
Ask HN: how did you fix problems with bad sleep? - Tichy
I am exhausted most of the time, because I never sleep well. Doctor diagnosed "restless legs syndrome" and wants to give me pills, but I wonder if there are any other things to try? Just interested in any stories of how people fixed their problems with bad sleep.
======
SwellJoe
Exercise is a cure for many things, including poor sleep. Take a brisk walk in
the afternoon. 20-30 minutes is fine. It's not guaranteed, I guess, but it
always works for me.

Also, if you're a coffee, tea or soda drinker, switch off to herbal tea or
plain water after lunch. Caffeine has a 6-8 hour period of effect, with the
peak effect happening at about the 4 hour mark. If you do drink things with
caffeine, consider reducing or cutting them out entirely. I can drink 2-3 cups
of green tea in moderation without any adverse effects, but more than one cup
of black tea is too much (and one isn't _quite_ enough, so I don't drink black
tea). Coffee and sodas aren't worth it, to me, as the caffeine in coffee is a
jittery spike and all the sugar in sodas makes me sleepy by lunch time (which
totally throws off getting to sleep when I actually want to at night).

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redsymbol
Hello! I used to have a lot of problems with sleep myself. In fact, there was
a period of time where I would take Nyquil to force myself to sleep, because
it causes drowsiness as a side effect. Obviously this is not recommended :)

I now have a pretty high quality of sleep without the assistance of any drug,
and have for several years. I believe that in my case, most of the change can
be attributed to making a regular habit of meditation and exercise.

When I say "meditation", please interpret that broadly as any activity that
might be considered meditative. There are many forms that people describe as
"meditation" that can help. In addition, I'd put activities such as yoga,
qigong and taichi in this category. I practiced many of them at least a little
and believe they all contributed.

As for exercise, I mostly did weight training, combined on and off with
martial arts practice. I did not do much pure aerobic exercise, but that is
only because I personally had a lot of difficulty with it and really did not
enjoy it - I think if I had persisted and only done aerobics (walking,
running, swimming, etc.) it would have had the same end result of improving my
quality of sleep. I don't think you have to do it every day - so long as it's
regular, like 30 minutes three times a week, that would be enough to notice
the effect.

Finally, one other thing you might try: wear earplugs and a blindfold when you
lie down to sleep. This may or may not help you get to sleep, but it's likely
to help you _stay_ asleep once you do drift off :) I find that an empty
pillowcase makes an outstanding blindfold - fold it a few times around its
long diagonal axis, then cover your eyes and tie its ends loosely at the back
of your head. Very comfortable and blocks out the light well.

This is what helped me. I really don't know if these will help you - I hope
you do discover what works well for you. Good luck!

-Aaron

------
rms
You can get an SNP test for restless legs syndrome if you want to find out if
you have a related genetic mutation

Also, and this is definitely not medical advice, anti-depressants might work
but they also sometimes cause restless legs syndrome. Restless legs syndrome
pills have gotta be under international copyright, but if you're personally
comfortable going on happy pills with the knowledge that you need to carefully
withdraw from them over 30 days that could also fix all of your sleep issues
much cheaper than restless legs pills.

------
ComputerGuru
I love how you assume we've "fixed" that problem :)

More seriously though, I suffer from the same problem. My issue is that I
can't clear my mind - so I'm lying in bed and actively thinking (verses
"passively" letting my mind wander) about people, events, projects, etc. until
I get bored and get back up.

My only solution (more of a workaround) is to just do the same as LogicHole:
stay awake for 36 hours - you'll force your body to go to sleep thereafter.

~~~
jsmcgd
I sometimes cannot sleep because I can't stop thinking about things. For me
the cure is reading fiction. I can't recommend it enough. It totally clears my
mind of everything that excites/agitates/stresses. Non fiction won't do and
can actually make it worse. Fiction!

~~~
Tichy
I always need a good book around for getting to sleep. It makes me nervous if
I don't have one.

Of course one of the sleep hygiene rules is to not do anything other than
sleep in bed, but I think there has to be an exception for reading.

------
LogicHoleFlaw
Basic sleep hygiene is a good starting point. Sleep on a consistent schedule 7
days a week. Use your bedroom only for sleeping. Don't read, work, or study
there. Avoid eating right before bedtime. Get away from bright lights,
emissive display devices, and loud noises for about an hour before you go to
bed. Exercise is great too, but not right before bedtime. Do note that once
you start using this routine it may take 4 to 6 weeks to really see the
benefits.

SwellJoe's comments on caffeine and sugar are true. My doctor told me that
caffeine has about a 10-hour half-life. After noon it's generally something I
avoid.

