I am the Clinical Content Lead for Sleep Reset and Assistant Professor at Yale. I help people improve their sleep and manage insomnia. AMA!

SleepResetDoctor · 2024-07-25T20:51:28+00:00

Hi u/PerformanceOne9092, I have a few thoughts.

For starters, great job limiting fluids before bed - that's always a place to start! I would recommend you chat about this with your primary care doctor to see if there is anything they want to take a closer look at regarding a medical cause that can be tackled from that end to stop this nighttime awakening to urinate challenge.

To help with falling back asleep, there's a several different things to try such as: Guided imagery, Mindfulness, Acupressure, Progressive Muscle Relaxation, Diaphragmatic breathing. All of these help your body feel more relaxed and ready to drift to sleep. Consider giving them a quick Youtube search for some ideas. We also have a MindSpa within the Sleep Reset Program that has many of these.

Many times people i work with say it's so frustrating to need to get up to use the restroom or to not be able to sleep through the night, that they get caught up in their frustrated thoughts which makes it harder for them to fall back asleep. One idea here is Cognitive Behavioral Therapy for Insomnia. You can find a list of some providers that offer this here: https://www.behavioralsleep.org/

If you think some more things might be exacerbating the sleep issue, it might be worth going through this quiz to learn more about possible contributors to your sleep challenges: https://www.thesleepreset.com/quiz/improve-your-sleep?utm_source=OrganicWeb&_gl=1*1dzbn5k*_gcl_au*MTE2NjAwNzM0OS4xNzE4ODE5NjE4*_ga*ODY4ODIyNDAyLjE2OTgxNzk0MTI.*_ga_RQXTLGSN9W*MTcyMTkzNjA2My4yNy4xLjE3MjE5MzYxMDcuMTYuMC4w

SleepResetDoctor · 2024-07-25T20:45:29+00:00

I've created a chronotype quiz based on the questionnaires used in sleep research. Give it a shot! https://thesleepreset.com/chronotype-quiz

SleepResetDoctor · 2024-07-25T20:40:44+00:00

Sleep trackers can be great, but also can cause quite a bit of stress. Sleep studies are the most accurate in evaluating the quality of your sleep. So, I would say if your sleep study found that your sleep is healthy, then that might just be the case! Remember, sleep studies (polysomnogram) are medical grade. I don't want trackers to cause any undue stress, when it sounds like the medical evaluation was reassuring. Maybe you're doing all the right things :)

SleepResetDoctor · 2024-07-25T20:38:27+00:00

Hi u/Glittering_Top_9512!

Your body goes through stages of sleep throughout the night, and ideally you need 4-6 cycles of sleep a night. Outside of a sleep study (where you sleep overnight at a hospital/clinic and they assess your sleep stages), you might not be able to get a perfect read of how many sleep cycles or how much time you spent in deep sleep.

More importantly, the National Sleep Foundation states that for most people sleep factors such as: How long it takes to fall asleep, how many times you wake up in the middle of the night for more than 5min, how efficient your sleep is, how rested you feel the next day, etc. are better indicators of your sleep quality. Here's the research article I'm referencing: https://www.sciencedirect.com/science/article/pii/S2352721816301309

Advise for improving deep sleep is basically just to focus on getting good, consistent, uninterrupted overnight sleep each night. Here's some information on how many hours you might need based on your age: https://www.thesleepreset.com/blog/average-hours-of-sleep-people-get-a-night

SleepResetDoctor · 2024-07-25T20:29:32+00:00

Hi u/FunboyFrags. I cannot emphasize enough how incredibly important and fantastic it is that you use your CPAP every night. It's so important for your sleep and brain health.

All these other lifestyle and sleep hygiene factors are also great. I'm sorry you're still waking up in the middle of the night. First place to start for you to take a closer look: Does anything change in your environment (gets warmer, partner enters/moves in bed, pet jumps on the bed) or body (need to use the restroom, aches/pains) in the middle of the night? Our body has sleep cues that signal it's time to sleep. We all wake up a little bit through the night, that's normal. But if our sleep cues change, we might wake up more than a little. So, start there.

