What to do in the middle of the night?

[Shore Snorer]

The conventional sleep hygiene wisdom on sleep maintenance insomnia is consistent, specific, and totally negative. There's lots of advice on what not to do if you wake up in the middle of the night and can't fall back asleep:

• Don't use a computer.
• Don't watch TV.
• Don't read a book.
• Don't exercise.
• Don't do anything that reinforces a habit of, "Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!"
• And for heaven's sake, if you want to fall back asleep, don't stay in bed!

As The Insomnia Workbook by Stephanie Silberman says:

... if you wake up during the night and have trouble falling back asleep, you should get out of bed and do something relaxing and boring in another room until you feel sleepy again. It's important that you don't lie awake in bed for a long time and that you don't engage in stimulating activities in bed.... doing so will cause you to associate your bed with wakefulness, not sleep.

As I said, very negative.

Presuming that Dr. Silberman's advice is good, what are some good things to do when you can't fall back asleep? What's worked for people here?

[Shore Snorer]

P.S.: "stimulating activities": Dr. Silberman, like most sleep hygienists, recommends: "Your bed should be reserved for sleep and sex only.... if you feel comfortable having sex in rooms other than your bedroom you may want to try that." Nudge, nudge, wink, wink, say no more, say no more ... really. Please.

[surf_rower]

Haha yeah I wonder about that too. What I usually do is get up (after lying there for an hour, waste of time) and work on the computer and just stay up and get work done. Usually I stay awake all day and then sleep REALLY well the next night. Like last night.
The advice to associate the bed with sleep is a good. I think one of the reasons I sleep better with CPAP is that putting on the mask says, "OK, all you can do is sleep now."

[Julie]

One problem with using the computer (and I do it too!) as in-between sleep time is that the light (even on a dim Flux program setting) artificially wakes you up as would a light box used to treat SAD, and that's counterproductive to being able to get sleepy again. What about a hot drink (no rum!) and boring book?

[49er]

Shore Snorer,

My advice is to ignore the sleep hygiene rules and do what works to get yourself back to sleep. It will involve a lot of trial and error.

What works for me is to eat a few almonds and do brief twisting exercises which causes me to get sleepy. If I follow the standard sleep hygiene advice to go into another room and do some quiet activity, that simply causes more anxiety.

By the way, Barry Krakow, in his book about sleep, suggests doing a fun activity if you wake up prematurely and feels that focusing on sleep hygiene can be counterproductive.

49er

The conventional sleep hygiene wisdom on sleep maintenance insomnia is consistent, specific, and totally negative. There's lots of advice on what not to do if you wake up in the middle of the night and can't fall back asleep:

• Don't use a computer.
• Don't watch TV.
• Don't read a book.
• Don't exercise.
• Don't do anything that reinforces a habit of, "Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!"
• And for heaven's sake, if you want to fall back asleep, don't stay in bed!

As The Insomnia Workbook by Stephanie Silberman says:

... if you wake up during the night and have trouble falling back asleep, you should get out of bed and do something relaxing and boring in another room until you feel sleepy again. It's important that you don't lie awake in bed for a long time and that you don't engage in stimulating activities in bed.... doing so will cause you to associate your bed with wakefulness, not sleep.

As I said, very negative.

Presuming that Dr. Silberman's advice is good, what are some good things to do when you can't fall back asleep? What's worked for people here?

[robysue]

The conventional sleep hygiene wisdom on sleep maintenance insomnia is consistent, specific, and totally negative. There's lots of advice on what not to do if you wake up in the middle of the night and can't fall back asleep:

• Don't use a computer.
• Don't watch TV.
• Don't read a book.
• Don't exercise.
• Don't do anything that reinforces a habit of, "Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!"
• And for heaven's sake, if you want to fall back asleep, don't stay in bed!

