Insomnia Answers

How can i relief my sleep disorder?

Dear I don't know where I am,   Thank you for your message and I understanding that you are having difficulties falling / staying asleep because of anxiety. Meanwhile this is a very common condition for those of us who are struggling with anxiety, you're definitely not alone.   In fact, if you are anxious all the time or suffer from an anxiety condition, chances are you don't find it very easy to fall asleep. Relaxing your mind at the end of a full day is challenging at the best of times, but when you also have anxiety to contend with, you may find yourself physically and mentally challenged when trying to convince your body to sleep. Being anxious during the day is tiring, which makes it all the more important to make sure you don't have to deal with it at night when your body is trying to recover.    The time before you go to sleep is a difficult one for anxiety sufferers, as you have mentioned. This is because all the worries you have accumulated over the course of the day choose now to float through your mind. Being alone in a dark room doing nothing but lying there with your worries allows you no distractions from them, which often allow them to seem to grow bigger and bigger and spiral out of control.    For some people, this is caused by generalized anxiety due to events occurring throughout the day, while for others it is the result of an anxiety disorder. Similarly, it may simply be your thoughts and thought patterns that keep you awake, or it may be the physical symptoms of an anxiety attack. Either way, difficulty getting to sleep can be uncomfortable, frustrating and occasionally frightening.   Anxiousness when you are trying to get to sleep causes both mental and physical struggles. Here are some descriptions of the types of problems encountered by anxiety sufferers trying to get to sleep, maybe you are experiencing some of them as well. Let's take a look.   Restlessness - You may find yourself tossing and turning as you try and get to sleep because your body refuses to relax, and must continue trying to find a comfortable position. This can make you sweaty and get you tangled in blankets or cause blankets to fall off, which can cause you to wake up from cold or not sleep as well if you do fall asleep due to discomfort. The discomfort keeping you awake will give you more of a chance to think the kinds of negative, anxious thoughts that can lead you to a panic attack.   Panic Attacks A panic attack before sleep will usually be characterized by sweating, a rapid heart rate, rapid breathing, and chest pain. These symptoms can be alarming because they mimic some of the symptoms of a heart attack, and may trigger the panicked belief that you are about to die (imagining that you are in physical danger or about to die is common during panic attacks). Panic attacks before sleep aren't as common as panic attacks during the day, but the reality of panic attacks is that they can occur at any time.   Nightmares - If you do manage to fall asleep after experiencing the above symptoms, you are far more likely to have nightmares. Nightmares can further disturb your sleep by waking you up, and if they are particularly bad, they may frighten you enough to keep you awake and cause you to have a panic attack.   Limited REM - All these effects add up to a very limited REM cycle. Most people get 80% non-REM and 20% REM sleep in a night. REM sleep only occurs after some non-REM sleep has taken place. Therefore, if it takes you a long time to get to sleep or you wake up soon after you do, you don't have as much time in the night to achieve that REM stage. Regular REM sleep is required to maintain a healthy mind and body.   Falling/Twitching - You may also find that you experience anxiety as a result of weird sensations you get while trying to fall asleep. Those with stress, for example, are more prone to this feeling as though their body is jolting them awake right before they're about to fall asleep. Scientists are not clear what causes this but know for a fact it's harmless. The belief is that your body thinks you're about to die, so it wakes you up. But since there's no danger, you get anxious from that feeling, thus increasing your nighttime anxiety and making it harder to fall asleep in the future.   So how do we minimize anxiety and maximize sleep?   To get to sleep more easily, you can try changing some of your pre-sleep habits to decrease your mental and physical stress levels. Habit-changing takes time and persistence, but if you stick to these changes, you will find yourself adapting and feeling less anxious overall in no time.   Time Travel This is a fancy way of saying that at least an hour before you want to get to bed, you should try to turn everything off and do something that engages more of your mind then, for example, gazing at your computer or the television screen. Dimming the lights helps alert your brain to the idea that it should be sleeping soon. Doing something casual that still forces your mind to engage, such as reading, drawing, or playing cards will help occupy your brain with something other than the worries of the day when it is time to lay down your head. Pictures on Instagram and funny scenes onscreen fade in comparison to real-life experiences, but the real-life experience of either winning or losing that hand at cards will stick more prominently in your mind and provide a longer-term distraction from your troubles.   Pick a Bedtime Deciding on a particular hour that you want to be in bed by will relax your body by providing it with a comforting, familiar routine to follow. It will also train your brain to get tired at a certain time of night, which will help you fall asleep sooner after you lay down to do so.   Keep a Journal Writing in a journal is another routine you can follow (and a good one to incorporate into your pre-bedtime time travel, as it doesn't involve any technology). Sometime before bed, jot down some thoughts about your day. If any worries or problems come up, be sure to write down possible solutions to accompany them. Once you do this, shut the book and imagine you are symbolically shutting away all the cares and thoughts from the day until you next want to open the journal and look at them.   Consciously Relax Your Body Once you are lying down in bed, try relaxing your body one piece at a time. You can start wherever your toes, for example, but relax each toe individually. Then move up to your ankles, your calves, your thighs, and so on. Make sure each part is thoroughly relaxed before moving on to the next. You may start to feel tingly and almost numb. This is good: it means your body is getting ready to sleep. Once you are completely relaxed, focus on breathing comfortably until you fall asleep.   Reserve Your Bed For Sleep Avoid doing non-bed-related things on your bed: for instance, texting, going online or doing homework. The more you reserve your bed for sleep, the more your mind will associate it with sleep, and the easier it will be to fall asleep on.   Get Up and Walk Around If you find that your anxiety is too strong, don't keep trying to sleep. Distract yourself for a while by cleaning the house or reading a book. Falling asleep when your anxiety is that strong is very difficult, so giving yourself a chance to relax may be beneficial.   White Noise Some type of white noise, calming music, or easy to ignore radio may also be helpful. Often these things can distract your senses, making it harder for you to focus on your anxious thoughts. Try something like talk radio, with a volume so low that you can only hear what they're saying if you try extremely hard. The noise and talking will make it much more difficult to focus on your anxious thoughts.   Avoiding the anxiety that keeps you from getting the sleep you need can be difficult, but following the above all-natural and healthy techniques may be all that you require taking back control over your sleep schedule. You can also start to make life changes that are specifically designed to help you cure your overall anxiety.    Also note that there are also a good number of meditation / guided-imagery exercises you can find on youtube, which can help us to fall asleep as well. I'd recommend that you try them for fun as well.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

How to get rid of dreams?

Dear Kate,   Thank you for your message and sharing.   I understand how difficult it is to try stopping your thoughts regarding your dreams. I could imagine how hard you have been trying and how frustrating to feel that nothing is working.    We can't stop our thoughts, but the more we practice being mindful of the present, the better we can catch ourselves with our thoughts and develop an alternative response to them, and learn to let go.   During moments like this I remind myself the teachings regarding worries, it is consisted with a 2 part questions:   1. Is this problem within my control? If so, then this problem will be solved given time and the right intervention. 2. Would worrying about it make any difference? If not, then is it worth it to sacrifice our time and mental health worrying over something that (1. can't be solved anyway / 2. will be solved anyway)?   This is definitely easier said than done, therefore as a fellow human being, I am working with you to pay attention to what is good, what is kind rather than our worries.   Obsessive or consuming thoughts can make living miserable when you are plagued by them, but this very situation can become the invitation to transcend mind and be free of suffering forever.   Can you stop obsessive thoughts? - If you could, it would be great, but the truth is that it's slightly more complicated than just suppressing your thoughts which at-most you can do for a few seconds. Plus suppressing thoughts is even worse than enduring thoughts. It builds up a lot of negative energy inside.   So how to stop these stops thoughts? The secret to stopping these thoughts is to detach from the mind because You cannot fight mind with the mind. Let's look at this in more detail.   What Causes Obsessive Thoughts?   If you generated the thoughts, you could've controlled them too.   The truth is that you don't generate thoughts, the mind does. And the mind is on auto-mode most of the time.   You can see this for yourself; can you predict what you will think 30 seconds from now? If you can't how can you assume that you are generating the thoughts?   If you believe that you are your mind, that's a false notion again.   If you are your mind then how can you observe the thoughts? So you must be separate from the mind to see what the mind is doing.   The mind generates thoughts, which are mostly just energy forms. These thoughts pass through like clouds. We identify with some of these thoughts and obsess over them.   So in truth, all thoughts are just neutral energy forms; it's your interest or association with the thoughts that makes them obsessive. If you can understand this truth, you have taken the first step towards getting rid of obsessive thoughts.   How to Stop Obsessive Negative Thoughts?   If you are asking this question, ask yourself another question - "is this question not another thought? It's a thought about killing thoughts".   All your attempts at suppressing and stopping thoughts fail because you are using the mind to stop the mind. The police man and thief are both the mind; so how can the police man catch the thief?   So you cannot kill the mind by force. The mind dies its own death by the poison of disassociation.   What gives power to a thought? - Your interest. If you have no interest in a particular thought then it loses its hold over you.   You can try this out now. Let the thoughts flow through your mind but don't take interest in them. Just stay as a bystander or a watcher and let the thoughts float.   Initially you might have a hard time watching thoughts because of your inherent habit of associating with each thought that arises.   It helps to know that you are not your thoughts, that thoughts are just energy forms created in the mind. Why does the mind create thoughts? No one knows - it's just something it does, why bother. Do you ever ask why does the heart beat?   With a little practice you will get really good at watching thoughts and not involving yourself with them.   You will stop giving power to thoughts by not giving them your interest. Thoughts die immediately when they are deprived of this fuel of interest. If you don't associate with the thought or give power to the thought, it will wither away quickly.   What Are Thoughts?   Past events get stored as memories. Your mind conditioning and beliefs are also stored as memories. All this is unconscious storage; the mind does all this in auto mode.   Perceptions and interpretations are created in the mind based on its past "external" conditioning and also its natural conditioning (genetics). These interpretations, perceptions and judgments come up as thoughts in the mind, and they can be positive or negative depending on the mind's conditioning.   Thoughts are generated based on the past incidents/memories, future projections and interpretations on the present life situation. It's like a computer trying to predict or conjure up projection based on the data it has collected so far.   When thoughts are negative in nature (thoughts of worry, anxiety, stress, lack, resentment, guilt etc.) they produce resistance to the movement of your life, and this resistance is felt as suffering. Negative thoughts will always stand in resistance to the movement of your life, like blocks of stone in the midst of a swift current of water.   Life is a stream of pure positive energy and hence any negative thought will stand in opposition to it, causing friction which is felt as suffering in the body.   The thoughts in your mind gain power from your attention and interest. Your attention is the fuel for your mind. So when you give attention to consuming thoughts in the mind, you are unconsciously fueling it and thus attracting more momentum for these negative thoughts.   The momentum of negative thoughts in your mind will slow down, and ebb away, automatically when you stop feeding your attention to it. Stay as an open space of awareness without focusing your attention on the negative thoughts of the mind, and soon they will lose their momentum.   You can focus on the positive thoughts generated in the mind, and thus develop a positive momentum in your mind. Every time your mind produces some positive thoughts, e.g thoughts of love, joy, excitement, abundance, beauty, appreciation, passion, peace etc, focus on it, milk it, and give attention to it.   This will cause your mind to attract more positive thoughts and thus build a positive momentum.   Whenever the mind thinks negatively, don't give it attention or interest, this will cause the ebbing away of the momentum of negative thinking. It's really that simple. Once you understand the mechanics of how thoughts gain momentum in the mind, you will be in total control of your state of being.   The Practice of Watching the Mind   All you need to do to get rid of obsessive thoughts is to watch the mind without getting involved.   You will get really good at this with just a little practice. This practice, or "sadhana" as called in Hindu scriptures, is the root of awakening from the illusion of mind.   Without trying to understand this practice just implement it. The more you try to understand the more mind gets involved. Just watch the mind and you will soon see that you are not the mind at all.   That the mind is like a machine in your head that generates thoughts based on your attention/interest. Be free of your mind by depriving it of your interest. This is the only direct path of becoming free of the mind.   Please let me know if this is helpful, looking forward to talking with you more :) Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

