Last post I talked about healthy sleep: if we’re tired after a night of sleep, or it’s taking us longer than 30 minutes to fall asleep, we might actually try going to bed LATER. The key is condensing our sleep/time in bed, while maintaining a consistent wake-up time and exposure to light. This is a behavioral treatment for insomnia called “Stepped Care.”

So we talked about behavioral adjustments to bed time, but what about what occurs during the day? How does our alcohol, marijuana, caffeine or over-the-counter medication affect our sleep? In a word, badly.

A key part of sleep is our cognitions about it. We can psyche ourselves out about it. Easily. The more we use a tool like Ambien or Benadryl to get a good nights sleep, the more we are telling our brains, “I can’t do this on my own” (which is not true). It’s also likely we might have a night where the substance is not available and the thought, “I sure hope I can get to sleep without my ___” occurs, followed by feelings of doubt and our body taking those cues and having a terrible night of sleep.

In psychology, we call this a decrease in self-efficacy, and it’s not a good thing. There are ripple effects to it – most obvious may be a dependence on a certain item to get to sleep (for example, smoking pot, or a couple of glasses of wine).

Often the substances that seem to relax us and promote sleep, actually are not giving us good, quality of sleep. Some people realize this with alcohol – while we can drink enough to knock ourselves out, we don’t typically feel well-rested the next day. That’s because we never really entered into that blissfully deep REM sleep, and we ended up waking up a few times or waking up prior to obtaining enough rest. Even Melatonin can affect our circadian phases, and regular use can increase dependence.

All these things work but do not promote long-term, healthy sleep like these components do:
exercise, daily routines, creating a comfortable sleep environment, and controlling the amount of stimulating activity we have prior to bedtime. Humans are like computers, we can program ourselves. In psychotherapy, we utilize strategies like relaxation training to do this.

There are resources available online, such as:
1. Sleepio
a. 6 sessions
b. Weekly or longer
c. $11.30 / week
d. $80 / 12 weeks

2. SlumberPro
a. 4 – 8 weeks
b. free for first week, then $39

3. Cognitive Behavioral Therapy for Insomnia
a. 5-week, 5 session course = $34.95
b. on-line or CD

4. Shut-I
a. 16 week subscription = $129
5. The Insomnia Doctor: www.get2sleepnow.com
a. $29.99 / 1 month
b. $69 / 3 months

List (and inspiration for this blog post) courtesy a training by Rocky Garrison, PhD, CBSM, a psychologist specializing in the treatment of insomnia. www.rockygarrison.com