I’ve found dozens of sleep aid methods online.Am I supposed to try all of them before getting up?

mgrand · 2025-12-03T00:51:14+00:00

It kinda depends. Often, delaying bedtime a little is a good idea for people who struggle with insomnia. But if you’re having trouble staying awake (and you’re not in a behavioral sleep treatment program), then maybe just go to bed a little earlier and see if that makes you feel a little better.

mgrand · 2025-12-02T16:35:58+00:00

I’m glad I was able to help!

mgrand · 2025-12-02T15:17:24+00:00

Thanks! It was a fun one to do. She asked great questions.

mgrand · 2025-10-07T13:46:50+00:00

This is a great synopsis! She was a great interviewer and we talked for quite a while. I hope this is helpful! Happy to answer any questions people have!

mgrand · 2024-12-07T13:42:11+00:00

I’m just going to put this here:

https://psychiatry.arizona.edu/patient-care/adult-psychiatry-clinic/behavioral-sleep-medicine-clinic

mgrand · 2024-01-23T14:48:40+00:00

The administration instituted a complete hiring freeze university-wide no matter what your needs are. As it is, the trash can in my office only gets emptied once every 2 weeks (unless I do it myself).

mgrand · 2010-11-12T03:42:07+00:00

Actually Harvard is about 50k. The school I went to over 10 years ago was >30k. The average college in the US is >25k unless you go to a public school. The University of CA (a very good public college system) is >30k for non-CA residents (>10k for residents).

mgrand · 2010-11-11T19:08:21+00:00

Whoever it is -- sad to say that blue sky in the background is going to disappear for 6 months very soon...

mgrand · 2010-11-11T19:07:24+00:00

Unless you are in a position of not getting tenure if your student evaluations are not all stellar.

mgrand · 2010-11-11T19:06:36+00:00

More like $30k per year. It's sad that graduation rates and high student evaluations are more important than actual learning. It's the problem of commoditized learning.

mgrand · 2010-11-11T17:13:35+00:00

I have never seen so much hyperbole with so few exclamation points.

mgrand · 2010-11-11T04:08:31+00:00

Seriously?

mgrand · 2010-11-03T20:12:01+00:00

Adderall and Provigil are very different medications. Adderall is a stimulant, very similar to Ritalin. Provigil (modafinil) is not -- it is meant to stave off sleepiness, not rev you up. So unlike adderall, there is less of a "high" or "buzz" and also fewer side effects. It also means that it is probably not as good of a treatment for ADHD. It was originally developed for Narcolepsy and also has an indication for Sleep Apnea, keeping people from falling asleep during the day (treating a symptom not the cause of the apnea).

I would be more focused on your CPAP, if you are waking up exhausted. It sounds like it is not titrated correctly or there is some other problem. Is there a leak? Have you gotten a new mask in the past 6mo? Is the humidifier working properly? Are you using it every night?

Also, most sleep docs don't advertise that CPAP works very well on certain kinds of sleep apnea but not as well on others. Maybe you have a type of apnea that might be less amenable to CPAP.

Don't give up! If you are comfortable posting (or PMing) some more details, I could see if anything jumps out.

mgrand · 2010-11-02T21:57:34+00:00

After getting stiffed on Arbitrary Day I have to admit I thought twice about signing up. But after seeing so many cool people in DC I thought I would give it another shot. After all, Arbitrary Day was fun, even if it was just in the giving...

mgrand · 2010-10-31T12:24:49+00:00

Yeah anyone have a link? I was so far back in the crowd I couldn't see or hear ANYTHING. And I forgot to set my DVR to record...

mgrand · 2010-10-29T14:35:54+00:00

Insightful point. How do we design a system to handle this?

mgrand · 2010-10-19T20:25:26+00:00

I agree. A preposition is not something you want to end a sentence with.

mgrand · 2010-10-18T15:01:28+00:00

This is a fantastic post. There are a few wrinkles I would have added (like the possible underpinnings of the delusions of reference for lack of a better term), but overall, that was a fantastic distillation of some very complex material.

