Matthew Edlund M.D., M.O.H.

Psychiatry and Sleep Medicine

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Returning to Sleep

February 28, 2016 by Matthew Edlund M.D.

People complain to me ceaselessly – they can’t get back to sleep.  Yet returning to sleep engages the same tools that help you fall asleep.

If sleep is as necessary to life as food, why is returning to sleep so difficult?  It seems many of us have forgotten how to rest.

To fall asleep most of us must first experience a sense of rest – so the body can effectively regenerate.  And one of the most useful tools is the badly named “sleep ritual.”

Sleep Rituals

No official church handles sleep rituals.  They are nothing more than patterns of behavior that let people calm down so their body clocks can gently nudge them into sleep.  Many of these small, restful acts that help us fall asleep at the beginning of the night also work throughout the night:

Turn down the lights

Turn down the bed

Put out your clothes for the next day

Floss and brush teeth

Have sex (entirely optional, but providing many health benefits)

Read somewhere outside the bed

Listen to music.

These small calming acts usually don’t include watching TV, checking emails, or otherwise thrusting your face sufficiently close to bright monitors and cellphones whose bright lights reprogram your body clocks, arouse and awake you, and blitz your melatonin production to zero. We did not evolve with electric lights – and certainly not with cellphones posting noisy, noisome infomercials.  Most of us rest better with a protected time zone around sleep, a time of invited calm.  For many it lasts an hour, for other ten minutes – a period of transition that tells your body it wants and needs you to rest.

So what to read?  What music aids the search for slumber?  There are many reading lists and playlists for the induction of sleep.  No, please don’t start reading insurance forms or the phone book – if you  can still find have one.

Pre-sleep reading often works effectively with texts and images that are themselves patterned, that let your mind escape the worries of the day,  provide distance and re-engage stories you’d like to find entering your dreams.

What works?  For some art history, for others travel pieces, for a few the history of mathematics.  Biographies, memoirs, books of photographs can all work.

And you want more than one.  There are many books that can help you sleep.

Poetry is a special sleep inducer for many, especially the grand verse of olden days.  Longfellow may be dramatic, Tennyson melodramatic, Dryden and Locke too classical for contemporary mores.  As sleep aids, however, they may  prove matchless.  Poetry, like music, is patterned to the innate pleasures of human thought, and may soothe savage demagogues as well as savage beasts.

And what of the worries of the day?  They are best tackled during the day – at times, like early evening, when the mind is generally more bright and alert.  A relentless focus on solving problems, a listing of worries and your productive plans for dealing with them – Plan A, Plan B, Plan C, or when all fails the simple act of acceptance – can prevent those concerns from waking you in the night – and keeping you awake.

When You Wake in the Middle of the Night

Will the pleasures of sleep ritual techniques  aid you back to sleep? Yes  – if a few other requirements are met.

First, please do not look at the clock until the wake alarm rings. Better, make all clocks difficult to visualize when bedtime beckons.. For all but those doing shift work, night time should be sleep time.  Sick children or ailing parents may require breaking that rule, but the human body is designed for the night as a special rest-regeneration time.

What also aids sleep is preparing a dark, cozy, calm, cool sleep environment which provides a sense of security and safety.  For some this involves dogs at the foot of the bed and the comforting presence of a bed partner, whose snoring  and involuntary movements must be handled if you are to achieve regenerating rest. But if you do awake and cannot fall back to sleep within 10-15 minutes, return to your special night -time  pile of books and – under relatively low light – select the piece that will entice you back to sleep.  It may be photographs of the Earth from Space; Eisenhower’s memoirs; the graceful biography of an ornithologist.  Choose something that will take you away from worries of daily life. When reading for sleep, it is not necessary and often unhelpful to dare to be dull.

Once ready to get back to bed, go to it.   Put your head on the pillow, and as an added behavioral cue, put on a night mask over your eyes.  The small reflex of placing pressure over the eyes can also help you rest.

If you’re reading and the alarm blares out, get up and get going.  Body clocks are powerful, and do far more than create the conditions and signposts of sleep.  But, if you found yourself reading for hours without slumber, consider choosing a different book the next night.

The ways that help you fall asleep can work at the beginning and the end of the night.  They are all ways to rest.  We should rest before we sleep.  We need sleep to live.

It can make life much nicer.

Filed Under: sleep Tagged With: back to sleep, insomnia, light, melatonin, music, partners, poetry, reading, sleep environment, sleep rituals, television, waking

Dr. Matthew Edlund
Psychiatry and Sleep Medicine
950 S. Tamiami
Sarasota, FL 34236
941.365.4308


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