9 ms·

Algorithmic Solution to My Insomnia

253 points by csmajorfive 9y ago

amasad 9y ago
I naturally stumbled upon this method but it's nice to have it formalized. At first I noticed how insomnia fed on itself and noticed how I start to question my ability to fall asleep and as the night comes around I start feeling anxious. I'm familiar with CBT methods for treating other issues so I naturally tried to break the cycle by doing basically what Ilya's talking about. It worked well for me but I always reverted to my old ways when I think I'm "cured" only to have insomnia strike back. I'm going to try to be regimented about it and see if this helps me long-term.
zaptheimpaler 9y ago
To the author - can you please share the name of the researcher who did the CBT-i program? It would help me and many others. Email me (link in profile) if you cannot post it here. Thanks.
rdudekul 9y ago
More than Insomnia I used to have sleep patterns where my mind wouldn't quiet down. After I started practising meditation, specifically the 8 point "Passage Meditation", I started experiencing a much better quality of sleep. http://bmcm.org/ http://bmcm.org/ For those who do not have time for meditation, you may find the second point called Mantram (repetition of holy name) useful: https://www.bmcm.org/learn/mantram/ https://www.bmcm.org/learn/mantram/
partycoder 9y ago
Pseudoscience! If you have sleep issues go see a healthcare professional. Don't follow advice from random strangers on the Internet. The circadian rhythm (aka sleep cycle) is regulated by a hormone called melatonin (not to be confused with melanin). It is produced by the pineal gland after exposure to light. Light intensity from artificial light is usually low (unless you use luminotherapy lamps), leading to melatonin production issues, which affect sleep. You can solve that by spending a bit more time outside. If you happen to live in a place with dark winters, get a luminotherapy lamp. Other than that, there are other aspects that have to do with how tired you might feel... nutrition, hydration, exercise, etc. You can do all of that correctly while still having insomnia.
- csmajorfive 9y ago
  I'm not sure what part you found to be pseudoscience. This technique was prescribed to me by a healthcare professional and can be found in medical journals. And, I fully agree -- light is important. Maybe I'll add an addendum on that.
  - partycoder 9y ago
    Melatonin has a strong influence on the circadian rhythm regulation and is nowhere to be found in the article. If you suffer insomnia this is where you should be starting with. PS: I suffered insomnia, spent a lot of time working through it, and got medical advice. Prefer residences and offices with natural light, or take a walk outside around noon (wear sunscreen). There you go... Then, amount of papers doesn't necessarily translate into scientific rigor. Since research universities adopted a "publish or perish" policy there's a deluge of junk science. update: corrected typo
    - csmajorfive 9y ago
      Thanks for the feedback. I'll add that to the "common wisdom" invariants to clarify that's an assumed prerequisite. FWIW, I live in California and spent four months on the beach prior to undergoing this regimen.
    - disinterred 9y ago
      This algorithmic method is a useful addition to the insomniac's toolkit. Please don't berate methodologies based on logic and then describe anecdotes with poor english (wtf is "singlest"?).
      - partycoder 9y ago
        Or placebo effect, we don't know. It's self experimentation, there's no control group, no accompanying data, etc. The perceived improvement could be due to other reasons rather than the therapy itself. Usually you establish a relationship between the therapy and results through something like statistical significance but this was not the case. Then, it is important to be responsible when offering health related advice to people. If you are not a healthcare professional, start saying: 1) Follow this advice at your own risk 2) I am not a healthcare professional this is a casual exploration of my sleep cycle. I think this is more responsible than implying this followed some sort of scientific approach. PS: rather than the ad-hominem try to add value to the discussion staying on topic.
PowerfulWizard 9y ago
Semi related, I had occasional trouble sleeping at the designated time (I would sleep an appropriate amount, but but not when I wanted to.) After reading gwern’s page on melatonin I tried it since it is easy and low risk, and now I can fall asleep consistently when I want to, by taking melatonin X minutes before. https://www.gwern.net/Melatonin https://www.gwern.net/Melatonin
lazyeye 9y ago
Here's what works for me:- Where blue-blocker glasses 2-3 hrs before bed. This has a big impact for me. https://www.swanwicksleep.com/products/swannies-blue-light-blocking-glasses https://www.swanwicksleep.com/products/swannies-blue-light-b... Swanwick make prescription blue-blocker glasses which I havent seen anywhere else. Try Uvex brand if you want something cheaper. A teaspoon of magnesium powder in a glass of water (about an inch full) before bed A hot shower about an hour before bed. Nasal spray before bed to improve breathing.
- sytelus 9y ago
  Any idea how this compares to Lenscrafter's Blue IQ lenses? Also what is this nasal spray?
- ta98789878 9y ago
  I got mine from here: https://www.readingglassesetc.com/ https://www.readingglassesetc.com/ (It took me forever to find that site when I was first looking. I don't Swanwick was making a prescription version then. Or maybe they were, but I didn't like the style.)
arikrak 9y ago
- I wonder what are the best ways to treat early morning awakening. I guess the sleep deprivation technique mentioned in the article could be a possible solution. Though it wouldn't be very helpful if it didn't last long term. - If one's tired during the day it might be worth getting tested for sleep apnea. You can see if you're likely to have sleep apnea by answering the eight questions here: http://www.stopbang.ca/osa/screening.php http://www.stopbang.ca/osa/screening.php
- csmajorfive 9y ago
  - Do you mean how to wake up best? If so, I can share some techniques I learned. - That's a really good point. I forgot that I was screened for it. I'll add that to the post.
  - arikrak 9y ago
    I meant how to avoid waking up too early. (Some techniques seem more geared at helping people fall asleep.)
    - csmajorfive 9y ago
      Ah, yeah, I found the CBT-i regimen naturally helped with that.
AznHisoka 9y ago
This is something I discovered awhile ago as well, and it definitely works. Some people call this "sleep restriction therapy". It's not well known, unfortunately, and I agree with the OP: a lot of the advice you find are just so hackneyed.
