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#4 on the list is taking sleeping pills. In a comment thread somewhere else, the author also said she stopped consuming caffeine, which is notably dismissed in this list.

I need HN to start accepting eyeroll emojis in comments.

In my view stopping caffeine should be the first thing to do if you have sleep problems. But somehow even mentioning this seems offensive to people.
I have sleep problems, and it’s to do with muscular/nerve problems, and things like the nerve sensations (mostly not pain) they cause. I’d find it irritating if you told me that, because I’m thoroughly sick of people assuming they know —- and that assumption is very common — what the causes and solutions are when I tell them I have sleep problems.
Assumptions are common, you're right.

I assume that people won't tell you to drink less coffee if you say something specific to your circumstance like "nerve discomfort keeps me awake at night" rather than something vague like "I have trouble sleeping".

How is “I have trouble sleeping” vague? It’s quite precise and clear.

The _why_ of the sleep problems is separate from the _fact_ of it.

Whether the _why_ is suitable to mention is totally context-dependent. In some situations it would make sense to mention the why. In others it would be weird and going into too much detail.

And it’s not just nerve discomfort. It’s muscular and there’s all sorts of details that are not easy to describe if I want to actually explain what it is.

Finally, you’re assuming that mentioning the reasons would somehow mean people wouldn’t then make assumptions, and this is false. If I mentioned the why they’re likely to assume (I know this from experience) irrelevant causes/cures to do with pain (much of the problem is very different to pain), pillows, mattresses, yoga, etc.

I have also found that it does not matter what you tell people the causes are, many will not let go of the idea that the sleep problems must actually be the result of psychological causes, due to being unable to relax, a restless mind, poor sleep hygiene, etc.

The specific details of anyone's medical condition typically isn't anyone's business, nor do they really want to hear it. "I had trouble sleeping last night" is a perfectly acceptable way to describe the impact of a medical condition without getting TMI with people to whom you are not close.
Then just don't mention you have trouble sleeping, as it's not their business, right?
It is 100% my team's business if my performance is suffering in my job due to my lack of sleep. It just isn't their business the gruesome medical details behind it.
> It is 100% my team's business if my performance is suffering in my job due to my lack of sleep.

It's actually not. It's 100% your team's business that you're underperforming, period, but any reason you give is on your dime. Since you're giving reasons, it is in your personal best interest to communicate to your team a need for reasonable accommodations under the Americans with Disabilities Act even if you don't describe to them the details of your condition.

I am not saying stopping caffeine is the fix for everybody and I am certainly not trying to take your experience from you.

What I am saying is that it’s worth to try this as one of the first steps because it’s easy to do, you can see results quickly and for a lot of people going off caffeine is helpful.

It’s like dealing with backpain. Exercise or yoga won’t cure everybody but it’s definitely trying to do that before taking other measures.

Or if you are overweight it’s a good first step to look at eating habits. Often better eating habits will help so it’s worth trying as a first step. If that doesn’t help definitely look at other things.

> What I am saying is that it’s worth to try this as one of the first steps because it’s easy to do

Why should someone try it if it’s abundantly obvious to them from the outset that the causes of their problem are of a different sort, for which this could not possibly help?

You’re still assuming that it is something that is potentially relevant to everyone.

Put another way, you’re assuming that all sleep problems are of a sort that could potentially be caused/exacerbated by caffeine, and that the person with the problems couldn’t possibly tell that caffeine was irrelevant unless they tried removing it.

“you’re assuming that all sleep problems are of a sort that could potentially be caused/exacerbated by caffeine, and that the person with the problems couldn’t possibly tell that caffeine was irrelevant unless they tried removing it.”

Yes. The keyword is “could” I am not saying “always is”.

“Could” is wrong. For someone like me, I know from the outset the kind of thing that causes the sleep problems. It could not be anything like coffee.

I wish I could wave a magic wand and make you experience what I do.

I have a lot sympathy for your situation and I am sure you have been worn down by stupid advice from a lot of people. I sometimes have depression and I am tired of advice to “lighten up”.

But let me just repeat: I believe that if somebody has sleep problems it’s worth as a first step to try going off caffeine. There is no guarantee but it will help a lot of people but not all.

