Sleep has always been a challenge for my wife and I. For the majority of her life; Kristen’s struggled with insomnia. When I greet her each morning, I don’t ask her how she slept. I stopped doing that a long time ago because I usually know the answer.
My nights as a child were restlessness ones with mind-racing and nightmares. I’ve only recently begun to enjoy a somewhat consistent sleep routine. Still, when my depression is bad, the nightmares and restlessness return.
My wife and I are not alone. Sleep issues are common among depression sufferers.
“Epidemiological data suggests that people with psychiatric disorders account for 30–40% of those in the community reporting symptoms of insomnia, and that depression is the most common psychiatric cause of insomnia. In individuals with insomnia, 40–60% have features of depression.” – Michael Berk MBBCh, MMed(Psych), FFSA, FRANZCP, Ph.D., a Professor of Psychiatry, Melbourne University
It seems like every person who shares their struggle with me also has some sleep issue; either they sleep too much, or they can’t sleep. Their depression just screws with their ability to normalize sleep patterns.
“It has been found that 60-80% of patients with depression report sleep disturbances. Persistent sleep disturbances are associated with a significant risk for depression relapse, increased risk of suicide and may also delay a depressed patient’s response to therapy. The majority of depressed patients report insomnia as the primary sleep disturbance, however, as many as 30% report hypersomnia” – Armitage, R., (2000). Can J Psychiatry;45: 803-809
Sleep is vital to our mental health just as much as our physical health, and lack of sleep can mess things up. It’s terribly ironic that depression can keep you from sleeping when you consider that the lack of sleep twists that knife of despair all the more. It feels defeating, like an uphill climb you’ll never complete.
And then there’s the anxiety about sleep. You dread going to bed because you know you aren’t going to get anywhere. You expect it to be a disappointment so you stress about going to bed which is the opposite of what you should do.
“Insomnia is one of the most common presenting symptoms in the primary care setting, and depression is one of the most common causes of insomnia. Insomnia is a symptom not a diagnosis, and has a wide differential diagnosis that includes psychiatric disorders such as depression and anxiety, and pain, medical conditions and psychological causes. Conditioned, or psychophysiological insomnia, is a common form of insomnia, and occurs when anxiety that centres on not sleeping well generates arousal at bed time.” – Michael Berk MBBCh, MMed(Psych), FFSA, FRANZCP, Ph.D., a Professor of Psychiatry, Melbourne University
With so many depression sufferers (and Sad Runner readers) dealing with sleep issues, I wanted to compile a list of tips to try. Because sleep and depression are so intertwined, if we can improve our sleep then maybe we can help the depression.
Before we get into the tips, I want you to keep a couple of things in mind:
Don’t jump in all at once and attempt everything on the list. Instead, select two ideas and try them for a few weeks. You want to ease in and not risk getting overwhelmed.
Test and Document Everything
Be sure to document your results so you can track your progress. After a couple of weeks, keep the tips that work and make them a habit. Next, replace something that didn’t with a new item from the list below and test that one. The idea here is to test these ideas slowly to find which ones enhance sleep and which ones don’t. In the end, you’ll have your personal list of road-tested tips to use when depression screws up your sleep.
When you pick a strategy or two, do them consistently. Try to do the same thing every night for as many nights as possible. You need to give each tip a good thorough testing. If you’re not making an effort every night, then you won’t get results.
Some of these strategies take time before they improve your sleep. In fact, sometimes things can get worse before they get better. Please be patient and stick with it. Your sleep (and your sanity) are at stake.
Alright, let’s jump into our list of sleep tips for people with depression. Grab your pajamas because it’s time to get sleepy.
Section One: Prepping Your Environment
These tips will help you get your bedroom ready for a good night’s sleep.
1. Reduce stimulation such as noise or lights. If possible, get rid of any light source. Eye masks and earplugs are great to produce a perfect sleep environment, but they take a little time to adjust.
2. Keep the room cooler rather than warmer because people sleep better in a cooler environment.
3. Put the bedside clock out of view to avoid ‘clock watching’ at night. Placing the clock out of view also gives you one less thing producing light in your room.