Interestingly, Dr. Krakow gives a decidedly and intentionally mixed message about this issue in Sound Sleep, Sound Mind. While sticking with "Don't stay in bed," he firmly rejects "Don't do anything that reinforces a habit of, 'Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!' ". Or more precisely, he argues that it is better to do something FUN (even if it is WAKEFUL) rather than sit around doing nothing except worrying about being awake in the middle of the night. Actually you can almost interpret part of his advice as bordering on "Embrace the fact that you're body doesn't want to be asleep and listen to it. Get out of bed and do something that's a real treat for yourself. Do anything except worry about the fact that it's the middle of the night and you're not in bed asleep."

Krakow also discourages doing anything WORK related in the middle of the night on the grounds that (a) this is punishment for waking up, which is a no-no in his mind and (2) this is stress inducing and likely to cause more worries when returning to bed. He does discourage using a computer or watching TV. The blue light emitted by those things plays havoc with the melatonin cycle in some people. The main problem with "read a book" is that too many of us choose books that are real page turners and once we start reading it's hard to put it down because we're so interested in the book ....

Presuming that Dr. Silberman's advice is good, what are some good things to do when you can't fall back asleep? What's worked for people here?

Traditional positive suggestions for things to do when you get out of bed include:

• Make yourself a cup of camomile tea (if you like it) or some other kind of "sleepy time" tea or warm milk and sip it slowly and enjoy drinking it.
• Listen to some quiet music in a semi-dark room (this one has been my "go-to" activity for serious middle of the night wakes going all the way back to when I had to get up to feed my babies at 3:00AM ....)
• Do a crossword puzzle with pencil and paper. (Unlike "read a book, you get to the end of the crossword and you're done ....)
• Play a game of solitare with a deck of real cards.
• Knit or crochet for a while (if you do either of those things)
• Do some very, very gentle stretching and/or focused relaxation techniques----relaxation techniques from yoga or mindfulness both can be used. Yoga relaxation sometimes works for me.

[squid13]

When I wake up like that and get up I usually read my book and it's not to long and I'm back in bed asleep.

[Shore Snorer]

One problem with using the computer (and I do it too!) as in-between sleep time is that the light (even on a dim Flux program setting) artificially wakes you up as would a light box used to treat SAD, and that's counterproductive to being able to get sleepy again. What about a hot drink (no rum!) and boring book?

Point well taken, Julie. I try to avoid this by wearing orange safety glasses; see the discussion at viewtopic.php?f=1&t=94004&p=868020#p868020

That, in combination with a boring book (I own many) and warm milk, is a reasonable approach. I wish it worked for me....

Anyway, thanks for the reply.

[Shore Snorer]

The conventional sleep hygiene wisdom on sleep maintenance insomnia is consistent, specific, and totally negative. There's lots of advice on what not to do if you wake up in the middle of the night and can't fall back asleep:

• Don't use a computer.
• Don't watch TV.
• Don't read a book.
• Don't exercise.
• Don't do anything that reinforces a habit of, "Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!"
• And for heaven's sake, if you want to fall back asleep, don't stay in bed!

Interestingly, Dr. Krakow gives a decidedly and intentionally mixed message about this issue in Sound Sleep, Sound Mind. While sticking with "Don't stay in bed," he firmly rejects "Don't do anything that reinforces a habit of, 'Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!' ". Or more precisely, he argues that it is better to do something FUN (even if it is WAKEFUL) rather than sit around doing nothing except worrying about being awake in the middle of the night. Actually you can almost interpret part of his advice as bordering on "Embrace the fact that you're body doesn't want to be asleep and listen to it. Get out of bed and do something that's a real treat for yourself. Do anything except worry about the fact that it's the middle of the night and you're not in bed asleep."

Krakow also discourages doing anything WORK related in the middle of the night on the grounds that (a) this is punishment for waking up, which is a no-no in his mind and (2) this is stress inducing and likely to cause more worries when returning to bed. He does discourage using a computer or watching TV. The blue light emitted by those things plays havoc with the melatonin cycle in some people. The main problem with "read a book" is that too many of us choose books that are real page turners and once we start reading it's hard to put it down because we're so interested in the book ....