Have you ever tried cutting caffeine out of your diet?
I’ve had lots of periods (from months to years) in my life with zero caffeine.

Including all of my childhood, and I’ve had the sleep problems all my life. Think about what that means for what you’re saying.

Yet people like you are so sure it could be the cause or contribute, and that I could never know without cutting it out of my diet.

Even aside from what I mentioned above, if you experienced what I experience you would know that it couldn’t possibly influence why I have sleep problems.

(comment deleted)
I concur. Common wisdom is to not consume caffeine after noon, but quitting it entirely has been a life changer. I essentially had to brainwash myself that I have a chemical intolerance to caffeine whenever the opportunity comes up. Now a lot of times even when I think I’m not tired or my mind is racing, I’m still snoozing ten minutes after my head hits the pillow
”Common wisdom is to not consume caffeine after noon,”

I can feel caffeine impacting my sleep and mood for days.

Some people have no problem with caffeine and sleep though. They'll even have a coffee shortly before bed, or an energy drink after dinner. It's not a universal rule that caffeine disrupts sleep.
> Some people have no problem with caffeine and sleep though.

True fact #1: all bodies are different.

True fact #2: caffeine is a CNS stimulant.

True fact #3: even if some people have no problem with caffeine and sleep, many do. The author acknowledges being sensitive to caffeine.

Indeed, I used to drink coffee until rather late and sleep well. 20 years ago, I started ti limit myself to 3 cups per day, and now drinking coffee at night keeps me awake (I think; never bothered to experiment thoroughly to find out). Age may have an influence, as might habituation.
Age is definitely a factor. In my 20s I could drink liters of coffee any time without problems. Now even one cup is having significant impact on me. I have heard the same from other people.
It was not dismissed, she specifically called it out as a common tip early in the article, then said:

"While some of these things helped me sleep better, there are also several tips that I often don’t see that helped me fix my insomnia. This article is devoted to those."

"I removed stimulants and added sleep drugs, but let's ignore those for now and focus on thinking positively" is seriously burying the lede.
I never miss an opportunity to rave about the "Sleep With Me" podcast.[1] Thanks to Scooter's soothing voice I no longer need medication to sleep every night.

I have no affiliation other than being a very happy listener.

[1] https://www.sleepwithmepodcast.com

YES! This podcast got me through a very difficult time in my life. I had the perfect storm of social, family, and work related anxiety going a few years ago, and suddenly my health crashed. I was a total basket case! Insomnia made me the WORST decision maker I could possibly be. "Sleep With Me" gave me a place to go in my head where I found sleep again.
She talks about going to bed only when she actually felt sleepy, not just physically tired.

Which I feel like isn't real insomnia. If I didn't go to bed until I actually felt sleepy (as in, almost falling asleep) most nights I wouldn't go to bed until 5am. That's with or without using my computer in the time between 9pm and whenever-I-feel-sleepy. And then my kids wake me up at 7:30. Even if they didn't, I'd be awake by 9am, not able to sleep anymore, but feeling really dragged out, stretched thin (like too little butter over too much toast), but not actually feeling sleepy.

Feeling sleepy, for me, is just not really a common occurrence. I occasionally feel sleepy in the mid-afternoon, especially if I've not managed my sleep well for several days. But if I relied on my sleepy-cue, I'd never get any sleep.

Yeah I have some pretty bad insomnia, and I don't really feel sleepy. At some point I just kind of, crash.

I could be drop dead tired from running/hiking, but unless I take sleeping pills, I have an extremely difficult time sleeping.

Consider checking your D3 vitamin metabolite levels in blood. I had trouble falling asleep, had single digits of 25(OH) D3 concentration (The norm is 20+ ng/ml).

For now I was prescribed 20k IU of vitamin D3 twice a week. Other things that helped - no caffeine after 3-4 pm and a cup of raspberry-hibiscus tea in the evening (It's very relaxing).

20,000IU in a day, only twice a week? Sounds really strange. To everyone else, don't follow this advice without a doctor prescribing it.

The only reason I've seen for exceeding the potentially toxic 10k limit is for fighting the flu (D3 Flu Hammer).

