Back in 2018, I did a post looking at the sleep hygiene recommendations that I was and was not following. I decided to look back and reflect on what’s changed since then.
What hasn’t changed is that I can’t sleep without medication. I’m not taking anything specifically for sleep, but a couple of my regular bedtime medications (quetiapine and mirtazapine) are sedating. I can usually sleep pretty well with the meds, although when the depression gets worse, I sleep less. Overall sleep hygiene isn’t that big a priority, but it’s still worth doing what I can to promote sleep.
Maintain a regular sleep schedule
I have a very regular sleep schedule, although it’s shifted to a later bedtime in the summer. By later, I mean around 8:30pm. Really.
There aren’t any external factors that would throw off my schedule. It’s been many months since I last worked, plus I don’t socialize, so there’s no reason for evening to even exist in my world. At the time of my post a couple of years ago, I wasn’t socializing then either, but I was working the occasional night shift that would temporarily throw off my sleep.
Avoid naps
I used to really like short afternoon naps. It was a problem when I was in university, because I’d fall asleep in the first class after lunch, whether I wanted to or not.
In the post from 2018, I was having a lie-down regularly in the afternoons, although I wouldn’t usually sleep. Now, it’s rare for me to nap in the afternoon. I just don’t get that after-lunch sleepiness that I used to. Occasionally I’ll lie down for a while to cuddle a guinea pig, but that’s about it.
Don’t stay in bed awake
If I wake up during the night, I usually have a good sense pretty quickly of whether I’m likely to fall back asleep or not. Sometimes lying in bed awake feels restful even if I don’t think I’m going to get back to sleep.
It makes a difference that I don’t really have much to do during the day; I’m not feeling pressured to try to stay in bed and hopefully get some more sleep in order to be rested for the day to come. When I was working night shifts, this was more of an issue because I really wanted to get an evening nap in before going to work, and given the time, getting up and waiting until I was sleepy to go back to bed just wasn’t feasible.
Don’t watch tv or read in bed
I spend most of my time on my bed, and I do just about everything there. Partly, I just like my bedroom, but mostly, it’s because I’m close to the guinea pigs — the girls are in the bedroom, and the boys are in the adjacent bathroom.
Something that’s stayed consistent from the last post is that I have a sitting side of the bed and a lying down side. The sitting side is for daytime use, and the lying down side is for nighttime and the occasional nap. For me, that feels like sufficient psychological separation.
In terms of screen time before bed, I don’t find that the screen exposure makes it hard for me to get to sleep, but what I’m looking at on the screen does matter. Less stimulating content seems to be fine for me.
Avoid substances that interfere with sleep
Any alcohol is usually around lunchtime, which hasn’t changed. I drink tea in the afternoon more often than I used to, but I’ve never found tea wakes me up all that much unless I’m drinking really large amounts.
Exercise regularly
Two years ago, walking was my main form of exercise. I had gone to dance classes before then, but it just wasn’t working anymore because of a few depression-related factors.
I used to walk to the grocery store about 3 times a week. Now, with a combination of COVID and persistent psychomotor retardation, walks are happening a lot less often. And given that I can barely go at a snail’s pace, I’m certainly not getting my heart rate up at all.
Establish a good sleep environment
I like where I sleep. My bedroom is cozy and calm. It’s quiet where I live and the nighttime temperature is usually comfortable. I’ve got blackout curtains, and I don’t have anything producing any unnecessary light.
The guinea pigs are used to my schedule. They’re usually sleeping when I go to bed, or quietly munching on some hay. They can tell when I wake up, I guess because I start moving around more in bed. Sometimes I’ll want to lie in bed for a while, but they’re not prepared to give that the green light, because they want their breakfast.
Establish a relaxing pre-bedtime routine
I guess I have a routine in that I do the same thing most days, but it doesn’t really involve much. I’m on my laptop until I naturally start getting tired, then I take my meds and crawl into bed. When the meds kick in, I go to sleep.
On rare occasions, I’ll think I already took my meds when I actually hadn’t, and I’ll wonder why I’m lying in bed really tired but can’t sleep. After some time has passed, I’ll start to think that maybe I didn’t actually take my meds, but I don’t want to accidentally double-dose, so I wait some more. When it becomes clear that I definitely didn’t take the meds, I take them, and a short time later I’m out like a light. Meds are definitely my friends.
Getting by
Overall, I guess I’m doing so-so in terms of sleep hygiene, but I think I’ve found a good balance of doing the things that matter more for me. I’m definitely very glad to be on meds that zonk me out at night. In the past, getting a half-decent amount of sleep while I was depressed was pretty tough, even with sleep meds like zopiclone and trazodone. Quetiapine may have contributed to making me fat, but it is most certainly my friend.
How do you do with sleep and sleep hygiene?
Sleep Better: The Little Book of Sleep is a mini-ebook that covers a range of strategies, both medical and non-medical, to help you get the best sleep you can. You can find it on the Resources page.
