15 do’s and don'ts to help you sleep like a puppy during the pandemic

2. Exercise for 30 minutes every day. Aerobic exercise in the morning, like cycling or walking, can make a huge improvement in your sleep quality. If you aren't able to exercise in the morning, try to finish at least five hours before bed, because strenuous workouts too close to bedtime can raise your body temperature and act as a stimulant, making it harder for you to fall asleep. Another benefit of regular exercise is that it helps ward off depression and anxiety, which also can contribute to or intensify your insomnia.

3. Meditate every day. Establishing a daily meditation practice will not only help you sleep but will positively impact almost every aspect of your life. Sleep problems often come from stress and worry, but meditation improves your relaxation response. It also improves control of the autonomic nervous system, which reduces how easily you’re awakened. Meditation can also increase melatonin (the sleep hormone), increase serotonin (precursor of melatonin), reduce your heart rate, decrease your blood pressure, and activate parts of the brain that control sleep. I have spent hundreds of hours using the two most popular mediation apps, Headspace ($69.99/year) and Calm ($69.99/year.) Headspace is my favorite because I love the narrator Andy and it has a wide variety of courses tailored to whatever you want to work on in your life with sessions, starting at just 3 minutes. It also has a great series for kids, separated by age. Calm was much more limited in variety so I often got bored with the meditation content. I would encourage you to start small, 3 to 5 minutes each morning, to establish your routine and try to build up gradually to 20 minutes per day.

4. Improve your diet by adding sleep-promoting foods during the day and avoiding sleep stealing foods before bedtime. There are plenty of foods and nutrients that have been found to improve your sleep. While you can’t try all of them today, I already have and implemented most of them into my sleep smoothie (invented by my husband Bennett) and vitamin regiment. Each ingredient has a different impact on sleep, immunity, and overall health. I spread out my vitamins and take them 8 times per day. Getting the pills ready each week became a chore so I bought enough of these vitamin sorters ($11.99 each on Amazon) to do one month's worth at a time. These sorters allow you to have four compartments per day, which is great for separating your vitamins. I have all of my vitamins on autoships so they are ready at the beginning of the month. I checked with all of my doctors before adding vitamins into the mix, you should too.

5. Get 30 to 45 minutes of early morning light exposure. Exposure to sunlight during the day helps maintain a healthy sleep-wake cycle. Getting bright morning sunlight is the best, but if you can’t do that you can invest in a light therapy box. Since I wake up at 4 am, the sun isn’t out for hours so I use my light therapy box for 30 minutes right after I meditate in the morning. I purchased this lightbox from Amazon for $89.99 because it has 10,000 LUX (meaning really bright.) There are cheaper options out there so you can easily find one that fits into your budget.

6. Eliminate bright lights and blue light at least two hours before bedtime. Bright light gives your brain the signal to stop producing melatonin so cutting out light pollution at least two hours before bedtime is crucial for healthy sleep. Technology like smartphones, tablets, and TVs emit sleep killing blue light so when you watch it right before bed, you will have a hard time falling asleep because your brain thinks it is morning. You don't have to give up your technology addiction, just purchase glasses that will eliminate the blue light. I wear glasses so had to buy a pair that would fit over my regular glasses. I got these glasses $24.99 on Amazon. Bennett doesn't need his to fit over glasses so ordered these from Amazon for $39.99. You also want to make sure you turn down (or off) all bright lights around the same time. If you want a good option to use in the lamp on your nightstand to read books or magazines, warm orange glow lights won't impact your sleep. I bought these Orange light bulbs for $19.99 on Amazon for all of our bedroom lamps. 

7. Lose the afternoon nap. Napping has never been a problem for me because I can’t turn my brain off long enough during the day to nap. However, this is an issue for most people suffering from insomnia as they try to “catch up” on lost sleep with daytime naps. Napping does not make up for inadequate nighttime sleep and will diminish your sleep drive for the next night, making it harder to fall asleep. While a nice quarantine nap sounds good amid a sleep-deprived moment of weakness, you will wish you skipped it when you are tossing and turning later that night.

8. Establishing a regular calming bedtime routine. A nightly routine helps your body recognize that it’s time to sleep. Everyone’s routine will be different but here is what works for me, for an 8:30 pm bedtime and 4:00 am wake time. 

• 5:00 pm - I shut down everything over stimulating including computer work, stressful conversations, or any type of drama. My friends know if they text me after 5:00 pm, they will hear from me the next morning at 4:00 am. 
• 5:30 – dinnertime and I treat myself occasionally with one Blue Moon or a glass of wine.
• 6:30 - I take a ten-minute hot shower. Hot showers and baths two hours before bedtime help the body’s natural flow to sleep by lowering your body temperature signaling to your brain that it’s time to sleep.
• 6:30 – Blue light blocking glasses go on and I do something relaxing like playing monopoly or cards with my kids.
• 7:00 – I go upstairs to one of the kids' rooms and read Entertainment news on my iPad and pet our loco cat Coco and new puppy Penny.
• 8:00 – I head back downstairs and watch reality TV in the living room.
• 8:30 – I go to bed and read a magazine until I doze off.

I very rarely deviate from this schedule, meaning sometimes I have to miss out on events that happen in the evening. The people who matter most to me don't mind and if they really want me to be somewhere, they schedule it before 5 pm.

