Insomnia Advice Can Miss the Mark

People sometimes offer advice when they hear about my insomnia. Their suggestions are not always helpful.

In fact, I used to feel impatient with–and occasionally hurt by—comments that to my ears sounded judgmental or attitudes toward insomnia that I felt were just plain wrong. The comments were well meaning, but that didn’t make them easier to tolerate. Here are a few that put me off and what I think about them now.

Advice about insomnia can hurt rather than helpPeople sometimes offer advice when they hear about my insomnia. Their suggestions are not always helpful.

In fact, I used to feel impatient with–and occasionally hurt by—comments that to my ears sounded judgmental or attitudes toward insomnia that I felt were just plain wrong. The comments were well meaning, but that didn’t make them easier to tolerate. Here are a few that put me off and what I think about them now.

There must be a part of you that doesn’t want to sleep.

No doubt this suggestion was meant to be insightful, but I found it exasperating. The idea that there might be a twin self lurking inside me that wanted to stay awake (to do what? force myself to read when my eyes could barely focus? play another round of Internet solitaire?)—just how crazy did that make me sound?

Normal sleepers may assume that people who have insomnia actually want to remain awake because of a belief that sleep can be regulated voluntarily. This belief is fairly common, and some people do seem to have quite a bit of control over their sleep. I once knew a woman who could will herself to take a 10-minute cat nap whenever and wherever she pleased. And what about the lucky ones that drop right off in their seats even before the plane is finished boarding?

Sleep is more complicated for people with insomnia. Yes, there are habits and attitudes we can adopt to avoid sleep problems and we should do this. Yet wanting sleep is not always enough to make it happen–any more than a person with asthma can breathe easily on command.

Something has to be causing your sleep problem. Maybe it’s time you went to a therapist to figure it out.

The suggestion that insomnia was a symptom of a larger psychological problem was dismaying. I doubted very much that an unresolved internal conflict was driving my insomnia–that, despite my years of psychotherapy, a dark secret buried in my unconscious was keeping me awake. Or that I was actually deriving some benefit from insomnia (the sympathy of friends, for example) and this was keeping it alive.

A general practitioner actually made the above suggestion to me not 10 years ago. Obviously he hadn’t read Harvard sleep scientist Gregg D. Jacobs’ book, Say Goodnight to Insomnia, in which Jacobs writes, “There is not one scientific study demonstrating that psychotherapy is effective in treating chronic insomnia.”

Theories about the psychological origins of insomnia were predominant for most of the twentieth century, though, so it’s not so surprising that people—even some doctors—put stock in them still. These days, people who study chronic insomnia say the disorder develops due to many factors: biological, situational, behavioral, and attitudinal. As for the suggestion that a therapist could help me “figure it out,” well, all the world’s sleep scientists haven’t been able definitively to do that yet. So a lone psychologist would surely come up short.

Have you tried melatonin/valerian/yoga/warm milk?

It still surprises me when people offer suggestions like these as though they were novel ideas. I know people are only trying to be helpful and that it’s curmudgeonly of me to complain. But anyone who hasn’t heard of these insomnia remedies has never been on the Internet or read a magazine!

These sleep aids remain popular because sometimes they work: Night owls, for example, can use melatonin successfully to shift their sleep to an earlier hour. Valerian taken nightly has been shown in some studies to improve sleep. The daily practice of yoga reduces arousal and builds resilience to stress, which will have a positive effect on sleep. Milk contains the sleep-friendly amino acid tryptophan. Combined with a complex carbohydrate, it makes a good bedtime snack.

But a person with chronic insomnia has probably been there and done that, not to mention experimenting with a raft of other sleep aids. Sometimes I think we could do with a few more expressions of sympathy and a little less “helpful” advice.

What suggestions have people made about your sleep problem that annoyed you?

A Second Look at Valerian for Sleep

Of all the botanicals used for sleep, valerian is the one we hear about the most. I tried it myself several years ago on a trip to Japan. The inky black tincture stank up our bedroom like a pile of ripe wet socks, tasted bitter, and, taken at bedtime, didn’t do a dime’s worth of good for my sleep. So I tossed it on my heap of failed alternative treatments for insomnia and moved on to the next thing.

Now I’m toying with the idea of trying valerian again.

valerian-extractOf all the botanicals used for sleep, valerian is the one we hear about the most. I tried it myself several years ago on a trip to Japan. The inky black tincture stank up our bedroom like a pile of ripe wet socks, tasted bitter, and, taken at bedtime, didn’t do a dime’s worth of good for my sleep. So I tossed it on my heap of failed alternative treatments for insomnia and moved on to the next thing.