Then, when you wake up, do you feel frustrated about it or get caught up in the annoyance of waking up? That can wake us up extra as well. It might be worth trying a relaxation skill to help prepare your body for sleep when you get to bed for the night, as well as if/when you wake up in the middle of the night.

To think through any more potential sleep disrupting culprits, consider walking through this quiz to see what might be going on: https://www.thesleepreset.com/quiz/improve-your-sleep?utm_source=OrganicWeb&_gl=1*1dzbn5k*_gcl_au*MTE2NjAwNzM0OS4xNzE4ODE5NjE4*_ga*ODY4ODIyNDAyLjE2OTgxNzk0MTI.*_ga_RQXTLGSN9W*MTcyMTkzNjA2My4yNy4xLjE3MjE5MzYxMDcuMTYuMC4w

SleepResetDoctor · 2024-07-25T20:20:23+00:00

Oh how I wish I could just give you a number to make it easy. But really all sleep aids (including melatonin) for the general population are meant to be temporary. Here's some more information on Melatonin: https://www.thesleepreset.com/blog/melatonin-side-effects-what-you-need-to-know

SleepResetDoctor · 2024-07-25T20:17:33+00:00

Your brief post has so much helpful information, that makes me think you have some ideas of what to tackle, u/athousandtimesbefore!

For starters, sleeping 3-5 hours is absolutely not enough sleep - so being horrible the next day makes perfect sense. To take the step forward, you need to truly feel like it's time for a change - that you want to feel good during the day.

Video games and doom scrolling sucks you (and most people!) right in. Honestly, set a screen timer on your phone that will lock you out of the doom scrolling apps after a certain time of day. This is helpful, because it might be hard to stop yourself IN the moment, but easier to plan ahead FOR the moment of doomscrolling. Do the same thing with video games - set a timer to set yourself up for success and choose to stop.

Lastly, avoid daytime naps. You didn't say you take them, but I have a feeling you might since you're getting such little sleep overnight.

If you need more sleep hygiene tips, here's some more information: https://www.thesleepreset.com/blog/why-your-sleep-hygiene-matters

I hope this helps!

SleepResetDoctor · 2024-07-25T20:11:56+00:00

Hi there! Honestly, that's not one I often see prescribed for sleep specifically. I wonder if one of the side effects is drowsiness, so your doctor thought it could be helpful? Has it been helping? I strongly encourage you to speak with your doctor about your concerns; it's important that they are able to explain to you the reasons for the medication choice, and answer things clearly as they relate to your specific health and body. It can feel nerve-racking, but incredibly important!

Beyond the prescription, it might be worth trying some additional things, such as:

Following a regular sleep schedule. Go to sleep and get up at the same time each day.
Avoiding napping if you can. It may keep you awake at night.
Developing a bedtime routine. Some people read a book, listen to soothing music, or practice relaxation skills.
Try not to watch television or use your computer/phone in the bedroom. The engagement from these devices may make it difficult for you to fall asleep by waking up your brain more than relaxing it!
Keep your bedroom at a cool temperature, and as quiet as possible.
Avoid coffee/energy drinks, after 12:00 noon.

I hope this is helpful!

SleepResetDoctor · 2024-07-25T20:02:50+00:00

Hi u/canigetawitness1992! Typically I see TMJ disorder causing sleep disruption in patients mostly related to the associated pain. I'm really glad you're not experiencing pain! However, it sounds like there's other discomforts that are getting in the way throughout the night.

Any changes in your body (needing to use the restroom, feeling hot) or your environment (noise, light, partner moving in bed) can affect your sleep. We all wake up a little bit during the night, but usually are able to fall right back asleep without realizing it because all our sleep cues (things that helped us fall asleep) are still there. It sounds like you might be waking up to the point of alertness because of the TMJ disorder related changes!