petilon 9y ago
I have seen multiple doctors, including sleep specialists, about my insomnia, and all they wanted to do is put me on prescription sleep meds for life. Those meds are addictive. I didn't want sleep meds. As a software engineer I was more interested in finding and fixing the underling problem -- there has to be one -- as opposed to the quick fixes the doctors were offering me. But that's not how doctors think, at least the ones I saw. After much research I believe I have succeeded in finding the root cause. Cells in your body need calcium to go into ON state, and to turn OFF magnesium needs to go in and displace the calcium. Stress depletes magnesium. When your body runs out of magnesium your cells can't turn off. Then your muscles become stiff and when your brain cells can't go into OFF state you can't sleep. The solution that works well for me: magnesium supplements, especially magnesium l-threonate, which can pass through what is known as the blood brain barrier. This solved my insomnia as well as muscle stiffness.
- agumonkey 9y ago
  I recently got difficulty to sleep. Gonna try and see if magnesium helps. Thanks
- nyrulez 9y ago
  Mg is one of the best supplements out there. For sleep and general stress. You can literally feel more chill the next day.
- senatorobama 9y ago
  What is your intake schedule for Magnesium?
- sytelus 9y ago
  Below is from nih.gov [1] - Adults age > 30 usually need 420mg of Mg however more than 350mg from supplements is discouraged - Going little bit over for Mg seems ok because kidneys just exerts it to urine. However very high dosage like 5000mg would cause magnesium toxicity. - Multivitamins like New Chapter Calcium tabs have 770mg Ca and 58mg Mg. This means these should be taken in morning. - Nuts like Almonds and cashews have tremendous amount of Mg. Just 4-5 ounces of these nuts will make up for daily dose. - Diets with higher amounts of magnesium are associated with a significantly lower risk of diabetes. - Magnesium is involved in bone formation and influences the activities of osteoblasts and osteoclasts - People who experience migraine headaches have lower levels of serum and tissue magnesium than those who do not. [1] https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ https://ods.od.nih.gov/factsheets/Magnesium-HealthProfession...
pyrrhotech 9y ago
step 1: don't trade crypto
ohhhlol 9y ago
sounds like you are calculating & shifting your "dim light melatonin onset" (DLMO)
agumonkey 9y ago
Got me to search for more: https://www.reddit.com/r/science/comments/382vyw/a_simple_onehour_therapy_session_has_helped_to/ https://www.reddit.com/r/science/comments/382vyw/a_simple_on...
phirschybar 9y ago
I suffered from insomnia as a child and it peaked when I hit 12-14 yo. My pediatrician told me to do EXACTLY as you suggest, namely "If you’re in bed for more than 20 minutes and haven’t fallen asleep yet, get out and do something else.". Basically, don't use your bed as the place to TRY to sleep. Only sleep there. This worked like a charm for me and I haven't had sleep issues since.
rsaarelm 9y ago
Why does the "make your target time earlier" branch have the upper limit of 0.95? There's already a "stay the course" region in [0.8, 0.9], shouldn't you move your sleep time earlier for anything above 0.9?
- csmajorfive 9y ago
  Good question. In my experience there is a danger of over-optimizing, trying to get too much sleep, and then regressing again. Some of the literature agrees with you though.
depressedpanda 9y ago
I have a form of insomnia where I just can't convince myself that I should just go to sleep and stop checking YouTube, hackernews, Wikipedia, various interesting articles. At it's core, solution presented in the article -- apart from methods for dealing with anxiousness -- is to deprive oneself of sleep, but making sure to always wake up at the same time. My issue is that I don't have any major problems when getting little sleep and I don't have anxiety. I just want to do more than there are hours of the day. Several days of too little sleep do end up being detrimental, however, so I would really like to break this habit. I would love to hear if anyone here knows of a way to deal with not wanting to go asleep, because there are other more interesting things to do. How do you convince yourself that you want to go to bed most of all, and not do anything else?
- gamerDude 9y ago
  For me. It is just habit. You go to bed at a certain time. And you reward yourself for doing it. Basically any habit is formed by the set of trigger, action, reward. The trigger is something that happens, an alarm, seeing a time on the clock etc. The action, get ready and go to bed. The reward needs to release dopamine. That can be as easy as just congratulating yourself. Other methods including enrolling other people into it. Your significant other either going to bed with you or keeping you accountable. Friends who will give real consequences for failure. A system that auto donates money to a charity that you hate or a personal enemy if you don't go to bed in time. Etc.
- zaptheimpaler 9y ago
  I had (have) a similar problem. For me it was a few things: 1. I did not recognize I was stressed, but I was - a lot. One day I bought a smartwatch that tracks stress levels (Garmin Vivosmart) and saw how high it was: 80-90/100 most days. That opened my eyes. You can be stressed and not know it. 2. I manage anxiety. First step was observing when it is there, what exactly it feels like. For me, it often manifests as jaw pain, body aches, tinnitus, tunnel vision, "narrow" thinking etc.. Then strategies to lower anxiety - quit smoking, meditation, more than anything building awareness of what it feels like for you so you can manage it - meditation helped with that. 3. Crystal clear goals, detailed goal-setting, and an acceptance of/commitment to slow and steady progress. Compulsions to read "interesting" stuff came from either a desire to escape the present moment, or idea that I was not reading/learning enough - which was a vague, unreachable goal that feels forever out of reach given the infinite amount of content on the web. 4. Feeds are designed to be addictive - stop it. Just don't do it for a few days and see how much clearer your mind is. And you will probably realize you don't "learn" anything from that kind of unstructured dopamine-seeking - it is more like watching TV all day than learning. Basically i had forgotten what relaxation feels like, to the point where anxiety-driven thinking felt completely normal. It is not. Find ways to reduce anxiety even if you don't think you are anxious and stick with them - nagging thoughts, random pains, tunnel vision kind of thinking are all signs of anxiety. I'm still working on it, but this was a huge revelation to me - the idea that when you are anxious for long enough, you literally forget what calm feels like. Well actually the idea itself doesn't do much for me, but experiencing it.. that changes things. This post is nice too (no affiliation at all): https://medium.com/the-strategic-review/background-ops-2-keystone-5d068b4f56a6 https://medium.com/the-strategic-review/background-ops-2-key...
