Bedtime Blues:
What to do when you can't sleep

By Carrie Angus, M.D - yogasite.com

It's 3 a.m. You're scheduled to give a big presentation at eleven, only eight hours away. You desperately need to sleep so you will be rested and alert when your big moment comes, but here you are staring wide eyed at the bedroom ceiling. Your mind is agitated and your body won't relax. The harder you work at getting to sleep, the wider awake you are. You've already tried counting sheep, watching the late show, and making yourself a snack-all to no avail. In desperation you reach for a sleeping pill.

This is a common scenario in the United States, where approximately one third of all adults suffer from some type of sleep disorder. Insomnia, the most common type by far, is clinically defined as the inability to fall asleep after lying in bed for thirty minutes or the inability to sustain sleep for more than a few hours without waking. Practically speaking, however, insomnia can be defined as unrestful sleep.

We've all experienced some form of insomnia at particularly stressful times in our lives. It's normal to have trouble sleeping at these times, and it usually passes after a night or two. Insomnia is a problem only when it becomes chronic. Although it is associated with certain physical illnesses-arthritis, heart failure, and chronic lung disease, for example-most experts agree that insomnia is a symptom, not an illness in itself. So what is it a symptom of? There are two answers-the ancient and the modern. At first glance they seem completely different, but a closer look reveals some remarkable similarities.

An Ancient Angle on a Modern Malady
Ayurveda, the healing science associated with yoga, tells us that all disease is caused by indigestion. That is, at some level-either physical, mental, or emotional-we haven't completed extracting what is helpful and eliminating what is indigestible. This is one of the keys to understanding insomnia.

On the physical level, indigestion is caused either by bad food or by weak digestion and leads to conditions like heartburn (a contributor to insomnia), flatulence, and diarrhea. Mental indigestion is the inability to let go of a certain incident or thought-usually an unpleasant experience. This can be a distant tragedy like the earthquake in Kobe, Japan, criticism from someone whose opinion we value, or a work-related problem we're trying to solve. Emotional indigestion is the recurrence of a feeling, often sadness or anger, long after the precipitating event. The emotion has not been sufficiently digested and remains just under the surface, springing up for no apparent reason. Mental and emotional indigestion are the most common causes of insomnia. Some of us even grind our teeth while we sleep in an attempt to chew and digest recurring thoughts and emotions.

The Contemporary Angle
Modern explanations for insomnia range from overstimulation and stress to mucking up our waking-sleeping cycle. Stimulants include caffeine (coffee, tea, chocolate, and some sodas), and sugar, as well as activities such as aerobic exercise, arguing, and watching violent TV shows (or the evening news, for that matter). All these taken (or experienced) too close to bedtime can rev us up so much that it is difficult to fall asleep. This is only another way of saying we are still attempting to digest these substances or events at the same time we are courting sleep.

Stress is another form of indigestion. Most of my patients who suffer from insomnia tell me, "My worries keep me awake," or "My mind won't stop. I don't know how to turn it off." Anxiety, worry, depression, unpleasant memories, and fears are the most common cause of sleeplessness. They seem to take on a life of their own and are determined to stay awake, even though it's way past bedtime.

The third common cause of insomnia, one which has become prevalent only in modern times, is tampering with the normal cycle of sleeping and waking. This is a mechanical problem of sorts. Human beings have a normal sleep rhythm; in general, we are designed to be awake in daylight and asleep at night. People who work the night shift, or travelers who have recently crossed several time zones, may experience insomnia simply because they are trying to sleep when their internal clock is telling their body to be awake.

Our bodies are designed for sleep to come effortlessly. When it doesn't, when we're holding on to the day's stresses and reaching out for tomorrow's too, there are a number of ways of inducing the body and mind to let go and slip gently into a restful sleep.

Create an Environment that Will Help You Sleep
Your bedroom should be tranquil and inviting. Make it comfortable and conducive to sleep. Eliminate ambient light and any noise that could disturb your sleep. If possible, reserve the bedroom for sleep and sex. Conduct other activities-reading work-related material, watching TV, paying bills, and disciplining your children-in another room. In time, this will create the expectation in your body that the bedroom is where it goes to relax and rest.

End the Day with a Calming Routine
Go to bed about the same time every night. Create a routine that prepares you for sleep. You may already have some kind of program you follow before you go to bed-locking the house, brushing your teeth, maybe reading a little. A pre-bed routine is a way of telling your unconscious that it's time to sleep.

Make sure that this routine is relaxing, not stimulating-winding down before bedtime increases the likelihood that your mind will let you rest. If you find the news disturbing, skip the late broadcast. If you live in a safe neighborhood, take a leisurely stroll. Read something pleasant and soothing-save the suspense novel for earlier in the day. Take a hot bath. Sit for a period of meditation. The trick is to calm your mind and quiet your nerves before you get into bed.

And speaking of routines, getting up at the same time every morning will make it easier to fall asleep at night. Attempting to compensate for a night of disturbed sleep by staying in bed longer in the morning will simply further disrupt your sleep cycle. Get up on time, even if you don't feel like you've had enough rest-you'll have a much better chance of falling asleep easily when bedtime rolls around again.

Do a Relaxation Exercise
Taking a few minutes to do a short relaxation exercise just before getting into bed is an excellent way of letting go. This doesn't have to be elaborate. Great benefits can be gained by simply lying on your back in the corpse pose (hands at your sides, palms upward, feet slightly apart). Close your eyes, and systematically address every part of your body. Start at your scalp and move toward your toes. Begin by softening your forehead, eyes, face, and jaw. Tensing and then releasing each muscle group help tight muscles loosen, especially those in the neck and shoulders. Continue giving attention to each area of your body-the arms, the trunk, and the legs-until you reach your toes. Surrender to gravity.

Stay in this relaxed state for a few minutes, letting the floor support you. Focus on your breathing, releasing all other concerns. Let your breath come from deep in your abdomen, and let it flow smoothly, slowly, and evenly. This simple exercise is a way of telling your mind and body that it is OK to stop thinking, working, and struggling.