good sleep hygiene for insomnia
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So, getting a good night’s sleep is vital for our lives and health.  Most disabling conditions cause or exacerbate sleep issues.  It’s a frustrating situation, and one that requires some consideration – and some planning to resolve!  Today, let’s talk about what good sleep hygiene is(and isn’t), and what you can(and can’t) realistically do to help yourself develop better sleep hygiene and treat your insomnia.

The need for consistent sleep patterns

We are used to there being patterns, rhythms, and routines in our lives.  In many cases, we do not have full control over what the patterns are – but they still greatly affect our lives.

Even though each night’s sleep may appear different, the more consistent the edges are,, the more easily your body falls into that pattern.

One thing that can really help our sleep hygiene is having a consistent bedtime and a consistent wake-up time.  Many of us had these enforced on us as children, but as adults, we have often fallen out of those habits.

If you are having trouble getting to sleep at night, one problem might be that your body doesn’t KNOW that you are trying to get to sleep then.

If one night you go to bed at 9, and another you go to bed at 11, and another you go to sleep at 2 AM, it’s unlikely that you will consistently get tired at any particular time.

However, if you know that most nights you are going to sleep around 11, over a matter of weeks, your body starts to expect sleep around then, and it becomes much easier to fall asleep at that time.

Think about what your natural sleeping pattern has been, and if it still works for you now.  If it doesn’t, think about what would work for you now.  Either way, pick a time that you want to aim to go to sleep by every night.

I aim to fall asleep around 11 PM most nights because I know I have a tendency to wake up early in the morning.  However, I have found that my sleep needs can vary dramatically, so I have learned that going to sleep at a consistent time doesn’t necessarily translate to waking up at a consistent time.

I just have nights where I need 9 or 10 hours, and other nights, where I only need 7.

My primary focus is to listen to my body, and when I start to feel tired, I go into a shortened version of my sleep ritual, even if it’s only 9 or 10 PM, and even if I don’t feel tired, I adjust the lighting around 10, and am usually in bed trying to sleep no later than midnight.

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The importance of creating and maintaining sleep rituals

You also can practice good sleep hygiene by creating a sleep routine or ritual before you go to sleep each night.  Many children, for example, will be told to put on pajamas, brush their teeth, go to the bathroom, and then get into bed for a story.

One of my common sleep rituals is to read for a while before going to sleep.

As adults, we often have stopped doing things like that.  Creating sleep rituals that work for us is another way to signal to our bodies that it’s time to go to sleep.  The more consistently we stick to a ritual, the stronger the pattern becomes, and the more often our bodies start producing more melatonin and signaling for sleep when the sleep ritual begins.

I have not been great about developing a sleep ritual, but I am working on it.  Throughout much of my life, though, I would read for a while before I went to sleep, and so lying in bed after the sun goes down reading something will often get my melatonin pumping.

My current conceptual sleep ritual involves oral hygiene, using the bathroom, listing at least three things I’m grateful for, and reading a bit before falling asleep.  I don’t manage it every night, but that is my goal.

Think about when and how you usually fall asleep and think about what habits you may be able to build around getting ready for bed.

left side holds a picture of Alison gazing levelly at the camera.  To the right, white text reads "Medical care decisions feel overwhelming?" and in smaller brown text "Click here to learn about my medical care coaching".  The far right of the banner holds the Thriving While Disabled logo

Artificial light – how to manage light for a better night’s sleep

televisions and computer screens are not conducive to a good night’s sleep!

Humans and our ancestors had our sleep patterns mostly controlled by sunlight – when the sun rises, we can do more things and see better, and when it’s dark at night, getting things done is a bit more challenging.

In modern times, we can have light, the same spectrum as sunlight, any time of day or night and any time of year.

One of the worst culprits for fooling our systems are computer and television screens.  These screens specifically release blue light, which our eyes generally interpret as sunlight. This keeps our bodies from producing melatonin, which helps us to sleep.

Lower-watt light bulbs put out less blue/white light, and computers can be set into ‘evening’ or ‘sleep’ mode to help your brain recognize that it isn’t daylight and the sun isn’t out anymore.