If you try these things (or at least a good portion of them) and you don't see
any improvement it's time to start looking at health conditions rather than
merely poor habits. Sleep apnea is a major cause of chronic exhaustion.
Restless Leg Sydrome is another. With both of these you are constantly waking
up during the night and never attain the deep sleep needed to rest.

My father had sleep apnea - when he did an overnight EEG sleep study the
doctors determined that he was waking up over 80 times an hour due to airway
blockage. He started using a CPAP about two years ago. The CPAP is a face mask
which generates positive air pressure to keep airways open. The difference was
dramatic. He's much more energetic, much less grumpy, and has in general been
much happier since he started using it.

I personally had awful sleep for years. I was perpetually exhausted. The only
way I was able to sleep was to stay awake for 24 to 36 hours and then pass out
for 12 to 18 hours. I was miserable. I finally broke down my pride and went to
see a sleep specialist. I implemented the sleep hygiene strategies and saw
slight improvements but no major gains. I didn't have RLS or apnea, so the
possible suspects were narrowing down. On a long shot we decided to try a
medication called Rozerem. It's a synthesized melatonin available as a
prescription. In most people the pineal gland regulates the sleep/wake cycle
via the production of melatonin. As it turns out I have extremely low
melatonin production, so my body never got the signal to shut down and sleep.
With the introduction of melatonin in pill form about an hour before bed I was
actually able to get a good night's rest. The difference was astounding. I had
forgotten what being rested even felt like. Interestingly the melatonin had an
immediate dramatic effect on me. It doesn't force drowsiness like a sedative
does. It allows me to feel sleepy (rather than just tired or exhausted).
Rozerem won't do anything for someone with normal melatonin production
however. Past a certain level the body just metabolizes the extra melatonin
and it is neutralized. For the same reason increasing the dosage of the
medication won't have any effect.

For me the combination of improved sleep hygiene and the synthesized melatonin
made a dramatic difference in my quality of life. Treating my father's sleep
problems made him a much happier individual. If your doctor thinks that a
medication for RLS will help you attain better sleep, I highly recommend that
you at least try his suggestions. There is no substitute for being well-rested
and you owe it to yourself to find out what will allow you to gain a good
night's sleep.

~~~
rms
Did you ever try regular melatonin?

~~~
LogicHoleFlaw
I did not. I would if I did not have easy access to the Rozerem. Over-the-
counter melatonin is not regulated by the FDA and is of wildly varying
quality. The advantage of the synthesized capsule is that the dosage is
consistent and effective.

~~~
jganetsk
Yes, OTC Melatonin is not regulated by the FDA, mainly due to the lack of
studies on its long-term effects.

If you were going to try it, go for a low dose. Try 300 micrograms [1]. Most
stores sell a minimum dose of 1 milligram, but you can find the lower dose
stuff on Amazon.

1\. <http://web.mit.edu/newsoffice/2005/melatonin.html>

------
Andys
I had restless legs syndrome. My (herbalist) wife diagnosed it as a magnesium
deficiency. There are a variety of reasons why habitants of western society
can be magnesium deficient, which I don't have time to go into here.

Rather than waste time with potentially ineffective dietary supplements, the
easiest way to get more magnesium is with a bath of Epsom Salts, which is
actually just magnesium phosphate. Run a very hot bath with two cups of epsom
salts diluted in it, and plenty of it gets absorbed through your skin.

The first day I tried this, I had the best night's sleep in years!

So in my case, I think her diagnosis was correct, and I took the baths every
second night until I felt completely better and my sleeping patterns were back
to normal. (My coding concentration improved too.)

ps. If you don't have a full-sized bath tub you can use a bucket and just
bathe your feet, though I imagine you won't absorb as much this way. Just make
it hot.

~~~
Tichy
Interesting. My family physician also wasn't happy about the restless legs
diagnosis from the sleep lab and first wants to test Magnesium and Vitamin B
(I went to the sleep lab of my own accord, it was not her recommendation).

------
calvins
I sleep much better since getting a white noise machine that I have on
overnight. I use the Marpac 980, which I'm very happy with:
<http://www.marpac.com/sound_cond.asp>

I got mine from Amazon for $50.

------
gruseom
I know of two things that help. One is exercise, which lots of people have
mentioned here. The other is meditation. My brother-in-law suffered badly from
insomnia for years and says it made the biggest difference out of all the
things he tried.

~~~
Xlp-Thlplylp
I have chronic insomnia. Now that I'm walking home from work (about 35
blocks), I feel even better, and my insomnia is worse. I tried resetting my
circadian rhythm by not eating 16 hours before going to bed: even worse
insomnia. Anything I do to control my insomnia exacerbates it.

