Matters of Sleeplessness - Part Two

Last week I talked about resetting sleep clocks and gaining better long term sleep quality, but what do you do if, despite your best efforts, you continue waking up in the middle of the night or still struggle to fall asleep?  There are still many options available to you, so don’t despair.  Ultimately, keeping good habits will eventually make you a better sleeper, but it does come easier for some than others.

A good place to start is increasing your activity level during the day.  Take a walk during your lunch break at work, get up early and go to the gym, or have a dance party with your kids after dinner.  Increased activity during the day will tire your body and make you more likely to sleep soundly.  You may also want to set your alarm a half hour earlier than usual and get up when it goes off every day, even on the weekends or when you have suffered a sleepless night.  You will likely experience a few days where you are seriously tired, but this will force your body to adjust.

Finally, if all else fails, teach yourself small meditations, breathing exercises or tension and release exercises.  It can be as simple as counting deep yogic breaths or practicing meditations.  Invest some time in finding CDs or podcasts of meditations that work for you.  Check out the Headspace application or Dr. John-Kabat Zinn’s mindful meditations.  For those who prefer an approach that involves more guided imagery, you can check out meditation CDs lead by Dr. Brian Weiss.  If you are unfamiliar with tension and release, it is truly simple.  Beginning at your feet, you tense and hold for a few seconds every muscle working your way up your body to your face.  As you release your hold on the muscle it should feel warm and loose.  This progression often helps your body to feel more relaxed and brings on sleep. 

If you are someone who doesn’t struggle to fall asleep but wakes often, try not to get out of bed when you awake during the night.  Keep your room dark and quiet.  Do not look at your phone or any other screen as this is stimulating to your brain and will affect your ability to sleep long afterward.  Changing bad sleep habits can take time, but the overall health and emotional benefits are worth all the work.

Matters of Sleeplessness

In my practice, I’ve noticed sleep deprivation effecting patients with increasing frequency.  Sleep is closely linked to your emotional state and your ability to control and regulate emotions.  A lack of sleep, especially for an extended period of time, can cause extreme mood swings and allow anxiety to run unchecked.  While I encounter a lot of people who struggle to fall asleep, I encounter just as many who wake up often throughout the night and struggle to stay asleep.  Unfortunately, waking during the night affects the quality of your sleep because it does not allow you to complete your body’s natural sleep cycles.  While quantity of sleep is important (the National Institutes of Health states that an average adult requires 7.5-9 hours of sleep each night), quality is even more important.  Without quality sleep your body cannot do the maintenance that is required for overall health and happiness.

If you are a poor sleeper, chances are this habit has developed over an extended period of time, but don’t despair.  There are things that you can do to improve the quality, and quantity, of your sleep.  Many doctors are now suggesting that people with sleep deprivation issues try melatonin to improve their sleep.  The problem with using melatonin long term is that it is possible that the use of artificial melatonin can decrease our body’s natural production of sleep hormones.  So while melatonin can be a useful tool to help reset our sleep clocks, it is my opinion that it should not be used for more than two weeks.  It is far better to try and reset naturally and create better long term sleep habits.

First, make sure that the place where you sleep is cool, comfortable, quiet and dark.  Use black out shades/curtains, and invest in a comfortable mattress and pillows.  For those that struggle to ignore outside noises a sound machine may be a good investment.  Second, avoid screen time within an hour of bedtime.  While we don’t always recognize it, the back lighting from screens is stimulating to our brains and can prevent quality sleep even when our bodies are obviously tired.  Third, avoid alcohol within an hour of bed time.  Studies have proven that we do not sleep as soundly when we drink alcohol right before bed.  If possible, it is good to try and keep your bedtime the same time throughout the week as well. Finally, create a good bedtime ritual.  A bedtime ritual can be anything that relaxes you and sends the signal to your brain that it is time to release sleep hormones.  A good bedtime routine is one that you can take with you no matter where you go.  Maybe you like to read a good book before bed, or have a cup of decaffeinated tea.  Perhaps you like to journal or do a mental breakdown of your day.  My favorite habit is a short meditation to clear your mind and relax your body.  Hopefully, if you make your sleep a priority you can improve your overall health and happiness.

The power of breathing

Breathing is something that everyone does every day without really thinking.  Therefore, most people don’t recognize the power to control anxiety, relieve stress, stimulate sleepiness or increase focus that can come from controlled breathing.  Diaphragmatic breathing is something that I teach most of my patients.  It is a useful tool that, when practiced, can be called upon automatically at trying and emotional times, but its benefits are far greater than a few applications.