I read the words ‘sleep hygiene’ and wondered what the heck is that? Taking a shower before bed? I am a night owl and the years I lived alone, despite working the ole 9 to 5 I could adhere to my natural rhythms, sharing living space knocks that all to hell I can tell you. The last 5 months or so I having been going to bed at the ungodly hour of 9:30pm, watching a video on my iPad and asleep usually by 10:30-11 and then getting up, depending on the days schedule either at 6am or 8:30am! Yes, I still have occasional bouts of insomnia when I get zero sleep for a day or two but for the most part I’ve been sleeping well (Oho!). I get dreadful leg cramps which have been alleviated by taking extra magnesium which tends to help with sleep as well but also has me loggy during the day…So I skip it the night before I have to be up early…
If I lived with someone my whole sleeping system would be fucked, so that really needs to not happen 😉
I have a roommate now, but she’s quiet and wonderful, so I am lucky there. Sometimes Gatsby wakes me up with his cat antics, and that can wreck my sleep, but there’s nothing I can do about him. I don’t follow the guidelines ~ I often read in bed or play phone games, I have caffeine in the afternoon, I don’t have a regular bedtime (varies between 10pm and 2am!), etc. But I definitely don’t take naps unless I’m sick.
Pain wakes me. Sometimes it’s my back, other times my head. There’s also not much I can do about this, though if I remain in bed too long after feeling uncomfortable, the pain will get much worse. My body needs to move around… to the Rx bottle!
Drugs are a wonderful thing! And yeah, furballs will operate on their own agenda.
I sleep a lot ! And yet I’m always tired when wake up..my previous medication would make get in a great sleep but then I would be sleepy for the rest of the day as well..
Oh that’s annoying. 8 or 9 hours has always been my ideal, and luckily my Seroquel seems to have worn off by the time I get to sleep.
I think you are doing a great job. I move my body more nowadays because I swim here. It makes me sleep faster. I really have to go earlier to bed though. It’s a struggle
Swimming sounds lovely!
I wouldn’t have much sleep without my meds.
I have forgotten to take them sometimes which causes a night of total wakeness.
My meds are separated for me by my best friend. He puts them in three pill bottles with a letter on them to signify when to take them.
I usually sleep at least 12 hours a night.
That’s convenient to have help with managing your meds. And great that you’re able to get the sleep you need.
The idea of my best friend came about because years ago I ended up double dosing. It was a decision between myself, best friend, Psychiatrist, family doctor.
I was prescribed Oxycontin which is where the problem was. I do not take any narcs now.
But sounds like the system still works well regardless.
It does. I remember a saying, “don’t change horses midstream”.
If it works don’t fix it!
Exactly!
Luckily my caffeinated beverage of choice is tea, and it’s not enough caffeine to interfere with my sleep.
I used to nap regularly and it didn’t interfere with my sleep. I think timing matters. The circadian rhythm has a natural lull in the early afternoon, and I would think that napping during that time would have less of an impact than napping at other times of day.
I sleep way too much. I know you’re supposed to stick to a schedule but I find it impossible to get up in the morning if I don’t have any previous commitments. I love to read in bed too, which I guess is also bad for you. But I do have a nighttime routine that I stick to and I found this one brief picture with yoga poses you can do, so sometimes I do that to calming music. Sorry you can’t sleep without your meds, that’s got to be tough!
I need to take the meds anyway, so I guess in the end it doesn’t really make that much difference. The yoga and music sounds nice and relaxing.
Glad you are doing a little better with your sleep hygiene. It can be hard getting into a good habit with sleep. I used to consistently go to bed around 8:00/8:30 in the evening as well.
My sleep hygiene is pretty good. I don’t avoid naps, and I usually take one every day and allow myself to sleep for however long I need to. I don’t really have a bedtime routine, but I do have a decent sleep schedule. I’ve been going to bed much later lately, and it helps me sleep more soundly.
Oh that’s good that you’ve found a strategy that works.
Yeah!
I do nap when possible. Can’t fight that. : (
When you need it, you need it, no matter what you “should” do.
I guess the advice is sound, but we need to balance according to our needs.
Definitely.
I can’t sleep without my meds too. Like you, I don’t have specific sleep meds but my amitrypline is sedative.
If i forget them, yeah I’ll be busy and wonder why I’m wide awake. Or why I’m so cranky and moody.
I made an effort to follow all the rules for good sleep hygiene but gradually I fell back to sitting on my bed reading, playing games, write, etc. And I browse my phone close to bedtime most nights. So I’m pretty bad at it!
I feel like a lot of the strategies aren’t quite effective enough to be compelling, especially when doing things in bed. for example, are just so comfortable.
I have problems with sleeping. I’m still trying to find a routine that works. I was prescribed trazodone but I found it too potent. I also tried melatonin and that didn’t work. Now, I use over the counter sleep aids combined with exercise. I try not to use my laptop or phone when I’m ready to go to sleep. I try to just lay still and relax.
That’s such a tough process trying to find something that works.
I’m glad to read that your sleep hygiene has evolved and improved. I’d love that. Unfortunately, due to pain etc, I only sleep when I can and that’s day or night. At other times, I can sleep for 18-20 hours per day.
That’s tough.
I struggle a little to fall asleep and need to make my mind a bit more silent otherwise it goes ‘rambling’ again. I sleep from 10pm to 6am and I wake up tired. I’m tired all the time. My doctor suspects that there is still a problem with my ‘deep’ sleep and we’re trying new medication. It’s difficult to get it right!
I hope you’re able to figure something out.
Yeah, it’s a journey…