Sleep struggles: how do I get better sleep quality?

If you wake up and can't fall back asleep, play this game:

Starting from 100, each time you exhale count down by one. If you do any movement (like scratching yourself, turning, swallowing, etc.), reset the number back to 100 and start over. I tell myself that if I reach 0, I'll just get up and do something else, but to be honest that has never happened.

There's something about mechanically counting down that is enough busy work for the brain to not spiral into other thoughts, while being simple enough (and tied to a biological function, your breathing), allowing the brain to start doing it automatically eventually so you can fall asleep.

I also had issues for many years. For the past ~4 years now it's not so bad.

My trick is to put video games gameplay videos from YouTubers that post daily. I tend sleep within 5 minutes. When I do wake up, I rewind the video halfway and then I'm back to sleep within 5 minutes or less.

My current selection is:

• PangaeaPanga - ~20 minutes every day of edited Super Mario Maker. He always says the same jokes for more than 5 years.
• Real Civil Engineer - He tends to play grind games, his videos are edited to cut all silences.
• Cephalopocalyse - He plays Brotatoe and talks like every video is a gameplay guide. He always talks with the same tone.
• Northenlion - Diverse games with good banter, though I don't really watch him as much nowadays because his banter started to become too interesting and I would watch the videos until the end. He is so unhinged sometimes. A true professional.

Why I think it works: I'm not too interested in the games themselves. They are interesting enough to prevent me from having my own thoughts, but not interesting enough to prevent me from sleeping. So once I start feeling tired, I'll close my eyes and eventually fall asleep to the background noise. They don't tend to have many unexpected noises or screaming (except for Northenlion which is why I removed him from my rotation lately).

The YouTube algorithm has learned my behavior because when it's my bedtime, the first suggested video is always from one of them.

Before, I used to not sleep until really late and I thought I had DSPD, but apparently not.

Oh also, for the days where I think I'm not sleepy enough, I take melatonin. I cut the pills into chunks of roughly 0.3mg. Combined with the videos, I'm usually asleep within 20 minutes.

I am shocked there are so many comments on this thread with so much bizzare advice and strategies and no-one has asked "do you have a good quality bed and mattress?"

Like sleeping environment is a huge deal, it can make your day time wonderful, or complete hell.

Please audit your bed, your bedroom, duvet, bed sheets and your mattress especially. A mattress that suits you will allow you to fall asleep and stay asleep because you're like... Actually comfortable? Same goes for temperature! If the room is too hot, too cold, or the light levels are wrong. You can count to a million hanging upside down from the roof and you won't get to sleep because the environment sucks.

The other one is actually being tired, and I saw some comments mention exercise. Cardio is great, do more cardio! But you can be completely shattered and still not sleep if your bed is like sleeping on nails.

Hello fellow new teacher! I'm middle aged and "officially" starting my career in elementary education next week, but I've been a day to day substitute for the past year.

You've already gotten a lot of good advice from others in this thread about how to manage your sleep schedule, and some things you can try to help. I think you should consider a few other ways to go at your issue: first, you should mention your sleep struggles to your doctors, especially your primary care and your medication prescriber if you have one for ADHD. In addition to stimulants during the day they can give you something like clonidine before bed which can help you sleep, and treat your ADHD symptoms.

Second, you should consider a sleep study to check for any form of sleep disorders. I was diagnosed and treated for sleep apnea before I was diagnosed with ADHD. I used to think that any light or noise in my room would wake me up and ruin my sleep, but what was actually happening was my apnea was waking me up, then the light was just something I focused on that kept me from drifting back to sleep. Now that I have proper treatment with a CPAP, I don't have to put black tape over all of the small lights in my bedroom to sleep. ADHD and sleep disorders are very common comorbidities.

Finally, talking to a therapist about my anxiety has helped me in so many ways. I knew I felt anxiety as a human, but I didn't realize the extent that it was permeating my life until I got help with it.

Lots of great info here but I wanted to add a few things that helped for me.

