Help! I Can’t Sleep!

Help! I Can’t Sleep!

By April Wilson Smith, MPH

Having trouble sleeping?  You’re not alone!  Most people who are trying to change their relationship with alcohol have difficulty sleeping.  Luckily there are many things you can do to get a good night’s rest. Here are some tips and tricks compiled by people who have been there. 


Turn off electronic devices an hour before bedtime. 


Put away your phone.  Stop texting.  Get off Facebook, TikTok, Instagram, Twitter, and The New York Times online.  Turn off the television.  Let your brain unplug, not just from the flashing lights and disturbing noises, but from the agitation that almost always comes with consuming social media, television, or texting.   


Putting your phone to bed an hour before you hop into bed will help your brain wind down.  It’s so easy to get caught up in a conversation via text, or in a thread on social media.  Do your brain a favor and stop the input.  Most smartphones have an app where you can set a sleep schedule that turns your notifications off at a time you prearrange.  With notifications off, people may text you, but you won’t know!  Leave the phone in another room overnight and resist the temptation to check on it.  It will be just fine without you until morning.  It may even enjoy the rest. 


Avoid difficult conversations at night. 


The early months of changing your drinking can be filled with difficult conversations.  Everyone seems to want to talk about it… a subject for another post!  Put these conversations to bed around dinner time or earlier.   


It seems obvious that you won’t get to sleep easily or sleep well if you’re riled up from a tense conversation, but it can be hard to set limits, especially if loved ones feel they are entitled to say what they’ve been holding onto.  We recommend that you ask friends and family to help you reset your sleep schedule by setting times for tough but necessary discussions, and scheduling those for daytime hours.  You’ll be more rested, you won’t be caught off guard, and you’ll start putting your sleep schedule back together. 


Have a wind-down routine. 


Humans love routines.  Our pets do too. Do you notice that your dog or cat likes to be fed at the same time, sleep at the same time, go for walks, or play at the same time every day?   


Develop a routine that tells your body that it’s time to relax.  I like to wash my face, brush, and floss my teeth, and read a light, not upsetting book for the hour before bedtime.  Taking a hot shower or bath is not just relaxing, it also helps you sleep through what scientists call the “Warm Bath Effect.”1  According to Harding Franks, and Wisden (2019), “In humans, immersion in hot water prior to, but not immediately before, the sleep period decreases sleep latency and increases sleep depth.”1  That means you’ll fall asleep faster and sleep more deeply.  We sleep best when our bodies are releasing heat from our core, and our body temperature is dropping.  Warm up in a nice bath or shower and cool down into a restful sleep.  


 Some people like to do light yoga or stretch.  Journaling before bed (using pen and paper) can put a punctuation mark on the day and make it easier to let the past go and be ready for the future.  A little aromatherapy with scented lavender or chamomile oil makes some people smell sleepy time.  Cuddle a beloved pet if one is available.  


Whatever you choose to incorporate into your bedtime routine, make sure it’s something you like to do.  (Okay, no one really *likes* to floss, but you like the feeling of clean teeth, right?)  Don’t force yourself to do a pigeon pose if your hips are tight and you hate yoga.  Don’t read if reading hurts your eyes – maybe try coloring or sketching instead.  Your bedtime routine should be a reward, not punishment.  I love to soak in Epsom salts to take out all the tension from the day. They’re cheap and make you feel like you’ve had a massage!  


Eat only a small snack, low in carbohydrate, shortly before bed… and finish your large meal three hours before bed. 


After you eat, the ongoing digestive process raises your body temperature.  This process is called thermogenesis and it’s terrible for sleep.  Try to finish eating three hours before your bedtime.   But to avoid a state of low blood sugar during sleep,  eat a high protein, small snack with some fat, like a little peanut butter or a piece of cheese.  Don’t eat a snack high in carbohydrates, such as candy or ice cream.  That will raise your body temperature even higher, and you’ll ride the sugar roller coaster.  Going on a sugar high followed by the predictable crash is the last thing you need before bed.  The old advice, “Don’t eat cookies in bed,” is still true, and not just because of the crumbs!  


Go to bed at the same time every night.  Wake up at the same time every morning. 


Sleep expert Matthew Walker, PhD, calls the practice of sleeping and waking at different times, especially on weekends vs. weekdays, “social jetlag.”2 You may not be taking a trans-Atlantic flight, but your body is just as confused!  Find a schedule that works for you and stay on it.  


If you’ve missed out on sleep and need to catch up, go to bed earlier the next night rather than sleeping in.  Sleeping late makes it harder to get to sleep and sleep well the next day, perpetuating an unhealthy cycle. 


Recognizing that you weren’t really sleeping when you were drinking – you were just unconscious. 


Alcohol disrupts REM sleep, the part of your night when your eyes move rapidly under the eyelids.  This kind of sleep is essential for processing events that occurred while you were awake.3,4 It is especially important for processing upsetting experiences and trauma.3,4 Poor sleep doesn’t just follow negative events because they are upsetting, it makes it hard to move on from challenging emotional situations.  This means that during the time when you were drinking, you were not properly processing the emotional events that went on in your life.  No wonder it feels like sadness, fear, and bad memories are hard to shake!  Starting to get real sleep is a step towards restoring health on mental as well as physical levels.  