Presuming that Dr. Silberman's advice is good, what are some good things to do when you can't fall back asleep? What's worked for people here?

Traditional positive suggestions for things to do when you get out of bed include:

• Make yourself a cup of camomile tea (if you like it) or some other kind of "sleepy time" tea or warm milk and sip it slowly and enjoy drinking it.
• Listen to some quiet music in a semi-dark room (this one has been my "go-to" activity for serious middle of the night wakes going all the way back to when I had to get up to feed my babies at 3:00AM ....)
• Do a crossword puzzle with pencil and paper. (Unlike "read a book, you get to the end of the crossword and you're done ....)
• Play a game of solitare with a deck of real cards.
• Knit or crochet for a while (if you do either of those things)
• Do some very, very gentle stretching and/or focused relaxation techniques----relaxation techniques from yoga or mindfulness both can be used. Yoga relaxation sometimes works for me.

robysue (and 49er), thanks for your general advice and your specific recommendation of Dr. Krakow's book. (This review suggests it's informative and written in a very soporific style. There's no downside! )

I've got some go-to-sleep MP3s and a Qigong video. I'll try those, too.

49er: I've been through many trials and at least as many errors. I'm beginning to run short of what else to trial. I'm also turning to professionals, but always value the suggestions on this board.

[49er]

The conventional sleep hygiene wisdom on sleep maintenance insomnia is consistent, specific, and totally negative. There's lots of advice on what not to do if you wake up in the middle of the night and can't fall back asleep:

• Don't use a computer.
• Don't watch TV.
• Don't read a book.
• Don't exercise.
• Don't do anything that reinforces a habit of, "Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!"
• And for heaven's sake, if you want to fall back asleep, don't stay in bed!

Interestingly, Dr. Krakow gives a decidedly and intentionally mixed message about this issue in Sound Sleep, Sound Mind. While sticking with "Don't stay in bed," he firmly rejects "Don't do anything that reinforces a habit of, 'Yippee, it's 3 am and I can't sleep, now I get to do (fun thing)!' ". Or more precisely, he argues that it is better to do something FUN (even if it is WAKEFUL) rather than sit around doing nothing except worrying about being awake in the middle of the night. Actually you can almost interpret part of his advice as bordering on "Embrace the fact that you're body doesn't want to be asleep and listen to it. Get out of bed and do something that's a real treat for yourself. Do anything except worry about the fact that it's the middle of the night and you're not in bed asleep."

Krakow also discourages doing anything WORK related in the middle of the night on the grounds that (a) this is punishment for waking up, which is a no-no in his mind and (2) this is stress inducing and likely to cause more worries when returning to bed. He does discourage using a computer or watching TV. The blue light emitted by those things plays havoc with the melatonin cycle in some people. The main problem with "read a book" is that too many of us choose books that are real page turners and once we start reading it's hard to put it down because we're so interested in the book ....

Presuming that Dr. Silberman's advice is good, what are some good things to do when you can't fall back asleep? What's worked for people here?

Traditional positive suggestions for things to do when you get out of bed include:

• Make yourself a cup of camomile tea (if you like it) or some other kind of "sleepy time" tea or warm milk and sip it slowly and enjoy drinking it.
• Listen to some quiet music in a semi-dark room (this one has been my "go-to" activity for serious middle of the night wakes going all the way back to when I had to get up to feed my babies at 3:00AM ....)
• Do a crossword puzzle with pencil and paper. (Unlike "read a book, you get to the end of the crossword and you're done ....)
• Play a game of solitare with a deck of real cards.
• Knit or crochet for a while (if you do either of those things)
• Do some very, very gentle stretching and/or focused relaxation techniques----relaxation techniques from yoga or mindfulness both can be used. Yoga relaxation sometimes works for me.

robysue (and 49er), thanks for your general advice and your specific recommendation of Dr. Krakow's book. (This review suggests it's informative and written in a very soporific style. There's no downside! )

I've got some go-to-sleep MP3s and a Qigong video. I'll try those, too.