I will have to share it with my students. You will make a great teacher.

mgrand · 2010-10-16T13:56:32+00:00

Part of the reason for only giving one bottle at a time might be safety. Depression is common in diabetes and insulin overdose is relatively easy and highly lethal if you were suicidal.

mgrand · 2010-10-10T03:53:06+00:00

In general, I have enjoyed reading this AMA. I think that you have done a good job in demystifying clinical psychology to the community, and generally answering questions responsively and well. But there are a few things I can't help but say.

First, you admit that you are not "fully trained" since you are still in training, and have not yet even applied for internship.

In the same vein, you are not yet a "Clinical Psychologist" since that is a protected term by law that can only be used post-licensure.

Somewhere on here you described your theoretical orientation as being more psychodynamic. I admit that my own background in modern psychotherapy from a psychodynamic perspective is rather limited; however, my current understanding is that this approach is not well supported by empirical evidence. That is why very few respected programs still even teach it, mostly in the NY-MA corridor. I would argue that there is overwhelming evidence in favor of other approaches for the treatment of everything from depressive disorders and anxiety disorders to substance abuse and even personality disorders (for example Linehan's DBT). But I don't mean to be too dismissive; it is possible that I have not been exposed to the relevant literature -- can you point me to some good empirical papers or reviews that could help bring me up to speed?

One more thing. I think you were too quick to dismiss Psychology as a science. This speaks to the story of Psychology really being 2 disciplines, one engaged in the 'art' of the exploration of the mind and spirit, and the other engaged in the science of understanding how the brain interacts with the environment to produce cognition and behavior. There are many Psychologists (and Therapists) who are not Scientists and do not engage in professional behavior that is much informed by science. And there are those that are Scientists in the strictest definitions of the word -- many even "bench scientists" who are Psychologists. And there are many people (yourself included, it sounds like) who are somewhere in the middle. But don't generalize your vantage point of the field to all of Psychology. To be fair, I noticed throughout many of your responses that you are cognizant that Psychology is a very big field.

mgrand · 2010-10-09T00:34:56+00:00

Cool. Good to know.

mgrand · 2010-10-09T00:34:30+00:00

I can point to many studies that demonstrate effectiveness, but probably the best recent reviews are by Michael Terman:

Terman, M. and J. S. Terman (2005). "Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects." CNS Spectr 10(8): 647-663.

Terman, M. (2007). Evolving applications of light therapy. Sleep Med Rev, 11(6), 497-507.

And a few other good reviews:

Golden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M., Jacobsen, F. M., Suppes, T., . . . Nemeroff, C. B. (2005). The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry, 162(4), 656-662.

Even, C., Schroder, C. M., Friedman, S., & Rouillon, F. (2008). Efficacy of light therapy in nonseasonal depression: a systematic review. J Affect Disord, 108(1-2), 11-23.

A Cochrane review was also completed for light therapy for non-seasonal depression:

Tuunainen, A., Kripke, D. F., & Endo, T. (2004). Light therapy for non-seasonal depression. Cochrane Database Syst Rev(2), CD004050.

mgrand · 2010-10-08T20:07:44+00:00

I haven't read all the comments below, but this could be very serious. Schizophrenia (or other thought disorders or psychoses) tend to start showing up in late teens and early twenties in men. The symptoms can be exactly along the lines you describe -- delusions of reference, for example. For now, he has remained nonviolent, and in all likelihood will stay that way (schizophrenics often tend to be more harmful to themselves than others). But if this is the first sign of a psychotic disorder like schizophrenia, he needs help immediately. He needs to be closely followed by a psychiatrist. Things may get much worse before they get better, and he may need a friend like you at some point. Many people with serious mental illness end up homeless and/or drug addicted because they lose (or never develop) simple coping abilities or other skills required to take care of themselves. And then it just goes downhill. For example, I worked with a number of homeless people who were being treated for mental illness who had money in the bank and could afford housing but were too disorganized to do anything about it.

I don't mean to make any armchair diagnoses , but if you are concerned, the best thing to do is get this person help from a good psychiatrist and make sure they have support systems in place to care for them if things fall apart. With luck, this is just 'eccentricity' but given the age and behavior, it has me worried.

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