Occasionally I get emails from people with take-charge, type A personalities wondering what to do about insomnia. Full of self-reliance, they’ve often scoured the internet for remedies—and tried every one—or amassed a mountain of books about sleep—and read them all—to little avail. Can I suggest anything that might help?
Here is Geri’s story (abbreviated to save space) and my response.
A Caregiver’s Hectic Life
I have had insomnia since 2005. I have four children (13, 10, 9 and 7) and at time of onset only had one. Triggered by changing jobs and trying to get pregnant—so stressful! I am a community mental health nurse. I have a caseload of 22 adults with psychosis and am their primary support. . . . [At night] it can take 2 hours for me to fall asleep and then I usually wake between 12 and 2 a.m. I do not go back to sleep. . . . I am naturally an over thinker, I do stress easily and worry a lot. . . . I’ve never been a great sleeper but yes I used to sleep. We are struggling financially so not working is not an option. . . . I have a library of books on sleep, have spent hundreds of pounds on various remedies and treatments—but alas nothing really seems to help. Can you suggest anything?
Geri had a lot on her plate. She was on the go all the time, caring for patients during the workday and children at night. Her busy schedule didn’t leave much time for self-care.
She knew what she needed: fewer responsibilities. If she won the lottery, she said, she’d resign from nursing, fix up her house, and be the mother and relaxed partner she’d like to be. But that was not in the cards.
Adding Things In, Cutting Things Out
Despite her time constraints, Geri was resourceful in looking for insomnia remedies. She’d also established some habits conducive to sound sleep: eating healthy foods, getting plenty of exercise by cycling to and from work and her patients’ homes, and practicing mindfulness.
But she’d also tried a raft of insomnia remedies that didn’t seem to help, from herbs and homeopathic insomnia cures to acupuncture and CDs with “odd sleep-inducing sounds.” When Geri wrote to me, she was planning to ramp up her efforts to improve her sleep by:
- Adding high-intensity interval training to the cycling she did everyday (though it was a struggle to find the energy for this activity)
- Cutting out alcohol completely (which, in times of desperation, she used to get to sleep)
- Cutting out processed sugar, including the “crap biscuits” (cookies) she was prone to eat when super tired
What did I think?
Regimentation, Stress and Sleep
My immediate reaction on reading Geri’s story was that I could never do half of what she does and expect to sleep consistently well. With so many responsibilities I’d be popping Valiums every day!
Seriously, though, Geri’s sleep problem may have been related to chronic stress and the double duty she was doing as caregiver for her patients and her children (i.e., caregiver stress). Even so, her inclination was not to find ways to make her responsibilities more manageable. It was to do still more, adding high-intensity interval training to an already busy schedule and restricting an already healthy diet still further.
I wondered if the restrictive regimen she was about to impose upon herself would sooner or later become yet another source of stress. It’s true that exercise is beneficial to sleep. But nowhere has it been suggested that a person should have to cycle to and from work and do high-intensity interval training to get better sleep.
Dietary Choices and Sleep
It’s also true that what we eat can affect our sleep. But having a cookie now and then is probably not going to make a difference. There’s a lot of information now suggesting that overindulgence in simple carbohydrates is harmful to health. We shouldn’t routinely have Hostess cupcakes washed down with Pepsi for lunch. But cut out sugar completely? I follow the literature on insomnia and sleep pretty closely, and not one study I’ve seen has shown that cutting sugar out altogether from our diets will improve sleep.
Likewise, it’s smart to avoid using alcohol for sleep. But a glass of wine at happy hour is probably not going to have much impact on the night at all. It sounds punitive for Geri to try to regiment her life still more than it already is.
Reduce Stress With Better Self-Care
It could be that Geri would benefit from consulting a sleep doctor or a sleep therapist and that cognitive behavioral therapy for insomnia, administered by a trained professional, might help. A sleep study might uncover an underlying sleep disorder (or show she was getting more sleep than she thought).
But I think Geri’s sleep would improve if she were to reduce her stress by engaging in more nurturing self-care. She’s got a head start on some of the ways to do this but other readers may not:
- Take half an hour a day for yourself and do something purely for pleasure (gardening, reading a novel, playing the piano)
- Learn and use stress reduction techniques such as meditation, yoga, or Tai Chi.
- Stay current with your own healthcare needs.
- Eat regular, healthy meals.
- Exercise daily.
- Take time off when you can.
- Maintain ties with friends and supportive family members, and when possible seek and accept their support.
- Seek counseling when you need it or reach out to friends
If you’re a full-time caregiver, what’s the best way you’ve found to take care of yourself?