9. Make your room a sleep cave. This is important but these items add up quickly so prioritize the items that are most important to you, and are within your budget. These are the items I depend on for great sleep:

• Soft pillows with a cooling silk pillowcase. I use this one from the Macy’s Hotel collection, currently on sale for $44.
• I turn the thermostat down to 65 degrees a few hours before bed. Your bedroom should be between 60 and 67 degrees for optimal sleep. I have tried other money burning cooling devices like the chili-pad, retailing for a whopping $1,000 on Amazon, and the $799 Ebb Sleep machine. Neither one of them helped me and I had to replace them multiple times during the warranty period after they stopped working. I eventually gave up on them both, and now they are gathering dust in the corner of my room.
• Silk eye mask – I use the $50 Slip Sleep Mask. I would suggest you don't go with a dark color, the ink will rub off on your new silk pillowcase.
• Bose Sleep Buds. We live very close to MacDill Airforce Base in Tampa. Usually, the planes don't fly at night but sometimes the supersonic planes do night training, flying throughout the night with noise so loud it shakes our house. My husband bought these for me out of desperation last December when the training went on for weeks. They block out every noise but there are major issues with the battery dying or failing to hold a charge so Bose has discontinued them. I am praying mine to hold up until they come out with a replacement.
• Weighted blanket. I read a lot of articles about how weighted blankets do (and do not) help with insomnia and anxiety. I decided to add one into the mix in 2018 and I have found it helps me.  Here is the one I purchased on Amazon. The price depends on the blanket size and weight. A rule of thumb is to get one that is 10% of your body weight plus one or two pounds. 
• Mini orange light for reading. It is probably overkill with my orange glasses and orange lamp, but I got this dim mini rechargeable light from Amazon for $14.95 when I read magazines in bed. 
• I also use a white noise machine as a backup when my sleep buds are acting up. I got this one from Amazon for around $30, and it works great. It has been discontinued but there are a ton of affordable options.

11. Cut back, or cut out, stimulants like caffeine and nicotine. Caffeine has a half-life of around 5 hours but can stay in your system for much longer. If your body is sensitive to caffeine, even a little bit lingering at bedtime will make it harder for you to fall asleep. While I have cut out all stimulants (except dark chocolate before lunch) but I realize that is not realistic for everyone. A good rule of thumb is to avoid caffeine after 11 am.

12. Limit alcohol before bedtime- While alcohol is well-known to help you fall asleep faster, too much too close to bedtime can disrupt your sleep in the second half of the night when your body begins to process the alcohol. This causes you to wake up and have difficulty falling back to sleep. Try to pay attention to the nights you have bad sleep after you have had too much to drink and adjust your alcohol intake before bed.

13. Schedule social time with your friends every single day. Isolation from others creates a perfect environment for anxiety and depression to flourish, which can lead to or perpetuate insomnia. The current pandemic requires the entire world physically isolate from other humans, which can be devastating to our mental health. Try to schedule virtual meetings with your friends or outdoor activities where you can be together albeit six feet apart. I am typing this blog looking out of the window for my bestie Susie who is coming to my porch to catch up in rocking chairs spaced exactly six feet apart. *Note the picture below was taken pre-pandemic.*

13. Acupuncture – I have been going to Dr. Zhang for acupuncture for eleven years now for all sorts of ailments, most notably insomnia.  Don't let the tiny needles scare you, I have been poked tens of thousands of times and have never felt one needle go in. My biggest complaint is that while most people sleep during a treatment, I have to struggle to stay awake so a nap doesn't set me back that night. The health benefits of acupuncture are well documented, but treatments aren’t cheap (around $80/each) and most insurance plans don’t cover it. However, if it is something you can afford, it is worth looking into if nothing else is working for you.

14. Enlist a sleep expert – When all else fails, don’t be ashamed to seek help if you aren’t able to get past your insomnia on your own. My insomnia was so severe that I sought treatment from Dr. Jaclyn Lewis-Croswell, a Psychologist specializing in the treatment of insomnia, about three weeks after my first no-sleep night. Dr. C's method of treatment for insomnia was Cognitive Behavioral Therapy For Insomnia (CBTI) and she also helped me to taper off all sleep medication. I still see her every two weeks, which has helped tremendously during high-anxiety times like launching a new app during a global pandemic.

15. Avoid sleep medications at all costs. When my insomnia started in 2017, I was prescribed so many different sleeping pills from various doctors that it is no surprise I became dependent on them to sleep in just a few weeks. When the pills stopped working (which always happens) my doctors would increase the dose or switch me to another medication and start the cycle over again. Sound familiar? Sleeping pills, both prescription and over the counter, are intended for occasional use only and are like putting a band-aid on a bullet wound. Long-term use is shockingly bad for your brain and body and the doctors prescribing them rarely explain these risks when they dole out the medication to patients desperate for sleep.  Your body becomes chemically dependent in weeks, if not days. It took me almost two years working with my sleep psychologist to finally taper off all sleep medication. If you are not currently taking sleep medication regularly, please don't start. If you are already taking it every night, don't try to quit cold-turkey or you will experience brutal withdrawal and rebound insomnia. You need to seek help from your doctor AND a sleep psychologist to *g r a d u a l l y* taper off the medication after the reasons why you had to start taking the medicine in the first place are addressed. Here is a list of all of the sleeping pills I have tried. Just like in other areas of my life, the quick fix never works long term and not one consistently helped me for more than a couple of weeks.

• Benzodiazepines (Klonopin, Ativan, and Xanex)
• Ambien
• Lunesta
• Trazadone
• Belsomra
• Tylenol Simply Sleep- In full disclosure I have only this in my nightstand for 911 sleep emergency nights. I still struggle mentally with the no-sleep nights and start to panic that my bad insomnia will come back. I only allow myself to take it once per month if I really need it and I usually feel guilty the next day.

While the list above is what works for me, every person is different, and I tried them all at my own risk and expense. You should find the combination that works for you and include your medical team when adding any significant changes to your diet, exercise routine, and/or medication. Know that anything you do to reduce stress and anxiety and build up your body’s natural sleep drive during the day will go a long way to helping you beat insomnia and get the restorative sleep you need during and after the pandemic.