First, I got rid of anything that shows the time. My first instinct on waking up was to check the time. The only right answer is 10 minutes before the alarm, but it's never that time, which led to stress and anxious thoughts about how I haven't gotten enough sleep. Now, I set a rain-noise app to run until near my alarm. If I wake up, I listen. If I hear the rain noise, I know it's not time to get up yet.

To fall back alseep, if I can remember my dream, I try to sort of re-enter the dream, to daydream about the same situation and it's oddly effective. If I start to really wake up, I do things as listed above - deep slow breathing and something to distract my brain into not thinking about sleep or life. I do the "longer exhale" form of breathing, since it's supposed to trigger sleepiness. I also focus on relaxing my body, because I often find that my jaw or other muscles are tensed.

Also, I lie to myself. That is, I tell myself that it doesn't matter if I get back to sleep, that it's just as good to lie here meditating and relaxing. Thinking about sleep or stressing about sleep makes it impossible for me to drop back under. So I try to just relax and trust the process and believe that resting is just as good. If I jerk awake while trying to sleep, I don't think "oh god it didn't work", I think "it's working, I'm close to asleep"

And if all that doesn't work, I get up for a bit, then repeat my sleepy-time ritual all over again. My sleepy-time ritual is about 15 minutes that dims the light in the room over time ending up with only a dim red bulb lamp for a nightlight. I try to incorporate multiple senses and enjoy it - scented lotion, a soothing playlist of bland instrumental music, the feel of my super-soft throw, everything in the same order and no thoughts of anything important. Then in bed I turn on some educational lectures that engage my brain enough to keep my thoughts away from sleep but not enough to keep me awake. I've noticed that when I switch to a different set of lectures, they don't work as well for a week or two, so remember that any changes you make will take time. I know they also make podcasts specifically designed to help you fall asleep - with a soothing voice that kind of rambles - I have used those as well and they are pretty good.

When my health issues were still bad about waking me up at night, I'd go sleep on the couch. For me, something about having to warm back up helps me get back to sleep, so having a secondary location is nice and helped me avoid the spiraling thoughts (and especially helped if I needed to be propped up more).
I also darken the lights of any electronics where I'm going to be sleeping. I find even if I can't directly see it, a lot of lights will reflect off the wall and help keep me awake.

Along the same lines as @tomf, you can pray. During times of tests and difficulties, people have turned to prayer and meditation as a source of solace for pretty much the entirety of human history, especially in those dark hours before morning breaks.

Pray for understanding, for strength, for patience, for guidance. Your own troubles are unlikely to resolve themselves without some form of growth and development, as they are needed for our maturation as people, but the sooner we find what qualities we need to acquire to overcome the challenges in front of us, the sooner their power to make us anxious and fearful decreases.

Restricting sleep time has been good for me. You probably know how much sleep you'd like to have and when you'd like or need to get up. If that works out to 10pm to 6am sleep time, prevent yourself from sleeping before 10, no matter how tired you are. Do whatever you need to do but no bed and no sleep before real sleep time.

The other thing I do, if I wake up, is to both remind myself that brains don't work properly half awake and all the anxious thoughts can be discounted and to do something else for 15 minutes if I can't sleep. Get up, wander about, look outside, whatever. But get out of the rut of want to sleep/can't sleep, forgive yourself, do something else and try again.

And all the sleep hygiene things others have suggested.

one method is to read something incredibly boring like the manual for a clock radio.

another method I grew up with is pitched as self-hypnosis, but I think it just distracts and regulates.,

1. lay flat with your eyes closed, but 'look' to your toes
2. visualize yourself in a location you know well that has an escalator
3. visualize yourself entering the building, walking around toward the escalator
4. get on the escalator and count the 'steps' from 1 - 20
5. get off and walk around and back
6. get back on the escalator and count the 'steps' from 20 - 1

For me, I get to about 16 coming down and I'm out cold.

Lastly, before you go to bed, write out everything you have to do and everything you're worried about... and then close the book.

