Have you ever woken up in the middle of the night and you are wide awake and wonder how to get back to sleep? You are not alone. Many people in Massachusetts come to my Elizabeth Rose Lavender Psychiatric Nurse Practitioner practice with insomnia concerns and ask me how to get more sleep and feel rested. I created the www.lavenderintegrativepsychiatry.com to provide a holistic integrative perspective on this sleep topic and so much more. Historically, Humans have slept according to their circadian rhythm, environmental rhythm, and their needs. Prior to industrialization when there were no electricity artificial lights, humans went to sleep when it became dark and woke up with the sunlight. It was natural for humans to fall asleep soon as sunset and then wake up around the middle of the night to take care of self and household matters. Then after stoking the fire and home activities, humans would sleep for another time period until daylight. Then with industrialization, electricity, and technology, humans have shifted their work and sleep schedules. Although humans shifted their sleep wake cycle to meet all the demands if insufficient rest and sleep it can come with a cost to health and wellbeing. In some cultures, such as in Europe, humans may sleep at night then sleep take a nap during a siesta one-to-two-hour break in the afternoon. My grandfather from Portugal would follow his natural rhythm in which he would go to work then come home for two hours to take a nap and to have a complete large lunch and then return to work and then would have a light meal and would go to bed early and wake up at sunrise. You can adapt and create a schedule that is best for your personal preference, your unique schedule, and biorhythm. The key is to be consistent with your schedule and to have your ideal routine. First identify your ideal schedule then like clockwork be consistent with your natural biorhythm.
If due to your work schedule you need to sleep one time block at night make sure you have good sleep hygiene. Sleep hygiene suggestions: Have a consistent routine for activities, meals, exercise, work, home life, wind down time, relaxing activities, and sleep as you can have. Get exercise physical activity early in your wake time schedule. Expose your body to sunlight or a light source during your desired wake time. Incorporate self-care and stress management throughout the day. Eat at a healthy meal for you at least three hours before your desired sleep schedule. Do not drink liquids before your sleep time to prevent urination from disrupting your sleep. Avoid alcohol before bed. Alcohol can make some people sleepy but then it is a poor quality of sleep and can increase urination in the night and cause dehydration and sluggishness the next day. Do not drink anything with caffeine or stimulating items such as nicotine stimulants prior to bed since it will keep most people alert and awake. Some people need to make sure they don’t drink any caffeine after midday and others that find caffeine and stimulants at any time too stimulating needs to avoid any caffeine and stimulants. Use your bedroom only for sleep and restful activities. Keep your bedroom dark and cool temperatures such as 60 degrees Fahrenheit or to what is comfortable for you. Create a bedroom that is comfortable, soothing, and relaxing. Make sure you have a comfortable bed, and you have soothing calm colors in your room, and you have a comfortable temperature for you and that you have the sound or complete quiet silence that you need. Go to bed at the same time and wake up at the same time. At least one hour before, dim lights and turn off electronics and stop any stimulating activities that keep your mind and body engaged such as the computer, TV, phone, social media, etc.) Do a wind down routine that works for you and that you need and that cues your body that it is time for sleep such as washing your face, taking a bath, brushing your teeth, light stretches, meditation, adn other activities that can make you sleepy. If worry and anxiety keeps you up at night, pick a time before your wind down routine to journal and talk about your worry, anxiety, stressors and to problem solve solutions. You can also journal about the positive of the day, what you were able to do, and what you are grateful for. then put it away the journal and switch to other switch off to distracting and soothing and relaxing activities. You have done all you can for the day and that time period and it is time for rest and self-care. Do relaxing activities that promote rest, relaxation, and sleep. Find what works for you. For some that can be a bath, or restorative yoga stretches or relaxing gentle stretches, deep breathing exercises, and/or meditation and progressive body relaxation exercises. If you can’t fall asleep within 20 minutes or if you wake up in the night and can’t get back to sleep then get up and go out of the bedroom and do a monotonous non stimulating activities such as meditation, progressive body relaxation, Yoga Nidra that guides your mind and body to relax, and listen to any relaxing sounds such as nature sounds or monotonous repetitive sound that you find soothing. Don’t stress about the sleep since this anxiety and worry will only prevent you from relaxing and getting back to sleep. Find any activities that work for you to calm your mind and body. If you do not get the full sleep that you need and need more sleep you can take an hour lunch break, taking a short nap for 20 minutes or less to calm the body and the mind may help. If a nap helps you and you are a Biphasic sleeper like my grandfather from Portugal then keep doing whatever makes you feel fully rested and rejuvenated to take on whatever you need. If you find the nap goes into a longer nap that makes you feel groggier and more unproductive and disrupts your fuller sleep schedule, then avoid the nap and make sure you obtain your sufficient ideal sleep hours at night.
Seek healthcare provider review, if these sleep suggestions have not helped you and you are having sleep deprivation, and it is impacting on your daily activities. Keep track and journal about your sleep and what wakes you up and causes distress during the day and night.
Seek a medical provider if you sleep is impacted by medical symptoms and if you are waking up with fatigue and daytime sleepiness despite having sufficient sleep. Your medical provider can review if any medical disorders are impacting your sleep wake cycles and what is the ideal medical treatment for your medical symptoms. Your medical provider can also order any diagnostic testing such as a sleep study to determine if you have any sleep apnea or other sleep disorder.
An integrative psychiatric perspective looks beyond habits alone, asking how regulation, stress physiology, daily demands, and internal pressure interact with sleep. Integrative psychiatry reviews the biological, psychological, social, and environmental factors that impacts sleep and provides holistic recommendations.
Seek a mental health specialist if sleep is impacted by psychiatric symptoms such as panic, excessive worry, and depression. A psychiatric prescriber psychiatrists, psychiatric nurse practitioner, and/or psychotherapist. If you need a Psychiatric Nurse Practitioner consultation in Massachusetts and/or Hawaii, my contact information is Elizabeth Rose Lavender Psychiatric Mental Health Nurse Practitioner (PMHNP) & Adult-Gerontology Nurse Practitioner (AGNP) Business number: 774-209-2291 Business email: rose@lavenderintegrativepsychiatry.com Psychology Today Profile Elizabeth Rose Lavender, Psychiatric Nurse Practitioner, South Dennis, MA, 02660 | Psychology Today Thoughtful outpatient psychiatric care grounded in clinical expertise, evidence-based practice; therapeutic understanding of the full context of a person's life; and individualized integrative treatment that includes the six dimensions of wellness.