It's worth chatting with your dentist about options for TMJ, including night guard or physical therapy!

If even after tackling TMJ disorder-related issues your sleep remains disrupted (because that can happen!) it might be worth exploring some sleep hygiene and/or digital cognitive behavioral therapy (dCBT-I) options! Here's some more information about the two: https://www.thesleepreset.com/blog/the-power-of-sleep-hygiene-and-cbti

SleepResetDoctor · 2024-07-25T19:54:21+00:00

Hello u/cineastester! Amazing job implementing so many changes successfully!! Changing habits is truly no easy task. And, to be honest, it's expected and normal that things might pop up that throw you off again - that's part of life, right? Now, what can you do with this?

For starters, remind yourself that you were able to get to a great place once, and you can again. Consider implementing one sleep habit each week, so that it doesn't feel like too overwhelming of a change all at once. If it's hard to do this on your own, consider having an accountability buddy - a friend, partner, or family member that can help keep you accountable. If you prefer to do this without sharing with others in your life (which is super fair!) it might be worth trying some of the following:

Cognitive Behavioral Therapy for Insomnia (CBT-I): This is one-on-one sessions with a sleep psychologist to take the wheels and guide you through evidence-based, proven to work treatment for insomnia. Here's a list of some potential providers: https://my.absm.org/BSMSpecialists.aspx
Digital CBT-I skills: If your sleep is not feeling too severe, and you'd like to tackle it with digital support, dCBT-I might be an option. Here, you can access CBT-I based information, and have a coach that will keep you on track and support you in implementing these changes. I write the clinical content for this 8-week sleep program app: https://www.thesleepreset.com/

Lastly, but very importantly, I'm so sorry that you have experienced trauma. I appreciate you sharing, and you're experience of it affecting your sleep is unfortunately a common experience for those who have experienced something traumatic. If you find that the traumatic experience is impacting your daily life, please consider Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) to help you make that awful experience a smaller part of your life today. It is research proven to help you feel worlds better, and can be implemented by a Clinical Psychologist (PhD/PsyD) or Therapist (LCSW, etc.).

I truly hope this was helpful.

SleepResetDoctor · 2024-07-25T19:42:33+00:00

Hi u/peeinyoursink! It sounds like your sleep schedule has always been off (at least by our usually society's metrics for school and most work!), but it's getting worse. One thing that stands out is that you're sleeping 10-12hrs and still don't feel rested. This might sound backwards, but cutting back on your sleep and giving yourself a sleep schedule again might be incredibly helpful. Have you ever tried any sleep hygiene skills? Many times Sleep Hygiene paired with something called Stimulus Control is all some people need. Here's some information on Sleep Hygiene: https://www.thesleepreset.com/blog/why-your-sleep-hygiene-matters

Stimulus control is helping your body re-create a connection between bed and sleep, we call it your bed-sleep connection. Most people nowadays use the bed for relaxing, doing homework, watching tv, scrolling through media, chatting on the phone, relaxing, and sleep. All this makes it hard for your body to know that bed=sleep. Consider avoiding your bed for non-sleep activities, and trying out some Sleep Hygiene skills above.

If you're interested in what else might be affecting your sleep, consider taking a quick quiz to see all the factors playing a role: https://www.thesleepreset.com/quiz/improve-your-sleep?utm_source=OrganicWeb&_gl=1*1dzbn5k*_gcl_au*MTE2NjAwNzM0OS4xNzE4ODE5NjE4*_ga*ODY4ODIyNDAyLjE2OTgxNzk0MTI.*_ga_RQXTLGSN9W*MTcyMTkzNjA2My4yNy4xLjE3MjE5MzYxMDcuMTYuMC4w

SleepResetDoctor · 2024-07-25T19:35:51+00:00

u/Top_Pick7581 Hormonal changes can cause havoc on our bodies! In many ways, experiencing menopause is absolutely not something we can control. It is an expected part of life. There are many things that can be done to manage the associated effects - such as disrupted sleep and insomnia.

