Cracking the Sleep Code

Strategy: Tip #3 to winning at the game of sleep

Sleeping tip discussion #3: Follow the 20 minute rule! 

So far we've covered...

1. The importance of a strict sleep schedule ---designated bed time
    and wake up time
2. Not going to bed until you are tired.
3. Getting up at your designated wake up time even if you're up all night.
4. Cutting back on your time in bed: quality verses quantity

The object of the sleep game is to achieve the optimal bed ratio. In other words you want 95% sleep to 5% wake time while in your bed.  When you wake up at night you need to follow the 20 minute rule.  Do not lay in bed more than 20 minutes.  Get up and go into another room and lay down until your tired, then return to your bed.  Repeat this as many times as necessary. With this rule I know personally that it is terribly painful to get up out of that warm bed, but your mind can associate being awake with your bed and that association needs to be broken.

Can you follow the 20 minute rule?  You will if you want to find your dreams again.  And trust me.  You will.

Strategy: "Tip"#2 to sleep bliss

My last article spoke about

1. The importance of a strict schedule ---designated bed time and
     wake up time
2.  Not going to bed until you are tired.
3.  Getting up at your designated wake up time even if you're up all night.

If you are already following the "schedule rule" and are still having problems staying asleep then it's time to get tough.  This is where they separate "the boys from the men", but you will sleep like a rock if you play this game right. You are going to cut back on on the amount of hours you are in your bed and then slowly increase it.  This could take a week (or less) but the outcome will be amazing. 

Pick the least amount of hours you think you can function on.  Most say 5 or 6.  Let's pick 6 for an example.  If your designated wake up time is 6:30 then you can't go to bed until 12:30am.  If you still wake up too much you'll need to cut back to 5 hours.  Yes, you will be a little tired but if have insomnia it won't be any worse than what you've already endured.  By cutting back on how long you're in bed you will actually be increasing the quality of your sleep.

See you tomorrow for more constructive tips...

The real deal. Constructive sleeping tips that will cure your insomnia.

Let's talk about scheduled sleep.  If you have insomnia you have probably heard the advice  "go to bed at the same time and get up at the same time everyday."  How important is this?  VERY.

Some insomniac's still have problems getting to sleep with this advice.  The trick is not to put yourself to bed until you are TIRED.  For example don't go to bed at 10:00 because you have to be up at 6:00 just  to make sure you get your 8 hours of sleep.  This won't work if you have insomnia.  Putting yourself in bed earlier, which obviously means you'll be in bed longer, will only make it worse.  Wait until you can't keep your eyes open before you go to bed.  If this means you don't fall asleep until 2:00am so be it...but you are still going to get out of bed at 6:00am (your designated wake up time!)   Will you be tired when you drag yourself out of bed? Absolutely.  Will you sleep better the next night?  Absolutely.

This is part of the plan and each night will get better and better.   See you tomorrow for more constructive sleep tips.

Tired of hearing sleeping tips? Let's talk about a real insomnia cure

As a recovered insomniac sleeping tips always sounded like a cliches to me.  Whenever I think about just writing  sleeping "tips" without any explanation or discussion to make the tip constructive I imagine what I would say in response to each sleeping tip.   Let me give you an example.  How many times have you heard...

1. Make sure that you have scheduled sleep times...(I have a scheduled sleep time but I can't fall asleep at the scheduled time)

2. Relax/meditate--imagine a beach or somewhere you find peaceful..(I imagine myself on a beach but the thoughts that are keeping me awake show up under my umbrella)

3. Avoid caffeine---(if you have insomnia and haven't figured out yet not to have caffeine to close to bed you might as well 'toss in the pillow' now)

5. Exercise at least 3 days a week---(I exercised like aerobic instructor on speed...no change with my sleeping)

6. Keep your room dark and quiet--(I have never known anyone with insomnia to have the sun blasting through their windows at sunrise)

These things are all true but seem so obvious to me.  When I had problems sleeping I heard these things regularly and I can't even tell you from where.  Maybe even on a TV commercial at some point.  Let's talk about a constructive plan that will get you your old sleep back.

I am going to break down a real plan to change your sleeping pattern during the next few days. I will have tips that if put into action will be life changing.  If you really want to get serious about changing your sleep pattern and sleep like the old you come back tomorrow and I will start you on cracking your sleep code.

Could snoring and other sleep problems in children be directly related to behavioral problems and hyperactivity?

How well does your child sleep?  Do they get enough sleep?  These are questions that should go through your mind if your child has behavioral and or hyperactivity issues.  This study done by the University of Michigan Health System talks about the direct link between snoring and behavioral problems in children. After this Michigan study, there have been more studies conducted with similar findings but the community awareness on this issue is still lacking.

http://www.med.umich.edu/opm/newspage/2002/sleepproblems.htm

Popular Snore Aides: Do they work?

I used to laugh at the products on commercials that made claims to cure snoring.  Then I started thinking about the people who are buying them.  Not all of the customers buying the snoring products have sleep apnea but some might. Could buying into the "snore cure" delay some people who need to seek medical help for an unknown breathing disorder?  I wanted to share this interesting study on snore aids.
                                          

                                         Popular snore aids: do they work?                 

                              Otolaryngol Head Neck Surg2004 Jun;130(6):649-58.

                                     

Michaelson PG, Mair EA                                                         

Comments:                                        

I am glad to see this study. When I served on the Clinical Practice Review committee of the American Academy of Sleep Medicine, we undertook an evaluation of the claims made by various snore-remedy manufacturers. There is an amazing number of them on the Internet. Only one claimed that their product had been evaluated objectively in a sleep center. I requested a copy of the study that had been done--and it revealed that the product didn't work!      