By cutting the blue light down or out during the last hour or two before you start your sleep ritual, you are signaling to your brain that the time to sleep is approaching.

left side holds a picture of Alison gazing levelly at the camera.  To the right, white text reads "Medical care decisions feel overwhelming?" and in smaller brown text "Click here to learn about my medical care coaching".  The far right of the banner holds the Thriving While Disabled logo

What are the other common things that keep you awake?

  • Pain can easily cause insomnia, either by keeping you from falling asleep or by preventing deep sleep
  • Anxiety often keeps people awake and is one of the more common causes of insomnia.  Often a ‘racing mind’ is a good description of stress or anxiety-caused insomnia
  • Lack of exercise – there are times when your physical, emotional, and mental fatigue don’t line up.  Your body and mind both need to be somewhat fatigued to sleep, so if you have been inactive when your body is more healed, that, too, will keep you up some nights as your health improves
  • Light – if your bedroom has a lot of lights on when you fall asleep, or even light comes into your room from outside(an open door letting in light from another room, or a street-light shining into your room), that can disrupt your sleep
  • Sound – if you hear noises that come at irregular intervals or are generally disruptive, it can be hard to fall or stay asleep

What can you do about them?

  • Pain medication, which frequently can also cause drowsiness, can help to reduce your overall pain level and help you fall asleep.  It is a reasonable short to medium term fix, but in the long run, you run the risk of addiction or developing a tolerance to the medication.  If you feel it is needed, please discuss it with your doctor.
  • Look into meditations that help with pain management to help yourself in the long term.
  • Anti-Anxiety medications and anti-depressants can reduce your anxiety levels, leading to easier sleep.  Use only under a doctor’s care.
  • sleeping pills can be useful in the short-term if you have insomnia. However, they can have severe long-term effects.  If you feel you need them, discuss your options with your doctor.  Sleeping pills can be useful for helping you to break an insomnia cycle. If needed, use them sparingly
  • Develop stress management techniques and meditation habits to help soothe your mind before sleep
  • Relaxation techniques such as gratitude exercises or journaling may help you relax too.  Coloring may also be a good way to help signal your brain that it’s bedtime.  Some people also drink herbal tea as a part of their nightly sleep habit. 
  • Exercising during the day can help you be tired in the evening.  Exercise is best done in the morning or afternoon.  Having an exercise routine is a healthy habit in general, but it also can help you to get a good night’s sleep.
  • Keep your bedroom as dark as possible whenever you go to sleep.  Get blackout curtains if needed.  Keep your bedroom door closed if necessary.  You may even want to invest in a sleep mask.
  • If you are hearing noises when you go to sleep, do what you can to keep them from happening: get the leaky faucet repaired, have the night-owl in your life use headphones, or whatever adjustments can be made in your home to protect yourself from distracting sounds when you fall asleep.  If you feel you need to, you can also get earplugs!
left side holds a picture of Alison gazing levelly at the camera.  To the right, white text reads "Medical care decisions feel overwhelming?" and in smaller brown text "Click here to learn about my medical care coaching".  The far right of the banner holds the Thriving While Disabled logo

Finding your own unique solutions

Sometimes the standard sleep advice just doesn’t work.  If these suggestions don’t work for you, get creative and try something else.

If you have trouble sleeping, experiment until you find something that works!

One of my biggest anxieties is over being or feeling alone.  I would watch movies to help myself get to sleep.  I would have the sounds of other voices around me and feel like I wasn’t alone.

I had a collection of movies, mostly apocalyptic and action movies(with hopeful endings), that I basically had memorized.  I would put one of my memorized movies on, and peacefully fall asleep to the murder and mayhem on the screen.

I’ve thought about why this worked for me.  I think that it’s because, at the time, anything that was designed to be relaxing would immediately bring out my movement symptoms, which made falling asleep really challenging.

With the apocalyptic movies, they were full of action and adventures, so I wasn’t feeling like anything was trying to force me to sleep. I knew the plot and the feel of the movie, so it didn’t surprise me out of my sleep, and it felt familiar and reliable, so it comforted me.

