Sleep Strategies

This is mainly for Rob, in response to his "I can't get back to sleep" Facebook post last night.

All this is from the context of a heavy sleeper (which I'm assuming everyone will agree with) who developed/was gifted sudden tinnitus, and then struggled to sleep...the root cause of sleeplessness is, however, the brains fixation on the sound (which I'd liken to an old CRT squeal coming from 6 inches behind my head), and the spiral of thought/annoyance/stress that stopped sleep coming easily. My specific problem was waking up ~2am and then not being able to go back to sleep, with an ever-increasing focus on the annoyance of the tinnitus.

I now do most of these things on a daily/nightly basis. This advice came to me from many sources;

• Berkshire Audiology at RBH
• Talking Therapies
• Holt Hearing and Balance

(yes, audiologists deal with a lot of sleep issues)

1) Accept that sleep may not be an automatic thing, and you need a strategy. Welcome to old age, bitches. Your body is less and less under your control, and you need to deal with it.

2) Do the basics. No caffiene in the late afternoon/evening. Strictly limit screen use for 1-2 hours before bed. Don't over-hydrate, keep the bedroom cool. Basic sleep hygiene, and a good bedtime routine. For me, there is a cup of (diet) hot chocolate about an hour before bed, and that tends to also be the end of screen use. No caffiene for me after I finish work (3pm). Scrolling social media before bed is one of the worst things you can do. Read a book, listen to an audiobook.

3) First one. The bed is for sleeping. If you cannot sleep, or wake up and are unable to get back to sleep, after 30-40 minutes leave the bed, go somewhere else. Break the link in your brain between "I'm just sitting here not being able to sleep" and the bed. Have anywhere else to go. Ideally out of the room, but out of the bed at least. A chair, a floor cushion. Anything. Not the bed. The bed is for sleeping.

4) First really specific one. Have a prepared "go to sleep" routine, based on either Meditation or Progressive Muscle Relaxation (PMR). The Berkshire Audiology link above has 3 Soundcloud links to what I have found to be very effective guides to them (done by a psychologist at RBH) that has a bit less ASMR-bullshit that some off YouTube. I've downloaded them, and added them to a locally stored playlist on my phone, followed by 9 hours of rain noise (I'll get back to that, I downloaded it from YouTube via YT-DL). This gives me a 20-30 minute guided routine, followed by a very long rain soundtrack. You may prefer something else. Have a listen around, and see. I would recommend having them in such a way that your half-asleep brain is not suddenly goig to have adverts and/or drum'n'bass injected into it (which is what I was getting streaming from Soundcloud).

FOLLOW THE GUIDED ROUTINE. This is really key. Don't just listen to it, really focus on doing what they say, and do it. They will walk you through getting comfortable, some basic relaxation, and then either some visualisation methods, or muscle relaxation methods. Your 100% focus is following the routine.

For me, the PMR probably has ~90% success rates. This is gonna sound weird out of context, but if I reach the "scrunch up your face" section, it's probably time to leave the bed and follow plan B. My other is the Mountain Meditation (I use Mount Teide in Tenerife, as I've seen it from the air, and also ridden up it a few times, so have some good mental visualisations of it). I personally don't like breathing exercises, but they may work for you.

5) Plan B (where you leave the bed and do "something else"). That something else should be quiet, relaxing, and absolutely not involving a screen or any interactions It should not be a household or work task. Read a book, listen to an audiobook/podcast. The goal here is to give the brain something to do, and not allow it to focus on your current stress/problem. Leave your phone on charge by the bed, don't use it (social media is an absolute plague for sleep hygiene). I tend to use audiobooks now, as I need glasses to read a book, and they still irritate me a bit. Once you start feeling sleepy, go back to the bed, and start (4) again.

6) The rain noises? Rain is what worked for me, but there are plenty of white-noise'esque/sleep sound apps. This gives a level of background noise that helps the brain turn off. Personally, I prefer rain (natural, un-patterned noise. I didn't like white noise generators). I use an mp3 so that I can have it follow the PMR/Mindfulness track. If I can teach my brain that "rain noises = sleepytime", then GREAT, I have a soundtrack to help me sleep. Also, Gill and I wake up thinking it's raining far more often that it actually is!

7) How do you handle SO's in the bed? Good question. For the background noise, we tested Gill with the noise generation, and shes fine with it...actually helps her sleep too. For the guided mediation/PMR, I use sleep earbuds, which are fine unless you lie directly on them on a firm part of the pillow. As a nuclear option, sleep in another room (I'm not sure you have that option, but mentioning it anyway). If I NEED sleep, and I know I'm not super-tired (for example, not trained that day) I may take the option of sleeping in the spare room to allow a more un-interrupted routine.

8) Ask for professional help. You have a lot of shit going on with your life. Talking Therapies can be self-referred to, and is set up for non-critical issues such as this. I had a couple of assessments, and then went on a 6-week Stress Control course (which was a little overkill for me, but teaches methods of stopping negative cyclical thoughts). As I said on Facebook, I don't normally recommend what I lovingly refer to as "hippie shit", but some of the stuff worked for me (some was obviously completely pointless, I'm fairly self-motivated), and overall it was a net positive. I don't know what the service rates are "down south", however TT-Yorkshire got me assessed and onto the course within a couple of weeks of self-referral.