I have serious problems with nightmare. The wake me up every night . Very stressful. All night long.

Hi Jack.  I agree, nightmares are very stressful... and scary!  Especially if you have no idea why you are having them.  Do they repeat or have a theme?  Have you suffered or are you suffering from any kind of trauma?  Do you have any physical ailments?  Do you live/work in a stressful environment?  Do you live alone or have some sort of emotional support person?  Do you remember your nightmares when you wake up or just wake up feeling some kind of way?  I know this is a lot of questions, but every bit of information you can present will help in recovery.  I highly recommend keeping a dream journal.  Record everything you remember, even if it is just a feeling.  If you do not like to write, draw it.  Review your journal each week to figure out if there are any sort of patterns.  The hope is that at some point you will be able to figure out the underlying source of the nightmares.  Keeping a log about thoughts, emotions, behaviors, memories, and situations each day may help as well.  It could look like, "I am (place, environment, atmosphere, around people...).  I feel ... (physically and emotionally - IE: angry, sick to my stomach, heart beating fast...).  Because ... (the reason why) or I don't know why.  The same idea is behind it, recognizing themes, patterns, and triggers... and allowing yourself to analyze where all this is coming from in order to address the issues.  Getting the information out of your head and onto paper will allow your brain to make the headspace for new memories, experiences, and feelings.  If your mind is full of emotions, there is no room to think logically (the same is true for the opposite, if you are too logical, there is no room for emotion) and it will make you ill, both physically and mentally.  If you are going to bed with a lot on your mind, it will manifest in your subconscious and affect your conscious self.  It sounds like you would benefit from some trauma processing therapy, perhaps EMDR, art therapy, or cognitive processing therapy.  The trauma will not go away, but you can learn how to better manage symptoms.  Also, you should see a psychiatrist and tell them what is going on with you.  They may be able to prescribe some medication to lessen the nightmares.  Just remember that if you do decide to take the medication, you must do therapy as well.  Medication will not work by itself, nor is it meant to be used long term.  It is merely a tool to help you get through this time in therapy until you have learned the skills to manage symptoms on your own.  It is not quick or easy work, but it is really worth your time if you are serious about improving your mental health. I hope this helps or at least gives you some options to think about.  Best wishes on your therapeutic journey.  
(LCMHC, NCC, ATR-BC)
Answered on 01/20/2022

Should I be concerned if I had no sleep in 3 days and I am feeling dizzy and I have ringing my ears?

Thank you for your question. I would say this question is more for your primary care physician or a sleep physician specialist, as it is a medical question rather than a mental health question regarding side effects. One of the things I can say is that anything out of the ordinary that you are experiencing is possible that it is related to the medication you are taking if that is the only thing that has recently changed and the side effects have come immediately following this change. If the purpose of the medication is for sleep, and it is not increasing your ability to sleep, you should definitely speak with a doctor, as it is not serving its purpose to support you in sleeping.  The aspect of this that is more within the realm of what a therapist can suggest is you consider the origins of your sleep issues and what your routine before you go to sleep is. Are you drinking caffeine later in the day, try not to do so after 2pm? What are you doing before you try to sleep? You should definitely limit screen time and do more relaxing activities before you go to bed, such as taking a bath with essential oils. Is worry getting in the way of you getting to sleep? If so, I recommend you keep a worry journal or write your thoughts out, so you do not have to waste mental space thinking about these things, as your brain is exerting more effort than it needs to on things that do not have to be internally stored in your memory or your mind. A medication such as the one you are taking us a short-term remedy, so you definitely want to work on sleep hygiene and the underlying sources impacting your sleep. These are the aspects of your issue a therapist can help you with. To understand expected side effects of your medication and whether there is normality to them is a question for the prescribing provider or a sleep specialist. I'm not sure how long you have been taking the medication, but your physician can support you in knowing if this is something that goes away or is normal in adjusting to the medication if you are newly prescribed the medication. I hope you find the answers you are seeking. Best of luck on your quest for more sound sleep utilizing prescribed remedies. 
Answered on 01/20/2022

How to stop having these reoccuring dreams?

Hi,  I am so sorry you are having this terrifying experience with sleep paralysis and recurring dreams. There are many possibilities that may be triggering these such as previous or current traumatic events, hormonal fluctuations, sleep disturbances such as obstructive sleep apnea, or other sleep-wave cycle phenomena that would need to be ruled out by a neurologist who might recommend a sleep study.  In addition, medication, alcohol, or other substances can trigger this phenomenon.   One suggestion I have for you before seeking out assistance from a neurologist to rule out something medical would be to keep a dream journal and write down exactly what you remember, what you see, what you feel, and what you interpret in those experiences--no matter how bizarre it seems.  Our unconscious state processes information in order for us to make sense of our day-to-day experiences and sometimes even gives us answers and solutions to issues that we are struggling with on a conscious level.  We also are wired to be highly intuitive beings, so there may be concerns you are processing on an unconscious level that haven't made their way to the conscious.  This is where dream journaling can really come in handy.  If it is difficult to write or type following waking up from a dream, if you have a recorder nearby, such as your voice memos or camera on your phone, you could record yourself recalling the experience and the dream imagery. Give it a few days and go back and read or listen to what you have recorded.  See if anything matches up with what you may be processing or dealing with in your day-to-day life. I know sleep paralysis, nightmares, and vivid dreaming can all be overwhelming and concerning.  The good news is that our brains are designed to help us process what we struggle with processing on a conscious level so it does work for us when we simply can't. Unfortunately, it can come out in very terrifying ways. That being said, if you are unable to come to a resolution and this issue persists or worsens, I strongly suggest seeking an appointment with a neurologist specializing in sleep disorders as it may be beneficial to have a sleep study. Additionally, if you have a smartwatch, the app autosleep is a great way to track your sleep cycle to get an idea of what your sleep quality looks like. If you have had traumatic events in your life, you might also seek assistance from a qualified trauma professional to help you unpack and heal from memories that are tormenting you in your dream and waking state.   I wish you all the best!
(MA, LMFT)
Answered on 01/20/2022

How do I overcome nighttime anxiety that creates insomnia?