~~~
gruseom
That sounds hard, and I'm sorry to hear it. If your point is that your
experience contradicts my statement, I agree. Had I run the "comment" command
with the -v option, it might have taken the following more accurate form: "I
know of two things that have helped me sleep better, although I didn't have
insomnia to begin with; somebody else I know who does, reports that both
helped him too, but of course it doesn't mean they'll help you, but they might
be worth trying."

------
aravindmc
It looks like there is some research leading to fixing sleeping problems by
simply changing your eating habits. I dont personally know how easy it is to
implement these ideas.

[http://parentingsquad.com/easy-way-to-reset-your-sleep-
cycle...](http://parentingsquad.com/easy-way-to-reset-your-sleep-cycle-stop-
eating)

<http://www.news-medical.net/?id=32333>

------
truebosko
I try to keep a regular schedule and if I can't get sleepy I read a book.
Reading puts me RIGHT to sleep.

Note that reading things online (RSS Feeds, Twitter, whatever) do NOT work :)
They'll probably keep you more awake. Grab a good, or boring novel if that's
your schtik and read it for 20 min while in bed. Puts me right to sleep on the
days I can't get tired (Or just have sex that works too)

------
JFred
You'll also want to look at this recent NYT article on fatigue:
[http://health.nytimes.com/ref/health/healthguide/esn-
chronic...](http://health.nytimes.com/ref/health/healthguide/esn-
chronicfatigue-ess.html?ref=health)

------
mattmaroon
Oh man, not the jimmy legs.

[http://www.thedailyshow.com/video/index.jhtml?videoId=147536...](http://www.thedailyshow.com/video/index.jhtml?videoId=147536&title=the-
jimmy-legs)

Just don't start gambling.

~~~
Tichy
That link crashes my browser, any other sources?

------
prakash
www.supermemo.com/articles/sleep.htm -- read this.

~~~
eru
That boring? ;)

Edit: Actually the linked article seems quite interesting.

------
JFred
Some people do better without caffeine. There is also a condition called
Mononucleosis that can cause fatigue, as well as other conditions. Lots of
things from vitamin deficiencies to cancer can cause fatigue.

If you look up the pill on the web you can get information but they tend to
list any side effect ever seen. Check out the list of problems with Tylenol
and you'll see the kind of CYA exaggeration I'm talking about.

I've never heard of any treatment for restless leg syndrome beside the
medicine.

------
m0nty
I had a tough time sleeping last year, mainly caused by anxiety about work,
and the onset of mild asthma which caused me to wheeze as I fell asleep. The
wheezing would wake me up, and the anxiety would keep me awake. Incidentally,
it took me four doctors to get this point across: I told them my son has
asthma, so does my mother, and I have hay-fever, so maybe I had asthma too?
Finally, sure enough, it was diagnosed and I was given an inhaler which fixes
the symptoms. My point being - whatever your doctor says, (s)he could be
wrong, and your problem might lie elsewhere.

Anyway, during the three months or so of bad sleep, I often went for several
days (the record being from Thursday until Sunday, ie 4 nights) without
sleeping. That puts you in a strange state of mind, believe me. My first,
regular doctor told me that I shouldn't worry about the sleep, since after a
night I'd be so tired I could sleep through anything. Riiiight. Another doctor
finally gave me sleeping pills, which were great - she even said she used them
herself quite often. The only problem was getting off the pills after a few
weeks, since they're addictive and coming off them causes anxiety and
sleeplessness, which seems a bit circular and counter-productive...

Anyway, the lessons learned, the hard way:

* Doctors are fallible and overworked, just like everyone else.

* Alcohol is not the answer. I tried. Sleeping alcohol off is not the same as a good night's sleep, and you'll damage yourself in other ways by over-imbibing.

* Tea is better than coffee. I have one strong, tasty cup of real coffee per day (in the morning) then drink tea. I know many non-Brits complain that tea is a watery, flavourless drink, so I would refer you to George Orwell, who knew a thing or two about making a tasty cuppa: <http://www.booksatoz.com/witsend/tea/orwell.htm>

* If you are anxious about work, relationships, money, your big project, whatever - deal with that. It's quite possibly the true cause of whatever's troubling you. Find ways to relax, especially socialising, exercising, etc.

* Work out for half an hour each day. I do this and the endorphine rush is fantastic. I don't even work out particularly hard - I'm sweaty but not nauseous by the time I've finished. You'll look better, feel better, and probably sleep better too. I use a rower and a bike machine, so I can watch a DVD or listen to music if it gets boring.

* Most of the crap about relaxation exercises ("tense up your toes, then relax, tense up your legs and relax", etc) is just that - utter crap which probably won't help at all.