I would consider a few things:

1. Are you using things to cope during the day with how tiring it is? Can be counterproductive when lack of sleep is an issue too. Consider avoiding stimulants like caffeine (and if you can’t, at least avoid after midday) until you get your sleep cycle better. Similarly, make sure you aren’t relying on alcohol to sleep as it can reduce sleep quality even if it helps you to sleep initially.
2. If you are ruminating and keeping yourself awake, personally listening to a gentle audiobook that you know well can help quiet the thoughts but not engage you enough to keep you awake either. The radio can also help with this (I like to relisten to comedy shows, I find the gentle laughter and idle chat quite reassuring!).
3. Sleep meditation can help quiet thoughts and still the body.
4. If I really can’t sleep, sometimes I find it helpful to get up for an hour then make an effort to go to bed again. Just read a book in some relatively low light, nothing with screens.
5. Consider other sleep hygiene: the bed is just for sleeping in, no phones an hour before bed, etc.
6. Milk has been shown to help elderly to sleep (and seems to help with babies too!) so you could consider this as well.

I hope something helps. Getting no sleep makes you feel rubbish and can be a bit of a reinforcing cycle!

I suffer from same, and everything I've read so far in this thread has been awesome (I already do the second sleep location, put on gameplay videos, and slow my breathing; gonna try the counting thing.) I've also found a trick to be able to put on noise (music, podcasts) without bugging my partner in the same bed: play it softly on your phone and tuck your phone under your pillow. I can turn my head to the side to put my ear right over my phone to listen to it, and my partner doesn't hear a thing. Additionally, if you want to "turn it off" without having to move much, just turn your head the other way; it should be inaudible or barely register at that point. I know they make sleep headbands and whatnot, but I hate wearing them, so this feels like the least intrusive way to listen to something without bothering others.

I read this and realized that this sounded like you... and it is. :(

I've had sleep issues my whole life. That's part of when I had a freer life (working overnights, and living abroad without a job), I refused to go to bed until I was drop-dead tired. Drinking also heavily factored into it, which is still a very real tagalong today.

But the reason I'm posting, not just because I feel for you and I consider you my friend, is because I found that ... playing Boggle helps me get sleepy. It's weird af, I know, and I doubt it will help you, but it was one of the few apps I bought on my iPhone back when I first got a smart phone. It's been one of the staples on every phone I've had since.

That being said, I also have similar problems, likely because I'm just old and I wake up to pee way too often (I also drink a lot, which we both know isn't necessarily alcohol-related), and even the last three nights when I had yesterday and today off, I woke up at 1230, 130, and 200, respectively and didn't drift back off until after 3. I tried the boggle, I tried clearing my mind (which I'd like to think helps, but it jumps back into other thoughts and ideas and situations and all sorts of things I don't want to dwell upon while trying to sleep, and most even just don't want to think about ever), and once I even just got up and did situps until I felt tired.

And we just got a new bed. It's amazing and stupid firm and I loved firm beds but this is brutal, which I'd like to say is the reason I'm not sleeping, but it's actually the reason I'm not waking up completely sore anymore. So I'm not saying the new bed isn't the solution, but it would not hurt (when you can, I know). But yeah, not gonna say kaffo is wrong, but the bed isn't the reason.

I also cannot fall asleep watching movies, tv, or listening to music, so those options I cannot suggest or relate to.

That being said, I really hope you are able to find peace. I know it's a rough time.

I have the same problem and ended up on a low dose of trazodone after years of struggling. Obviously not for everyone and I'm not sure how it interacts with other meds, but it has at least removed the absolute dread I faced when I woke up in the middle of the night and knew wasn't going to be able to go back to sleep. I still wake up, but now I can usually go back to sleep. Yoga also helps get my mind to shut up, especially breathing exercises

I have this same problem, I have been a very light sleeper my entire life. The best things I have come up with are making sure that my room is extremely dark (effective curtains, no bright LEDs anywhere), my mattress and pillow are comfortable, no caffeine after midafternoon (3PM or later causes me issues), and weirdly, not trying to go to sleep too early. The last one is rarely a problem as I am a "night person" in general, but if I try to go to sleep before 11pm I will get the worst sleep. If I my mind is especially active and it keeps me awake, I find that if I try to think of and focus on abstract patterns, like a screen saver for my brain, it tends to calm everything down after a few minutes. YMMV Brains are weird.

