Explore tips for improving sleep when depressed

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.

Establishing a Sleep Routine (To Increase 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

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. 

How to Get out of Bed When You Don't Want to

Many people wake up in the morning and think, “what’s the point?” Or they may feel such overwhelming sadness, anxiety, heaviness, etc. that it seems impossible to get out of bed. Below are a few tips to help you get out of bed:

  • Stay Hydrated: Drinking some water can bring about some mental clarity, especially if you’re dehydrated.
  • Meditate: Do a short (5-10 min) meditation, such as The Daily Calm on the Calm app or the Meditation Minis podcast. These can help to encourage a sense of presence, acceptance, and  readiness for the day.
  • Think About the Benefits of Getting Up, and Whether Staying in Bed Would Be Helpful: 
    • What is something that could entice you to get up in the morning? Getting a cup of coffee at your favorite coffee shop? Going on a walk and listening to a good podcast?
    • Ask yourself, would staying in bed make me feel better?
  • Start Off Small: 
    • Wiggle your fingers and toes
    • Make larger movement with your limbs
    • Now try sitting up by propping yourself up with your pillow.
    • Now move your legs to the side of the bed.
    • Finally, stand up, taking all the time you need. You’re up! Praise yourself for doing something difficult.

*Note:  it is very easy to judge yourself for not being able to get out of bed, or taking small steps to get out. Try to find some way to reassure yourself that you are struggling with depression right now, and you are doing your best. Just as if you had a broken leg, you are taking extra time to do things, and that is OK.