What I Do To Overcome Insomnia & "Why it Works"
I mention this in the article but I feel like I can't stress it enough: I don't have a medical or science-based degree of any kind. All the information I am sharing with you is just what I have learned over the years when doing my own research on sleep. That being said, I hope this either helps or entertains you.
It's kind of funny; I had been planning on writing about this for about a month now because I had finally been sleeping pretty well for the first time in years, and I wanted to share what I had found to work for me since so many people with Multiple Sclerosis (MS) are in the same boat. But for whatever reason, the last couple of weeks have brought insomnia back into my nightly life. Insomnia, the inability to fall or stay asleep, something you probably know all too well about. Well, I guess I was never going to claim that "I had cured insomnia," just that I had developed a good strategy for beating it (for me at least). But whether it is a strategy in sports, combat, a game of chess, or whatever, one thing is the same about every single strategy out there: it doesn't always work. It could be the best strategy known to man, but that doesn't mean it is immune to defeat, and as I have learned in the last couple of weeks, my personal strategy for overcoming my insomnia is not exempt from that rule. Nonetheless, today I want to talk a bit about what I have learned about sleep and how I have used what I have learned to finally get some shut-eye.
Sedation is not the same as sleep
First and foremost, let's start this off with what I found to be a rather disappointing truth about sleep: the "sleep" you get after taking a "sleeping pill" is not the same as natural sleep, at least not the “falling asleep” part. Technically, this medication just sedates us, and sedation is not the same as sleep, so when you are sedated your brain doesn't get to experience the same benefits it does when it is asleep. I suppose this is one possible reason why you can sometimes take a sleeping pill, sleep for 10 hours, and wake up feeling like you didn't sleep at all. Maybe you never actually switched from being sedated to being asleep? I don’t know. Keep in mind, I am no expert. I don't have any sort of medical or science degree, this is just what I gathered in my own personal research, and what I used as the basis for my quest to catch some Z's.
Different brain waves
Anyway, the scientific side of this is kind of simple; when we monitor brain waves (the electrical activity of our brains) using an electroencephalogram (EEG), we can see that our brain waves are different when we are awake than they are when we are asleep. Obvious, right? Our brains are doing something different when we are asleep than when we are awake. Similarly, when we measure our brainwaves when we are sedated and compare them to when we are asleep they are also not the same because something different is going on in there. Maybe not as obvious…
Natural sleep involves a pretty specific pattern of brain waves that make up the sleep cycle which consists of 5 sleep stages (the last of which is the popular REM sleep) and lasts about 90 minutes. When we take a sleeping pill, we are basically trying to make it easier to slip into this cycle; rather than going from wakefulness to sleep, we are trying to transition from sedation to sleep. Now don't get me wrong, I have nothing against sleep medication because I, unfortunately, have to turn to it on a pretty regular basis. But after I spent a good amount of time reading about what sleep is and how it works, I realized that all those pills my doctor gave me when I told him that I couldn't sleep were just a tool to try to help get me to the finish line. In terms of strategy, sleep medication can definitely help you achieve the goal, but just because it may help doesn't mean it is the only or best strategy. Regardless, I just felt like I take so many pills, and when I realized I was depending on a pill to get me to sleep, and I was depending on another pill to keep me awake, I decided I needed to come up with a new strategy for sleeping. How else could I achieve sleep without the use of medication?
Training my brain to enter the sleep cycle
I honestly can't remember a time since my MS diagnosis that I could turn my brain off for the night without popping a pill before bed. I am not saying I have never been able to fall asleep on my own, just that it was always such a rare thing for me. So when I sat down to come up with a new strategy, I pretty much thought of it like this: for most my life I had been able to fall asleep on my own, but after MS entered the picture and sleep became more and more difficult to achieve, I started taking sleep medication more often. This meant (to me) that my brain had slowly started to depend on this medication to fall asleep and as a result, slowly forgot how to enter the sleep cycle on its own (at least that’s how I saw it). So how could I learn to sleep without the use of medication? Yes, learn, I said learn; how could I actually train my brain to transition into the sleep cycle without first being sedated?
Creating a bedtime ritual
One of the first strategies I came across online was something the National Sleep Foundation actually recommends: creating a bedtime ritual. I am not talking about a ritual involving lighting candles, chanting, and tapping into the spiritual world (I mean you could do that if it helps you), I am talking about creating a routine. A routine that you do every night before bed to help teach your brain that it is time for sleep, which of all the things I now do, probably helps the most.
Avoiding artificial light
Most experts would agree that one of the most important parts of this routine is to avoid lights for about one hour before you plan on going to bed, especially artificial light like that of your phone, computer, or TV. Our brains depend on the information our eyes send it to know when it is time to start shutting down. Think about it in terms of ancient man; when the sun comes up it is time to wake up, and when the sun goes down (robbing our eyes of light) it is time to go to sleep. You see, when our eyes tell our brain that the daylight is starting to fade our brain starts to produce a hormone called melatonin which tells the different parts of our brain that it is time to start calling it a night. But when our eyes tell our brain that it is still light out, the production of melatonin is inhibited which is why it is so important to turn off all our electronic devices before we go to bed. Our screens produce a blue wave of light that is similar to a blue wave of light produced by the sun, so staring at a screen before bed is basically telling our brain that there is still sunlight out and that it is not time to go to sleep.
Do something relaxing
Instead, it is recommended that you do something relaxing away from bright light, something like reading a book. Now that may not be an option for you much like reading isn't really a good option for me (thanks to my awesome MS-vision), but I still tried to develop a routine based on this idea of light and doing something that I only do before bed so my brain would know it's time to go to sleep. I bought a dimmer switch for one of my lamps and put the other (which uses a bright white LED bulb) on a timer so that at the same time every day the bright light turns off, and I would slowly begin to dim the warm light from the other lamp more and more as the night progressed (like how the light outside begins to fade as the sun sets). During this time, I would turn off all my screens, as well as the notifications I get on my many devices, and listen to relaxing music or an audiobook to help get my mind off work while I started to get ready for bed.
Other sleep strategies
Once in bed, I would practice other sleep strategies like imagining that one body part at a time was becoming paralyzed and not responding to any sudden urge to turn over, stretch, or scratch some random itch on my skin (try it, it’snot that easy haha). I also listen to binaural beats (or some other form of sleep/meditation music) with my headphones while practicing to not think about everything there is to think about. This is all much easier said than done which is why I said before that it might involve a degree of learning and practice. Lots and lots of practice.
Sleeping is a skill
Sleeping is a skill, and while there are lots of strategies to get better at it, there are no, as I learned, fail-proof methods. You sort of just have to figure out what works best for you to better fall asleep. Maybe, with time and practice, you will be able to depend less on medication? I know I did for a while, but again, I am not saying that I think there is a way to indefinitely eliminate sleep medication from your life, especially not when you have MS because insomnia is like any other symptom; sometimes something random just triggers it and there really isn't much you can do to stop it. When this happens, I can definitely say I would rather be sedated than staring at the ceiling all night.But even so, I still think there are ways to better deal with insomnia than just taking a pill, and that is all I am trying to do for myself, find a better way. Right now, because I haven’t been sleeping well, I am taking medication as well as re-establishing the routine I seem to have drifted away from so that I can depend less on pills, or at least spend less time watching the clock at night. So hopefully this little bit of knowledge is enough to help you to start learning to sleep better or even motivate you to start to research different ways that you can start to improve your sleep. On average, people are asleep for about 1/3 of their life, and I would say that it is worth learning how to get better at something we do (or try to do) so much of.
Do you celebrate your MS Anniversary?