Hello,   Thank you for reaching out on The Betterhelp Platform with your question: How do I overcome night time anxiety that creates insomnia? I will share some information about night time anxiety and insomnia and some tips to overcome this situation.   Facts About Anxiety and Insomnia   Experiencing occasional bouts of anxiety can be fairly common for most people, as anxiety is just an echo of our past survival mechanism of “fight, flight, or freeze” when faced with danger. Although the dangers have changed from animal predators to a fear of being late for meetings, the physiological components of our brains haven’t changed much: our brains still see the cause of our anxiety as a “danger” and thus kicks into action trying to find a possible solution or escape route.   Occasional anxiety is not a cause for concern, but many Americans experience a much more acute, recurring, and overpowering sense of anxiety, which can be the development of an anxiety disorder.   Anxiety disorders can be caused by very specific triggers (known as “phobias”) or can simply be excessive anxiety for extended periods of time that get in the way of everyday life, regardless of a specific trigger or actually being in danger. In these cases, the brain may flood the body with adrenaline, causing a person to experience heart palpitations, shortness of breath, or causing them to lose their concentration at work or school. Additionally, anxiety can cause serious sleep issues, such as insomnia. While experiencing anxiety attacks may cause many people to feel exhausted or fatigued, the act of falling asleep may actually become harder due to the anxiety and the body’s sense of worry or fear.   Types of Insomnia From a medical standpoint, there are multiple levels to measure the severity of insomnia, as well as different types of insomnia. The severity of insomnia can be broken down into five categories:   highly distressed, often struggling with neuroticism or prone to anxiety, feeling tense. moderately distressed, sensitive to rewards or positive events. moderately distressed, not sensitive to rewards or positive events. slightly distressed, high reactivity, or being very sensitive to stressful life events. slightly distressed, low reactivity, or being lowly sensitive to stressful life events.     Effects of Insomnia Sleep is an essential function that the body needs in order to recuperate, heal, and maintain energy. If you’re struggling to get sleep due to anxiety, insomnia, or a mix of both, this can have some unfortunate side effects on the body if left untreated for an extended period of time.     Mental Health Side Effects Additionally, insomnia can cause adverse mental health side effects, including: Depression. Anxiety. Feelings of confusion, irritability, or frustration. Emotional instability.    Insomnia may also result in an increased risk for accidents due to daytime sleepiness or may cause other issues related to work and school. It may also affect your sex drive, memory, and judgment.   How Anxiety Can Affect Sleep   Lack of sleep can lead to increased chances of anxiety, but anxiety can also cause a lack of sleep. Unfortunately, the two can intertwine quite a bit, causing one to exacerbate the other.   Anxiety can have a negative effect on your body’s ability to fall asleep as your brain is in “fight or flight” mode, thinking of all potential outcomes for whatever is causing the anxiety. Furthermore, anticipatory anxiety and specific anxiety about sleep can lead to sleep disturbance and insomnia, which then creates a feedback loop that can make both conditions worsen. Insomnia can also make you more irritable and more worried, as your brain is not getting all the sleep it needs in order to function at normal levels.   However, it’s not uncommon to experience anxiety related to sleep anxiety is a form of performance anxiety. Many people may stress about not getting enough sleep to function, but the stress alone of trying to sleep can cause people to sit awake for hours. Additionally, other fears such as recurring nightmares, fear of sleep apnea (not breathing while being asleep), and more can all lead to disturbed sleep.   Does Anxiety Go Away?   For those people that are diagnosed with a legitimate anxiety disorder, the condition is unlikely to go away. Some people may be able to better control their anxiety disorder with the help and guidance of a therapist or psychologist, and medications may help further control the condition. There may also be specific coping mechanisms to help manage anxiety disorders, however, a permanent “cure” for anxiety does not currently exist.   For those that do not suffer from an anxiety disorder, but only have occasional or intermittent anxiety from time-to-time, this is normal and healthy behavior for many people. Temporary anxiety is likely to diminish over time, and if it is related to a specific place or person, removing yourself from those situations may help the anxiety go away after some time.   How to Get Rid of Anxiety So You Can Sleep Better   If you’re struggling to fall asleep due to anxiety, it could be that treating the anxiety will help solve your insomnia and lack of sleep as well. Anxiety disorders should only be diagnosed by a licensed therapist or medical professional, and these professionals can also help you find treatment regimens as well as, potentially, medications to control the condition. You should not try to self-medicate for anxiety disorders, and should only medicate per the medical advice and supervision of a psychiatrist.   Therapy   One of the most common and effective treatments for anxiety disorders is continued and guided therapy with a professional counselor or therapist. Cognitive Behavioral Therapy CBT) can be effective for many people, as it helps patients suffering from anxiety disorders create new, positive thought pathways that can help when in anxious situations. There are three different types of CBT, each with an individualized approach in treatment, including interpersonal therapy, thought records, and modern exposure therapy.   Another form of therapy is Accepting and Commitment Therapy (ACT).  This form of therapy is more focused on mindfulness training and taking action based on personal values, and is unique in that it is not focused on symptom reduction.   Mindfulness   Another useful tactic to combat anxiety is the act of mindfulness when faced with certain situations - Acting mindfully can help individuals make radical shifts in how they think and perceive situations by looking at them without judgment.   Mindfulness can be tricky to start, and it may help to have the guidance of a trained healthcare professional, but mindfulness can provide a new perspective that allows you to re-evaluate your anxieties and develop healthy coping mechanisms to rethink situations in which they arise. For sleep, mindfulness can help your body naturally fall into unconsciousness as you focus solely on your breath.   Shifting Your Perspective   Shifting your perspective can help some people gain more sleep. It’s completely normal to have bad nights of sleep, and sometimes it’s unavoidable, but when you can tell yourself that you expect it to happen, your body may be more likely to relax and naturally fall into sleep.   What to Do When You Can’t Sleep: Tips   Prioritizing a good night’s sleep isn’t just important for your general health, it can also help with feelings of anxiety, as your body is less likely to feel overwhelmed or on edge when you’ve slept well.   However, falling asleep can be difficult, so it’s important to build a strategy for a better night's sleep.  Below are some tips to try in order to improve your chances of falling asleep naturally.   Try Staying Awake   Often, one of the most ineffective ways to fall asleep is to try to force yourself to lay down. This will only result in you tossing and turning for hours, unable to fall asleep.   Instead, try avoiding the bedroom until you naturally feel sleepy. If this means spending the whole night awake, not getting any sleep, then try saving this technique for the weekend so you can catch some sleep when your body naturally wants to sleep.   Many people have a different circadian rhythm — the natural clock in our head that helps us fall asleep — and it could be that your rhythm simply occurs at an abnormal hour of the morning. Once you do start feeling sleepy, allow yourself to go to bed and focus on your breathing instead of any other anxieties.   Keep a Sleep Log   Sleep logs can be useful to help you catalog when you fall asleep and how much sleep you were able to get. You can also take note of all the activities you do before you fall asleep, and this may help you notice a pattern.   Get up at the Same Time Daily   Creating a routine can be an effective way to combat sleep anxiety and insomnia. By getting up at the same time every day, your body will naturally start to adjust your internal clock or circadian rhythm.   Getting up at the same time every day helped the participant’s body feel sleepy around the same time every night. Over time, this helped the participant’s bedtimes become consistent.   Creating a nightly routine can help relax your body as it starts to anticipate and expect sleep as you follow through each step. It can also help relieve anxiety, as you know what to expect each night and each morning.   Do a Bedroom Makeover   Another helpful trick is to make your bedroom a place for nothing but sleep. For some people living in small loft apartments, this might be tricky, but by putting up a divider or curtain, you may be able to simulate a similar “separate room” effect.   Regardless, redecorating your bedroom for a more comfortable and quiet environment can do wonders for your sleep health. Consider decluttering the room and regularly changing the bedding or adding a rug to make the space more appealing and comfortable.   If you come into your bedroom and still can’t sleep, don’t just lay there and wait for slumber to hit. Instead, get up after 15 minutes and work on some small projects until your body naturally feels sleepy.   Keep Your Room Cool   Keeping your room dark and cool can also have major effects on your ability to fall asleep. Avoid putting a space heater in your room (unless you really need it) so as to keep the room cooler than the rest of your house. You can also cut out some of the natural light and heat by installing blackout or custom curtains over your windows. The more “cave-like” you can make your bedroom, the easier it may be to fall asleep every night.   Limit Caffeine and Other Stimulants   For many people, cutting out caffeine from their diet can be very difficult, but caffeine can greatly hamper your ability to fall asleep. Additionally, as a stimulant, caffeine can make your anxiety much more pronounced, and you may have a difficult time calming down if you drink excessive amounts of coffee.   It could also be getting in the way of you achieving a good night’s sleep. Try avoiding caffeine at least four to five hours prior to when you want to go to bed.   If you know of any other forms of stimulants that you may be taking, try avoiding those at least a few hours before bedtime.   Use “blue light” (any light that is blue in hue, which is common with televisions, laptops, and smartphones) can keep the brain active, stimulated, and awake, as it suppresses the secretion of the hormone melatonin. This is the hormone responsible for helping you fall asleep, so try avoiding blue light, or wearing amber glasses to suppress the effects of the light, at least two hours prior to bedtime.   Get Rid of Your Clock   Clocks can be a common trigger for anxiety, especially when you’re trying to fall asleep. Instead of having a clock by your bedside — where you can glance at it every time you struggle to fall asleep — keep a clock outside your room instead. Looking at the clock will only cause your anxiety to get worse, so avoid it altogether.   Try Relaxation Techniques Another way to prep your body for bedtime is to practice some relaxation techniques as you prepare for bed. This can include: Creating a warm bath to sit in for a few minutes prior to going to bed. Listen to calming music as you brush your teeth, change, and get ready for bed. Practice some deep breathing exercises or guided meditation.     Combine this tip with going to bed and getting up at the same time every day, and you may be able to create a relaxing sleep routine that will help your body naturally get sleepy. Routines can really do wonders in calming the brain. You can also get meditation-themed bedroom decor to make the space more conducive to relaxation, even when you aren’t trying to sleep.      There is hope and there is help for you - consider reaching out to a mental health therapist for support if you need some guidance with your situation. I wish you the best of luck!   In Kindness, Gaynor     
(MA, LCSW)
Answered on 01/20/2022

Why can't I fall asleep easily?

A lot of different factors can affect our ability to get a restful night’s sleep. Even the continued frustration of being unable to get a restful night’s sleep can make it more difficult as it can become a preoccupation and feeling like there isn’t a solution in sight. This is especially true when it has been going on for a considerable amount of time. In the past year, many people are reporting more difficulty falling and staying asleep than usual brought on from more than usual stress, interrupted daily routines, uncomfortable work from home situations, and distractions. The constant flood of news and developments can lead to individuals feeling more hypervigilant than usual which leads them to a state of awareness and anxiety that can make it difficult to fall or stay asleep.  As always it's important to check with your primary care doctor for preventative care and yearly checkups to rule out any medical conditions that can be contributing to lack of sleep. Through discussions with an MD, you can explore other options such as medication management therapies the doctor feels may benefit you in assisting you to have a better sleep pattern.  A consultation with a psychiatry practitioner can also provide further evaluation and treatment options that can assist in addressing any mood issues that may be contributing to difficulties with sleep. After an evaluation, a psychiatrist will recommend treatment options and discuss the costs and benefits of medication management therapies.  However, engaging in therapeutic behavioral health services can help you get some of the issues you want to get off your chest that may be subconsciously nagging to address. Often unaddressed issues can manifest in a number of ways including mood disturbances and physical and somatic reactions.  Engaging in therapeutic services can allow you to identify behaviors, patterns, and other issues in your daily life that may be impacting your ability to fall and stay asleep. This can include developing a sleep plan that allows you to engage in mindfulness and track your progress on what works and what doesn’t. Through collaboration, you and your behavioral health practitioner will design a treatment plan and goals that address your difficulties with sleep alongside addressing other issues that also affect it. 
(MA, LMHC)
Answered on 01/20/2022

What are some strategies that I can use when finding it difficult to sleep at night.