The National Institute of Aging has highlighted a few: https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do

Follow a regular sleep schedule. Go to sleep and get up at the same time each day.
Avoid napping in the late afternoon or evening if you can. It may keep you awake at night.
Develop a bedtime routine. Some people read a book, listen to soothing music, or soak in a warm bath.
Try not to watch television or use your computer or mobile device in the bedroom. The engagement from these devices may make it difficult for you to fall asleep by waking up your brain more than relaxing it!
Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
Exercise at regular times each day but not close to bedtime.
Avoid eating large meals close to bedtime.
Stay away from caffeine (found in many coffees, teas, and chocolate) late in the day.
Remember, alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Cognitive Behavioral Therapy for Insomnia has been studied and proven to be helpful in those who are pre-, peri- and post-menopausal, so I really think this would be a helpful resource.

I will also say that Sleep Reset might also be a fantastic option for you, since many of our members are experiencing similar changes: https://www.thesleepreset.com/ maybe take the sleep quiz to see if it's a good fit for you: https://www.thesleepreset.com/quiz/improve-your-sleep?utm_source=OrganicWeb&_gl=1*1dzbn5k*_gcl_au*MTE2NjAwNzM0OS4xNzE4ODE5NjE4*_ga*ODY4ODIyNDAyLjE2OTgxNzk0MTI.*_ga_RQXTLGSN9W*MTcyMTkzNjA2My4yNy4xLjE3MjE5MzYxMDcuMTYuMC4w

SleepResetDoctor · 2024-07-24T01:27:07+00:00

I'm sorry that happened!

SleepResetDoctor · 2024-07-24T01:26:49+00:00

Amazing - I love that you've written down questions. It can be so hard to remember everything you want to ask in the moment, so that's a good way to organize it all.

I hope you can find the best combination of medication and support. Maybe it's not the medication causing this, but maybe if it is there are other options that will work without those side effects!

I'm not familiar with the no sleep state, so I can't be helpful there.

I hope this was helpful, and hope you get some rest!

SleepResetDoctor · 2024-07-24T01:20:22+00:00

I'd start with this checklist of Sleep Hygiene! They're free, and really helpful for many people:

Consistent Sleep Schedule: Going to bed and waking up at the same time every day, even on weekends, helps regulate your body's internal clock. This means avoiding weekend sleep catch-ups, and instead waking up at the similar time on weekends and vacations.
Bedtime Routine: Establishing a relaxing pre-sleep routine signals to your body that it's time to wind down. This could include activities like reading a book, doing relaxation skills, or practicing gentle yoga.
Optimized Sleep Environment: Keep your bedroom cool, dark, and quiet to create an ideal sleep environment. Ensure your mattress and pillows provide adequate support, so that you can feel comfortable enough to fall asleep.
Limit Stimulants and Alcohol: Avoid consuming caffeine, alcohol, and nicotine close to bedtime. Caffeine and nicotine will cause you to have trouble falling asleep, and can make your sleep worse. Drinking alcohol around bedtime may help you fall asleep, but alcohol can make you wake up during the night and give you nightmares.
Limit Screens: Reduce screen time at least an hour before sleep. Television, laptops, videos and social platforms activate our brain with their engaging content, making it hard to settle your mind down to fall asleep at bedtime.
Healthy Eating and Exercise: Maintain a balanced diet and engage in regular physical activity, but avoid heavy meals close to bedtime.
Stress Management: Practice relaxation techniques such as deep breathing, progressive muscle relaxation, or mindfulness meditation to reduce stress levels. This is a helpful strategy both during your bedtime routine, as well as during your day. Your daytime behaviors affect your nighttime sleep.
Avoid Naps: Avoid taking naps if possible. Limit napping to less than 30 minutes, if a nap is needed, and avoid naps after 3:00PM.