 “I’m resting.”  


Even if you “can’t sleep,” try to relax, get into a comfortable position in bed, and just rest.  Tell yourself, “I’m resting,” and let upsetting or stressful thoughts float out of your mind.  Even if it feels like you’re awake, you likely are experiencing microsleep (short periods of time when you are sleeping).  Your body will get rest, and you will feel much better than if you get up and read a book or worse, jump on the internet! 


No caffeine in the afternoon or evening. 


If you think you are immune to caffeine, you are the person who needs this tip the most!  You may be tolerant to the effects of caffeine, which means you’re not feeling it much in the morning, but you ARE feeling it while you try to sleep.  Decide what constitutes afternoon or evening for you: I get up around 5 am and go to bed close to 9 pm, so I cut off caffeine at noon.    Caffeine stays in your system longer than you think. If you have a cup of coffee at noon, half of the caffeine is still in your system at midnight. So, it is best to not have caffeine 12 hours before you are going to go to bed. Not only will you sleep better, your morning coffee will have that zing again!  


No television or phones in bed (but you might want to try a white noise machine!)  


Bed should be for rest… not aggravating devices like TV or phones.  But what about if you like to fall asleep to the noise of the TV?  Try a white noise machine with either plain white noise or nice sounds like birdsong, a gentle rain or waves lapping against the beach.  A white noise machine can block out distracting city or house noises and signal your brain that it’s safe to sleep.  


 Keep the lights down. 


Turn off your lights and use light blocking blinds to keep the sun from coming in your room early in the morning (unless you’re like me and up before the sun!)   


 Make a list of your worries… and kiss it goodnight!  


Worrying in bed makes bed a bad place to be.  To put your worries to bed before you try to sleep, make a list of your worries, and then place the list somewhere that is not in your bedroom, maybe a special box, that’s out of sight.  Make your list in a room other than the one where you sleep. Then, put the list to bed, and tell yourself loudly, “I am putting these worries to bed.”   


 Keep your room cool. 


A cool, but comfortable room will make it easier to fall asleep and stay asleep!  


 Drink less fluid, even water, in the evening. 


Feeling like you need to run to the bathroom makes it hard to get to sleep and waking many times in the night interrupts what could be valuable sleep.  Try cutting back on liquids for the three hours before bedtime.  Another tip, if you feel thirsty but don’t want to drink much, take tiny sips.  You will feel more satisfied without as much liquid!  


 Exercise, but not right before bed. 


Daily exercise can help you sleep but exercising right before bed can hype you up.  So, exercise regularly, but cut it off three hours before bed. 


 Turn the clock away. 


If you sleep with a clock on your bedside table, turn those glowing numbers away.  It’s best to sleep with your phone in another room, but if you must sleep with your phone in your room, try not to pick it up to check the time (or worse, your texts!  But that shouldn’t happen because you turned off notifications… right?)  Knowing what time it is will only stress you out.  Until the alarm goes off, assume it’s sleepy time!   


 Chasing sleep?  


If you’ve been using alcohol to fall asleep, or fall unconscious, for a long time, it may feel like you’re chasing sleep when you first reduce or eliminate alcohol.  Try not to worry!  If you follow these tips and use these tools, you will soon be getting good, real sleep.  You’ll be on your way to your best health!  


References:  


1 Harding EC, Franks NP, Wisden W. (2019) The Temperature Dependence of Sleep.  Frontiers in NeuroscienceFrontiers | The Temperature Dependence of Sleep (frontiersin.org) 

Attia, P. (Host)  (August 31, 2020).  Episode #126: Matthew Walker, PhD: Sleep and Immune Function, Chronotypes, Hygiene Tips and Addressing Questions About His Book.” #126 – Matthew Walker, Ph.D.: Sleep and immune function, chronotypes, hygiene tips, and addressing questions about his book – Peter Attia (peterattiamd.com) 

3  Werner GG, Schebas M, Wilhelm FH, Blechert J.  (2020) Differential Effects of REM Sleep on Emotional Processing: Initial Evidence for Increased Short-term Emotional Responses and Reduced Long-term Intrusive Memories.  Behavioral Sleep Medicine(PDF) Differential Effects of REM Sleep on Emotional Processing: Initial Evidence for Increased Short-term Emotional Responses and Reduced Long-term Intrusive Memories (researchgate.net) 

4 Glosemeyer, R.W., Diekelmann, S., Cassel, W. et al. (2020) Selective suppression of rapid eye movement sleep increases next-day negative affect and amygdala responses to social exclusion. Sci Rep 10, 17325 (2020). Selective suppression of rapid eye movement sleep increases next-day negative affect and amygdala responses to social exclusion | Scientific Reports (nature.com) 

April Wilson Smith, MPH

April Wilson Smith, MPH