Hi Lilo45,  Thank you for reaching out and asking about strategies that can help you sleep at night. Sleep is one of the foundations that our body needs to be able to function properly and when we do not get enough, it affects everything from our mood to our ability to cope with everyday life stressors.    One of the most challenging things that we are faced with is lying in bed when our body is tired but our mind won't shut off. Here's a fun fact. Playing on our phones while trying to fall asleep actually stimulates our brains more and further pushes sleep away. Essentially when the bright light from the screen hits the brain, it thinks that it's time to wake up. One of the things that can be helpful is to go into your phone's settings and find the "night shift" or similar setting. This changes the colors of the display to warmer tones and may help you get to sleep sooner. You may also want to consider cutting off your phone time at a certain time before going to bed and when in bed. When we use our bed for other activities besides sleeping, our brain begins to make an association between the bed and activity rather than sleep. When we limit our time in bed to just sleeping, the brain automatically makes a connection between the bed and sleep time. This can take a while to make the connection but will happen after a while. Think of the brain as a sort of muscle that you can train. When you are lying in bed and find that you cannot sleep try utilizing square breathing.  Breathe in through your nose for a count of 5. hold for a count of 5, breathe out through your mouth for a count of 5, hold for a count of 5. You can repeat this cycle as many times as you would like. Engaging in this exercise provides a distraction for your brain from all the thoughts that it is thinking of. This exercise also helps to send a message to your nervous system that it can start revving down and relaxing.  Another technique that may be helpful is called Progressive Muscle Relaxation. While laying in bed with your eyes either open or closed focus on the sensation in your feet. Notice how they feel; warm, cold, relaxed, prickly. After a moment begin to tense your feet by curling your toes and the arch of your foot. Hold on to the tension for a count of 5 and notice what it feels like. Then release your toes and notice how the relaxation feels.  Repeat this noticing tensing, and relaxing with your lower legs, upper legs and pelvis, stomach and chest, back, arms and shoulders, neck and head, and finally your entire body. Remember to keep your breathing even and smooth as you progress up your body.  You may find that you fall asleep before you have worked your way all the way up to your head and neck and entire body. If you do, that is absolutely ok! If you find that you are still awake and restless after trying all of the techniques, get out of bed and move to a different room if possible or even just a different place within your room to play on your phone or do an activity. Once you start to feel sleepy return to bed and lay down. This works on that brain-body connection I mentioned earlier with associating the bed as a place to sleep. I hope this answer helps to shed some light on your question.
Answered on 01/20/2022

Self problem

Hello Mandy, I am glad you reached out for support at this time.  I am sorry you are struggling at this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even though you may feel like you are alone at this time.  During the therapy process, you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.  I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through your struggles and be able to ask for support from others. After reading your questions about struggling with sleep I wanted to send you reading and skills on insomnia and how it may impact you, and how you can overcome that with some tools.  Insomnia—difficulty in falling or staying asleep—affects as many as 1 in 3 people, and almost anyone could do with better, more restorative sleep. Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability.The relationship between insomnia and depression is far from simple, as insomnia can both cause and be caused by depression. Insomnia not only predisposes to depression but also exacerbates existing depressive symptoms, making it harder to pull through. Insomnia also predisposes to other mental disorders such as anxiety disorders and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and motoring and other accidents.Aside from depression, common causes or contributors to insomnia include poor sleeping habits, other mental disorders such as anxiety disorders and psychotic disorders, physical problems such as pain or shortness of breath, certain prescription medications, and alcohol and drug misuse. The most important causes of short-term insomnia (the commonest type of insomnia) are a stressful life event, a poor sleeping environment, and an irregular routine.If you are suffering from insomnia, there are a number of simple measures that you can take to resolve or at least reduce the problem:1. Set up a strict routine involving regular and adequate sleeping times (most adults need about seven or eight hours sleep every night). Allocate a time for sleeping, for example, 11pm to 7am, and don’t use this time for anything else. Avoid daytime naps, or make them short and regular. If you have a bad night, avoid sleeping late, as this makes it more difficult to fall asleep the following night.2. Devise a relaxing bedtime routine that enables you to wind down before bedtime. This may involve breathing exercises or meditation or simply reading a book, listening to music, or watching TV.3. Enjoy a hot, non-caffeinated drink such as herbal tea or hot chocolate. In time, your hot drink could become a sleeping cue.4. Sleep in a familiar, dark, and quiet room that is adequately ventilated and neither too hot nor too cold. Try to use this room for sleeping only, so that you come to associate it with sleep. In time, your room could become another sleeping cue.5. If sleep doesn’t come, don’t become anxious or annoyed and try to force yourself to sleep. The more aggravated you become, the less likely you are to fall asleep. Instead, try to clear your mind and relax. For example, I find that making myself feel grateful for something soon sends me off to sleep. Alternatively, get up and do something relaxing and enjoyable for about half an hour before giving it another go.6. Exercise regularly. This will also help you with your low mood. However, don’t work out too close to bedtime as the short-term alerting effects of exercise may make it harder to fall asleep.7. Reduce your overall stress. At the same time, try to do something productive or enjoyable each day. As da Vinci said, a well-spent day brings happy sleep (and a well-spent life brings happy death).8. Eat a wholesome evening meal with a good balance of protein and complex carbohydrates. Eating too much can make it difficult to fall asleep; eating too little can disturb your sleep and decrease its quality.9. Avoid caffeine, alcohol, and tobacco, particularly in the evening. Alcohol may make you fall asleep more readily, but it decreases the overall length and quality of your sleep.10. If insomnia persists despite these measures, speak to your doctor. In some cases, insomnia has a very specific cause such as a physical problem or an adverse effect of your medication that requires your doctor’s attention. Lack of sleep can have major consequences on your mood and productivity at work, and even life-threatening dangerous implications for commuters or individuals operating vehicles or heavy machinery. Lack of sleep has also been linked to the emergence and worsening of many chronic health problems, including type 2 diabetes, cardiovascular disease, obesity, and depression.How can you get better sleep to perform better at work and in life? Here are the 10 steps you can take.1. Minimize DistractionsBan TVs and computers from the bedroom. TVs and computers emit blue light that tricks the body into believing it’s daytime, making falling asleep more difficult. They are also distracting and might keep you awake even when you’re feeling tired.2. Avoid CaffeineSteer clear of caffeine in beverages and food for six to eight hours before bedtime.3. Minimize Alcohol ConsumptionDrinking may help you feel drowsy, but it has been shown to disrupt sleep patterns and create a lower quality, less restorative night’s rest. Don’t have alcohol close to bedtime— it can wake you up three to four hours later. (A drink with dinner is OK.)4. Develop a RoutinePick a bedtime and awake time and stick with them from night tonight. Signal to your body that it’s time for bed taking a shower or bath, playing soft music, doing a light reading, or eating a small snack.5. Establish a Bedtime“I’ll sleep when I’m dead” may sound inspiring, but sleep should be a top priority. Designate seven to eight hours in your daily schedule for sleep.6. Create a Safe SpaceOptimize your bedroom for a good night’s sleep by keeping your bedroom comfortable, dark, and quiet. Clean bedding, cool temperatures, and serene quiet can make a big difference in helping you fall asleep.7. Use Your Bed Exclusively for SleepJust because you are in bed doesn’t mean that you’re asleep. Many people use their beds as a comfortable place for lounging, browsing the internet on their laptops, and scrolling through social media on their phones. Reserve your bedroom exclusively for sleeping and sex. This will help you associate your bed with sleep.8. Power Down the ElectronicsTwenty to 30 minutes before bedtime dim your lights and switch off electronics. Like TVs and computers, cell phones and tablets emit blue light, tricking your body into believing it’s daytime.9. Practice Relaxation TechniquesTry relaxation exercises at bedtime if you need to unwind before hitting the hay. Some activities that can help you fall asleep include yoga, deep breathing, or guided meditation.10. Avoid Lying in Bed AwakeFew things feel worse than lying in bed for hours trying to sleep. If you don’t fall asleep within 15 to 20 minutes, get out of bed, leave the bedroom and try some of your calming before-bed activities again.   Think about all the factors that can interfere with a good night's sleep — from work stress and family responsibilities to unexpected challenges, such as illnesses. It's no wonder that quality sleep is sometimes elusive.While you might not be able to control the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple tips.1. Stick to a sleep scheduleSet aside no more than eight hours for sleep. The recommended amount of sleep for a healthy adult is at least seven hours. Most people don't need more than eight hours in bed to achieve this goal.Go to bed and get up at the same time every day. Try to limit the difference in your sleep schedule on weeknights and weekends to no more than one hour. Being consistent reinforces your body's sleep-wake cycle.If you don't fall asleep within about 20 minutes, leave your bedroom and do something relaxing. Read or listen to soothing music. Go back to bed when you're tired. Repeat as needed.2. Pay attention to what you eat and drinkDon't go to bed hungry or stuffed. In particular, avoid heavy or large meals within a couple of hours of bedtime. Your discomfort might keep you up.Nicotine, caffeine, and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine take hours to wear off and can wreak havoc on quality sleep. And even though alcohol might make you feel sleepy, it can disrupt sleep later in the night.3. Create a restful environmentCreate a room that's ideal for sleeping. Often, this means cool, dark, and quiet. Exposure to light might make it more challenging to fall asleep. Avoid prolonged use of light-emitting screens just before bedtime. Consider using room-darkening shades, earplugs, a fan, or other devices to create an environment that suits your needs.Doing calming activities before bedtime, such as taking a bath or using relaxation techniques, might promote better sleep.4. Limit daytime napsLong daytime naps can interfere with nighttime sleep. If you choose to nap, limit yourself to up to 30 minutes and avoid doing so late in the day.If you work nights, however, you might need to nap late in the day before work to help make up your sleep debt.5. Include physical activity in your daily routineRegular physical activity can promote better sleep. Avoid being active too close to bedtime, however.Spending time outside every day might be helpful, too.6. Manage worriesTry to resolve your worries or concerns before bedtime. Jot down what's on your mind and then set it aside for tomorrow.Stress management might help. Start with the basics, such as getting organized, setting priorities, and delegating tasks. Meditation also can ease anxiety. How can I get a better night’s sleep?Sleeping well directly affects your mental and physical health. Fall short and it can take a serious toll on your daytime energy, productivity, emotional balance, and even your weight. Yet many of us regularly toss and turn at night, struggling to get the sleep we need. Getting a good night’s sleep may seem like an impossible goal when you’re wide awake at 3 a.m., but you have much more control over the quality of your sleep than you probably realize. Just as the way you feel during your waking hours often hinges on how well you sleep at night, so the cure for sleep difficulties can often be found in your daily routine.Unhealthy daytime habits and lifestyle choices can leave you tossing and turning at night and adversely affect your mood, brain and heart health, immune system, creativity, vitality, and weight. But by experimenting with the following tips, you can enjoy better sleep at night, boost your health, and improve how you think and feel during the day.Tip 1: Keep in sync with your body’s natural sleep-wake cycleGetting in sync with your body’s natural sleep-wake cycle, or circadian rhythm is one of the most important strategies for sleeping better. If you keep a regular sleep-wake schedule, you’ll feel much more refreshed and energized than if you sleep the same number of hours at different times, even if you only alter your sleep schedule by an hour or two.Try to go to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. Choose a bedtime when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime.Avoid sleeping in—even on weekends. The more your weekend/weekday sleep schedules differ, the worse the jetlag-like symptoms you’ll experience. If you need to make up for a late-night, opt for a daytime nap rather than sleeping in. This allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm.Be smart about napping. While napping is a good way to make up for lost sleep, if you have trouble falling asleep or staying asleep at night, napping can make things worse. Limit naps to 15 to 20 minutes in the early afternoon.Fight after-dinner drowsiness. If you get sleepy way before your bedtime, get off the couch and do something mildly stimulating, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.Tip 2: Control your exposure to lightMelatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Your brain secretes more melatonin when it’s dark—making you sleepy—and less when it’s light—making you more alert. However, many aspects of modern life can alter your body’s production of melatonin and shift your circadian rhythm.How to influence your exposure to lightDuring the day:Expose yourself to bright sunlight in the morning. The closer to the time you get up, the better. Have your coffee outside, for example, or eat breakfast by a sunny window. The light on your face will help you wake upSpend more time outside during daylight. Take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.Let as much natural light into your home or workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.If necessary, use a light therapy box. This simulates sunshine and can be especially useful during short winter days.At night:Avoid bright screens within 1-2 hours of your bedtime. The blue light emitted by your phone, tablet, computer, or TV is especially disruptive. You can minimize the impact by using devices with smaller screens, turning the brightness down, or using light-altering software such as f.lux.Say no to late-night television. Not only does the light from a TV suppress melatonin, but many programs are stimulating rather than relaxing. Try listening to music or audiobooks instead.Don’t read with backlit devices. Tablets that are backlit are more disruptive than e-readers that don’t have their own light source.When it’s time to sleep, make sure the room is dark. Use heavy curtains or shades to block light from windows, or try a sleep mask. Also, consider covering up electronics that emit light.Keep the lights down if you get up during the night. If you need some light to move around safely, try installing a dim nightlight in the hall or bathroom or using a small flashlight. This will make it easier for you to fall back to sleep.Tip 3: Exercise during the dayPeople who exercise regularly sleep better at night and feel less sleepy during the day. Regular exercise also improves the symptoms of insomnia and sleep apnea and increases the amount of time you spend in the deep, restorative stages of sleep.·         The more vigorously you exercise, the more powerful the sleep benefits. But even light exercise—such as walking for just 10 minutes a day—improves sleep quality.·         It can take several months of regular activity before you experience the full sleep-promoting effects. So be patient and focus on building an exercise habit that sticks.For better sleep, time your exercise rightExercise speeds up your metabolism, elevates body temperature, and stimulates hormones such as cortisol. This isn’t a problem if you’re exercising in the morning or afternoon, but too close to the bed and can interfere with sleep.Try to finish moderate to vigorous workouts at least three hours before bedtime. If you’re still experiencing sleep difficulties, move your workouts even earlier. Relaxing, low-impact exercises such as yoga or gentle stretching in the evening can help promote sleep.Tip 4: Be smart about what you eat and drinkYour daytime eating habits play a role in how well you sleep, especially in the hours before bedtime.Limit caffeine and nicotine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Similarly, smoking is another stimulant that can disrupt your sleep, especially if you smoke close to bedtime.Avoid big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Spicy or acidic foods can cause stomach trouble and heartburn.Avoid alcohol before bed. While a nightcap may help you relax, it interferes with your sleep cycle once you’re out.Avoid drinking too many liquids in the evening. Drinking lots of fluids may result in frequent bathroom trips throughout the night.Cut back on sugary foods and refined carbs. Eating lots of sugar and refined carbs such as white bread, white rice, and pasta during the day can trigger wakefulness at night and pull you out of the deep, restorative stages of sleep.Nighttime snacks help you sleepFor some people, a light snack before bed can help promote sleep. For others, eating before bed leads to indigestion and makes sleeping more difficult. If you need a bedtime snack, try:·         Half a turkey sandwich·         A small bowl of whole-grain, low-sugar cereal·         Milk or yogurt·         A bananaTip 5: Wind down and clear your headDo you often find yourself unable to get to sleep or regularly waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. Taking steps to manage your overall stress levels and learning how to curb the worry habit can make it easier to unwind at night. You can also try developing a relaxing bedtime ritual to help you prepare your mind for sleep, such as practicing a relaxation technique, taking a warm bath, or dimming the lights, and listening to soft music or an audiobook.Problems clearing your head at night can also stem from your daytime habits. The more overstimulated your brain becomes during the day, the harder it can be to slow down and unwind at night. Maybe, like many of us, you’re constantly interrupting tasks during the day to check your phone, email, or social media. Then when it comes to getting to sleep at night, your brain is so accustomed to seeking fresh stimulation, it becomes difficult to unwind. Help yourself by setting aside specific times during the day for checking your phone and social media and, as much as possible, try to focus on one task at a time. You’ll be better able to calm your mind at bedtime.A deep breathing exercise to help you sleepBreathing from your belly rather than your chest can activate the relaxation response and lower your heart rate, blood pressure, and stress levels to help you drift off to sleep.·         Lay down in bed and close your eyes.·         Put one hand on your chest and the other on your stomach.·         Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.·         Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.·         Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.To follow along with a guided deep breathing exercise, click here.A body scan exercise to help you sleepBy focusing your attention on different parts of your body, you can identify where you’re holding any stress or tension, and release it.·         Lie on your back, legs uncrossed, arms relaxed at your sides, eyes closed. Focus on your breathing for about two minutes until you start to feel relaxed.·         Turn your focus to the toes of your right foot. Notice any tension while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for at least three to five seconds.·         Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. Then move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up your torso, through your lower back and abdomen, your upper back and chest, and your shoulders. Pay close attention to any area of the body that feels tense.·         After completing the body scan, relax, noting how your body feels. You should feel so relaxed you can easily fall asleep.For a guided body scan meditation to help you wind down and clear your head at bedtime, click here.Tip 6: Improve your sleep environmentA peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses. Sometimes even small changes to your environment can make a big difference to your quality of sleep.Keep your room dark, cool, and quietKeep noise down. If you can’t avoid or eliminate noise from neighbors, traffic, or other people in your household, try masking it with a fan or sound machine. Earplugs may also help.Keep your room cool. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.Make sure your bed is comfortable. Your bed covers should leave you enough room to stretch and turn comfortably without becoming tangled. If you often wake up with a sore back or an aching neck, you may need to experiment with different levels of mattress firmness, foam toppers, and pillows that provide more or less support.Reserve your bed for sleeping and sex. By not working, watching TV, or using your phone, tablet, or computer in bed, your brain will associate the bedroom with just sleep and sex, which makes it easier to wind down at night.Tip 7: Learn ways to get back to sleepIt’s normal to wake briefly during the night but if you’re having trouble falling back asleep, these tips may help:Stay out of your head. Hard as it may be, try not to stress over your inability to fall asleep again, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your body.Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest. I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 01/20/2022

