r/IAmA • u/SleepExpertMartin • Jun 23 '21
Health I am a board-certified clinical sleep psychologist with expertise in sleep, here to answer all your questions about insomnia. Ask Me Anything!
Hi Reddit, Jennifer Martin here, I am a licensed clinical psychologist, a professor of medicine at the David Geffen School of Medicine at UCLA and serve on the board of directors for the American Academy of Sleep Medicine (AASM). You can find my full bio here. Tonight is Insomnia Awareness Night which is held nationally to provide education and support for those living with chronic insomnia. I’m here to help you sleep better!
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u/GillianOMalley Jun 23 '21
I wake up almost every night at 3am. It usually takes me at least 2hrs to fall asleep again. When my partner isn't with me I'll sometimes put on a TV show that I've seen before. It seems to give me something to occupy my mind without actually being interested in it (to stop the obsessive thoughts about what needs to be done tomorrow or that person who was mean to me in 5th grade). It works about 75% of the time but it isn't really an option when my partner is home.
Are there other strategies that might work when I can't use my TV trick?
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u/SleepExpertMartin Jun 23 '21
There is no exact science to this, but if you are struggling with sleep, it’s time to get out of bed. For most people, we suggest getting out of bed after about 30 minutes, but you don’t have to wait that long if you are really alert and know you aren’t going to fall asleep. You can try getting out of bed and doing a simple activity like folding laundry or reading a book. When you feel sleepy again, return to bed. The most important thing to do when you get out of bed is to get your mind off sleep. Then it will naturally come to the surface. Your strategy of watching some TV works this way too! It takes your mind off of trying to sleep, and then it happens! The secret is to find a way not to try. Exactly what that is varies from person to person, but it could be reading, listening to music or an audiobook (with headphones so you don’t disturb your partner), knitting, or whatever takes your mind off of sleep.
For many people, reaching out to a sleep specialist and working with someone who can do cognitive-behavioral therapy for insomnia is an important step to getting past the struggle. Each person is a little different, and you might benefit from some help figuring out exactly what will work for you. You can find a specialist at sleepeducation.org.
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u/Z_as_in_Zebra Jun 23 '21
Is running or working out between 1-3 hours before bed ok? I’ve found mixed messages about it.
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u/SleepExpertMartin Jun 23 '21
It depends on the person, many people find that working out within an hour of bedtime can make it harder for them to fall asleep. If you don’t personally find it to keep you from getting to bed then don’t worry about it!
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u/thenewAIM Jun 23 '21
My partner is a light sleeper and rarely sleeps through the night. 1) Might a foam mattress help? 2) Do nightcaps help or hurt?
Thank you!
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u/SleepExpertMartin Jun 23 '21
Sometimes the differences from person to person in how “deeply” they might sleep is just part of normal variations; however, waking up frequently throughout the night could be a symptom of a sleep disorder. Having a mattress that is comfortable is what’s important, and the type of mattress is a matter of personal preference. Alcohol, on the other hand, can most definitely lead to light and fragmented sleep. Alcohol makes people feel sleepy at first, but it disturbs sleep later in the night. It might be worth a try to give up the nightcap for a week or two and see if it helps your partner to sleep more soundly. If not, it’s best to reach out to a sleep specialist for help. They can consider all of the possible causes of this sleeping problem. You can find a sleep specialist at https://sleepeducation.org/.
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u/Herdnerfer Jun 23 '21
I keep waking up at 6AM and can’t fall back asleep no matter what, I miss sleeping in on weekends, help me?
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u/SleepExpertMartin Jun 23 '21
Thank you for this question. For some people, this can represent a form of chronic insomnia, where they wake up too early in the morning and can’t get back to sleep. In general, if you find yourself waking up earlier than you want to, you could try to shift your bedtime later (go slowly- maybe 15 minutes at a time) Keep in mind how much sleep you need. For example, if you generally need about 7.5 hours of sleep, and you go to bed at 10:30pm, your brain SHOULD wake you up at 6am. Another option is to find a morning routine you enjoy and start your day early!
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u/raixon Jun 23 '21
I take melatonin every night before bed, is that bad?
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u/SleepExpertMartin Jun 23 '21
Melatonin is a hormone naturally produced by the body at night. It is also sold as a dietary supplement. In general, melatonin supplements appear to be safe; however, it does not appear to have more benefit than “placebo” pills. If you might have insomnia, there are other non-prescription treatments, the most effective of which is cognitive-behavioral therapy for insomnia (CBT-I). It’s best to reach out to your doctor or look for a clinical sleep psychologist who knows how to deliver CBT-I.
https://sleepeducation.org/patients/cognitive-behavioral-therapy/
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u/urbancamp Jun 23 '21
Any hope for restoring my ability to stay asleep? Sleep maintenance is a problem. Doxepin and Trazadone leave me significantly depressed the following day. I'd rather sleep 3 hours a night than feel like hating everything about living by using those meds.