JesseAldridge 9y ago
I also have pretty serious stress induced insomnia like the author describes. This sleep deprivation stuff didn't really help me. In fact, I wonder how much it really helped the author. I know I've tried various strategies and proudly proclaimed myself cured on a number of occasions only to have the sleeplessness return the next time shit hit the fan. I recently bought this sleep tracking thing which works really well: https://www.beddit.com/ https://www.beddit.com/ It's a thin strip that goes under your sheets and talks to your phone. It tracks heart rate and respiration and as far as I can tell it's quite accurate. The things I've found most helpful are cognitive restructuring and the relaxation response. Both of which are recommended in this book: https://www.amazon.com/Say-Good-Night-Insomnia-Drug-Free/dp/0805089586 https://www.amazon.com/Say-Good-Night-Insomnia-Drug-Free/dp/... Cognitive restructuring is part of the CBT stuff mentioned by the author. You catch yourself thinking thoughts like, "Oh shit I'm going to be so stupid tomorrow" and argue against them with thoughts like, "I've managed to do my job on no sleep before and I can do it again. Worrying won't help." The relaxation response is very similar to mindfulness meditation: you systematically relax every muscle in your body while taking slow deep breaths that expand your belly. You do this for 15 minutes at some point in the middle of the day. You can also do mini versions of it for shorter sessions integrated into your regular activities. The point is to lower cortisol levels. If your cortisol levels get elevated during the day, they tend to still be high at night which makes it hard to sleep.
shameerc 9y ago
"Never get in bed and try to sleep because “it’s bedtime”. Only get in bed when you are dying to go to bed" This is one important thing I've learned. I try to read books until I feel sleepy and then go to bed.
- Fnoord 9y ago
  If I brush my teeth (+ all other things in preparation such as locking the door, feeding the cats, etc) and go to bed, then read (without disturbing my partner) then I am ready to fall asleep as soon as I feel tired. However, if I stay up without brushing my teeth (+ the other preps) then I cannot go to sleep right away when I'm tired. Because I still got errands to do. When I read in the first situation I am already lying in bed horizontally. In the second situation I am sitting. Also, while you're reading, you should use an e-reader without much blue light.
machiaweliczny 9y ago
If you have trouble with sleeping and are using computer late at night - remember to use flux[1]. It really helps from my experience. [1] - https://justgetflux.com https://justgetflux.com
- sytelus 9y ago
  Windows 10 now also has night light setting specifically to reduce blue light emitted from the screen and better sleep! With just press of a button it would automatically go to "night light" mode from sunset to sunrise. Very cool. I think iOS also has similar setting. Plus there are lot of "blue light" blocking screen protectors out there but most of them are from China and hard to tell which one really works.
  - Fnoord 9y ago
    Nowadays, latest versions of Android have this native (called LiveDisplay in LineageOS), macOS/iOS have this native (called Night Shift in macOS). Windows 10 have this native (as you already mentioned called Night Light). Windows was last btw. There was a time where F.lux was basically the only way to reduce blue light. BTW, F.lux has more advanced options than any of these OSes but it requires rooted device on Android/iOS. For macOS and Windows it will work out of the box.
mherrmann 9y ago
What really helps me is to keep my mind occupied when lying in bed at night. In my case, I try to solve P vs NP. That way, I actually enjoy the "sleepless" time, and am not stressed about not being able to sleep. One of the imho very interesting aspects of insomnia is the "self-perpetuating" feature. Can't sleep -> stress about not being able to sleep -> even more difficult to fall asleep. I think this is a common feature of several ailments. Another is not being able to get an erection for men or not being able to orgasm for women ("it doesn't work!" -> stress / adrenaline -> it works even less). Would be interesting to find out what common "pattern breakers" are for short-circuiting the vicious cycle. Does anyone have experiences?
- uoaei 9y ago
  I'd recommend trying meditation, since it is simply training your mind to introspect so you may recognize these moments of stress and let them go with minimal effort. But what you do can also be seen as a form of meditation, since it is also an intentional taking-your-mind-off-things.
a_c 9y ago
> Never get in bed and try to sleep because “it’s bedtime”. Only get in bed when you are dying to go to bed This is in contrary to my belief. I have insomnia for many years and I thought one of the reason was because I never had a regular schedule for sleep. Over the years I can only sleep when I am dying to go to bed. Yet, most of the days, I just can't sleep. Anyway, would definitely try out the advice
owens99 9y ago
Melatonin and Vitamin D. In modern day life, our bodies do not get enough exposure to sunlight to produce D and Melatonin, which the brain and body need to sleep well.
petercooper 9y ago
I struggled to get to sleep for years until I realized I could doze off more easily when other people were around making noise. Now I listen to audiobooks and podcasts and fall asleep within 5-10 minutes most nights. Other speech seems to shut down my internal monologue and overly sensitive threat detection circuits :-D Only mentioning in case this clicks with someone else.
ayezot 9y ago
I have had also wonderful results from CBT. However, the 'sleep restriction' part requires a lot of willpower and determination and was no easy feat for me to hold on. However, after restricting my time in bed to 5 hours for 2 weeks, I had definitely no problem getting to ZZZland after crashing in bed at midnight. By the way, there is an online digital CBT-I course available called Sleepio.
jakestein 9y ago
