"I have had a lot of trouble sleeping lately, and my doctor has suggested sleeping pills. I don't really want to take them, what can I do instead?" Tired

Sleep is one of life's great mysteries. While there are many theories, we still don't really know why we sleep. But one thing we do understand is how difficult it can be when sleep eludes us night after night.

Sleeplessness is associated with many mental health disorders, most commonly depression and anxiety. It can make mood and anxiety levels worse. Even mild sleep deprivation can affect mood, our metabolism - causing weight loss or gain, concentration and memory problems. In extreme cases sleep deprivation can cause extreme confusion and even psychosis. It is literally torture.

To me, sleep is often a red flag that the stresses and strains of day-to-day life are interfering with our ability to relax and allow sleep to come. The first question I always ask people about sleep is: "What is keeping you awake?" because being able to then more deliberately engage with the actual problems is imperative.

In the short term sleeplessness can quickly become a slippery slope. Once we start worrying about sleep it can be impossible to relax. It's just not possible to make yourself go to sleep.

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While medication will make you unconscious, there are a number of things you can do to attend to insomnia. They're called "sleep hygiene", which I've always found an odd term, especially when you consider its opposite.


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How to practice "sleep hygiene"

• Don't use your bed for anything other than sleep and sex. Avoid training yourself to relax while awake on your bed, for example during the day
• Stick to a regular bed time and rising time
• Avoid all caffeine (tea, coffee, soft drinks) from about 3pm
• Avoid alcohol, especially if you use it to get to sleep
• Allow at least 30 minutes for winding down, don't go straight to bed after being out, working, exercising or watching TV
• Use this time to engage in quiet relaxing activity i.e. reading, warm shower or bath, listening to (relaxing) music
• Minimise all bright lights. If you have bright lights in the bathroom, use candles or other lighting while preparing for bed
• This is a biggie: don't take your phone, tablet or laptop to bed, and avoid using them 30 minutes before bed. The back lights and closeness to your eyes have been shown to interfere with sleep. For some they can cause insomnia
• Once in bed, if you're struggling to sleep, allow 30 minutes to try to drop off, then get up. Go and do something quiet out of bed and in a dimly lit room. TV is OK, reading is better. Avoid devices then try to sleep again. Avoid long periods of time in bed trying to sleep
• Learn and use mindfulness techniques to focus on relaxation. Accept not being able to sleep, and allow yourself to simply rest
• Allow some time to retrain yourself. If you must use medication, minimise it to every third or fourth night

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Where to get help:

Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youth services: (06) 3555 906 (Palmerston North and Levin)
Youthline: 0800 376 633
Kidsline: 0800 543 754 (available 24/7)
Whatsup: 0800 942 8787 (1pm to 11pm)
Depression helpline: 0800 111 757 (available 24/7)
Samaritans: 0800 726 666 (available 24/7)
If it is an emergency and you feel like you or someone else is at risk, call 111.