Can counselling help my sleep issue?

Dear CM,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions, affecting your sleep.   As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress / depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result we would do everything we can to avoid / fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight / avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

Will I ever sleep again?

A varied range of difficulties including anything from shifting hormones to a snoring bed partner to a stressful day at work can cause a middle-of-the-night wake-up call for so many of us.  I see that this has been going on for about 2 weeks or so for you, so I am glad that you have reached out to see if you can break this pattern and get yourself back on a healthy sleep pattern once again.  There is nothing worse that waking up and feeling in a fog and then trying to get on with our daily responsibilities. Read below to consider the do’s and don’ts to a healthy night's sleep: Here are your Don'ts: 1. Do not Stay in bed. You might think spending more time in bed will boost your odds of catching extra shuteye. Actually, the opposite is true. You cannot will yourself to sleep (just like you cannot will yourself to be hungry). A better option is to get up, go to a different room and do something calm and relaxing. Then, wait until you are sleepy once again before going back to bed. 2. Do Not Watch the clock. Counting how many hours you have slept or how many more you have until you need to wake up—will only add to your stress. The more worked up you get, the more difficult it will be to fall back to sleep. 3. Do Not Turn on your devices. Once you are up and out of bed, it can be tempting to check your social media page, watch YouTube videos on your phone or even catch up on work emails. However, using electronics near your eyes (e.g., phones, tablets, laptops) is known to interfere with your body’s natural inbuilt clock, making it even more difficult to sleep. 4. Do not Work. It is best not to do anything that reinforces middle-of-the-night wakefulness. Avoid work, chores, or hobbies or anything that could serve as a reward for waking prematurely and then become a habit. 5. Do not Use caffeine in the late afternoon. Caffeine may help you wake up in the morning, but avoid taking a hit in the afternoon. Caffeine can linger in your system for up to 8 hours, making sleep more restless.  Set yourself a healthy schedule and drink your last brew in good time! 6. Do not Use alcohol as a nightcap. Although alcohol can have a depressant effect and yes it can make you feel sleepy, however, it ultimately interferes with sleep. When alcohol is metabolized, it actually has an alerting effect that can lead to middle-of-the-night disruptions. Here are your To Do's: 1. Do Watch mindless TV.  This may sound counterintuitive if you have heard the advice to shut off your screens before bedtime, but if you cannot sleep, go to the living room and turn on the TV.  Here is the difference - the television screen is usually set at a distance from your eyes, its effect on your circadian rhythms - which is basically the body's body's internal clock which signals us to feel bright and awake in the morning and drowsy in the night. Rhythmic exposure to light and dark is essential to your internal clock and thus for proper health and organ function) -  is a lot weaker. Spending perhaps 30 minutes watching a mindless show even one you have seen previously, can often help you pass the time until you feel sleepy again. 2. Do Stick to a schedule. Our bodies function at their best potential when we maintain the same sleep schedule, even on weekends. If you happen to wake up in the middle of the night, avoid napping the next day so you are tired at bedtime. 3. Do Read a book. Paging through a pleasant yet not engrossing novel can help relax you back to sleep. Just do not turn on that tablet, e reader or open up an all engrossing thriller.  Select something you enjoy but that you can easily put down, and that does not emit bright light. 4. Do Create white noise. If you are a naturally light sleeper, unexpected noises—a furnace clicking on, a barking dog, a loud neighbor—can wake you up. Even a bird singing at dawn can rouse you prematurely.  So the solution is to amplify your background noise. The low continuous hum of a fan or noise machine can actually help drown out those disruptions. 5. Do Practice stress reduction techniques.  Relaxation exercises before bedtime or when you find yourself wide awake in the wee hours can help your mind wind down. A few techniques to try: mindful meditation (select one of the many apps that are available eg. Headspace or Calm) yoga, deep breathing and writing in a gratitude journal.  What To Do If All The Above Strategies Do Not Work For You: The above strategies would best apply to someone who is having a passing sleep disturbance. For example, maybe temporary stress at work or having some sort of minor illness which seems to be the route cause for you waking you up at night. The idea is to prevent these issues from developing into a long-term sleep problem.   If you think there is a more pervasive issue going on with you. So, if you indeed still stressed out about your poor sleep patterns and this persists, and you have tried the above suggestions then I would suggest you consider seeking help from a mental health professional to consider what might be causing your sleep disruptions. This guiding rule might help you decide what to do next. Consider the rule of 3's Are you waking up 3 nights (or more) each week?  Does it take longer than 30 minutes for you to fall back to sleep? Have you been waking in the middle of the night for at least 30 days? If you answer yes to these 3 questions, it may be time to see a professional counselor or even a sleep specialist.   Together you may be able to devise a plan to ensure you get the sleep you need.   Best of luck to you, Gaynor 
(MA, LCSW)
Answered on 01/20/2022