Is there a chance you're going through perimenopause or menopause? I don't want to assume your gender, but this is an often overlooked cause of sleep suddenly becoming hot garbage.

If not, one thing I've found that worked for me is getting a good amount of natural light early in the morning and keeping lights low in the evening. Pairing this with regular exercise and reducing stress has been the only thing that's really helped me keep a somewhat regular sleep schedule after many years of trying different things (also ADHDer). You have to be consistent about it for it to really pay off, which can be hard. I know it sounds like something you'd see people complaining about on r/thanksimcured. Unfortunately my bladder is now conspiring to screw it all up so I'll eventually have to figure something else out. Good luck!!

My partner has the exact same problems with sleep as you, right down to the ADHD. Hoping some of the solutions you get here work for you, as he hasn't found a long-term answer yet either. I've also had my own sleep problems, enough that I saw a sleep doctor for it for a while. I think everyone here has given some really good advice, here are some additional things I do when I have difficulty sleeping due to anxiety:

• If I wake up and can't fall back asleep within fifteen minutes, I get up and do something else. I try to keep light levels low, and do something that's not too mentally stimulating. I'll try doing it for 30-60 minutes, then try going back to sleep again. This was advice from my sleep doctor.
• If I really can't sleep due to anxiety, I'll go to the couch and put on a tv show from my childhood. Something simple without a deep plot, and that I know fairly well. I'll turn the brightness all the way down, and put the volume down to a level I can just about hear. Then I'll lay down on the couch and watch the show until I drift off. Something about it just works for me, helps take my brain away from worrying about current stuff. Currently using dragon ball for this, but I've used pokemon and gundam wing in the past.
• I also have ADHD, and sometimes I know I can fall asleep if I can get my brain to stop thinking on overdrive. I tried variations on counting games to quiet my brain, but it was never quite interesting enough. So instead I try this thing where I'll pick a word, something that doesn't bring to mind strong emotions and that's no longer than 5 letters. Say for example the word SKIP. Then, I'll take each letter in the word, and come up with a new word that starts with that letter, and then the second letter in the word descends alphabetically. So, using the S from SKIP, I might go SALT, SBARRO, SCISSORS... etc. If, I can't find a word for each letter, I skip it until I get to the end of the alphabet. I then start with the next letter in the original word. This sounds complicated, but it manages to be both interesting and mindless for me. The key is to pick words that don't have a lot of emotional meaning for you, and to try and visualize each one. I don't think I've ever gotten past the 3rd letter of the original word when I play this game.
• Was recommended these guided meditations once from UCLA (https://www.uclahealth.org/uclamindful/guided-meditations). They have one for sleep that I've sometimes found helpful.
• And this last one is a recommendation from my therapist. Sometimes, I just can't sleep or fall back to sleep. In that case, I just accept that it's the way it's gonna be. It still can be valuable to lay in the dark and just rest. If I can't sleep, resting is still good. I'll try to direct my brain a little bit, if I'm gonna rest I want to think about things I like, so I'll try to do so. Maybe a video game I like, or a tv show I'm watching. Sometimes, I still fall asleep in the end this way.

I had a couple of years of stress and started listening to sleep podcasts. My staple is Otis Gray/Sleepy Radio, who reads public domain books twice a week - Wednesdays are full length short stories, about 30 minutes, and Sundays are the first N chapters of a novel for an hour-ish. It's quite peaceful with just a little intro music and IMO very much worth the $2/month for ad-free. My other favorite is Sleep With Me, which is what I listen to when things are industrial strength stressful. SWM is chaotic, nonsensical, and distracting, which may not work for everyone, but it's the kind of noise that drowns out your own thoughts and kind of becomes a blur.