4. Put a board under your mattress if it sags. A lot of times our mattresses can be either too firm or too soft. Experiment to see how your body responds.
5. Make sure your bedding is clean and that you are warm enough, but not too hot. (Remember, the cooler, the better.) But clean bedding makes a huge difference, trust me.
6. While we’re talking about bedding and temperature, be sure to avoid too many blankets and electric blankets. If you’re too hot, you won’t go into deep sleep. Your body needs to hit that deep sleep zone for maximum results.
7. Remember the rule of Three S’s. Use your bed only for sleep, sex or when you’re sick. Although it is tempting to read, watch TV, or work on your computer while in your bed, this may not be best for your sleep hygiene. Train your body to associate being in bed with sleeping only.
Section Two: Pre-Bedtime Habits
What you do, before bed makes a big difference in how you sleep. Try some of these tips before bedtime to set your body up for sleep.
9. Avoid stimulating activities, such as work or heated discussions before going to sleep.
10. Avoid caffeine (i.e., coffee, cola drinks, chocolate) within 8 hours of bedtime. Although many people think that caffeine doesn’t affect their sleep, it does.
11. Avoid alcohol within 6 hours before bedtime; it can reduce the quality of sleep.
12. Avoid smoking at least 2 hours before bedtime; nicotine is stimulating
13. A light snack at bedtime can be helpful but don’t eat too heavy or anything stimulating. Clean and simple protein is ideal, so your body doesn’t have to work too hard to digest it but also so your body has plenty of nutrients to help you recover during sleep. I recommend a vegan protein shake mixed with water or almond milk. That lack of dairy and other animal products will ensure you’re not working too hard to digest anything, but you’ll get all the nutrients you need.
14. A wind-down routine before going to bed can help you relax and make it easier to sleep. Your method can include activities such as reading (but nothing that stimulates your brain too much), having a warm bath or listening to music. Personally, I switch to certain TV shows that I watch only right before bed. My body responds and knows that it’s time to chill out.
15. Pre-bedtime relaxation exercises are a great addition to your nightly wind-down routine. Try progressive muscle relaxation and breathing techniques because they can reduce anxiety and ultimately assist sleep. These methods have been proven to be particularly useful for conditioned insomnia like when insomnia gets generated by excessive worry about not sleeping
16. Whatever you do, be sure to relax mentally and physically for an hour before bedtime. Nothing strenuous or intense should happen within this relaxing time.
17. Stay up until a reasonable bedtime even if you feel sleepy earlier and go to bed only when you feel exhausted.
18. Limit your exposure to light in the evenings. Dim everything and it will help relax your body.
19. Be sure to reduce your fluid intake before bedtime. Would you rather pee or sleep? You decide.
20. Do yoga or take a light walk before bedtime.
21. Make a list of the things on your mind, then forget about them. Listing things will keep your thoughts from racing through all the things in your head and allow you some peace.
22. Do a security check to reduce anxiety but only do it once. If you’re one of those people who seem to panic about noises and other nighttime scariness, allow yourself to inspect your home so that you can be at ease. But, again, don’t make this a repeating habit. Check everything once and then go to bed.
Section Three: While in Bed
What you do when you crawl in bed alters your sleep quality as well. Here are a few things to keep in mind.
23. If you can’t get to sleep after awhile, get up, go into another room and do a relaxing, quiet and soothing activity such as listening to music, then return to bed. Don’t toss and turn and stare at the clock. Get up and do something.
24. Replace negative thoughts with positive ones. We underestimate the power of our thought life. Instead of saying, ‘Oh no I can’t sleep.’ Remind yourself that you can sleep and tell yourself to go back to sleep. Keep your mind working toward a solution, not the problem.
25. Get out of bed as soon as you wake. Don’t go back to sleep or try to make up for lost sleep when you have a bad night. Get up already. You should never lay awake in bed for more than 15 minutes.
26. Making an effort to fall asleep will not produce sleep. Sleep should be effortless and come naturally. So don’t try and force yourself to sleep.
