Difficulty Falling Asleep
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Do you have difficulty falling asleep?
Is it hard to get off? Slow to fade away at bedtime? Can't drift into
that unconsciousness which seems so easy for everyone else?
The Chinese have had your same problem for 3000 years too! And their doctors have thought hard about it.
They eventually split it into four main kinds of 'syndrome'.
However, before beginning, please check our page on Insomnia, because there are many conditions which you might think come under 'difficulty falling asleep', but don't!
© Rohit Seth
- when you've caught a head cold and the stuffiness in our head makes you sneeze and cough, and stops you getting off to sleep for half the night. That situation isn't really insomnia because after the cold gets better, you'll get back to normal sleep. Possibly you have what Chinese medicine calls an invasion of Wind-Cold.
- when you are upset, tense or frustrated by something: this would keep most people awake, but it's not true insomnia because when the problem is resolved, you sleep well again. This could be Qi Stagnation.
- Children keeping you awake, the house falling down ... These would certainly keep me awake, but if these causes were removed, you would get to sleep all right. However, if, even so, you cannot get to sleep, this page is for you.
Here are the basic four syndromes for this condition:
So, if you have an ongoing difficulty falling asleep, have a look at which of the syndromes described above seems closest.
Then click on the link below to take you to the page that describes that syndrome in more detail.
By the way ... You might have more than one of these 'difficulty falling asleep' syndromes together!
Also, you might be someone who not only has difficulty falling asleep but also someone who often wakes up in the night, or suffers from excessive dreaming.
Alternatively, if you have sleep apnea, click here: likewise for restless sleep. Those have different syndromes although the above four contribute to them too.
Here are the four difficulty falling asleep syndromes summarised above. Don't worry if the name you click on seems mysterious or frightening, or even misleading: these are just the names of the syndromes. Click on the link to read more about them.
What Can You Do to Help Yourself?
There are hundreds of tips, both on the internet and in books, for people who have difficulty falling asleep. But until now, they haven't been matched with the syndromes actually causing difficulty falling asleep.
That means you don't know which suggestion might help you.
So for each of the different syndromes we're going to add the suggestions that we think probably help most.
This page will certainly improve if people contribute suggestions and their experience re difficulty falling asleep.
You can contribute in the section below or on our Facebook page.
However, before we get to these suggestions, remember that sleep is a good habit which you've
got out of. Like any good habit, it's harder to acquire once
you've lost it than a bad habit.
But remember, many good habits take 28 days to become habitual. So don't give up just because it doesn't work at first.
Go to bed at the right time
I found this tip in a book well over 30 years ago. I've suggested it to lots of patients and many find it works well.
First you must spend a few evenings noting when and if there is a time in the evening when one or more of the following happens:
- You yawn a few times
- You think about having a cup of tea
- Your back gets itchy
- Your scalp feels sensitive or itchy
- You find yourself rubbing or stroking your face or head
- You take a few deep breaths, for no obvious reason
- You start dozing off
These messages comes from a million years of genetic evolution and inheritance: in other words, what our genes found actually worked.
Each one could be saying
'Find a comfortable place and LIE DOWN!'.
In my personal experience, if I yawn once or twice, I shall yawn again after about another 20 minutes. So I have twenty minutes to get ready for bed, to climb in and be ready to turn off the light.
20 minutes! If you are in bed when the second yawn or desire to close your eyes - or whichever - occurs, TURN OFF THE LIGHT! Your body is turning over to sleep mode. After a few evenings' practice, most people find that they naturally get to sleep quite fast.
What time is this for many people?
In my experience, it's usually between 9pm and 10-30pm. If you ignore
it, and of course you easily can, then you start waking up again. If
that happens you may be able to keep going for another hour or two
before you start feeling really tired again.
then, you've wasted several hours when your body was actually primed
and ready to take you down to the theta and delta wave levels of sleep.
That's where most Human Growth Hormone is secreted and you get the
deepest most restorative sleep of the night.
I have known people for whom this time was much earlier, and for some
it is later - for example if you are an 'OWL'. But the warning is nearly
always still there if you choose to look out for it.
Other General Advice
- Black-out the bedroom so that during sleep no light penetrates. Make sure your alarm clock's light is obscured. (Get an eyemask?)
- If you are otherwise healthy and neither aged nor very young, avoid taking naps during the day.
- Keep your bed just for sleep, not watching TV or reading.
- Maintain regular hours for sleep.
- Don't get into the habit of sleeping in after waking at your preferred time in the morning
- Avoid watching TV or working at a computer before bed. The light can upset the hormones you need to sleep.
- Avoid LED lights in your house, especially in the evening: their light waves upset your sleep hormones.
- Ensure your bedroom is either quiet or has a steady (low) noise level (consider earplugs)
- Take fresh air before bed: a short walk outside, perhaps.
- Make going to bed into a routine so teaching your body what to expect, then what to do.
- Get a comfortable pillow. People often like one that adapts to their head, neck and shoulders.