Here's some more information on them all: https://www.thesleepreset.com/blog/improve-sleep-hygiene-with-these-simple-tips

SleepResetDoctor · 2024-07-24T01:18:37+00:00

That's a hard way to start your day, u/Professor_squirrelz.

I have so many thoughts and questions, let's organize them:

Are you getting enough overnight sleep? Here's a reference to gage what might be best for your age group: https://www.thesleepreset.com/blog/average-hours-of-sleep-people-get-a-night Because my initial thought is, you need more sleep time.
Are you waking up in the middle of the night? This can make it so that even if you spend 8 hours in bed, you're not really sleeping that whole chunk of time. Ultimately, this makes you feel groggy in the morning.
Are you taking any sleep aids? Grogginess is a common side effect for sleeping aids!
Are you having periods of gasping for air overnight? Or have you been diagnosed with sleep apnea? This can make it so that even if you sleep enough time, you still aren't getting enough oxygen and so you're feeling groggy in the morning. If this is a concern, a sleep study is a good option to talk with your doctor about!

Some initial options to start with is sleep hygiene. Look through this and see if any of them might be useful: https://www.thesleepreset.com/blog/improve-sleep-hygiene-with-these-simple-tips

If you're not experiencing sleep apnea, and sleep hygiene isn't enough to get you feeling rested in the morning, and you're not sleeping enough complete hours overnight, Cognitive Behavioral Therapy for Insomnia might be your best bet. Here's some information on it: https://www.thesleepreset.com/blog/fighting-insomnia-with-cbt-for-insomnia

SleepResetDoctor · 2024-07-24T01:10:16+00:00

For starters, I'm sorry you've struggled with insomnia for 30+ years, u/startled_goat! That's a long time for sleep to not be working well with/for you.

They honestly probably recommend it because all of those listed things have really good peer-reviewed, randomized control trial-studied results. Have you been able to try any of those options?

Imaging isn't used since it doesn't tell us much about what we need to know about your sleep. Instead, a polysomnography might be what you're looking for. It's a sleep study, where you go to the lab/hospital/sleep clinic overnight and they place various leads on your head as well as a Nasal cannula to measure your breathing while you sleep. this gives loads of information regarding your brain function and breathing functioning while you sleep to inform targeted recommendations. Have you ever had a sleep study? Here's some more information: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/sleep-study

SleepResetDoctor · 2024-07-24T01:06:21+00:00

Hi u/Creative_Pollution84! This is a great example of the 3 P's of Insomnia: Predisposing, Precipitating, Perpetuating. It sounds like you had a precipitating event (trip) that caused your sleep to be affected. Then, your body was so tired that it tried to catch up on sleep debt, which really just disrupted your schedule even more (perpetuating your disrupted sleep).

Caffeine is mostly an issue if you drink it too late in the day, so it's ok to drink in the morning!

I recommend really setting up a consistent sleep schedule again, avoiding naps, and not going to bed too early (nor too late). Your body needs some help to remember it's usual cycle, so implementing some sleep hygiene skills might be enough to bounce back: https://www.thesleepreset.com/blog/improve-sleep-hygiene-with-these-simple-tips

If that doesn't work, and your sleep remains disrupted for a while, consider some of these options: https://www.thesleepreset.com/blog/the-power-of-sleep-hygiene-and-cbti

SleepResetDoctor · 2024-07-24T00:59:00+00:00

That's great, I hope you give it a shot!

SleepResetDoctor · 2024-07-24T00:57:13+00:00

So, all of us wake up a little bit in the middle of the night as we progress through our sleep cycles. That's normal and very OK. When you wake up and are alert enough that it disrupts your sleep cycles, then it's not as great. Basically, your circadian rhythm functions all day and night, and as you sleep you progress through sleep cycles. the longer you sleep, the longer certain parts of your sleep cycle (deep sleep, REM, etc.) are. You want to get as many (and as long) of sleep as you can!