I am without work and I cannot find a job. I have gone through difficult conditions in my country an

Hello, I am glad you reached out for support at this time.  I am sorry you are struggling in this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even though you may feel like you are alone at this time.  During the therapy process, you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week. I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through your struggles and be able to ask for support from others. Insomnia—difficulty in falling or staying asleep—affects as many as 1 in 3 people, and almost anyone could do with better, more restorative sleep. Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability.The relationship between insomnia and depression is far from simple, as insomnia can both cause and be caused by depression. Insomnia not only predisposes to depression but also exacerbates existing depressive symptoms, making it harder to pull through. Insomnia also predisposes to other mental disorders such as anxiety disorders and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and to motoring and other accidents.Aside from depression, common causes or contributors to insomnia include poor sleeping habits, other mental disorders such as anxiety disorders and psychotic disorders, physical problems such as pain or shortness of breath, certain prescription medications, and alcohol and drug misuse. The most important causes of short-term insomnia (the commonest type of insomnia) are a stressful life event, a poor sleeping environment, and an irregular routine.If you are suffering from insomnia, there are a number of simple measures that you can take to resolve or at least reduce the problem:1. Set up a strict routine involving regular and adequate sleeping times (most adults need about seven or eight hours sleep every night). Allocate a time for sleeping, for example, 11 pm to 7 am, and don’t use this time for anything else. Avoid daytime naps, or make them short and regular. If you have a bad night, avoid sleeping late, as this makes it more difficult to fall asleep the following night.2. Devise a relaxing bedtime routine that enables you to wind down before bedtime. This may involve breathing exercises or meditation or simply reading a book, listening to music, or watching TV.3. Enjoy a hot, non-caffeinated drink such as herbal tea or hot chocolate. In time, your hot drink could become a sleeping cue.4. Sleep in a familiar, dark, and quiet room that is adequately ventilated and neither too hot nor too cold. Try to use this room for sleeping only, so that you come to associate it with sleep. In time, your room could become another sleeping cue.5. If sleep doesn’t come, don’t become anxious or annoyed and try to force yourself to sleep. The more aggravated you become, the less likely you are to fall asleep. Instead, try to clear your mind and relax. For example, I find that making myself feel grateful for something soon sends me off to sleep. Alternatively, get up and do something relaxing and enjoyable for about half an hour before giving it another go.6. Exercise regularly. This will also help you with your low mood. However, don’t work out too close to bedtime as the short-term alerting effects of exercise may make it harder to fall asleep.7. Reduce your overall stress. At the same time, try to do something productive or enjoyable each day. As da Vinci said, a well-spent day brings happy sleep (and a well-spent life brings happy death).8. Eat a wholesome evening meal with a good balance of protein and complex carbohydrates. Eating too much can make it difficult to fall asleep; eating too little can disturb your sleep and decrease its quality.9. Avoid caffeine, alcohol, and tobacco, particularly in the evening. Alcohol may make you fall asleep more readily, but it decreases the overall length and quality of your sleep.10. If insomnia persists despite these measures, speak to your doctor. In some cases, insomnia has a very specific cause such as a physical problem or an adverse effect of your medication that requires your doctor’s attention. Lack of sleep can have major consequences on your mood and productivity as work, and even life-threatening dangerous implications for commuters or individuals operating vehicles or heavy machinery. Lack of sleep has also been linked to the emergence and worsening of many chronic health problems, including type 2 diabetes, cardiovascular disease, obesity, and depression.How can you get better sleep to perform better at work and in life? Here are the 10 steps you can take.1. Minimize DistractionsBan TVs and computers from the bedroom. TVs and computers emit blue light that trick the body into believing it’s daytime, making falling asleep more difficult. They are also distracting and might keep you awake even when you’re feeling tired.2. Avoid CaffeineSteer clear of caffeine in beverages and food for six to eight hours before bedtime.3. Minimize Alcohol ConsumptionDrinking may help you feel drowsy, but it has been shown to disrupt sleep patterns and create a lower quality, less restorative night’s rest. Don’t have alcohol close to bedtime— it can wake you up three to four hours later. (A drink with dinner is OK.)4. Develop a RoutinePick a bedtime and awake time and stick with them from night tonight. Signal to your body that it’s time for bed taking a shower or bath, playing soft music, doing a light reading, or eating a small snack.5. Establish a Bedtime“I’ll sleep when I’m dead” may sound inspiring, but sleep should be a top priority. Designate seven to eight hours in your daily schedule for sleep.6. Create a Safe SpaceOptimize your bedroom for a good night’s sleep by keeping your bedroom comfortable, dark, and quiet. Clean bedding, cool temperatures, and serene quiet can make a big difference in helping you fall asleep.7. Use Your Bed Exclusively for SleepJust because you are in bed doesn’t mean that you’re asleep. Many people use their beds as a comfortable place for lounging, browsing the internet on their laptops, and scrolling through social media on their phones. Reserve your bedroom exclusively for sleeping and sex. This will help you associate your bed with sleep.8. Power Down the ElectronicsTwenty to 30 minutes before bedtime dim your lights and switch off electronics. Like TVs and computers, cell phones and tablets emit blue light, tricking your body into believing it’s daytime.9. Practice Relaxation TechniquesTry relaxation exercises at bedtime if you need to unwind before hitting the hay. Some activities that can help you fall asleep include yoga, deep breathing or guided meditation.10. Avoid Lying in Bed AwakeFew things feel worse than lying in bed for hours trying to sleep. If you don’t fall asleep within 15 to 20 minutes, get out of bed, leave the bedroom and try some of your calming before-bed activities again.   Think about all the factors that can interfere with a good night's sleep — from work stress and family responsibilities to unexpected challenges, such as illnesses. It's no wonder that quality sleep is sometimes elusive.While you might not be able to control the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple tips.1. Stick to a sleep scheduleSet aside no more than eight hours for sleep. The recommended amount of sleep for a healthy adult is at least seven hours. Most people don't need more than eight hours in bed to achieve this goal.Go to bed and get up at the same time every day. Try to limit the difference in your sleep schedule on weeknights and weekends to no more than one hour. Being consistent reinforces your body's sleep-wake cycle.If you don't fall asleep within about 20 minutes, leave your bedroom and do something relaxing. Read or listen to soothing music. Go back to bed when you're tired. Repeat as needed.2. Pay attention to what you eat and drinkDon't go to bed hungry or stuffed. In particular, avoid heavy or large meals within a couple of hours of bedtime. Your discomfort might keep you up.Nicotine, caffeine and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine take hours to wear off and can wreak havoc on quality sleep. And even though alcohol might make you feel sleepy, it can disrupt sleep later in the night.3. Create a restful environmentCreate a room that's ideal for sleeping. Often, this means cool, dark and quiet. Exposure to light might make it more challenging to fall asleep. Avoid prolonged use of light-emitting screens just before bedtime. Consider using room-darkening shades, earplugs, a fan or other devices to create an environment that suits your needs.Doing calming activities before bedtime, such as taking a bath or using relaxation techniques, might promote better sleep.4. Limit daytime napsLong daytime naps can interfere with nighttime sleep. If you choose to nap, limit yourself to up to 30 minutes and avoid doing so late in the day.If you work nights, however, you might need to nap late in the day before work to help make up your sleep debt.5. Include physical activity in your daily routineRegular physical activity can promote better sleep. Avoid being active too close to bedtime, however.Spending time outside every day might be helpful, too.6. Manage worriesTry to resolve your worries or concerns before bedtime. Jot down what's on your mind and then set it aside for tomorrow.Stress management might help. Start with the basics, such as getting organized, setting priorities and delegating tasks. Meditation also can ease anxiety. How can I get a better night’s sleep?Sleeping well directly affects your mental and physical health. Fall short and it can take a serious toll on your daytime energy, productivity, emotional balance, and even your weight. Yet many of us regularly toss and turn at night, struggling to get the sleep we need. Getting a good night’s sleep may seem like an impossible goal when you’re wide awake at 3 a.m., but you have much more control over the quality of your sleep than you probably realize. Just as the way you feel during your waking hours often hinges on how well you sleep at night, so the cure for sleep difficulties can often be found in your daily routine.Unhealthy daytime habits and lifestyle choices can leave you tossing and turning at night and adversely affect your mood, brain and heart health, immune system, creativity, vitality, and weight. But by experimenting with the following tips, you can enjoy better sleep at night, boost your health, and improve how you think and feel during the day.Tip 1: Keep in sync with your body’s natural sleep-wake cycleGetting in sync with your body’s natural sleep-wake cycle, or circadian rhythm, is one of the most important strategies for sleeping better. If you keep a regular sleep-wake schedule, you’ll feel much more refreshed and energized than if you sleep the same number of hours at different times, even if you only alter your sleep schedule by an hour or two.Try to go to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. Choose a bed time when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime.Avoid sleeping in—even on weekends. The more your weekend/weekday sleep schedules differ, the worse the jetlag-like symptoms you’ll experience. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm.Be smart about napping. While napping is a good way to make up for lost sleep, if you have trouble falling asleep or staying asleep at night, napping can make things worse. Limit naps to 15 to 20 minutes in the early afternoon.Fight after-dinner drowsiness. If you get sleepy way before your bedtime, get off the couch and do something mildly stimulating, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.Tip 2: Control your exposure to lightMelatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Your brain secretes more melatonin when it’s dark—making you sleepy—and less when it’s light—making you more alert. However, many aspects of modern life can alter your body’s production of melatonin and shift your circadian rhythm.How to influence your exposure to lightDuring the day:Expose yourself to bright sunlight in the morning. The closer to the time you get up, the better. Have your coffee outside, for example, or eat breakfast by a sunny window. The light on your face will help you wake upSpend more time outside during daylight. Take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.Let as much natural light into your home or workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.If necessary, use a light therapy box. This simulates sunshine and can be especially useful during short winter days.At night:Avoid bright screens within 1-2 hours of your bedtime. The blue light emitted by your phone, tablet, computer, or TV is especially disruptive. You can minimize the impact by using devices with smaller screens, turning the brightness down, or using light-altering software such as f.lux.Say no to late-night television. Not only does the light from a TV suppress melatonin, but many programs are stimulating rather than relaxing. Try listening to music or audio books instead.Don’t read with backlit devices. Tablets that are backlit are more disruptive than e-readers that don’t have their own light source.When it’s time to sleep, make sure the room is dark. Use heavy curtains or shades to block light from windows, or try a sleep mask. Also consider covering up electronics that emit light.Keep the lights down if you get up during the night. If you need some light to move around safely, try installing a dim nightlight in the hall or bathroom or using a small flashlight. This will make it easier for you to fall back to sleep.Tip 3: Exercise during the dayPeople who exercise regularly sleep better at night and feel less sleepy during the day. Regular exercise also improves the symptoms of insomnia and sleep apnea and increases the amount of time you spend in the deep, restorative stages of sleep.·         The more vigorously you exercise, the more powerful the sleep benefits. But even light exercise—such as walking for just 10 minutes a day—improves sleep quality.·         It can take several months of regular activity before you experience the full sleep-promoting effects. So be patient and focus on building an exercise habit that sticks.For better sleep, time your exercise rightExercise speeds up your metabolism, elevates body temperature, and stimulates hormones such as cortisol. This isn’t a problem if you’re exercising in the morning or afternoon, but too close to bed and it can interfere with sleep.Try to finish moderate to vigorous workouts at least three hours before bedtime. If you’re still experiencing sleep difficulties, move your workouts even earlier. Relaxing, low-impact exercises such as yoga or gentle stretching in the evening can help promote sleep.Tip 4: Be smart about what you eat and drinkYour daytime eating habits play a role in how well you sleep, especially in the hours before bedtime.Limit caffeine and nicotine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Similarly, smoking is another stimulant that can disrupt your sleep, especially if you smoke close to bedtime.Avoid big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Spicy or acidic foods can cause stomach trouble and heartburn.Avoid alcohol before bed. While a nightcap may help you relax, it interferes with your sleep cycle once you’re out.Avoid drinking too many liquids in the evening. Drinking lots of fluids may result in frequent bathroom trips throughout the night.Cut back on sugary foods and refined carbs. Eating lots of sugar and refined carbs such as white bread, white rice, and pasta during the day can trigger wakefulness at night and pull you out of the deep, restorative stages of sleep.Nighttime snacks help you sleepFor some people, a light snack before bed can help promote sleep. For others, eating before bed leads to indigestion and make sleeping more difficult. If you need a bedtime snack, try:·         Half a turkey sandwich·         A small bowl of whole-grain, low-sugar cereal·         Milk or yogurt·         A bananaTip 5: Wind down and clear your headDo you often find yourself unable to get to sleep or regularly waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. Taking steps to manage your overall stress levels and learning how to curb the worry habit can make it easier to unwind at night. You can also try developing a relaxing bedtime ritual to help you prepare your mind for sleep, such as practicing a relaxation technique, taking a warm bath, or dimming the lights and listening to soft music or an audiobook.Problems clearing you head at night can also stem from your daytime habits. The more overstimulated your brain becomes during the day, the harder it can be slow down and unwind at night. Maybe, like many of us, you’re constantly interrupting tasks during the day to check your phone, email, or social media. Then when it comes to getting to sleep at night, your brain is so accustomed to seeking fresh stimulation, it becomes difficult to unwind. Help yourself by setting aside specific times during the day for checking your phone and social media and, as much as possible, try to focus on one task at a time. You’ll be better able to calm your mind at bedtime.A deep breathing exercise to help you sleepBreathing from your belly rather than your chest can activate the relaxation response and lower your heart rate, blood pressure, and stress levels to help you drift off to sleep.·         Lay down in bed and close your eyes.·         Put one hand on your chest and the other on your stomach.·         Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.·         Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.·         Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.To follow along with a guided deep breathing exercise, click here.A body scan exercise to help you sleepBy focusing your attention on different parts of your body, you can identify where you’re holding any stress or tension, and release it.·         Lie on your back, legs uncrossed, arms relaxed at your sides, eyes closed. Focus on your breathing for about two minutes until you start to feel relaxed.·         Turn your focus to the toes of your right foot. Notice any tension while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for at least three to five seconds.·         Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. Then move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up your torso, through your lower back and abdomen, your upper back and chest, and your shoulders. Pay close attention to any area of the body that feels tense.·         After completing the body scan, relax, noting how your body feels. You should feel so relaxed you can easily fall asleep.For a guided body scan meditation to help you wind down and clear your head at bedtime, click here.Tip 6: Improve your sleep environmentA peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses. Sometimes even small changes to your environment can make a big difference to your quality of sleep.Keep your room dark, cool, and quietKeep noise down. If you can’t avoid or eliminate noise from neighbors, traffic, or other people in your household, try masking it with a fan or sound machine. Earplugs may also help.Keep your room cool. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.Make sure your bed is comfortable. Your bed covers should leave you enough room to stretch and turn comfortably without becoming tangled. If you often wake up with a sore back or an aching neck, you may need to experiment with different levels of mattress firmness, foam toppers, and pillows that provide more or less support.Reserve your bed for sleeping and sex. By not working, watching TV, or using your phone, tablet, or computer in bed, your brain will associate the bedroom with just sleep and sex, which makes it easier to wind down at night.Tip 7: Learn ways to get back to sleepIt’s normal to wake briefly during the night but if you’re having trouble falling back asleep, these tips may help:Stay out of your head. Hard as it may be, try not to stress over your inability to fall asleep again, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your body.Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest. I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 01/20/2022