Cognitive behavioral therapy for insomnia was the biggest improvement I have ever made to my quality of life. Like OP, I struggled with insomnia my entire adult life. I didn't realize that sleep was a thing that you could see a doctor about. I was sleeping about 4-6 hours per night before CBT and 6-8 hours afterward. One of the amazing things about CBT is that instead of building up a tolerance, like you would with a sleep aid like Ambien, it gets more effective over time. It's self reinforcing, positive feedback loop. My sleep isn't perfect, and I still take an Ambien every once in a while like on a red eye flight. However, if you're having trouble with sleep, I can't recommend CBT highly enough.
_qbxp 9y ago
My entire life, but especially in graduate school, I've had horrible sleep. Both falling asleep, and staying asleep. I did multiple sleep studies, used sleeping medications, took supplements, tried to meditate, etc. and had no luck. I went and did CBT-I, where they had me change my sleep hygeine (all your standard recommendations of "no TV in the bedroom", etc). But the biggest thing was they had me start off by going to bed at 1 am and waking up at 5am every day for a week or two. I'd be so insanely tired, I would start falling asleep quicker and staying asleep less interrupted (this was recorded on a worksheet). Then they had me go to bed an hour earlier, record it. After a while, we found my optimal schedule (bed at 11am, wake up at 630am), and I stick to it no matter what, every single day. It's solved my sleep issues, full-stop. I get tired by 11 pm, and wake up at 6:30 am feeling just fine. FWIW, grad school - with no solid schedule - was disastrous on my sleep. Moving to my 9-5 corporate job has made scheduling my sleep a whole lot better. Just my experience.
- dkersten 9y ago
  > bed at 11pm, wake up at 630am Interestingly, this is on a 90 minute boundary, so you should naturally be in a wakeful sleep state when you awake. I’ve found that 7.5 hours is best for me too, because 6 hours isn’t long enough and 9 hours is too long, so 7.5 is the sweet spot (and anything not on a sleep cycle boundary and I wake up very tired). 11pm also seems to be the best time for me to go to bed, although I’m naturally a night person, but if I have to work, going to bed later doesn’t leave me with enough time to get 7.5 hours and still make it to work. So... I didn’t try a process like yours to find my optimal times, but mine seems to be quite similar to yours. Having said that, I’m not a light sleeper in that some noise doesn’t bother me or wake me and I normally don’t have much trouble getting to sleep, but I do find I often wake up still tired. Its mostly solved by keeping a consistent sleep schedule and sticking to 7.5 hours.
  - tarnith 9y ago
    I've found the same, more than 7.5 or less and I wake up either feeling groggy or tired.
crazygringo 9y ago
When I was younger, I'd be able to play intense video games and fall asleep right after. Now, the older I get, the more I need to force myself to relax 1-2 hours before bed -- meditation, massage, quiet reading, chill music, whatever it takes -- just to be able to fall asleep. It's a big bummer, really. It's so easy to want to code into the night -- to make that final commit at 12:30 am and then hop into bed satisfied with real progress on a project. But the reality is, I'll be wide awake until 2:30 am thinking "oh if I refactor it that way!" "what if I did that as a next step" "did I account for that edge case? can't remember...". So now I force myself to stop at 10, to give myself 2 hours to let all the thoughts fade away (and often put them in a notebook as they pop up during those 2 hours so I can let go of them), but it's frustrating.
falsedan 9y ago
> CBT Yes, good. > don’t nap I think the authors insomnia may have been more of a disturbed sleep schedule & I would consider “sufficient sleep but not in a single nightly 7ish hour block” to be different to insomnia. Pedantic blah blah insomnia refers to irreversible awakenings not simply trouble falling asleep blah blah.
- csmajorfive 9y ago
  No, I wasn't napping prior. I did get an urge to nap when the CBT-i started.
  - falsedan 9y ago
    Rad. It never occurred to me that some people could nap in the daytime after a poor nights sleep and then struggle to get to sleep and not see the connection. Glad to see I’m wrong as h*ck.
ProxCoques 9y ago
Like many people here, I've been through a long period of suffering from insomnia and tried a large number of approaches to cure it. From what I can tell, there are essentially two main causes, which can be interrelated: 1) Physiological. Things like low levels of magnesium, muscle pain, noise, temperature, light, circadian disruption, etc. 2) Psychological. Anything that leads to being anxious about not sleeping. Both can manifest either as sleep onset insomnia (getting to sleep) or sleep maintenance insomnia (waking up in the night). But here's the thing: sleep anxiety trumps all other causes of insomnia in terms of its power to prevent you going to sleep. Nobody ever felt a quiet nap coming on while running away from a lion. Not everyone who suffers from insomnia also experiences sleep anxiety (at least at first). Those people are probably only one step from a cure because they can usually find a physiological cause (hence the number of comments here about magnesium or regular sleep/rise times, for example). But grasping this fundamental point about sleep anxiety is extremely important. Regardless of whether you need more magnesium, less clocks in the bedroom, or to sleep naked etc., if you're anxious when you're trying to go to sleep then it's instantly game over. So it follows that anything that increases anxiety about getting or maintaining sleep should be avoided, even if the underlying cause is something else. For example, CBT-I's prescription of getting out of bed after 15-20 minutes of wakefulness was counter-productive for me. It made me even more anxious about going to sleep after that. So too was sleep restriction. Waiting for what seemed like an eternity every night before being allowed to get into bed at 1:00am left me a nervous wreck. Better instead to go to bed at 11:00, stay in bed and work on something that alleviates any anxiety (I used mindfulness meditation). So, if you suffer from sleep anxiety, prioritising strategies to reduce anxiety at night should be your number one aim. Everyone seems to find their own way in this. Mine was to follow the principles of ACT-I, but others may need different methods. https://contextualscience.org/acceptance_and_commitment_therapy_for_insomnia_act https://contextualscience.org/acceptance_and_commitment_ther...
tomcooks 9y ago
To cure my insomnia I look for >1h long philosophy talks on YouTube, set the video fullscreen, turn the phone face down and let my mind drift into the coziest of sleep. No worries now, only post-freudian communist distopian dreams thank you Žižek.