A major concern that we on the committee had was that use of these unproved remedies could delay initiation of appropriate, effective treatment--which could prove dangerous, given the often catastrophic and irreversible complications of severe sleep apnea. Another concern was that some of the sprays are oil based, such that conceivably, they could increase the risk of lipoid pneumonia.                                     

The only use that my sleep center has found for the nasal strips has been wearing them with (rather than instead of) positive airway pressure at times of upper respiratory infections with severe nasal congestion, in those patients who feel that the nasal strips make PAP (positive airway  pressure) easier to tolerate at times of such congestion.                                     

Fortunately, yet another study showed that some two-thirds of patients on CPAP experience a marked reduction in the frequency of sinus infections--and use of heated humidifiers render them all the more helpful in preventing such infections during the dry winter months.

Insomnia: Kick the habit!

This question came from Leanne in Maine:

I have always been one to wake up in the night at least once.  But the past year I sometimes wake up 3 or 4 times in the night and it's so frustrating.  Many times I can't get back to sleep... I am slipping into an insomnia pattern and am so tired during the day.  My husband says he has never heard me snore and as far as I know--my breathing is fine.  I have no trouble going to sleep when I first go to bed---but how can I keep myself from waking up in the middle of the night? 

Thanks for asking Leanne.

There are a few things you can do to break this pattern of waking up.
Your brain works on repetition. It becomes programmed with habits.  So in order for you to sleep through the night you have to break the habit.  You need to have a set time to go to bed and a set time to wake up EVERY MORNING. Poor sleep patterns/insomnia are made worse by 'sleeping in' to make up for lost sleep. You're just going to make your next night worse if you try to make up for sleep the next morning.

It's important to focus on quality of your sleep not quantity.  For example if you slept 6 hours straight through you would feel better than sleeping 9 choppy hours of "up and down" all night. This plan cured me and many others.  I now sleep 7.5 hours and wake up only once.

Let's look at it in steps...

1. In the start of your cure plan pick the least amount of hours you can function on.  5 or 6 hours?

2.  Pick a designated wake up time. For example if it is 7:00am then don't go to bed until 1:00am.  Don't worry this is only in the beginning--you will increase your hours in bed after a few nights.   Do whatever you have to do to make it to that 1:00am bedtime.  *If you want to sleep like a normal person and feel refreshed like a normal person, you're going to have to have some self discipline to get the results. Even if you don't sleep at all get out of bed at your designated wake up time.

3. After you have settled in to this routine and are happy with the quality of your sleep start moving your bedtime back by approximately 20 minute increments.  Some need only a couple of nights to get in the routine others need more.  Whatever it takes for you.

4. When you wake up in the night make sure you follow the "get out of bed rule".  Don't lay in bed for more than 20 minutes.  Get up and go lay somewhere else---anywhere but your bed.  Your brain can associate 'being awake and your bed' if you are consistently awake in your bed.  This is part of the cause of insomnia---bad habits.

5. When you've established your routine... for example 11:30pm to 6:30am, make sure you stay with this.  Don't get loose and start cheating with a half and hour here or there.  It's like with an alcoholic... you as a former insomniac, can fall off the wagon.

6.  Don't stress about the occasional bad night.  Most likely you will have a good night after a bad night ...so don't worry!

7. Don't drink much of anything past 6:00pm.  If you wake up to go to the bathroom try to get your bladder as empty as possible before going to bed.

To read more about curing your insomnia go to "Crack the Insomnia Code" and "The Sleep Journal"

Recommended reading: Desperately seeking snoozin' by John Wiedman

Good night and sleep tight.

Can a Tonsillectomy in Children Cure Attention Deficit Disorder?

Many things have been questioned as being the cause for ADHD (attention deficit/hyperactivity disorder) i.e. television, genetics and now sleep disordered breathing.  As parents we need to have heightened awareness of how our children are sleeping. If your child is showing signs of ADHD, start by being aware of how they breathe while asleep and how well rested they are after significant amount of sleep. If sleep deprivation is hard on an adult imagine what a negative impact it can be for a person who's brain is trying to grow and develop.  Here is a great article that tells of the study results on tonsillectomies and sleep deprivation as well as ADHD and sleep disordered breathing in children.

http://www.med.umich.edu/opm/newspage/2006/sleep.htm

Sleep Quote for April 20th

"Not being able to sleep is terrible. You have the misery of having partied all night... without the satisfaction."

Lynn Johnston - Cartoonist creator of 'For better or For worse'

Is it sleep apnea or a nose problem?

Turbinate Enlargement (Hypertrophy)

It would be great if we could plug ourselves in to a sleep machine and unplug it 8 hours later.  Maybe in 100 years scientists will come out with "the sleep machine."  Unfortunately many of us have to claw, scrape and fight our way to the land of dreaming.  Breathing seems to be a common word used when there is talk of sleep issues and the word "snoring" has become a buzz word for possible sleep apnea diagnosis.

Even though rare, there have been people who have found that their sleep breathing/problems were not created by obstuctive sleep apnea as originally thought. If you have problems with your sleep and have chronic nasal congestion in one side or both sides of your nose then this article might be for you. Even if the congestion is only at night, visiting an otolaryngologist will allow you to find all possible causes.  The great thing about finding the problem in your nose is that most often is that it can be cured with minor surgery---no CPAP (continuous positive airway pressure), no soft palate surgery and no sleep studies are needed.  Advanced Ear, nose & throat Associates, PC in Atlanta GA gives this description...