HTH. Don't just think about the immediate problem. Look for underlying causes
and try your best to deal with those. And good luck.

~~~
euccastro
Actually, alcohol has an enervating bounce effect that kicks in a few hours
after intake.

~~~
m0nty
Also followed by a depressant effect which can last for days. So overall,
alcohol only "works" in the short term, after which it's all downhill.

------
chriskelley
When my girlfriend has problems (studying for the bar... talk about anxiety) I
will make her play cards with me for 30-45min or we'll both read our books
awhile. As others have mentioned, the key for some is to clear an anxious mind
from the days activities before you try to sleep. It would be nice if our
bodies has a switch, but until then...

------
khafra
Eugeroics. Use adrafinil when you need to be awake and alert, let the sleep
take care of itself.

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luckystrike
As others have mentioned, regular physical workout helps one get in to a good
sleep schedule (apart from it's various other benefits). e.g. an hour in the
gym in the morning, makes me hit the bed at a very consistent time every
night.

------
gms
Earplugs

~~~
eru
They really help with some problems - especially snoring room mates. But they
are not a cure-all.

------
icey
Nothing has improved my ability to sleep more than quitting smoking and
quitting or severely limiting my caffeine intake.

------
rokhayakebe
Start working out and you will sleep well whether you want it or don't.
Guaranteed.

~~~
Tichy
The problem with working out is that I am frequently too exhausted to do it. I
do sports, but something on a regular basis in general was impossible to me so
far.

~~~
rokhayakebe
Tylenol PM

------
ephextom
I can't imagine cavemen having problems like "restless legs syndrome", and
they managed to get by pretty well without CPAP machines too. The causes of
these types of things can generally be found in modern diet and lifestyle
factors.

The most effective things I've found in improving sleep and general wellbeing
are:

\- giving up caffeine;

\- reducing anxiety and stress generally particularly before bed.... don't
work long hours or work right up till bedtime as you can be running on
adrenaline which is terrible for sleep and mental health.

\- avoid diet drinks and anything containing artificial sweetener
(<http://www.google.com/search?q=aspartame>) ... I only recently discovered
how terrible this stuff is, and giving it up has done wonders for my
wellbeing.

\- If you snore, have sleep apnoea or any other respiratory condition, look
into natural remedies like Buteyko or Pranayama... CPAP machines can help you
get better sleep but are counter-productive in the long term as they reinforce
your habit of hyperventilation.

\- Consider seeing an osteopath or similar type of physical therapist to
straighten out your skeleton and attend to any muscle tension you have - most
people, particularly desk-based workers - have lots of tension which restricts
blood flow, contributes to stress and reduces quality of sleep.

\- Regular exercise is great but be careful if you are already prone to
anxiety, as over-exercising can push you into depression (this is counter to
what most people understand about exercise & depression)

\- Consider detoxing and liver cleansing - I've undertaken the lemon detox
("master cleanse") about every 6 months for the last year or two, and found
it's done wonders for muscle tension, quality of sleep, digestion and mental
health.

Some of these points - in particular the last one - are very contentious and
frequently under attack from skeptics, usually who are practitioners of
conventional medicine, vendors of costly commercial solutions like CPAP
machines, or professional skeptics like Skepdic, which whilst often valuable,
is often skeptical about things purely because they are unconventional.

Whilst I don't have any problems with conventional medicine, it generally
focuses treating symptoms of clear-cut diagnosable illnesses, and is not
particularly good at addressing the vague lifestyle-related conditions like
fatigue, poor sleep, anxiety, muscle tension, digestion etc.

These types of conditions can generally be overcome by understanding the
fundamentals of the way the body works, and doing everything you can to help
your body to work as it was designed.

It's not easy, the world of "natural medicine" is a dangerous place but my
experience is that with persistence, a willingness to experiment, and a
healthy level of skepticism, it has much to offer to improve your life
greatly.

Some helpful links:

<http://www.kuro5hin.org/story/2005/5/9/83936/58483>
<http://www.kuro5hin.org/story/2005/5/16/81428/8007> (I know you didn't
mention any issues with depression, but quality of sleep is closely related to
anxiety and depression, and can be a warning sign, and many of the same
principles apply in overcoming the problem.)

<http://www.buteyko.com/> \- if you have breathing/snoring problems.

------
agentbleu
also try monitoring your body temperature, especailly head and feet (socks and
a hat), this can also help.

------
sutro
Alcohol. To quote Homer Simpson, it is the cause of and solution to all of
life's problems.

~~~
gruseom
Alcohol induces wakefulness in the second half of sleep, so this is a bad
idea. (There are many sources on this. I found
<http://alcoholism.about.com/cs/alerts/l/blnaa41.htm> in a quick search.)