253 points by csmajorfive 9y ago

I naturally stumbled upon this method but it's nice to have it formalized. At first I noticed how insomnia fed on itself and noticed how I start to question my ability to fall asleep and as the night comes around I start feeling anxious. I'm familiar with CBT methods for treating other issues so I naturally tried to break the cycle by doing basically what Ilya's talking about. It worked well for me but I always reverted to my old ways when I think I'm "cured" only to have insomnia strike back. I'm going to try to be regimented about it and see if this helps me long-term.

zaptheimpaler 9y ago

To the author - can you please share the name of the researcher who did the CBT-i program? It would help me and many others. Email me (link in profile) if you cannot post it here. Thanks.

rdudekul 9y ago

More than Insomnia I used to have sleep patterns where my mind wouldn't quiet down. After I started practising meditation, specifically the 8 point "Passage Meditation", I started experiencing a much better quality of sleep. http://bmcm.org/ http://bmcm.org/ For those who do not have time for meditation, you may find the second point called Mantram (repetition of holy name) useful: https://www.bmcm.org/learn/mantram/ https://www.bmcm.org/learn/mantram/

partycoder 9y ago

Pseudoscience! If you have sleep issues go see a healthcare professional. Don't follow advice from random strangers on the Internet. The circadian rhythm (aka sleep cycle) is regulated by a hormone called melatonin (not to be confused with melanin). It is produced by the pineal gland after exposure to light. Light intensity from artificial light is usually low (unless you use luminotherapy lamps), leading to melatonin production issues, which affect sleep. You can solve that by spending a bit more time outside. If you happen to live in a place with dark winters, get a luminotherapy lamp. Other than that, there are other aspects that have to do with how tired you might feel... nutrition, hydration, exercise, etc. You can do all of that correctly while still having insomnia.

csmajorfive 9y ago
I'm not sure what part you found to be pseudoscience. This technique was prescribed to me by a healthcare professional and can be found in medical journals. And, I fully agree -- light is important. Maybe I'll add an addendum on that.
- partycoder 9y ago
  Melatonin has a strong influence on the circadian rhythm regulation and is nowhere to be found in the article. If you suffer insomnia this is where you should be starting with. PS: I suffered insomnia, spent a lot of time working through it, and got medical advice. Prefer residences and offices with natural light, or take a walk outside around noon (wear sunscreen). There you go... Then, amount of papers doesn't necessarily translate into scientific rigor. Since research universities adopted a "publish or perish" policy there's a deluge of junk science. update: corrected typo
  - csmajorfive 9y ago
    Thanks for the feedback. I'll add that to the "common wisdom" invariants to clarify that's an assumed prerequisite. FWIW, I live in California and spent four months on the beach prior to undergoing this regimen.
  - disinterred 9y ago
    This algorithmic method is a useful addition to the insomniac's toolkit. Please don't berate methodologies based on logic and then describe anecdotes with poor english (wtf is "singlest"?).
    - partycoder 9y ago
      Or placebo effect, we don't know. It's self experimentation, there's no control group, no accompanying data, etc. The perceived improvement could be due to other reasons rather than the therapy itself. Usually you establish a relationship between the therapy and results through something like statistical significance but this was not the case. Then, it is important to be responsible when offering health related advice to people. If you are not a healthcare professional, start saying: 1) Follow this advice at your own risk 2) I am not a healthcare professional this is a casual exploration of my sleep cycle. I think this is more responsible than implying this followed some sort of scientific approach. PS: rather than the ad-hominem try to add value to the discussion staying on topic.

PowerfulWizard 9y ago

Semi related, I had occasional trouble sleeping at the designated time (I would sleep an appropriate amount, but but not when I wanted to.) After reading gwern’s page on melatonin I tried it since it is easy and low risk, and now I can fall asleep consistently when I want to, by taking melatonin X minutes before. https://www.gwern.net/Melatonin https://www.gwern.net/Melatonin

lazyeye 9y ago

Here's what works for me:- Where blue-blocker glasses 2-3 hrs before bed. This has a big impact for me. https://www.swanwicksleep.com/products/swannies-blue-light-blocking-glasses https://www.swanwicksleep.com/products/swannies-blue-light-b... Swanwick make prescription blue-blocker glasses which I havent seen anywhere else. Try Uvex brand if you want something cheaper. A teaspoon of magnesium powder in a glass of water (about an inch full) before bed A hot shower about an hour before bed. Nasal spray before bed to improve breathing.

sytelus 9y ago
Any idea how this compares to Lenscrafter's Blue IQ lenses? Also what is this nasal spray?
ta98789878 9y ago
I got mine from here: https://www.readingglassesetc.com/ https://www.readingglassesetc.com/ (It took me forever to find that site when I was first looking. I don't Swanwick was making a prescription version then. Or maybe they were, but I didn't like the style.)

arikrak 9y ago

- I wonder what are the best ways to treat early morning awakening. I guess the sleep deprivation technique mentioned in the article could be a possible solution. Though it wouldn't be very helpful if it didn't last long term. - If one's tired during the day it might be worth getting tested for sleep apnea. You can see if you're likely to have sleep apnea by answering the eight questions here: http://www.stopbang.ca/osa/screening.php http://www.stopbang.ca/osa/screening.php

csmajorfive 9y ago
- Do you mean how to wake up best? If so, I can share some techniques I learned. - That's a really good point. I forgot that I was screened for it. I'll add that to the post.
- arikrak 9y ago
  I meant how to avoid waking up too early. (Some techniques seem more geared at helping people fall asleep.)
  - csmajorfive 9y ago
    Ah, yeah, I found the CBT-i regimen naturally helped with that.