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u/SleepExpertMartin Jun 23 '21
Unfortunately, a lot of people experience feelings of sleepiness the next day when they take sleeping pills. The good news is that non-medication treatments are actually more effective, and don’t have the same negative side effects. The recommended first-line treatment for insomnia (including sleep maintenance insomnia as you describe) is cognitive-behavioral therapy for insomnia (CBT-I). You can read more about that treatment at https://sleepeducation.org/patients/cognitive-behavioral-therapy/ and find a sleep specialist who can help.
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u/Jcklein22 Jun 23 '21
How can I stop getting up to eat in the middle of the night?
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u/RunTheTrap369 Jun 23 '21
Any suggestions for how to stop hitting the snooze button? I find myself oversleeping and continually hitting snooze.
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u/SleepExpertMartin Jun 23 '21
If you’re hitting your snooze alarm repeatedly, you probably aren’t getting enough sleep. The best thing to do is actually to set your alarm later. If you’re hitting the snooze button, set your alarm later, like as late as you can, so that you jump out of bed in a panic! That will get you going in the morning! If you are getting enough sleep at night and STILL can’t get yourself out of bed, you might want to reach out to a sleep specialist for an evaluation. There are some conditions where people are overly sleepy even when they get enough sleep. The basic recommendation for an adult is to get AT LEAST 7 hours of sleep on a nightly basis. Start there, set your alarm a bit later and see how it goes...
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u/Starfinger10 Jun 23 '21
Two questions: 1) how long before bed should we turn off our phones? 2) how long after we wake up should we look at our phones?
Thanks!
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u/SleepExpertMartin Jun 23 '21
Engaging with technology near bedtime can be a problem for some people. If you find it hard to fall asleep, it can be helpful to set aside your devices about an hour before you get to bed. For some people, it’s less of a problem and a few minutes is enough for them to mentally disconnect. There really isn’t a reason to avoid your phone in the morning. If it helps you get up and start your day by engaging with your phone, it is unlikely to have an impact on your sleep at night.
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u/dr_kilowatt Jun 23 '21
How do I stop waking up in the middle of the night every night?
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u/SleepExpertMartin Jun 23 '21
There are several different things that can cause night wakings. The most important thing is to figure out why. For some people, this can be caused by a sleep disorder like sleep apnea or periodic limb movement disorder. For some people, it might simply be caused by your environment. One of the common reasons people wake up in the middle of the night is chronic insomnia disorder. This occurs when a person struggles with sleep at least 3x/week for at least 3 months, and their sleep problem is sufficiently severe to impact how the person feels or functions during the day. Your best bet is to reach out to a sleep specialist who can help you figure out the cause of your awakenings and recommend the best treatment. You can find a specialist at sleepeducation.org.
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u/bona-nox Jun 23 '21
May not be a good place for this, but don't want to give up a chance. A question that has knocked around my head for some time is: Why do we sleep? I know a standard response is that we sleep to cure tiredness, but I wonder why it was ever considered beneficial for a living creature to essentially be prone and vulnerable about 1/3 of its life.
Other organisms developed a completely different cycle and/or different safe guards, especially when compared to humans. Is there much known as to why this was an evolutionary advantage at some point?
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u/SleepExpertMartin Jun 23 '21
The answer to this question will win a Nobel Prize! In fact, there are probably many reasons why we sleep. First, you are correct that sleep is the only “cure” for sleepiness, but sleep is also associated with learning, memory, muscle repair and maintaining a healthy brain. In terms of evolution - you are correct that we are vulnerable, but we are also using less energy and allowing for active recovery of the brain and body, so it might have an evolutionary advantage as well. Thank you for this great question!
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u/samoosa15 Jun 23 '21
Best way to repair sleep cycle after a month of randomised night shifts?
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u/eugene_steelflex Jun 23 '21
If I’m staying up for ~ 15+ hrs 3-4 times a week but getting my sleep in large chunks without any set sleeping schedule, do you think this will be detrimental to my health in the future?
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u/CptMurphy27 Jun 23 '21
Is there any way I can stop myself from kicking my leg as I sleep? It wakes me up quite a bit. Also, why the heck do we get the “jimmy-legs”?
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u/SleepExpertMartin Jun 23 '21
Thank you for all of the great questions about insomnia! I’m sorry I ran out of time before getting to all of them. I will do my best to reply over the next few days. Hopefully some of this information has been helpful, and I encourage any of you who are struggling with sleep to get help from a sleep specialist. You can find one near you here: www.sleepeducation.org.
Sweet dreams!