I spent several years using that method to sleep whenever I was home alone for the evening or overnight, and it worked pretty well.

Eventually, I got better control over my symptoms and my subconscious, and more traditional practices worked for me. It took time, and therapy, and support. 

I just want you to know that even if something that helps you sleep seems weird or counterintuitive – it might be that it’s something you do need, at least for a while.  And that’s okay too.

left side holds a picture of Alison gazing levelly at the camera.  To the right, white text reads "Medical care decisions feel overwhelming?" and in smaller brown text "Click here to learn about my medical care coaching".  The far right of the banner holds the Thriving While Disabled logo

Conclusion: Sleep hygiene for insomnia

If you have trouble sleeping, you are not alone.  Your disability has likely enhanced any sleep issues you may have had previously, and it’s possible to likely that you also simply need more sleep than you did before your condition got more serious.

You can choose to form habits for yourself that will help you sleep more and have a higher quality sleep at least most of the time.

Our modern environment is very unfriendly to healthy sleep and we are best served by making a conscious decision to prepare our minds and bodies to sleep every night – by minimizing blue light before bed, giving ourselves a dark and quiet space to sleep in, and developing consistent sleep habits, we can improve our sleep hygiene and improve our quality of life.

Thinking about what you have read, pick out one sleep habit that you think would help you get a good night’s sleep, and implement it tonight!

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  1. A very helpful guide for sleep. I did my first sleep study in university at age 21. I also read my first sleep book. It’s called Lights Out and that book still resonates deeply with me 20+ years later. I find the topic of sleep fascinating – probably because I barely get any. 🙂

    Routines are very important and I rarely deviate from mine. My sleep disorder is severe and it’s important to stay on track. Most of your tips here are my regular habits. My favorite is a hot bath though. Plus a cold, dark cave, I mean room, are also essentials.

    1. Carrie,
      Thank you for sharing! I spent a lot of the summer with the air conditioning running at night – my partner and I have very different ideas of ‘ideal sleep temperature’ so that makes life interesting. In the winter, we usually have two different covers on the bed – one pretty light for me, and a down comforter for him. In the summer, I keep the air blasting overnight, and he’s curled up under the sheets, considering a blanket!
      The warm bath sounds like a lovely idea too – not an option for me currently since we no longer have a bathtub(we do have a newly-created bathroom with a generous standing shower).
      I know how deeply important sleep is, and I’m glad to hear that my suggestions are so familiar to an expert like you!

  2. So helpful! I did sleep CBT a few years ago and it involved a of the things you have spoken about here. I have fallen off the wagon with a few though . . . I guess I need to get back on the wagon!

    1. If your sleep schedule’s off-base, it likely will help!
      I’m staying awake a little later than I’d like, but that’s mainly because I keep finding interesting books to read and get a little carried away. Fortunately, it’s all on my kindle, and I turn the backlight off, so I’m doing the right things in terms of sleep habits.
      Whenever I do get to sleep, I’m out for the night, which is great. I have also found myself taking naps on occasion, I suspect because of the heavy dose of gabapentin I’m taking for the migraines. Since it’s not a daily occurrence, I’m still taking it, but it’s something I’m keeping an eye on.
      Good luck getting back on the wagon if you need to!

  3. This is all so helpful Alison!

    I have tried my best to create a routine but I do have some days during the week where I don’t manage it, but majority of the times I do.

    There is one thing that is very important for my sleep – a clean space. whether it’s my bed-side table, bedsheets, duvet, pillow case, night clothes which I wear after a warm shower. A clean me and an environment helps to reduce reactions to dust allergies and makes me feel fresh and comfortable in bed. It’s like it’s a new and important activity of the day that requires me getting ready for it and I really enjoy the rituals around it.

    1. The more consistent you are, the better! Love how you value cleanliness for your physical and mental health! I’m really not good at consistent housekeeping, and the allergen I’m most sensitive to is cat dander(discovered this after adopting two cats – the cat we’d had prior hadn’t triggered my allergies for some reason). Still love having the kitties lay on me though, so I’m just grateful that my zyrtec does the job most of the time.

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