AznHisoka 9y ago

This is something I discovered awhile ago as well, and it definitely works. Some people call this "sleep restriction therapy". It's not well known, unfortunately, and I agree with the OP: a lot of the advice you find are just so hackneyed.

petilon 9y ago

I have seen multiple doctors, including sleep specialists, about my insomnia, and all they wanted to do is put me on prescription sleep meds for life. Those meds are addictive. I didn't want sleep meds. As a software engineer I was more interested in finding and fixing the underling problem -- there has to be one -- as opposed to the quick fixes the doctors were offering me. But that's not how doctors think, at least the ones I saw. After much research I believe I have succeeded in finding the root cause. Cells in your body need calcium to go into ON state, and to turn OFF magnesium needs to go in and displace the calcium. Stress depletes magnesium. When your body runs out of magnesium your cells can't turn off. Then your muscles become stiff and when your brain cells can't go into OFF state you can't sleep. The solution that works well for me: magnesium supplements, especially magnesium l-threonate, which can pass through what is known as the blood brain barrier. This solved my insomnia as well as muscle stiffness.

agumonkey 9y ago
I recently got difficulty to sleep. Gonna try and see if magnesium helps. Thanks
nyrulez 9y ago
Mg is one of the best supplements out there. For sleep and general stress. You can literally feel more chill the next day.
senatorobama 9y ago
What is your intake schedule for Magnesium?
sytelus 9y ago
Below is from nih.gov [1] - Adults age > 30 usually need 420mg of Mg however more than 350mg from supplements is discouraged - Going little bit over for Mg seems ok because kidneys just exerts it to urine. However very high dosage like 5000mg would cause magnesium toxicity. - Multivitamins like New Chapter Calcium tabs have 770mg Ca and 58mg Mg. This means these should be taken in morning. - Nuts like Almonds and cashews have tremendous amount of Mg. Just 4-5 ounces of these nuts will make up for daily dose. - Diets with higher amounts of magnesium are associated with a significantly lower risk of diabetes. - Magnesium is involved in bone formation and influences the activities of osteoblasts and osteoclasts - People who experience migraine headaches have lower levels of serum and tissue magnesium than those who do not. [1] https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ https://ods.od.nih.gov/factsheets/Magnesium-HealthProfession...

pyrrhotech 9y ago

step 1: don't trade crypto

ohhhlol 9y ago

sounds like you are calculating & shifting your "dim light melatonin onset" (DLMO)

agumonkey 9y ago

Got me to search for more: https://www.reddit.com/r/science/comments/382vyw/a_simple_onehour_therapy_session_has_helped_to/ https://www.reddit.com/r/science/comments/382vyw/a_simple_on...

phirschybar 9y ago

I suffered from insomnia as a child and it peaked when I hit 12-14 yo. My pediatrician told me to do EXACTLY as you suggest, namely "If you’re in bed for more than 20 minutes and haven’t fallen asleep yet, get out and do something else.". Basically, don't use your bed as the place to TRY to sleep. Only sleep there. This worked like a charm for me and I haven't had sleep issues since.

rsaarelm 9y ago

Why does the "make your target time earlier" branch have the upper limit of 0.95? There's already a "stay the course" region in [0.8, 0.9], shouldn't you move your sleep time earlier for anything above 0.9?

csmajorfive 9y ago
Good question. In my experience there is a danger of over-optimizing, trying to get too much sleep, and then regressing again. Some of the literature agrees with you though.

depressedpanda 9y ago

I have a form of insomnia where I just can't convince myself that I should just go to sleep and stop checking YouTube, hackernews, Wikipedia, various interesting articles. At it's core, solution presented in the article -- apart from methods for dealing with anxiousness -- is to deprive oneself of sleep, but making sure to always wake up at the same time. My issue is that I don't have any major problems when getting little sleep and I don't have anxiety. I just want to do more than there are hours of the day. Several days of too little sleep do end up being detrimental, however, so I would really like to break this habit. I would love to hear if anyone here knows of a way to deal with not wanting to go asleep, because there are other more interesting things to do. How do you convince yourself that you want to go to bed most of all, and not do anything else?

gamerDude 9y ago
For me. It is just habit. You go to bed at a certain time. And you reward yourself for doing it. Basically any habit is formed by the set of trigger, action, reward. The trigger is something that happens, an alarm, seeing a time on the clock etc. The action, get ready and go to bed. The reward needs to release dopamine. That can be as easy as just congratulating yourself. Other methods including enrolling other people into it. Your significant other either going to bed with you or keeping you accountable. Friends who will give real consequences for failure. A system that auto donates money to a charity that you hate or a personal enemy if you don't go to bed in time. Etc.
zaptheimpaler 9y ago
I had (have) a similar problem. For me it was a few things: 1. I did not recognize I was stressed, but I was - a lot. One day I bought a smartwatch that tracks stress levels (Garmin Vivosmart) and saw how high it was: 80-90/100 most days. That opened my eyes. You can be stressed and not know it. 2. I manage anxiety. First step was observing when it is there, what exactly it feels like. For me, it often manifests as jaw pain, body aches, tinnitus, tunnel vision, "narrow" thinking etc.. Then strategies to lower anxiety - quit smoking, meditation, more than anything building awareness of what it feels like for you so you can manage it - meditation helped with that. 3. Crystal clear goals, detailed goal-setting, and an acceptance of/commitment to slow and steady progress. Compulsions to read "interesting" stuff came from either a desire to escape the present moment, or idea that I was not reading/learning enough - which was a vague, unreachable goal that feels forever out of reach given the infinite amount of content on the web. 4. Feeds are designed to be addictive - stop it. Just don't do it for a few days and see how much clearer your mind is. And you will probably realize you don't "learn" anything from that kind of unstructured dopamine-seeking - it is more like watching TV all day than learning. Basically i had forgotten what relaxation feels like, to the point where anxiety-driven thinking felt completely normal. It is not. Find ways to reduce anxiety even if you don't think you are anxious and stick with them - nagging thoughts, random pains, tunnel vision kind of thinking are all signs of anxiety. I'm still working on it, but this was a huge revelation to me - the idea that when you are anxious for long enough, you literally forget what calm feels like. Well actually the idea itself doesn't do much for me, but experiencing it.. that changes things. This post is nice too (no affiliation at all): https://medium.com/the-strategic-review/background-ops-2-keystone-5d068b4f56a6 https://medium.com/the-strategic-review/background-ops-2-key...

