A Better Night’s Sleep
I have always been a terrible sleeper. I remember when I was a child, my mother lying in bed with me, singing a Japanese lullaby to help me sleep, and then hearing silence as she dozed off herself while I stared at the glow-in-the-dark stars on my ceiling. I would nudge her and she would continue a few verses, slurring as she sang in her slumber.
Throughout the years I developed ways to get enough sleep to go on with my day, but there were still many nights I would toss and turn, read a book with a small light under the covers, and resented my peaceful husband snoring next to me while I was up for three, four, five hours begging my brain to turn off. During college I took Ambien when doctors were giving it out like candy, a miracle drug that could get us those zzz’s we all so desired. It worked beautifully, but I never felt completely rested. Then I stopped when I found out all the side effects it could cause, and one night on my overnight ER shift during medical school, had to stitch up a chin after a young woman fell down the stairs while sleepwalking on Ambien. That was it for me.
Another time I went home to study for my medical boards, locked myself in my room to learn for 14 hours a day, and was only sleeping four to five. I confessed to my father about my troubles getting the rest I needed to retain all the information I was cramming. He said, “Why not try some alcohol? I’ll give you a glass of wine—it sometimes helps me sleep.” I tried it for a few nights and fell asleep quickly, but only to wake up multiple times throughout the night. In the morning, I felt worse and exhausted. Although alcohol can help with sleep onset, it worsens sleep quality, ultimately not helping with feeling rested at all.
I was desperate and I continued my search for the perfect pill. I tried every herb and supplement I could find, and many worked for a few days or even weeks. Chamomile calmed my nerves, but was too mild an herb to help me sleep. Valerian helped me fall asleep but I felt very groggy during the day. Kava kava made my tongue feel numb, and made me feel better about not sleeping, decreasing the anxiety I had towards sleep, but didn’t do much to give me good shut eye. For a while a few sprays into my mouth of Sleepy nights by Wish garden with skullcap, passionflower, and hops was very helpful, but then I needed more and more to continue the effect. The same thing happened with phosphatidylserine, inositol, and melatonin. But every time, I was back to square one—tossing and turning.
After a while, I tried to listen to what I had been told all along—change my sleep behavior and habits. No more late night binging on TV (or dark chocolate), go to sleep at the same time each night (and wake up on a schedule), stop screens for an hour before bed, do something relaxing during that time (my go-to was listening to a body scan meditation), rub sesame oil on my feet (advice from the Ayurvedic tradition to calm Vata energy), and get out of bed in 20 minutes if I wasn’t asleep. During those 20 minutes, I practiced my forward folds I had learned during my yoga teacher training that could help calm the nervous system, keeping my legs up the wall until my tight hamstrings couldn’t take anymore. I tried my hardest not to worry about my sleep, but as a doctor, I knew very well what could happen if I didn’t let my body rejuvenate overnight. I had given talks about how chronic insomnia, over time, could lead to horrible medical illnesses like heart disease, type II diabetes, increased infections due to lower immune response, memory loss and even obesity. I reminded myself that one bad night wouldn’t wreak too much havoc on my body, that it wasn’t the end of the world. All of these tactics worked most nights, but about once a week I would be up for hours, and would take my pillow to the guest room so I wouldn’t wake up my husband.
Soon I heard about something called Cognitive Behavioral Therapy (CBT) for insomnia. I had tried CBT when I became a new mother and times were hard, and learned how it could help change negative thought patterns and ultimately emotions tied to those thoughts. Similarly, CBT for insomnia attempts to change our attachments to certain ideas around sleep, while also shortening time in bed to only sleep when very tired, then slowly increase that time to teach the body to stay asleep longer. I joined a virtual group visit run by another physician and watched as people complained about being allowed only 5-6 hours a night to sleep. Cranky and upset in the beginning, soon these people started sleeping longer—something they hadn’t experienced in years. They were able to get off sleep aides, and felt more energy and happier. It took weeks and a lot of commitment, but in the end proved powerful. Watching on the sidelines, I saw how sleep restriction along with changing our perception of sleep was an important part of getting the rest we were all looking for.
One day I decided to dig a little deeper. What was my body telling me? What did I need to calm my nerves and my mind? I had had a few stressful years with my son’s cancer treatment, and then the Covid pandemic, all the while working and seeing patients during unknown and worrisome times, so my cortisol levels were probably quite low at this point. I had treated many of my patients for their gut health, stress, and insomnia, but I had not fully treated myself. I thought through what my body needed the most and came up with a plan of various supplements and herbs to treat my gut, adaptogens to improve my stress, and vitamins and minerals that I might not be getting through my food. I cleaned up my eating habits, increasing the amount of vegetables and protein, and decreasing the delicious pastries we got used to eating while living in Spain. I exercised more regularly and incorporated yoga back into my routine. I allowed myself time for self care, enjoying time outdoors on hikes or reading books about health (which to me is relaxing) while sipping a cup of herbal tea. All of my hard work has paid off. Even during tough times—while my kids transitioned back to living in the US, I started a new job, and my mom got diagnosed with cancer—I have been able to maintain my eight hours of sleep a night and have felt a world of difference in my psyche and my overall well being.
After struggling to get my beauty sleep for so many years, I realized I couldn’t just hope for a magic pill. And I couldn’t only rely on a good sleep schedule, eating well and getting my exercise to feel well. It took time and effort to improve my sleep, and to figure out what my body needed at this moment in time. I had to analyze myself the way I did with my patients and remember that every body is different—what works for one might not for another. I had taken some of these botanicals in the past when my son was sick and I didn’t feel anything. I was too stressed for my body to accept it at that time. But after processing, and changing my behavior and habits, along with the right combination of supplements and herbs, I had finally figured out what I needed to get a better night’s sleep.
My Tips:
Sleep Hygiene is important:
Exercise regularly for at least 20-30 minutes a day, preferably 4-6 hours before bed
Avoid caffeinated beverages after lunch or at all
Avoid alcohol and nicotine near bedtime or at all
Stop eating 2-3 hours before bed
Get some sunlight during the day (outside or open windows)
Adjust the bedroom environment (keep the room dark, room temperature around 60-67 degrees F, remove clock from eyesight, use noise machine or earplugs if noise is bothersome)
Avoid screens before bed for at least an hour (Turn on night light or night shift on phone or turn down brightness to decrease amount of blue light before bed.
Keep a regular sleep schedule: sleep and wake up at the same time each night with the goal of 7-8 hours a night
Develop sleep rituals (bathing, listening to relaxing music or meditation, reading, etc.)
If you can’t fall asleep within 20 minutes, do something boring until you feel sleepy
Stay in bed only for sleep and avoid working, reading, watching TV in bed
If your mind won’t shut off consider writing things down (a journal or To Do list), listen to meditation, breath counting
Consider Cognitive Behavioral Therapy for Insomnia (CBT-i) with a practitioner or an app
Work with a practitioner on herbs and supplements that are right for you
This content is provided for general informational and educational purposes only. It is not intended as, and should not be interpreted as, medical advice, diagnosis, or treatment.
