Do you suffer from insomnia and poor quality sleep? So do I. At least I used to, until I implemented the tool I’ll be telling you about.
Insomnia isn’t just having trouble falling asleep. It refers to sleeplessness and poor sleep quality in general. Trouble falling asleep, trouble staying asleep, waking up too early, waking up exhausted – each counts as a sleep quality issue.
Diagnosing Insomnia
If you’ve been dissatisfied with the quality of your sleep for three or more nights a week, for more than three months, you officially suffer from insomnia.
This definition may be a wake-up call for you. It was for me.
I was forced to re-examine my sleep after attending a Lifestyle Medicine course at Harvard Medical School. When Eric Zhou, PhD, from the Division of Sleep Medicine shared this definition of insomnia, it caught me off guard.
You see, most of the time I sleep pretty well.
Most of the time. Say, four nights a week. The other nights I may have trouble falling asleep or wake up way too early. It’s been a stressful year, so I hadn’t been sleeping as well or as much as usual.
Alarm bells went off: poor sleep quality, three times a week, for months. Insomnia.
Zhou emphasized something I already knew, that Cognitive Behavioral Therapy for Insomnia (CBT-I) is the “first-line” treatment (I stay on top of my health, so there wasn’t a medical issue causing sleeplessness).
The first step in CBT-I?
Keeping a Sleep Log
I went home from Boston and did this. For the next couple of weeks, I noted the following points in my journal every morning (not every sleep journal is this detailed):
- The time I started getting ready for bed (if it was unusually late, I noted why)
- The time I turned the lights out
- The time (roughly) I fell asleep
- The time (roughly) it took to fall asleep
- The time I woke up
- The number of hours I was actually asleep
- The number of total hours in bed (this is used to calculate “sleep efficiency”)
- Whether I had had wine, or exercised the day prior
- General quality of sleep
- How I felt the next day
It was eye-opening.
The Power is in The Details
For 7 of 14 nights, I slept less than 7 hours. Some nights 6 hours or less. How was this possible?
I’m normally that person who gets 7 to 8 hours, but something clearly went awry. My sleep gradually got this bad without my realizing how frequent it was.
When I looked at the log, on the “bad” nights I started getting ready for bed after 11 pm. When my husband and I reviewed this, it was usually because we’d stayed out late or stayed up late chatting. On several occasions we arrived home from short or longer road trips much later than planned. My wake-up time was also erratic.
We made a plan. I’d start getting ready for bed shortly after 10 pm every night, as those were the nights that I had gotten my best rest. Lights out before 11 pm.
If we were out, or driving in from somewhere, we had to plan to leave on time, to be home by 10 pm at the latest.
Optimize Your Circadian Schedule
Because of the importance of a consistent wake-up time, I aimed to get up at 7 am. As soon as I woke up, I’d go into the living room and open the blinds to expose myself to daylight.
After just one week, the impact was remarkable. I’d expected to have to implement the “sleep restriction” process which is the next step in CBT-I, but didn’t have to. I continued to keep a log, and within a couple of weeks was sleeping 7 to 8 hours a night, every single night. And I was sleeping much more soundly. It was like a miracle.
Try keeping a sleep log, and optimize your sleep habits based on what you observe.
It’s important to point out here that there is more to CBT-I that is beyond the scope of this article, and not all sleep problems are this simple (though many are!).
If you struggle severely with sleep, it’s critical to let your doctor know so that the issue, and appropriate treatment, can be more specifically determined.
For more information about CBT-I, Dr. Zhou recommended two online programs: Sleepio and SHUTi.
If you’re interested in reading more on the topic of sleep, check out the following article:
How To Sleep Better and Get More Sleep
Hopeless for me until my little, elderly (17 yrs old!) poodle is no longer waking me up 1 or 2 times a night to go outside. Very disruptive and hard to fall back asleep! Also, to escape chronic tinnitus,
I take clonazepam to sleep. So I’m tired and groggy every morning. In fact, waking up feeling good is beyond my comprehension…
Hi Diane, I’m so sorry to hear of your challenges. I know what it’s like to have a disruptive dog in the bed (mine is a chihuahua/terrier cross). For a time, when I was having more difficulty sleeping I had to make the very difficult decision to put her in the living room at night in her own bed. Of course it’s not so simple when your dog is elderly and has particular needs. It’s too bad it sounds like there isn’t a way for your dog to go outside or relieve itself without having to wake you (pee pads??). I can understand that you wake up feeling groggy and awful, clonazepam is pretty nasty for that and definitely a suboptimal solution. I wish you the best and hope you are able to somehow sort out the sleeping issues.