Ask HN: I need help sleeping, any suggestions?

I have been an anxiety sufferer for a few years now and things got quite bad last year so I decided to see a councillor and have CBT. This has helped me manage my anxiety on a day to day basis, and the worrying I used to suffer during the day have definitely calmed down. However, for the last 2 months I have been falling apart when I have been trying to go to sleep. I have been very at peace with myself, incredibly happy but then as soon as my head hits the pillow I get incredibly bad physical symptoms - intense chest pains, palpitations and this incredible feeling of adrenaline being pumped around my body - as though I have just been mugged or scared.

I have seen my doctor and physically everything is fine - my bloodwork is in perfect order and I am a non drinker, smoker and not in any way obese.

This is beginning to really effect me - I am getting no sleep and because I am getting no sleep my anxiety during the day is becoming worse and my work is suffering. I am struggling to keep going at the moment as I am just so exhausted. Even if I do get to sleep, I suddenly wake with the symptoms I described above.

As I say, I feel as though I am happy - good job, nice partner, nice home, no real worries to speak of but it is though my body has a phobia of going up to the bedroom to try and get some sleep.

What I desperately need, and what my councillor is not giving me, is ideas on how to: 1. Stop the pains from coming on in the first place (vary bed times, put film on in the background, meditate before bed etc). 2. When the pains do kick in, how to then manage those so they don't take over. At the moment, the first sign of a pain and I panic myself into thinking that I am going to get zero sleep.

If anyone has any advice or tips (no matter how stupid!), or reading that I can do/meditation techniques - anything - then I would be most grateful if you can share these with me. Thanks!

This is a temporary fix. The long term fix would be a drastic change in lifetime. Maybe living in Paris, working 32 hours a week, 2 hour lunch break might set you on the path to recovery.

Cheers!

question: Do you have trouble going to sleep, or is the trouble actually in the waking up?

advice: As someone who has trouble sleeping sometimes due to the racing mind, Sonata has worked well as a medication. It's a hypnotic, so it just helps you get to sleep - it doesn't keep you asleep. But if you can't sleep because your brain won't settle down (for whatever reason), it might be a good thing to investigate. I wind up using on a weekly to semi-weekly basis, one to three nights, until my rhythm returns.

secret: I sleep a lot better next to my spouse.

Assuming those basis are covered, how is your breathing/posture? Programmers especially can develop bad posture because of sitting all day. Make sure you don't slouch when you sit. Here is something to try - when you feel anxiety coming, immediately stand still, straighten your back, slow down your breathing taking normal size breaths (don't deep breath, just breath normally) and clear your mind for 30 seconds.

How is your sleep, do you snore loudly and don't feel rested? You might want to check if you have sleep apnea.

That's all I can think of for now. There are also drugs, both non-prescription and prescription that can help. Personally I'd only use them as a last resort.

Do you eat within 1-2 hrs before bedtime? Maybe you shouldn't. Or if you don't, maybe you should. Healthy stuff, either way, of course.

Do you do fairly strong aerobic exercise regularly? (25+ min, 3-4x/ week, work up to ~80% max hr, which is 220-age, roughly).

I beat bedtime anxiety by listening to religious audio casts on arcane topics, despite not believing in them. I find it soothing and I fall asleep within the first 10 minutes.