adage about getting 8 hours of sleep isn't right. Many people don't…

#4 is a big one.

The more time one spends in bed not sleeping or having the sex, the more likely it becomes that they will struggle with falling asleep.

That said, some people are built different and can do all sorts of crap in bed and still sleep alright.

Re: Improving sleep

#106

Post by FirmwareBurner »

Balgair wrote: post #87
necessary wrote: post #80

Earlier quoted context omitted.

It has been incredibly hard for me to quit as the consumption of caffeine feels directly tied with work performance and mood for me. It also doesn’t help that I love the taste of coffee and the routine.

There are a lot of good decaf coffees out there. Also teas. You don't have to give up the taste or the ritual to cut back on the caffeine, you don't even have to give up caffeine totally. You can cut down a lot on it too.

All decafs I tried tasted like ass. And I buy quality beans from the hipster roasters.

Re: Improving sleep

#107

Post by Rewrap3643 »

nunez wrote: post #101

Four things that doing six months of CBT-i (Cognitive Behavioral Therapy for Insomnia) taught me are: - Routine is EXTREMELY important (I.e. getting in bed and waking up at the same time, every day, even weekends) - The best way to associate the bed with sleep (and, thereby, falling asleep more quickly) is to ONLY use the bed for sleep and sex, - You're gonna have bad nights, but the key to preventing the insomnia fr…

Trazodone should not be compared with those other drugs. It is hardly anticholinergic, and it lacks many of the side effects of Seroquel or Ambien. It can actually improve sleep architecture; it acts as a slow-wave sleep enhancer. In addition, it may increase the "arousal threshold" in certain patients with sleep apnea. This translates into less disruptions to sleep overall. [1][2]

Comparing this to something like Ambien- which disrupts sleep cycles and correlates with increased mortality overall- just isn't factual. [3]

Anecdotally, a low dose of trazodone (25 mg) prevents sleep maintenance insomnia for me. You should definitely have a sleep study done regardless. Wishing you some restful sleep!

[1] https://pubmed.ncbi.nlm.nih.gov/30689583/

[2] https://pubmed.ncbi.nlm.nih.gov/25719754/

[3] https://pubmed.ncbi.nlm.nih.gov/30353805/

Re: Improving sleep

#108

Post by superultra »

FirmwareBurner wrote: post #4

Biggest improvement to sleep quality I had was giving up caffeine, which isn't mentioned in this article. I'm inclined to bet, most people in the west who self report suffering form poor sleep, can narrow it down to caffeine over-consumption, since it leads you slowly to this march of death burning the candle at both ends where you drink coffee to compensate for poor sleep and you sleep poorly because of too much caf…

I’m curious how much coffee you drank, and others who drank coffee, quit, and had similar results.

I drink one 10oz cup a day. Occasionally more but rarely. I do love it.

Knowing that everyone’s physiology is different, I wonder if I would generally see notable gains in quitting 1 cup a day.

I find that the people who say quitting made a difference were often drinking a pot a day. But maybe that is not true for you?

Re: Improving sleep

#109

Post by erictd »

I don't want to give up caffeine, but I have my two shots before 7 or 8am and that's it for caffeine. You didn't mention alcohol, maybe you aren't a drinker? Giving up alcohol for ~4 days definitely improves my sleep - no 2am wakeups, more dreams - but then it's the weekend again, whoops. If I can't fall back asleep after around 15-30 minutes, I get up and read for an hour; that always works. I try to think in terms of sleep cycles - did I get enough? can I get one more? I'm surprised a sleep mask doesn't improve sleep onset. I am addicted to my scarf eye cover's total darkness.

Re: Improving sleep

#110

Post by eyelidlessness »

FirmwareBurner wrote: post #106
Balgair wrote: post #87

Earlier quoted context omitted.

There are a lot of good decaf coffees out there. Also teas. You don't have to give up the taste or the ritual to cut back on the caffeine, you don't even have to give up caffeine totally. You can cut down a lot on it too.

All decafs I tried tasted like ass. And I buy quality beans from the hipster roasters.

Maybe see if one of those roasters mentions the Swiss water process. IME it makes for quite good decaf (and I too have a hipster’s taste in coffee).
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