Even though the stressful time is over I still listen to the podcasts every night back to back. I've got some 10 hours of podcast playlist lined up.

I do have a similar issue of falling asleep like the dead right away and waking up at 1 or 2am feeling too refreshed to easily go back to sleep. I tend to get back pain and find sleeping in the recliner cradles my body in a way that is lower-back supportive but also cozy.

There’s a lot of good suggestions in here in terms of what you can do long term to improve your sleep. But for the immediate term, since it seems like you’re already unintentionally experiencing bi-phasic sleep, you could try just making it an actual part of your sleep schedule.

Go to bed a couple hours earlier, wake up whenever you wake up and just make something out of that time instead of fighting it. Read a book, play or watch something relaxing. Anything you can do to casually pass the time that won’t be too mentally engaging (personally I find anything too engaging before bed just keeps me up).

Then just…go back to sleep after a couple hours, and wake up at your usual time. This is actually how most people would have slept before electricity, since it was otherwise expensive to stay up past sunset. Which is just to say, there is precedent for a sleep schedule like this working for people.

Hi.

Also ADHD (for me specifically it's AuDHD) and have had sleep consistency issues near all my life.

Things to try (in no particular order).

Physical exercise on a regular, scheduled basis. You DO NOT have to exhaust yourself or push until you feel like crap, thus demotivating yourself and providing reinforcement that 'I don't like doing this'. Physical exercise can help with a lot of things including mood stability and sleep. During the times I've had the motivation to go on 2-3 mile walks on my local trails / parks I feel like it helped me. Edit: oh, and the 'something is better than nothing' principle applies here. Don't 'not do exercise' just because you feel you can't allocate 'enough' time or effort to it. If all you have time for is a 15 minute walk, that 15 minute walk is better than nothing and may later build into something more, jogging or whatever.

Sleep study / CPAP. If you have any issues that interfere with sleep due to snoring / apnea then CPAP can make a significant qualitative difference.

Certain Marijuana products (health and safety disclaimers apply here) - from talking with my father there are gummies he gets from Lume labeled 'Dream' that contain 5mg THC and 10mg CBN - the CBN has been anecdotally attributed to improved sleep quality and ease of getting to sleep / staying asleep. Be aware there are potential contraindications of mixing Marijuana products with certain ADHD meds as both can have the effect of increasing heart rate, and thus increasing blood pressure. This is not exactly an absolute 'you can never do this', more a need to discuss with your provider, assess your cardiac health / heart rate / blood pressure, and also take into account the biological half life of each and that you would (most likely) be taking any ADHD meds in the morning and any Marijuana products (for the purpose of sleep) at night, thus not mixing either of their peak effects due to time separation. I'll actually be discussing this with my provider next time we meet as it's something I'm considering.

Look for / discuss with psych provider or therapist ways of addressing or counterbalancing sources of stress and anxiety as this may help deal with one of the root causes. Yes, I know, easier said than (effectively) done.

If I recall correctly, and human memory is fallible so maybe I'm wrong, resting in bed while awake even if you are failing to sleep still has some utility compared to not lying down at all. Something to consider in terms of 'give up on trying to sleep and get up at X-oclock AM' vs staying in bed.

That's all I can think of at the moment.

Specifically for dark and terrible thoughts: I used to wake up and have panic attacks when I was in grad school, which would spiral into a doom circle that I really didn't need. In addition to all the other advice here, the most important skills I learned for leaving (and staying out of) the doom spiral were a few mindfulness tricks.

First, recognize that you're in a doom spiral. You don't want to be in there! Dooming isn't going to do anything positive for you. Once you know you're in the doom spiral, I use a sensory game to break the cycle and get my breathing back to normal. I usually do this when I'm still in bed and with my eyes closed, but if you've abandoned sleep you can add visual cues as well. Basically, go down your five senses and focus on one thing you can see or hear to start with. Start by identifying one thing. Take a deep breath. And then find a second thing. Take a deep breath. Etc. I learned to do this awake and eyes open with 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, and one thing you can taste. You can mix and match the senses as needed, but take a deep, slow breath between each one. I have found that I never need to go through the whole list, and usually I'm pretty calm by the time I get to the end of 4.