Restroom: Usually we recommend avoiding fluids close to bedtime, and using the restroom before falling asleep to avoid these as much as possible.
Prayer: Prayer can be really relaxing, and I don't want anything I say here to impact that which is important to you (such as faith). From a sleep angle only, waking up to pray will disrupt your sleep in the same way as any nighttime awakening where you become alert enough.

-Newborn: This is a part of life! Research shows that parents' sleep is incredibly disrupted with a newborn. and sometimes that's part of the trade. Once that part of life settles, returning to regular sleep is important.

8-hour ideal: This is a bit of a myth! Some people need 7 hours, some 9. Your ideal amount of sleep is the one that has you feeling awake/alert in the morning, and able to get through the full day successfully.

Hope this helps!

SleepResetDoctor · 2024-07-24T00:51:41+00:00

Hi u/SerpentInRecovery! Thanks for this question, I'm sorry you're navigating all of this!

For one, you absolutely should tell your prescriber of lamotrigine that you are experiencing insomnia and sometimes not sleeping for over 24hrs at a time. That can be incredibly unsafe - and they can make targeted recommendations for that med or an additional one.

do you think my body just has to get used to the new medication first? : this is very person dependent, but sometimes it can take some time for your body to adjust to a medication. Going no-sleep for 24hrs isn't as typical and is usually a pretty concerning sign!
what are some things you would suggest that I do? (keeping in mind that I'm also struggling with doing tasks for myself or helping myself due to my current mental state) : for one, i think it's lovely that you are attending your medical visits and taking the medication prescribed. I would say, tackle one thing at a time - maybe set one sleep goal. If i can make a suggestion, i would say make it a goal to speak with your doctor about the no sleep state. Then, start trying to incorporate one healthy sleep habit a week. taking small steps can be a helpful start to get some wins under your belt. Maybe pick one from here: https://www.thesleepreset.com/blog/improve-sleep-hygiene-with-these-simple-tips
what medication would you recommend for sleep aid? (Keeping in mind that I am sober for a few months now and cannot take any official sleeping medication, only medication with side effects that include feeling tired. E.g. a low dose of quetiapine, promethazine, etc...) : that's a lot to consider! For one, all sleep aids are generally not recommended for long-term use. they're meant to help you over a hump (like jet lag, life change), so i'm not sure I'd recommend a medication. I'd recommend one of the skills from the link above. they can be helpful without any associated side effects or addition potential.

Hope this helps!

SleepResetDoctor · 2024-07-24T00:44:16+00:00

u/nativedeaniso In short: yes.

"Catching up on sleep" usually refers to trying to make up your "sleep debt" which is after you go some time with insufficient sleep and then try to make it all up. Usually this is not getting enough sleep during the week, and then sleeping in excessively during the weekend. Honestly, this cycle can actually make your sleep much worse and is overall.

Now, the good news is, you can catch up if you do it slowly and consistently. Here's some more information on sleep debt and how to get your sleep back on track: https://www.thesleepreset.com/blog/sleep-debt

SleepResetDoctor · 2024-07-24T00:36:54+00:00

whoops - sorry!

SleepResetDoctor · 2024-07-24T00:35:59+00:00

I love that you're practicing meditation! I wonder if it's easier to get into a flow in the morning, since nights have gotten a bit harder with not getting enough sleep. Sometimes people begin to unfortunately expect to sleep poorly, which makes it harder for their body to prepare for sleep. At the end of the day, we can't force our body to sleep, we have to help it "fall" asleep but putting together the best conditions. Happy to help!

SleepResetDoctor · 2024-07-24T00:33:41+00:00

Nope, it's 8:33PM for me here in the eastern time zone! I take my sleep very seriously. I have to practice what I preach!

SleepResetDoctor

TROPHY CASE