How can I get a better nights sleep?

Hi! I've worked successfully with many clients with sleep issues. When your mind won't let you sleep, it is having issues with too many brain waves stuck in beta frequency. The science of brainwave entrainment overcomes the beta wave pattern and gently downshifts your brainwaves towards calm (alpha waves) and eventually sleep waves (delta waves). Much of this technology available on music and video platforms is watered down and/or not high quality. I have my own specialty wave generator that I can customize to your needs at no extra cost as your therapist. It has been robustly successful for me and my clientele and has a mountain of research mostly supporting it's effectiveness. The presence of anxiety, worry, panic and life events tend to keep the brain in beta waves and in fight or flight or freeze and since this is mostly regulated by the autonomic nervous system which places you automatically into sympathetic response which makes any length of healthy and sustained sleep impossible. The goal is to activate the parasympathetic mechanism by reducing your stressors, having a consistent exercise program, maintaining a proper diet, receiving a regular massage, and/or adopting a lasting practice like yoga and/or meditation, all of which can help sleeping problems and disorders. Without adequate sleep, you descend into sleep deprivation, a state in which your ability to see your issues and deal with life events is severely impaired as is sound judgment and decision-making. Your cells perform a variety of functions while your mind sleeps that are essential to good health and overall body rejuvenation that if not functioning properly, usually begins a cascade and onset of more stressors in your outer world due to the compromised nature of your coping skills and reactivity, judgment, decision-making and many other abilities.  For many people, it is hard to overcome their stressors and the like through more conventional methods, which is why I advocate the use of high quality and effective brainwave entrainment utilizing Binaural beats and Isochronic beats set to nature sounds. My custom program can also use white or pink noise if you prefer.
(LPCS)
Answered on 01/20/2022

Burnout since march 2020

Hi Thank you for reaching out to Betterhelp.I would suggest reaching out to your primary care physician for a regular exam and blood work to rule out and medical problems and explain your concerns. The primary care physician can then refer you to a specialist based on your lab and exam results. If there are no medical problems I would reach out to a clinician on Betterhelp to assist you with sleep habits. I can assist you with some suggestions through this message. Here are some tips: Do not drink caffeine: no tea, coffee, energy drinks or soda after 4 pm. Limit sugars later in the day. Do not eat a big or spicy meal late in the evening. Do not go to bed hungry. Avoid alcohol as it can interfere with sleep.  Try to get physical exercise/outdoor time daily. Taking a walk in the late afternoon can help to make your body tired and help you sleep. Sleep only at night time and do not have day time naps no matter how tired you feel. Naps will keep the problem going by making it harder for you to go to sleep at night. Have a regular bedtime routine to teach your body when it's time to go to sleep. Have a soothing drink such as chamomile tea or a milk. Have a warm bath/shower or a routine of washing your face and brushing your teeth. Try using relaxing body wash in the shower/bath/or face wash. Go to bed at the same time each night. Wake up at the same time each morning. (There are applications on your phone such as the iPhone health application that can assist you with a sleep schedule) When in bed think of positive things such as 5 nice things that happened that day, positive mantras, etc. Avoid tv/looking at the computer or phone screen before bed. Try a breathing exercise for relaxation (such as triangle breathing) or progressive muscle relaxation. Make your bedroom a pleasant place for sleep. Keep it clean and neat. Only use your bed for sleeping. Try lavender oil or other natural essential oils for relaxation. If you cannot go to sleep within about 30 minutes of laying in bed then get up and do an activity somewhere else such as reading a calming book or listening to calming music with minimal lighting. Then try going back to sleep in your bed after about 15 minutes. Repeat this if necessary. If these do not work after being done consistently you could consult your primary care physician or a psychiatrist for medication to assist with sleep. I would try to make serious life changes before trying medication.  Best of luck!
(LMHC)
Answered on 01/20/2022

How do I get back to sleep?