27. Avoid mobile phone use in bed. You don’t need to text right before you sleep. Personally, I sleep with my phone face down. First, there’s no chance of light entering my room, and second, there’s no chance I’ll see a notification which will stimulate my brain.
28. Stop checking social media in bed. Just because number 27 said mobile phones doesn’t mean you can check Facebook on your tablet. Quit being social before bed. You’re screwing things up.
29. Don’t read or watch TV in bed if that stimulates your brain. While reading can be a wonderful wind-down activity, if it fires you up then avoid reading that topic. Even more, try reading in another room instead of bed. Remember the 15-minute rule. You don’t want to lay awake in bed for very long. I watch TV before bed but only right before going to sleep and only shows that won’t keep me awake.
30. Try using white noise. Some people can’t sleep in complete silence. Try using a nature app on your phone (but keep the phone face down when sleeping). Here is an app I use when I need white noise to sleep.
Section Four: Daytime Support
Did you know that what you do during the day impacts how well you sleep at night? Try some of these tips to ensure you’re tired at bedtime.
31. Don’t take naps. Daytime sleep adds to your 24-hour sleep cycle so avoid naps as much as possible.
32. A regular exercise program will help you sleep better at night. Just be sure not to workout right before bed.
33. Your routine is critical. Getting up around the same time each day helps set your day/night clock. Be consistent with your wake-up time at all costs. Believe it or not, studies prove that waking up at the same time every day is more important than going to bed at the same time.
34. Stop sleeping in on the weekends. You’re forcing your body to endure jet lag every weekend when you sleep in late. So cut it out. You’re a grown up now so leave the Saturday mornings in bed to the kids.
35. If you’re a late sleeper, force yourself to get up a little earlier which makes you more tired by bedtime.
36. Spend time outside in the light each day. Exposure to sunlight helps to set the biological clock. Additionally, being exposed to bright light (outdoor or artificial) can help with both sleep problems and depression.
37. Cognitive Behavioral Therapy is quite helpful for sleep issues, and it’s great for depression and anxiety. A therapist may assist you in overcoming some of the deeper issues keeping you from sleeping.
38. Journal your thoughts and worries and then forget them. Throughout the day, we have things that build up in our brains. Get them out of your head almost as fast as they enter so that you’re good and empty by nighttime. I use Evernote to accomplish this.
39. Breathing relaxation during the day will cut down on the stress in your life, alleviate the depression and help you get a better night’s sleep. Sounds like three good reasons to try it, to me.
Section Five: Natural Remedies
You want to avoid taking sleeping pills. If you do need to, don’t use them for more than a week because they can be addictive. While it may be great at first, you’re going to mess up your sleep cycle in the long run so don’t rely on presumption drugs to help you sleep. Here are some natural ways to encourage sleep.
40. Listen to music, while this may seem too simple for a natural remedy, let’s not forget how powerful music is. It can stir up positive or negative emotions. So knowing how to use that to your advantage can make a big difference.
41. Meditation is not only great for depression; it’s an excellent habit to use during the day to reduce stress which ultimately helps you sleep better.
42. Like meditation, Tai Chi Chih can be considered a useful nonpharmacologic approach to improving sleep quality in older adults and has the potential to ameliorate sleep complaints possibly before insomnia even develops.
43. Essential oils and aromatherapy are game changers for me. When stressful life conditions are contributing to anxiety or depression, lemon balm, and lavender or other essential oils which are considered calming can be useful.
44. Bach Flower remedies or other flower essence therapies may be helpful in reducing or even eliminating anxiety and depression. These gentle healers are non-toxic, non-habit-forming essences of flowering plants that help to re-balance negative emotional states such as fear, anxiety, depression, or poor self-image, sometimes so well that some call them ‘Nature’s Prozac.’ They have no floral scent or taste and are not related to aromatherapy, which is closer to herbology. Rather, like homeopathy, they are classified as ‘vibrational’ or ‘subtle energy’ medicine.
Please take any of these tips and get started today. Your sleep and your health depend on it. Personally, I’ve used many of these methods over the years to enhance my sleep and, when my sleep begins to go downhill, I return to my list of things that work to try and correct the course.
Best of luck with your depression and insomnia and sweet dreams.
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