JesseAldridge 9y ago

I also have pretty serious stress induced insomnia like the author describes. This sleep deprivation stuff didn't really help me. In fact, I wonder how much it really helped the author. I know I've tried various strategies and proudly proclaimed myself cured on a number of occasions only to have the sleeplessness return the next time shit hit the fan. I recently bought this sleep tracking thing which works really well: https://www.beddit.com/ https://www.beddit.com/ It's a thin strip that goes under your sheets and talks to your phone. It tracks heart rate and respiration and as far as I can tell it's quite accurate. The things I've found most helpful are cognitive restructuring and the relaxation response. Both of which are recommended in this book: https://www.amazon.com/Say-Good-Night-Insomnia-Drug-Free/dp/0805089586 https://www.amazon.com/Say-Good-Night-Insomnia-Drug-Free/dp/... Cognitive restructuring is part of the CBT stuff mentioned by the author. You catch yourself thinking thoughts like, "Oh shit I'm going to be so stupid tomorrow" and argue against them with thoughts like, "I've managed to do my job on no sleep before and I can do it again. Worrying won't help." The relaxation response is very similar to mindfulness meditation: you systematically relax every muscle in your body while taking slow deep breaths that expand your belly. You do this for 15 minutes at some point in the middle of the day. You can also do mini versions of it for shorter sessions integrated into your regular activities. The point is to lower cortisol levels. If your cortisol levels get elevated during the day, they tend to still be high at night which makes it hard to sleep.

shameerc 9y ago

"Never get in bed and try to sleep because “it’s bedtime”. Only get in bed when you are dying to go to bed" This is one important thing I've learned. I try to read books until I feel sleepy and then go to bed.

Fnoord 9y ago
If I brush my teeth (+ all other things in preparation such as locking the door, feeding the cats, etc) and go to bed, then read (without disturbing my partner) then I am ready to fall asleep as soon as I feel tired. However, if I stay up without brushing my teeth (+ the other preps) then I cannot go to sleep right away when I'm tired. Because I still got errands to do. When I read in the first situation I am already lying in bed horizontally. In the second situation I am sitting. Also, while you're reading, you should use an e-reader without much blue light.

machiaweliczny 9y ago

If you have trouble with sleeping and are using computer late at night - remember to use flux[1]. It really helps from my experience. [1] - https://justgetflux.com https://justgetflux.com

sytelus 9y ago
Windows 10 now also has night light setting specifically to reduce blue light emitted from the screen and better sleep! With just press of a button it would automatically go to "night light" mode from sunset to sunrise. Very cool. I think iOS also has similar setting. Plus there are lot of "blue light" blocking screen protectors out there but most of them are from China and hard to tell which one really works.
- Fnoord 9y ago
  Nowadays, latest versions of Android have this native (called LiveDisplay in LineageOS), macOS/iOS have this native (called Night Shift in macOS). Windows 10 have this native (as you already mentioned called Night Light). Windows was last btw. There was a time where F.lux was basically the only way to reduce blue light. BTW, F.lux has more advanced options than any of these OSes but it requires rooted device on Android/iOS. For macOS and Windows it will work out of the box.

mherrmann 9y ago

What really helps me is to keep my mind occupied when lying in bed at night. In my case, I try to solve P vs NP. That way, I actually enjoy the "sleepless" time, and am not stressed about not being able to sleep. One of the imho very interesting aspects of insomnia is the "self-perpetuating" feature. Can't sleep -> stress about not being able to sleep -> even more difficult to fall asleep. I think this is a common feature of several ailments. Another is not being able to get an erection for men or not being able to orgasm for women ("it doesn't work!" -> stress / adrenaline -> it works even less). Would be interesting to find out what common "pattern breakers" are for short-circuiting the vicious cycle. Does anyone have experiences?

uoaei 9y ago
I'd recommend trying meditation, since it is simply training your mind to introspect so you may recognize these moments of stress and let them go with minimal effort. But what you do can also be seen as a form of meditation, since it is also an intentional taking-your-mind-off-things.

a_c 9y ago

> Never get in bed and try to sleep because “it’s bedtime”. Only get in bed when you are dying to go to bed This is in contrary to my belief. I have insomnia for many years and I thought one of the reason was because I never had a regular schedule for sleep. Over the years I can only sleep when I am dying to go to bed. Yet, most of the days, I just can't sleep. Anyway, would definitely try out the advice

owens99 9y ago

Melatonin and Vitamin D. In modern day life, our bodies do not get enough exposure to sunlight to produce D and Melatonin, which the brain and body need to sleep well.

petercooper 9y ago

I struggled to get to sleep for years until I realized I could doze off more easily when other people were around making noise. Now I listen to audiobooks and podcasts and fall asleep within 5-10 minutes most nights. Other speech seems to shut down my internal monologue and overly sensitive threat detection circuits :-D Only mentioning in case this clicks with someone else.

ayezot 9y ago

I have had also wonderful results from CBT. However, the 'sleep restriction' part requires a lot of willpower and determination and was no easy feat for me to hold on. However, after restricting my time in bed to 5 hours for 2 weeks, I had definitely no problem getting to ZZZland after crashing in bed at midnight. By the way, there is an online digital CBT-I course available called Sleepio.

jakestein 9y ago

Cognitive behavioral therapy for insomnia was the biggest improvement I have ever made to my quality of life. Like OP, I struggled with insomnia my entire adult life. I didn't realize that sleep was a thing that you could see a doctor about. I was sleeping about 4-6 hours per night before CBT and 6-8 hours afterward. One of the amazing things about CBT is that instead of building up a tolerance, like you would with a sleep aid like Ambien, it gets more effective over time. It's self reinforcing, positive feedback loop. My sleep isn't perfect, and I still take an Ambien every once in a while like on a red eye flight. However, if you're having trouble with sleep, I can't recommend CBT highly enough.