You may be asking what diaphragmatic breathing really is.  It is a type of breathing that fully inflates your diaphragm, thus creating deeper breaths.  The basic idea is that you inhale until your diaphragm is fully inflated and hold your breath for a split second before exhaling completely.  The key is to have your exhalation be twice as long as your inhalation.  In my opinion, the best way to achieve this is to count during your breath cycle.  Everyone has a different lung capacity based on many factors including size, gender, etc.  Therefore, I often suggest starting with an average count and adapting it to what works for your natural breath capacity.  The average inhalation is a count of 6 with a one second hold and an exhalation count of 12. If you are struggling to find a count that works for you, you can even download an application to help you.  For added stress relief benefit you can breathe in through your nose and out through your mouth.

I recommend doing the full cycle ten times and practicing it every morning or night before bed even when you don’t feel as though you need it.  Since bedtime practice helps your body settle and may improve the quality of your sleep, it can be a good option for people who struggle with sleep issues.  Morning practice is good for people who need to work on focusing to get their day started and accomplish tasks.  Practicing regularly, as mentioned above, helps individuals who struggle with panic attacks call on this technique quickly to help minimize panic symptoms.  The counting aspect of this exercise helps to bring your mind to the present and distract you from other factors that may be causing paralyzing fear or unhappiness.

So now it’s time for you to start using something you already know in a new way.  The power of breathing may just amaze you.

When is a child old enough for chores?

Parents regularly come to see me feeling completely overwhelmed with jobs, overscheduled kids and household responsibilities.  They often lament about children not being quite old enough to pitch in and help with these household responsibilities.  The conversation inevitably comes to the question: when is a child old enough for chores?  They are surprised by my answer: as soon as they are old enough to ask for toys or candy at the store!

Although some people are quite surprised by this response, I believe that it is true.  I would never suggest something to a patient that I wouldn’t be willing to put into action in my own personal life.  My poor children often become my guinea pigs for different parenting philosophies that I have discovered through research over the years.  However, this idea just makes sense.  What better way to teach your children to be responsible and what it means to be part of a family unit.  If they are old enough to want something, they are old enough to be motivated by allowance because allowance will let them buy anything…[even if their parents say no][REALLY?  IF THEIR PARENTS SAY NO?]!

So how do you implement a chore system with young children?  First you must pick tasks that they are capable of completing and that make sense.  My son brought garbage cans in from the curb and checked the mail as early as four years old.  My daughter cleared her place at the dinner table almost as soon as she was out of a high chair.  Notice I never said that these tasks would be carried out perfectly.  Many stray pieces of mail were later found in the flower beds or food mess needed to be cleaned off the floor.  However, these small inconveniences were worth the long term benefits.  My six year old puts her own laundry away in drawers, helps load and unload a dishwasher, sets a table, and unpacks her own backpack.  While this is helpful to me as a parent, it is also greatly intrinsically rewarding for them. They feel a sense of accomplishment and they love being able to save money for bigger items that I would consider a waste.  Their understanding of money and how much things truly cost is a wonderful added bonus.

If you didn’t start your children out with chores at a young age it is never too late.  Your incentives for their participation may need to be higher though.  If your children are old enough to understand the big shift chores will make in the household, I encourage a family meeting to discuss the change.  Kids will be much more motivated to complete chores if they are part of the creation and implementation of the system.  Pick a few items that you really need help with and let them pick a few that they are willing to do.  That way everybody gets a bit of what they want and has input in the situation.  In terms of allowance, I believe it should be different for different ages.  Let’s face it, the items they want go up in price drastically as they age.  At 6 and 9 my kids get $2 a week unless they do extra chores.  This would be meaningless to a 16 year old.  In fact, if your children are teenagers I recommend a chart where you can list different tasks that need to be done and assign a money value to the task.  If your child needs some extra spending money for the weekend they can pick the tasks that will earn them the amount they need.  It may be a great way to get the car washed or the lawn mown and you can feel good about teaching them the beginning steps for good work ethic.

Battling Procrastination

A significant issue for most procrastinators is the lack of motivation to complete the task at hand.  It can be hard to muster the motivation necessary to focus on a project when you view the project negatively or question your able to manage and complete the project.  It can be even harder if that job is competing with something more desirable to you such as watching TV or going out with friends.  The question becomes, how can you break that cycle and get your tasks accomplished efficiently?

The first step is to break the task down into smaller, more manageable, items.  One suggestion is to make a list of what actually needs to happen for you to complete the task in question.  When you look at that list, you are likely to start hearing that voice in your head telling you that this task will take forever or you can’t handle everything that needs to get done.  The second step is to stop that voice.  Instead, tell yourself that if you take it one step at a time it will get done.  As soon as you tell yourself you can’t do something, the battle is always over!

The most crucial part is often getting started.  You may notice that once you get started, things move along and you are done before you know it.  The key to getting started is often to take a look at just the first step on your list.  If you can complete that task, reward yourself with a TV show or something else that you would rather have.  You may often find that once you convince yourself to get started you do a lot more before you offer yourself the reward.  The best reward will be your sense of accomplishment when you are completely finished.

As Lao Tzu once said, “The journey of a thousand miles begins with one step.”  Don’t lose the battle before that step is taken.  Take your first step and don’t give up on the journey.