- Write a list of your worries before going to bed and ask your subconscious mind to produce solutions in the morning. Then forget the list and everything on it - you've handed it over!
- For some people, praying or meditating (if they know how), replaces the need for the list.
Caution! These 'difficulty falling asleep' syndromes develop in time
The following syndromes may seem a little extreme: you may not have developed them fully. As they grow older, many people in the West have a combination, such as '(Heart and) Spleen Deficiency', with '(Heart and) Kidney Yin deficiency'. The Spleen and Kidney deficiencies come first, only later affecting the Heart.
Heart and Spleen Blood Deficiency
The following is a summary: there's far more about it here.
This occurs where (to use the quaint description from Chinese medicine) your Blood isn't thick enough to receive and nourish your Spirit as it relaxes: the bed (Blood) isn't comfortable!
Briefly, symptoms of this cause of difficulty falling asleep include (but you may only have some of them):
- Tired, physically, with desire to rest and sleep
- Appetite reduced
- Vision blurred
- Poor concentration,
- Poor memory
- Tendency towards anxiety
- Desire for sweet foods
- Pale face
However, click on the link to read more about it and how it tends to develop in people.
What to DO?
If your difficulty falling asleep is due to this syndrome, then there are many things you can do to help. Although not a serious health condition, it can, in time and if not treated, lead to other more serious conditions, so don't ignore it.
- A small snack before bedtime can really help. It should be small, nutritious, not sweet, not spicy, and certainly should not include any stimulants like tea or coffee.
- For example, a warm, milky drink (could be made from almonds or oats if you don't tolerate milk from cows)
- A few nuts at bedtime, eg brazil, almond, hazel, help even more immediately with this syndrome than with Heart and Kidney deficiency (see below).
- Some forms of meditation and prayer use chanting, which helps this particular syndrome greatly. It should be very quiet, almost under the breath, so disturbs nobody. There are many religious texts, mantras and prayers or psalms that have helped others and may help you. This is really a form of humming, which seems to calm the Spleen. The sound of your chanting or humming helps calms your Shen, your Spirit, helping it to relax, overcoming your difficulty falling asleep. However, I suggest you do this, sitting upright on a chair, before going to bed. (Make sure you wrap up well if the room is cold, and keep your feet warm).
- Longer term for this form of difficulty falling asleep, you need to improve the nutrition your body receives. This can be done by getting treatment, such as acupuncture, to enhance your Spleen's ability to transform the food you eat into the Blood you need. However, you still have to eat the right foods; and not just the right foods, but enough of them, properly chewed. Chewing well is really important for Spleen and Heart deficiency people. Good food habits are often at the root of curing this syndrome.
- A warm bath before bed helps to compensate for your deficiency. Not too warm, however. After the bath get into bed and put the light out within 10 minutes. (The warmth provides Yang and when you leave this source of Yang your body begins losing Yang and moving towards a Yin state, which is exactly what you need to sleep.)
- Write out a list of your Blessings: the beneficial things to have happened to you in your life.
- For more on this, click Heart and Spleen Blood deficiency.
- Note about caffeine, coffee and similar. These will probably make you feel great at the time, but they deplete your Kidney Qi, which makes your Heart Qi unstable. Some hours after the coffee you'll feel very tired or cross, and you'll want more of it. Long-term, not good: short-term, disturbs your sleep patterns. (Actually, it's more complicated than that! See Coffee.)
Heart Blood Stasis
There is much more about this here.
If you decide that this syndrome is causing your difficulty falling asleep, you should certainly see your doctor for his advice, and then visit your friendly neighborhood acupuncturist or Chinese medicine practitioner. This syndrome can sometimes become serious quickly.
With this syndrome, food before bedtime is not usually a good idea because it puts an additional load on the Heart.
I've noticed, however, that many people
with this syndrome like a little alcohol before bed. In Scotland, this
seems to be Whisky. They say it helps them get to sleep, but their pulses suggest to me that their sleep is un-refreshing, to say the least.
Sleeping partly propped up helps some people who have difficulty falling asleep because of this syndrome.Click for more on Heart Blood Stasis
Nutritive and Defensive Energies Disharmony
For more on this, click here.
If you've decided this is the syndrome that gives you difficulty falling asleep, then your body is still fighting an underground battle against an invader. Usually, you get rid of this only after having another full-blown fever during some other acute disease, like another cold.
Meantime, you will have signs of hot and cold, small flushes of perspiration from time to time, and palpitations etc.. Avoid eating food before bed or in the evening that makes you hotter, such as rich, oily, fatty, sweet or spicy food. Vegetables and rice are better.
Mentally, one would think that counting sheep or counting backwards would work but the problem causing difficulty falling asleep is that your body is on 'Yang-Alert'. You can't settle.
Consequently, don't take caffeine or similar stimulants!
