Sleep

Sleep becomes so messed up when we’re depressed. We’re either sleeping all the time, or we can’t sleep at all because thoughts just keep running through our mind. For some of us, it’s easy to fall asleep and we’re sleeping way too much, and for others, it’s hard to fall asleep. 

The tips below are to give you information and resources for developing healthy sleep habits, and what to do when you just can’t catch those zzz’s.

Tips for Healthy Sleep / Increasing The Likelihood of Sleep

Follow a Consistent Sleep Schedule, Even on Weekends
  • Go to bed and get up at the same times each day. This sets the body’s “internal clock” to expect sleep at a certain time night after night.
  • Set a bedtime that is early enough to get at least 7 hours of sleep. 
  • Avoid napping. If you must nap, try to keep it short and before 5 p.m.
Do Not Use Your Bed in the Daytime
  • Even if it means moving from your bed to the couch, try to do so for the sake of sleep health. Do not use your bed for things like watching TV, talking on the phone or eating. Your bed should only be used for sleep and sex.
Avoid Caffeine, Nicotine, Alcohol, Heavy Meals, and Exercise 4-6 Hours Before Bedtime
  • Stimulating chemicals and energizing activities keep you awake, so try to limit their intake before bed,
  • While alcohol may help to bring on sleep, after a few hours it acts as a stimulant, which decreases sleep quality. Try to limit drinking to 0-2 drinks/day and avoid drinking in the hours before bedtime.
Go to Sleep When You Are Truly Tired
  • Struggling to fall asleep can be frustrating. If you can’t sleep after ~20 minutes, get out of bed, go to another room, and do a relaxing activity, such as reading or meditating, until you are tired.
Establish a Soothing Pre-Sleep Routine
  • Signal to your mind that it is time to wind down with a period of relaxing activities about 30 min-1 hour before bed. Some activities can include: 
    • Taking a bath/shower (the rise and then fall in body temperature promotes drowsiness)
    • Reading a book
    • Meditating to calm your thoughts. You can do this  on your own or using an app like Calm, Headspace, or Insight Timer.
Turn Your Bedroom Into a Sleep-Inducing Environment
  • A quiet, dark, and cool environment best promotes sleep. To achieve this, use earplugs or invest in a white noise machine to lower noise volume, use blackout curtains or an eye mask to block light, and keep the temperature between 60-75 degrees Fahrenheit. 
  • Keep computers, TVs and work materials out of the room in order to strengthen the mental association between your bedroom and sleeping.
  • Make sure you have a comfortable mattress and pillows.
Try an App

Sources: Harvard Division of Sleep Medicine, SleepEducation.org, American Sleep Association, DBT Skills Training Manual, Second Edition

What To Do When You Can't Sleep

Feeling Calm But Wide Awake
  • Get out of bed, go to another room, and do an activity that will not wake you up further, such as reading a boring book. As you start getting tired, go back to bed. 
  • Try a light snack, such as an apple or crackers.
Feeling Anxious, or Ruminating

Put Your Face in Cold Water
  • This technique is known as the temperature TIPP skill of dialectical behavioral therapy. 
  • In order to calm down your thoughts, try holding your breath and putting your face in a bowl of cold water or holding a cold pack on your eyes and cheeks for at least 30 seconds.
  • This will cue your mammalian diving reflex, which causes our body chemistry to change—heart rate drops down immediately and the “rest and digest” nervous system is activated to prompt a relaxation response
  • For a demonstration of this skill, click here. 
Try Meditating
  • The 9-0 meditation technique can be helpful. Breathe in deeply and breathe out slowly, saying in your mind the number 9. On the next breath out, say 8; next breath out, say 7, and so on until 0. Then, start over, but this time start with 8 as you breathe out, followed by 7, and so on until 0. Keep focusing on the numbers. Continue this until you fall asleep. 
Focus On The Bodily Sensation of the Rumination
  • How does the rumination make your body feel? Tight? Heavy? Is a particular area of your body more affected than another area? 
Reassure Yourself
  • Ruminating at night is often just “middle-of-the-night-worries.” In the morning you will usually think and feel differently.
If the Rumination Does Not Stop
  • If it is solvable, solve it. If it is insolvable, think about what the very worst outcome you can imagine would be, and imagine coping ahead with that catastrophe. 

Source: DBT Skills Training Manual, 2nd Edition
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