

The Evidence Points to a Better Way to Fight Insomnia - credo
http://www.nytimes.com/2015/06/09/upshot/the-evidence-points-to-a-better-way-to-fight-insomnia.html

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rs534
This breathing exercise done just before sleep time has helped me sleep
better: 5 minutes of even breathing, each breath consisting of a 3-second
inhalation and 6-second exhalation. You want to exhale about the same volume
of air you inhale, so you should exhale more slowly than you inhale. If 3-6
seconds is too long for you, begin with 2-4 seconds (2 seconds inhale, 4
seconds exhale). It helps to have a metronome app to time your breathing.

This method is discussed in "Anatomy of Hatha Yoga" by David Coulter, Chapter
2. Why does this work? I quote from this book (page 91): "This connection
between heart rate and breathing, known as respiratory sinus arrhythmia, ...
causes the heart to beat more slowly during exhalation than it does in
inhalation. ... If you take longer to exhale than to inhale, especially when
you are relaxing, the slowing-down effect of exhalation will predominate."

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ph0rque
I've seen several articles that tout the benefits of cognitive behavioral
therapy as a solution for various issues.

Is there a self-guided CBT app out there that one could try out?

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ebiester
The article points to
[http://www.cbtforinsomnia.com](http://www.cbtforinsomnia.com) but it's not an
app. I'm likely to give it to my partner to try.

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jamesrcole
As someone who has a lot of sleep problems due to physical problems, I find it
frustrating that insomnia seems almost always assumed to be always a
psychological issue.

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m0nty
I share that frustration. Also the assumption that increasing sleep time by
10% would be helpful - 10% of zero is still zero. My last marathon of chronic
insomnia was 96 hours without sleep. Not being restless in bed, but just not
sleeping at all. I'm about to start CBT for this but I'm skeptical, given that
it's related to a medical problem for which I'm still awaiting treatment.

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baldfat
I laughed when he said he was helped by seeing his "bad" night was one hour
less than his targeted 7.

I can go 4 or 5 days a week not going to sleep before 4 AM and I am at work by
7 AM. I can also go 3 or 4 days waking up every hour on the hour and take 20
or 30 minutes to go back to sleep.

Most people don't know I am that tired thankfully.

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pjonesdotca
Every time I've looked back on a period when I've woken up every hour on the
hour, I find that I was under untenable stress levels. Just a thought.

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baldfat
It's been since I was 15. I have gone through a sister and a son having
terminal cancer and I don't notice a difference when I was in high stress or
low stress. Just frustrating.

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ccvannorman
This reminds me of a TED talk* about dealing with stress, when stress is
assumed to be a huge killer / detriment to life. It turns out it's all in how
your mind perceives stress. It never ceases to amaze me the power your
conscious mind can have over your overall life -- I'm reminded of a quote that
"The brain is an elephant, and you are the rider on the back. You cannot steer
sharply, but you can urge the brain to go somewhere over a long period of
time."

*[http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_...](http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend?language=en)

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tannerc
McGonigal has this really elegant and captivating way of presenting the
importance of maintaining a healthy perspective on stress. Recently she
presented a similar talk (or the same one? I haven't watched the full TED talk
yet.) at the 99u Conference in NYC, in which she made the point: "You can use
that stress not as a signal that there’s something wrong with you...but to
actually use that same stress as a sign that something you care about is at
stake. Take that stress as an opportunity to think about what you care about,
to view the situation as an opportunity to learn and grow, to trust you can
handle the challenge."

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russ5russ
A lot of my issues stem from work - I have a hard time winding down before I
can fall asleep and if I ever wake up to grab a drink etc., it's incredibly
difficult for me to fall back asleep. I've started working on meditation to
help clear my mind, but even then...

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HenryTheHorse
Indeed. Most of us suffer from work-related stress issues, which in turn lead
to sleep problems, particularly after one crosses the mid-30s.

What has worked for me is a gym routine in the evening, avoiding browsing the
iPad in bed at night, firing up a long podcast to listen to (something without
music, loud noises etc). But meditation has been another big factor. Though I
must caution you: meditation rarely has a quick payoff. So be patient and
don't get anxious about results and keep working at it.

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StefanKarpinski
It is pretty poor form for a New York Times article to not bother to define
what "cognitive behavioral therapy" is in an article touting it, or even give
any examples of what specifically CBT might entail in the context of treating
sleep problems.

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tptacek
The second half of the article answers the question of how CBT addresses sleep
problems.

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StefanKarpinski
Where? It describes some effects of CBT may have but nowhere does it describe
what CBT treatment actually entails.

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tptacek
It links both to an academic paper and an online self-help thing prescribed by
his doctor, and it talks at a high level about what CBT is. Are you familiar
with CBT? If you aren't, the trouble you might be having is that CBT is pretty
subtle: it's (in loose terms) a set of exercises you perform to train your
mind to respond differently to stimuli. If you've ever read David Foster
Wallace's Kendall College Commencement, when he talks about the "default
setting", he's giving a pretty decent layman's explanation of the goals of
CBT.

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StefanKarpinski
My point is that when reading an article in a publication like the New York
Times, one should not need to follow links to academic papers or be familiar,
a priori, with the subject matter. Providing a high-level overview without
requiring the reading of additional sources is precisely what a properly
written article in a newspaper like this is supposed do. This article fails at
that quite badly.

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mrfusion
Anyone know if melatonin helps?

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douche
Not terribly, I've found. I've just come off a pretty terrible stretch of
insomnia (being unable to sleep for two or three days in a row every week for
months), and what I've found helpful is taking a bunch of Vitamin D3, 8000 IUs
a day for me. I'm 260 lbs, so you may want to adjust downward if you're not
similarly large and male, because it is a fat-soluble vitamin.

Taking four gelcaps in the morning has made all the difference in the world to
my mood, and I actually sleep now, which is a huge improvement.

[https://www.vitamindcouncil.org/blog/why-does-the-
vitamin-d-...](https://www.vitamindcouncil.org/blog/why-does-the-vitamin-d-
council-recommend-5000-iuday/)

~~~
mrfusion
Good point about D3. I remember reading somewhere that it might also help to
take them first thing in the morning. (I guess you're already doing that
though).

Have you tried cutting out caffeine? How about exercise?