The goal is to stop the panic and misery, so whatever trick you have works - this one worked really well for me, especially when I was lying in bed and wondering what I was doing with my life and judging all my prior life choices. You're doing a tough and important job, and I hope you're able to relax enough to get some sleep. It's incredibly frustrating to be tired and not able to get the rest you need, so I hope some of the advice in this thread helps!

I find myself awake at 2/3am without fail and just toss and turn until either I eke out a half hour of sleep before my alarm at 5am or just give up and get up. Of course those hours I spend lying awake in bed are the perfect time for my mind to turn to dark and terrible thoughts as well.

This sounds very familiar. The following is not medical advice, but for me, this pattern ended when I started to take probiotics. Not just yogurts or sauerkraut or such, but higher dozes in over the counter pill form. I had tried all sorts of things to manage my sleep, but it turns out sleep wasn't the problem, my digestive system was.

My theory is that what woke me up was the gut not working properly. And my brain interpreted that feeling in the gut literally as a "gut feeling", that something wasn't right, and then proceeded to invent things that I could be stressed about, leading to that endless spiral of nighttime thoughts. Again, this is not medical advice or robust science, but for me probiotics changed my sleep, and in many ways my life.

It might also be a good idea to keep a diary of things that you do, eat and experience during the day and track the quality of your sleep, either manually or with an app or a sleep tracker. I did that for a year or so and learnt a lot about what seems to affect my sleep both positively and negatively. Some findings were quite understandable, others surprising. Knowing what seems to affect my sleep has been very helpful.

As for dealing with those nights of tossing and turning, just like some others here have already suggested, for me the best way to go back to sleep was to move to another place to sleep, and then put on something that I could listen to which was interesting enough to maintain my focus, but soothing enough to put my brain to sleep. For me, it was the YouTube channel Cracking the Cryptic (they do sudoku and cryptic crossword solves), and Simon's videos in particular.

One thing I haven't seen mentioned here is melatonin, but not the 10 mg industrial strength stuff, and not right before bed. You actually want to take no more than 1 mg (I found 1 mg gummies and I just bite or cut them in half) and you're supposed to take it 12 hours before you plan to wake up. Taking it at this time mimics your body's natural melatonin cycle. So if I need to wake up at 7 am, I'll take it at 7 pm the night before. I find the melatonin helps me fall asleep AND stay asleep throughout the night. (I can't remember the exact source of this information, but it was a study on the effectiveness of melatonin for sleep quality in humans.)

Actually now that I think about it, I also take 20 mg of cetirizine to help me stay asleep. Ever since I got long covid, I'd wake up around 3 or 4 am all panicky and could not get back to sleep. I find the cetirizine helps stop the spike in whatever hormone was causing the panic (cortisol? adrenaline? who knows).

Like everyone else I also use audiobooks and if that doesn't work, micro doses of melatonin, 100mcg- 300mcg. I wont take it after 3am. It's a terrible sleep habit, but it beats lying in bed for hours with nothing going on but dark frustrating thoughts. I actually have multiple audio books with multiple apps. I have a hundred BBC Radio Sci Fi audio books, the ones I have are frankly terribly entertaining pulp fiction, I will put one on for 30 minutes, then when I wake up I rewind about 30 minutes. If after 30-60 minutes I am not asleep, I tend to switch to something a little more interesting, like PKD, and will listen to that in 30 minute increments. I use Shockz over the ear bone conduction headphones. It's gotten so I can't sleep without them. So don't be like me, and only use it when you wake up.

Veterans Affairs (VA) has online tools and apps that are still free for the public to use. The methods are not specific to veterans and sound advice and interventions for insomnia for anyone.

https://www.veterantraining.va.gov/insomnia/index.asp