49er: I've been through many trials and at least as many errors. I'm beginning to run short of what else to trial. I'm also turning to professionals, but always value the suggestions on this board.

I hear you Shore Snorer.

Thanks to this thread, I just remembered that I was able to get back to sleep for one of my better sessions on the mask after watching a baseball playoff game. As a result, I am going to order a DVD of one my favorite world series games and see if that works.

Strangely, watching regular TV never worked but that did. Hard to explain.

Might watching a DVD of something work for you?

My other question are you sure your therapy is completely optimized and that you have looked into every possible medical reason why you could be having trouble staying asleep on the mask? The reason I am asking is if you haven't, consulting someone like a CBT professional could be an exercise in frustration.

49er

[surf_rower]

I think the orange glasses work. I wear them in the evening when I'm on the computer, like right now, and have been falling asleep pretty well right after.
If I wake up worrying about getting work done, then if I do some of it, I am less worried about it, and can fall asleep relaxed.

[kteague]

My wakeups are usually several but brief, but when it is apparent I am wide awake, sometimes just turning the radio on an oldies station is enough to lull me back to sleep. If not, I actually do get out of bed and turn on the light and the computer. Not for a long time, but just enough to trick my mind into starting over with going to bed. I don't seem to be sensitive to the lights. But just turning off the computer and light, going to the bathroom, and masking back up signals my mind it's sleep time. I am fortunate to not have morning obligations.

[Iowamv]

I have old-time radio podcasts on my iphone. They were made in an era when people invested time and money in writing decent story lines and using sound effects to make radio broadcasts more realistic. They are free, and there are quite a few to choose from. I make sure I have 3-4 30 minute programs queued up, set the podcast app's timer to turn off after an hour or two, and just lay in bed (masked up of course) with the lights off. You have to follow the storyline just enough to get your mind off of the stuff that might be keeping you awake.

Based on what I can remember of the stories the next day, I usually get back to sleep fairly quickly (lately, 10-30 minutes).

I've listened to comedies, Westerns (Gunsmoke!), mysteries... I'm making my way through a detective series now, called "Yours Truly, Johnny Dollar."

In some ways, this feels like using technology to have someone tell you bedtime stories til you fall asleep.

[49er]

I have old-time radio podcasts on my iphone. They were made in an era when people invested time and money in writing decent story lines and using sound effects to make radio broadcasts more realistic. They are free, and there are quite a few to choose from. I make sure I have 3-4 30 minute programs queued up, set the podcast app's timer to turn off after an hour or two, and just lay in bed (masked up of course) with the lights off. You have to follow the storyline just enough to get your mind off of the stuff that might be keeping you awake.

Based on what I can remember of the stories the next day, I usually get back to sleep fairly quickly (lately, 10-30 minutes).

I've listened to comedies, Westerns (Gunsmoke!), mysteries... I'm making my way through a detective series now, called "Yours Truly, Johnny Dollar."

In some ways, this feels like using technology to have someone tell you bedtime stories til you fall asleep.

That is a fantastic suggestion lowamv.

Because I don't have an iphone but do have a Kindle, I just did a google search and found this site in which you can download old radio broadcasts if you have an MP3 player.

https://archive.org/details/oldtimeradio

[Iowamv]

Yeah, there seem to be lots of sites with them. They are easy to find with the built-in Podacst app on iPhone, and I assume that's true for Android podcast apps too. Nice to be able to set a timer, so they aren't playing all night long (though I know some people sleep with a tv on all night long, I think that'd eventually wake me up).

I've been going to sleep with podcasts on and using them to fall back asleep for years. Definitely works.

Side benefit: you get to experience all sorts of old-time commercials on some of the podcasts. Funny to hear commercials for Jello as a new and exciting product. They also sometimes make reference to making broadcasts available for soldiers in World War 2, selling of war bonds, etc. You really get transported back in time with those podcasts.