I used to be that enviable person who could sleep anytime, anywhere. In university I would regularly fall asleep in my first class after lunch. When travelling, I would be able to fall asleep on planes, trains, and automobiles, making travel companions uber-envious. And then mental illness came along and it was a whole new ballgame. I rely heavily on my meds for sleep (quetiapine and mirtazapine), although at this point I’m not taking any that function solely as sleep meds. I also try (at least sort of) to practice what I preach when it comes to sleep hygiene. Here’s a bit of a personal report card on how I’m doing, based on the American Sleep Association‘s recommendations.
Maintain a regular sleep schedule
I’m pretty good at this for the most part. I go to bed ridiculously early (think 8pm) and wake up around 3am. It’s weird, but I’ve always been a morning person and it works for me. Things get thrown off when I work night shifts, but I’ve found that if I split my quetiapine dose and take 300mg at around 4:30pm and then the other 300mg in the morning, I’m able to sleep for a few hours before work and then a few more hours when I get home.
I love napping. I generally have an energy lull after lunch, and if I can lie down for an hour I am a very happy camper. I may or may not actually sleep for any or all of that time, but an hour is my sweet spot, and I’m not interested in giving that up.
Don’t stay in bed awake
This can be a tough call. Sometimes staying in bed awake works out and I will get back to sleep, which makes me a little reluctant to get up if I’m still feeling sleepy. Usually, though, I can tell pretty quickly if I’m up and there’s no way I’ll be getting back to sleep. And then there’s other times I just feel like lying there zoned out rather than getting up and facing the day. In the end, I think it’s important to get to know your mind and body and recognize what they’re telling you.
Don’t watch tv or read in bed
Fail and fail. I don’t actually have a tv in my bedroom, but I do watch tv on my laptop in bed. Reading in bed is one of the quickest ways for me to get to sleep, as long as it’s not overly stimulating.
In one of my little idiosyncrasies, I’ve divided my bed into the sleeping side and the awake side. I spend quite a bit of time in my bedroom, mostly because that’s where my darling guinea pigs’ cages are. All of my awake stuff happens only on one side of the bed, and napping and sleeping happens only on the other side. Perhaps it’s a bit silly, but in my own strange way it’s how I incorporate the sleep hygiene idea that the bed should only be for sex and sleep. Maybe it’s a good thing I don’t have a partner in the picture, because it would throw off my system.
Avoid substances that interfere with sleep
I’m usually pretty good about this. I rarely have caffeine in the later part of the day, and if I’m having any alcohol it’s usually in the afternoon and at most 2 glasses of wine.
This is definitely an area where I could do better. I find that in winter I exercise less because it’s wet and gross outside here in rainy Vancouver, and being outside just makes me feel miserable. I’ve never been a fan of going to the gym to work out, and dance classes have always been my exercise of choice. The cognitive symptoms of my depression have made it hard to keep up with choreography, so I’ve only been taking classes with teachers whose styles I’m really familiar with.
Establish a good sleep environment
I live in a very quiet neighbourhood, so there’s no bothersome noise to interfere with my sleep. I keep my bedroom cool and dark. My phone is usually at my bedside because I use a meditation app before bed, but I’ve got notifications turned off so there’s nothing to disrupt my sleep during the night. I have an old-school alarm clock so I don’t have to reach for my phone to check the time.
Establish a relaxing pre-bedtime routine
I don’t have a set routine necessarily, but I take my meds half an hour before I plan to go to bed, and keep things pretty low stimulation for that half hour. Bedtime has always been one of my favourite times of day, a time to escape from the real world into peaceful oblivion.
So, that’s my attempt at sleep hygiene. I’m not doing great at it, but I think I’ve found the happy medium that works for me. And after all, rules are meant to be broken, aren’t they?