That being so, if you have the energy, particularly good for you before bed are:
- A walk in the fresh air, enough to get you slightly out of breath at the start but gradually going slower until when you reach home your metabolism has slowed down
- A warm bath, not hot, just above blood temperature for 10 minutes, before bed, can help steady your Yang energy
- For you, the occasional nap during the day may be a good idea because it helps keep your energy levels up
- Yoga-type breathing before bed (using the alternate nostril technique) can help to balance your Yin and Yang Qi.
- Men: sex before bed is a short-term cure and not recommended because your body needs the energy. Although it usually helps you get to sleep, you may find that if this syndrome is your problem, you'll feel worse over the next few days.
- Women: sex before bed may be good as long as you don't become exhausted physically.
- Make sure the bedroom is well ventilated. Your body needs oxygen when it is fighting a bug.
- Although you may be prescribed antibiotics and painkillers it is better not to take these if possible because they suppress any fever your body is trying to achieve, prolonging the problem.
- Acupuncture theory understands this syndrome so see an acupuncturist!
For more, click Nutritive and Defensive Energies Disharmony.
Heart and Kidney not Harmonised
There's more about this here. Briefly, this is what happens:
- This cause of difficulty falling asleep appears over time, seldom overnight
- anxiety (strong to severe)
- great mental restlessness
- inability to relax
- depression: sometimes a sense of dread
- poor memory
- Insomnia: waking often, sleep restless: you feel hot but sweating
- Nights sweats can be drenching, requiring change of bed-clothing
- Sleep; disturbed by many dreams; not deep enough or long enough to really refresh you
- Sexual – men: ejaculation during sleep.
- Sexual – women: reduced libido and/or lack of lubrication
- Mouth and throat are often dry, or the lower teeth feel dry. You often want to sip (cool) water or suck a sweet or chew an ice-cube.
- Dizziness: not just postural (ie occurring when you sit up or
stand up) but at any time.
- Tinnitus: noises in the ears or head which hum, hiss, whistle. buzz or drone.
- Hearing gradually reduces.
- Back pain, mostly in the small of the back.
What to DO?
If you are having difficulty falling asleep from this syndrome, the following suggestions may help. However, please do realise that this particular syndrome doesn't usually improve without treatment by someone who knows what to do and how to advise you.
Even then it takes time. Moreover, what you do yourself, and just as important, what changes you make in your life, long-term, can make a huge difference. Even so, this syndrome seldom improves quickly. Anyway, here are some suggestions!
- No caffeine or coffee or similar stimulants!
- Nuts, hazel, brazil, almond and seeds
like sesame at bedtime are particularly helpful because they supply what
your Kidney energy needs to husband your reserves.
- Note: Western science has isolated zinc as being the vital ingredient, but don't take zinc! Take nuts, which contain fats and other nutrients you need, all combined so as to make them digestible and absorbable in the right quantities. Zinc, on the other hand, is a mineral, which plants know how to eat but you don't.) However, only take 6 - 10 such nuts. Too many will have a heating or slightly indigestible effect. Chew them well!
- Being held or stroked gently by someone close
- Steady supportive massage on your back feels good. Gentle massage for two minutes over your inner legs, specifically around Sanyinjiao, Spleen 6, (about a hand's breadth up from the medial malleolus) and around the medial end of your elbow creases at Shaohai, Heart 3, can strengthen your Yin energies temporarily. Don't press here for too long or too hard though: after a while it becomes counter-productive.
- Reflexology on the feet may help you relax: it helps to take energy downwards, away from your head.
- A short walk before bedtime uses up anxious energy and gives you oxygen to help the heart muscle
- Reassurance from people you trust that you aren't going mad and that you're not dying
- Exercises (earlier in the day) to strengthen your back and your abdominal muscles - your core - really helps
- Sleeping in a cool room but with enough bedclothes to keep you warm, arranged so that you can easily stick a limb out to cool down. However, be careful, because you may find that your leg, say, gets chilled fast and you get a cramp - technically this is probably a localised case of Blood stagnation from Cold.
- Sex? For men, probably not a brilliant idea because although they may fall asleep after sex, it uses up a vital 'jing' energy which depletes their Kidney (both Yin and Yang). This means that they'll then wake up around 3am or 4am and be unable to sleep because their heart and mind are racing. For women sex is good if it's not painful: unfortunately this syndrome usually reduces the availability of lubrication where it's needed.
- NB You will gain most if you combine the above with treatment such as acupuncture which will aim to clear the 'empty' Heat and then to strengthen your Yin energy.
Click for more on Heart and Kidney not harmonised
What if Difficulty Falling Asleep Is Not your Problem? But One of the Following?
Click on the following links :
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Have Suggestion About Difficulty Falling Asleep?
Do you have a contribution on the question of difficulty falling asleep? Would you share it?
Note: if you've been having trouble getting to sleep for a long-time, you'll almost certainly also have developed Qi Stagnation. This is such a big subject, I've written a book about it. See below:
Jonathan Clogstoun-Willmott Books
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Qi Stagnation - Signs of Stress
Yin Deficiency - Burnout and Exhaustion
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