Hi,   First of all, congratulations on quitting smoking! That is a huge step to take for your own health and wellbeing. If you haven't done so lately, give yourself a pat on the back!   Restful sleep/REM sleep is essential to our health, both emotional and physical. I suspect that once you are sleeping well, you will feel better overall.   What you want to put into place are some practices referred to as "sleep hygiene." Here are some suggestions that could help. I would recommend trying as many as you can. If you still don't have success, you could speak with your doctor about whether a natural supplement such as melatonin might be helpful to you.    - Get at least 30 minutes of exercise during the day. - Get at least 20 minutes of sunlight during the day. - Avoid caffeine (coffee, energy drinks) after 3 pm. - Avoid large meals after 7 pm. - Try a hot bath 1-2 hours before bedtime - Try relaxation techniques such as hatha yoga or progressive relaxation (there are many examples available on YouTube). - Abstain from drugs and alcohol and processed sugar (they tend to make sleep quality worse). - Keep the room dark. - Read a book instead of watching television or using the phone. - Try a white noise machine.   There are also a number of apps that claim to help with sleeping, but to my knowledge none are research-based. You are certainly welcome to try them, however! My motto is "Whatever works."   If you find yourself up at night worrying, you might try writing down your worries and putting them in a box. You could write a journal entry or message your counselor on the BetterHelp platform to try to get things out of your head. I always recommend writing a gratitude list at night. In fact, one fun trick for insomnia is to try to make a list of things you are grateful for in alphabetical order: one for A, one for B, etc. It's difficult enough to keep your mind busy and you will almost definitely find yourself drifting off before Z!   I encourage you to continue to seek support for your symptoms. You are definitely on the right track. Hang in there!
Answered on 01/20/2022

How to cope with invasive / intrusive thoughts ?

Hello and thank you for reaching out to Betterhelp with this question related to your mental health. It sounds like evening/night are difficult times for you and transitioning from your daily life to tranquil time for bed is not coming easily. When you are constantly plagued by your past, there is probably a lot to talk through and process in order to give yourself a better sense of closure. Regardless of what you have experienced and endured before, we are all survivors of our own circumstances. You are allowed to work towards closing chapter and finding forgiveness in others and within yourself, and you don't need the feedback of anyone else to do so. When it is specific thoughts that come to mind, it can be useful to try journaling prior to sleep as a means of giving your mind permission to put those thoughts on paper and cleanse them from your head before trying to sleep.  Routine and consistency are most important when it comes to creating a stable sleep environment. If you give yourself a 3 step plan and then try to keep it going throughout the week evenings, it can help your mind transition over easier. Whether that include reading, listening to soothing music, speaking with a loved one, journaling, etc. Anything that will help you leave those negative thoughts behind is useful. A cognitive behavioral technique is when these specific thoughts come to mind, visualize a Stop Sign and internally tell yourself, "Stop!" Then implement a replacement thought in it's place. Sometimes we just have to be creative and seek control for what we are allowing to ruminate in our mind.  If there is much that has happened in your past, I would also suggest participating in therapy if you have the means as a way of talking through and finding acceptance for what your journey has included. Avoid caffeine past the afternoon and practice compassion for yourself. People can develop sleep anxiety just in fear of not being able to fall asleep but hopefully with some routine changes, cognitive strategies and implementing relaxation more effectively it can have a positive impact for you. 
(LMHC, CRC)
Answered on 01/20/2022

What can be done if anxiety doesn't let you sleep?

In your case the best way to overcome and deal with this bout of sleep deprivation or disorder you are struggling with is by treating the problem at the exact moments in which it is happening; those hours you lie in bed wondering. You can do this by using one or both parts of this activity I will outline for you to follow on the way to achieving better sleeping habits and longer sleep time. The first part of this activity or treatment approach is physical; please remember, do not attempt any physical activity or exercise unless you are cleared by your medical doctor or a licensed physician to do so and also to stretch and warm-up properly prior to starting any physical routine, and the second part is one or a series of mental exercise. The key to achieving success while using this method is by staying focused on the routine and not allowing your mind to wonder aimlessly about while attempting to fall asleep. You must be willing to invest the time and effort needed and not just try it one time then say it does not or won't work for you as your dedication and commitment to the process are also very intricate in making this work now and overtime. So let us begin your journey to falling asleep faster, sleeping longer and waking up more refresh and alert. When you are ready to go to bed begin by doing a physical activity you are comfortable with until becoming exhausted without overexerting yourself. Aim for at least three repetitions then lie down, inhale and exhale slowly in and out for about three seconds each breath until you begin to breathe naturally. Follow this by doing one or a series of the mental exercise; any of these can be counting from one to a hundred, reciting a poem or quote, narrating a story; fictional or otherwise, or reliving a specific pleasurable moment. Don't worry about time as you will eventually fall asleep just continue until you get the urge to begin again from step one. Please don't forget that I recommend you skip the physical activity part if you're not fit enough, recovering from injuries or medically cleared to do so. Practice this repeatedly until you begin to fall asleep without effort.
(DSW, LCSW, ACSW)
Answered on 01/20/2022

How can I better motivated myself and get a better sleeping pattern?

Dear Dec,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions that affects your sleep. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/20/2022

Can therapy help with insomnia and the anxiety that ultimately becomes associated with sleeping?

Hello MP,    I am so sorry to hear that you have been suffering from insomnia. I would agree that it does seem that it is more the worry about not being able to fall and stay asleep that has you awake. One of the things that will help you is to keep a sleep schedule. I would try to be sure to go to bed at the same time every night and wake up at the same time every morning, even if you are able to sleep in. This helps your body to know when it is time to be asleep, and time to be awake-like muscle memory. Also, going to bed early might cause you to wake up earlier, or sleeping in may lead to fragmented sleep. Trying to avoid caffeine and nicotine will help you, along with avoiding alcohol which can make you wake up in the middle of the night and have difficulty falling back asleep. Getting regular exercise, but being sure that you are not exercising before bed, will also help prevent insomnia. I would also try to develop a routine right before bed, that you do every night, again to use that muscle memory to remind yourself that it is time for bed, maybe taking a warm bath or shower and reading a book. Relaxing about 30 minutes before bed will help you to get in the right mindset for sleep. Also, I would be sure that any screen or phone time has ended well before you begin your nighttime routine.  Although I know you have not identified insomnia in and of itself as an issue, I wanted to go over some of the things that will help with your sleep, so that you can use some of the strategies I will discuss next before going to sleep.  One strategy that you can begin trying when you are laying in bed about to go to sleep, is visualization. This is where a therapist could be extremely beneficial, as using guided imagery can help you to calm your body and mind and help to reduce or eliminate the thoughts that are running through your mind and making it difficult to fall asleep. Practicing relaxation techniques such as meditation with the counselor would be helpful as well.  Lastly, one last thought would be to keep a sleep diary or log that will help you to keep track of your sleep patters and routines that you could then use to make note of trends and discuss when you are in treatment. Sometimes we have stressors that are preventing us from getting a healthy amount of sleep that we may not even realize exists. You are absolutely right when you say that trying not to think about something makes it almost impossible to stop thinking about that very thing! So using the visualization and guided imagery to stop those thoughts will probably be the most successful way in dealing with this issue, and a counselor can absolutely help you on that path. I want to wish you the the best, and I hope that you found this response helpful!Thank you, Melissa   
(MSW, LICSW)
Answered on 01/20/2022

Anxiety, depression, sleeping problems

Hello and thank you so much for reaching out. It sounds like you are having some difficulties with your sleep due to anxious thoughts and the physiological consequences of anxiety such as a racing heart. For you, I would recommend cognitive behavioral therapy for insomnia. This is a structured, evidence-based treatment for disturbed sleep especially insomnia. With this type of therapy, you first start with lots of psychoeducation on how anxiety can negatively impact sleep and start a very vicious cycle that is difficult to get out of. This therapy also includes both sleep hygiene tips and stimulus control which is making sure that you are doing everything to promote good sleep. Stimulus control is really important and helps you associate your bed with good sleep. With this being said, the bed is for sleep and sex only. So you have to be sure to do anything else away from your bed or even outside your bedroom and this includes worries! Every time you worry in bed, you are teaching your brain that you worry in bed. So to teach your brain new associations every time you catch yourself worrying in bed, get up and go to a different room. Write down your worries and wait until you get sleepy again. Once you are sleepy, you return to bed and attempt to fall asleep again. If you find yourself tossing and turning and worrying, get up out of bed and repeat the process. Some folks have to repeat this whole cycle a couple of times but your brain is a great learner and will catch on quickly. Others also find it helpful to write down all their worries in a designated place at a designated time each day. Then leave those worries until you come back to them the next day. After you implement sleep hygiene tips and practice stimulus control, some people engaging in cognitive behavioral therapy for insomnia will be instructed to restrict their sleep. It sounds counterintuitive but it actually helps with resetting your circadian rhythm. You either go to bed later or wake up earlier for a set number of days. This intentional tiredness is called a sleep tsunami and we use it to help you get more quality sleep instead of poor sleep spread across more hours. This way you are more tired and likely to reach those deeper stages of sleep that you are looking for. The final part of cognitive-behavioral therapy for chronic pain is cognitive restructuring where you examine your sleep-related thoughts and emotions and see how to make those better. Because worries about sleep are more likely to lead to negative emotions which can lead to more difficulties with poor sleep. So if you think this is something that would benefit you, I would definitely seek a therapist who is trained to provide cognitive behavioral therapy for insomnia. Good luck with your search! 
Answered on 01/20/2022