Now I’m toying with the idea of trying valerian again. Support for its efficacy as a sleep aid is mixed, but the latest published study shows that it can improve sleep quality in postmenopausal women. One hundred women with insomnia participated in this study, a randomized, controlled trial. Thirty percent of those who used 530 mg of concentrated valerian extract twice a day for four weeks reported significantly improved sleep. Only 4 percent taking a placebo reported a similar improvement.

Why Valerian May Improve Sleep

Why valerian might work as a sleep aid for women aged 50 and above is still unknown. Postmenopausal women are more prone to insomnia than younger women. Menopause brings about decreased levels of estrogen and sleep-protective progesterone, in turn altering the balance of other hormones and neurochemicals helpful and harmful to sleep.

Laboratory studies have shown that valerian should help to promote sleep. It enhances the ability of GABA, the main inhibitory neurotransmitter, to tranquilize the brain at night. To a lesser extent, valerian supports the serotonin system in its efforts to improve mood and promote relaxation and sleep.

But the proof of the pudding is always in the eating, and, while 30 percent of the women taking valerian in the study above had improved sleep, 70 percent did not.

Use It Correctly

If you decide to try valerian, don’t expect to see results overnight, said Jerome Sarris, who studies herbs as alternative treatments for mood disorders and sleep at the University of Melbourne, in an interview two years ago.

“You’re not going to get the same punch from herbal medicine” as you do from a sleeping pill, Sarris said. “The herbal medications generally take longer to work, whereas some people just want that quick fix. I think herbal meds may have more of a role in long-term assistance for sleep rather than as an acute measure” to hasten sleep.

So use valerian and other herbal sleep aids not as you would use Ambien but rather as a vitamin, taken daily to gradually tip the balance of hormones and neurochemicals to favor those friendly to sleep.

Have you tried valerian? What did you use it for, and was it effective?

Effect of Valerian on Sleep Quality

Herbal Medicine for Depression, Anxiety and Insomnia

A Long Slog to Better Sleep

Persistent insomnia can be exhausting, and not just because you can’t sleep. The search for relief can sap your energy, and the remedies available often come with caveats.

For insomnia, I tried every remedy in the bookPersistent insomnia can be exhausting, and not just because you can’t sleep. The search for relief can sap your energy, and the remedies available often come with caveats.

Insomnia became a serious problem when I was in college, where the main point was to exercise my brain. Playing the piano could sometimes put a stop to the mental calisthenics that kept me from nodding off at night. When that failed, a couple glasses of my piano teacher’s home brew would usually do the trick. Trouble was, I woke up to hangover in the morning. No fun.

Sleep came no more easily when I started earning a paycheck. A friend suggested I take a muscle relaxant at night. The pill didn’t make getting to sleep any easier, but it sure packed a punch in the morning. I was lucky when I could hoist myself to a standing position—never mind trying to think.

On the advice of a doctor, I tried diaphragmatic breathing. “In, two, three, four, out, two, three, four,” and so on. It worked the first few times I tried it, and I was thrilled! But then there were nights when no matter how long I counted or how deeply I breathed, I could not manage to slide over the hump. Grrrrrr! My body had a mind of its own, or so it seemed.

The Big Guns

Then there were the little blue sleeping pills I carried around the year I taught in Mexico. They were fabulous. I kept them in a square pillbox, and one day I left it open on the bathroom sink. When I turned on the faucet (the water gushed like a geyser at the slightest touch of the handle) the pills got soaked. They swelled up like mushrooms and probably took in some iffy bacteria, but no matter. I let them dry out and eventually used every single one. But there was not a prayer of renewing my prescription. The 1980s were lean, mean years for users of sleeping pills. You might as well ask a doctor for crack cocaine.

The Alternative Route

Next came my years in California, when I tried every New Age insomnia cure under the sun. I talked about my insomnia with a therapist (to little avail). I listened to a relaxation CD, but the guy on the CD had an obnoxious voice. I took a meditation class. Traveling in Japan, I stank up rooms of sweet-smelling tatami mats with liquid valerian. The sole take-away was bad breath.

Back in the U.S., I discovered the soporific effect of nature programs I could play at low volume at night. In the late 1990s, the monotonous voice of Marty Stauffer and his leaping gazelles and lumbering polar bears could coax me into slumber. But the show lasted only half an hour—not long enough to put me into a deep sleep. The French horns trumpeting the end of the program were infuriating because they could jolt me awake again.

Better Options

My quest to beat insomnia eventually bore fruit. Knowledge of the sleep/wake system, cognitive-behavioral therapy (CBT) and well-timed exercise have led to better sleep for me. But what exhausting lengths I went to—and many insomniacs I interviewed for my book report going to the same lengths—before finding strategies that worked.

If you’re fed up with half-measures and can’t get help from your doctor, I suggest going beyond the insomnia remedies listed on the first page of a Google search. Consider trying CBT, and other strategies that are research-based.