_qbxp 9y ago

My entire life, but especially in graduate school, I've had horrible sleep. Both falling asleep, and staying asleep. I did multiple sleep studies, used sleeping medications, took supplements, tried to meditate, etc. and had no luck. I went and did CBT-I, where they had me change my sleep hygeine (all your standard recommendations of "no TV in the bedroom", etc). But the biggest thing was they had me start off by going to bed at 1 am and waking up at 5am every day for a week or two. I'd be so insanely tired, I would start falling asleep quicker and staying asleep less interrupted (this was recorded on a worksheet). Then they had me go to bed an hour earlier, record it. After a while, we found my optimal schedule (bed at 11am, wake up at 630am), and I stick to it no matter what, every single day. It's solved my sleep issues, full-stop. I get tired by 11 pm, and wake up at 6:30 am feeling just fine. FWIW, grad school - with no solid schedule - was disastrous on my sleep. Moving to my 9-5 corporate job has made scheduling my sleep a whole lot better. Just my experience.

dkersten 9y ago
> bed at 11pm, wake up at 630am Interestingly, this is on a 90 minute boundary, so you should naturally be in a wakeful sleep state when you awake. I’ve found that 7.5 hours is best for me too, because 6 hours isn’t long enough and 9 hours is too long, so 7.5 is the sweet spot (and anything not on a sleep cycle boundary and I wake up very tired). 11pm also seems to be the best time for me to go to bed, although I’m naturally a night person, but if I have to work, going to bed later doesn’t leave me with enough time to get 7.5 hours and still make it to work. So... I didn’t try a process like yours to find my optimal times, but mine seems to be quite similar to yours. Having said that, I’m not a light sleeper in that some noise doesn’t bother me or wake me and I normally don’t have much trouble getting to sleep, but I do find I often wake up still tired. Its mostly solved by keeping a consistent sleep schedule and sticking to 7.5 hours.
- tarnith 9y ago
  I've found the same, more than 7.5 or less and I wake up either feeling groggy or tired.

crazygringo 9y ago

When I was younger, I'd be able to play intense video games and fall asleep right after. Now, the older I get, the more I need to force myself to relax 1-2 hours before bed -- meditation, massage, quiet reading, chill music, whatever it takes -- just to be able to fall asleep. It's a big bummer, really. It's so easy to want to code into the night -- to make that final commit at 12:30 am and then hop into bed satisfied with real progress on a project. But the reality is, I'll be wide awake until 2:30 am thinking "oh if I refactor it that way!" "what if I did that as a next step" "did I account for that edge case? can't remember...". So now I force myself to stop at 10, to give myself 2 hours to let all the thoughts fade away (and often put them in a notebook as they pop up during those 2 hours so I can let go of them), but it's frustrating.

falsedan 9y ago

> CBT Yes, good. > don’t nap I think the authors insomnia may have been more of a disturbed sleep schedule & I would consider “sufficient sleep but not in a single nightly 7ish hour block” to be different to insomnia. Pedantic blah blah insomnia refers to irreversible awakenings not simply trouble falling asleep blah blah.

csmajorfive 9y ago
No, I wasn't napping prior. I did get an urge to nap when the CBT-i started.
- falsedan 9y ago
  Rad. It never occurred to me that some people could nap in the daytime after a poor nights sleep and then struggle to get to sleep and not see the connection. Glad to see I’m wrong as h*ck.

ProxCoques 9y ago

Like many people here, I've been through a long period of suffering from insomnia and tried a large number of approaches to cure it. From what I can tell, there are essentially two main causes, which can be interrelated: 1) Physiological. Things like low levels of magnesium, muscle pain, noise, temperature, light, circadian disruption, etc. 2) Psychological. Anything that leads to being anxious about not sleeping. Both can manifest either as sleep onset insomnia (getting to sleep) or sleep maintenance insomnia (waking up in the night). But here's the thing: sleep anxiety trumps all other causes of insomnia in terms of its power to prevent you going to sleep. Nobody ever felt a quiet nap coming on while running away from a lion. Not everyone who suffers from insomnia also experiences sleep anxiety (at least at first). Those people are probably only one step from a cure because they can usually find a physiological cause (hence the number of comments here about magnesium or regular sleep/rise times, for example). But grasping this fundamental point about sleep anxiety is extremely important. Regardless of whether you need more magnesium, less clocks in the bedroom, or to sleep naked etc., if you're anxious when you're trying to go to sleep then it's instantly game over. So it follows that anything that increases anxiety about getting or maintaining sleep should be avoided, even if the underlying cause is something else. For example, CBT-I's prescription of getting out of bed after 15-20 minutes of wakefulness was counter-productive for me. It made me even more anxious about going to sleep after that. So too was sleep restriction. Waiting for what seemed like an eternity every night before being allowed to get into bed at 1:00am left me a nervous wreck. Better instead to go to bed at 11:00, stay in bed and work on something that alleviates any anxiety (I used mindfulness meditation). So, if you suffer from sleep anxiety, prioritising strategies to reduce anxiety at night should be your number one aim. Everyone seems to find their own way in this. Mine was to follow the principles of ACT-I, but others may need different methods. https://contextualscience.org/acceptance_and_commitment_therapy_for_insomnia_act https://contextualscience.org/acceptance_and_commitment_ther...

tomcooks 9y ago

To cure my insomnia I look for >1h long philosophy talks on YouTube, set the video fullscreen, turn the phone face down and let my mind drift into the coziest of sleep. No worries now, only post-freudian communist distopian dreams thank you Žižek.