Yes, obviously doses this high are prescription only. Should have mentioned that.

Guess I have to trust my doctor, who mentioned this is a saturation dose, and later on I will switch to lower doses available over-the-counter.

Getting up early and going for a run before breakfast 5x/week solved insomnia for me. I changed from a night owl to a morning person almost immediately. It's been years now with no regression.
I had intense insomnia when I was younger. The points the author laid out helped me immensely - particularly limiting sleep. Specifically, I limited sleep to 7 hours a night, in bed at 10 and up at 5 no matter what. Additionally, as soon as got out of bed I exercised for 45 minutes. As the author mentioned the first couple weeks were brutal, exercising at 5 in the morning on 2 hours of sleep is not fun. After a couple months it stopped being so painful, and after 6 months I fall asleep in 1-2 minutes. I don't have children which I imagine would make this much more difficult. I also have a consistent work schedule which helps as well.
Those sound like two horrific months. I am not exactly insomniac but very much a night owl. The few times I have tried morning running have been simply awful. (Adrenaline gets me though my one race a year, though I would love to try the Las Vegas Marathon, which begins at midnight.)

I don't doubt that my body would adjust if I forced it that hard, but it sounds excruciating.

I've tried everything, and once my 2 year old daughter goes to kindergarden I plan on trying again, BUT the only working quick fix has been 300-450micrograms of melatonin taken at exactly the same time every night.

Melatonin at this small dosage is just amazing for me.

I don't want to dismiss all the good practices, but meltonin in the 300-450 mcg range just lets me fall asleep within one hour of taking it, as long as I take it the same hour everyday.

I'm also searching for some time-release low dosage melatonin because I only sleep about 7 hours.

No doctor here but maybe the rigorous schedule to go to sleep is what really made a difference. Sleep hygiene is a lot just controlling the predictability of the sleep environment and time it happens.
Can also confirm that all the usual advice people give (maintain "life hygiene", eat well, have a cold shower, stop staring at screens, don't do exercise prior to sleeping, don't think about sleeping, etc.) either don't work or are impossible to maintain in stressful situations, whereas a single melatonin pill does the trick. I'm frankly amazed that it works to be frank. I'm also dreading the day when it becomes unavailable seeing how I live in a country where any drug that's actually working eventually gets restricted whereas homeopathy gets handed over-the-counter.
> 2 year old daughter

Aw man. I feel you there. That's tough. But cute...good memories. Haha.

Melatonin works well for me too, though the effect does wear off as you said. You might check out the "bi-layer" melatonin tablets. I haven't tried them, but they are available.

I'm one of those freaks who is OK using doxylamine after researching it, and I find it really beneficial on top of the melatonin. It has a staying power for sleep that's really nice. When I take it, I take about 8mg, which is something like a third of a tablet but they're easy to break up.

I wonder also if one could split up the melatonin effect by putting a second tablet inside something like a small piece of cheese, for a simple time-release mechanism.

I also found that sleep cycles matter a lot to my body. If I wake up early, it's probably right on the button, 4-5 90-minute sleep cycles in. Falling asleep at this point is hard just because of where I'm at in the natural cycle. So it's usually a matter of waiting in bed for sleep to come back. I use these techniques to help me wait it out:

- Turning on a long lecture or podcast that I've listened to before. There is a scientific lecture on sleep and dreaming that works really well. :-) I use an XHDATA D-328 which has tactile playback controls and no screen. I also put some relaxation / ambient tracks on the memory card.

- Designing houses, neighborhoods, and vehicles in my imagination. I get into the most tactile details that I can.

- Making some quick changes to get more comfortable: Shedding clothing if necessary, a quick trip to the bathroom, a drink of water, fixing my pillow.

I also like to use this calculator periodically to get a rough idea of how my sleep cycles are going to work:

https://sleepyti.me/

Anyway...I know you said you tried everything. So I mainly posted this to mention the bi-layer melatonin.

Seven hours is a great amount of time to sleep, unless you are awake a bunch of the time in between and counting it as sleeping.
I have seen many doctors, including sleep specialists, regarding insomnia. They all pointed to one source as the reason for the sleep issues: stress. And they all wanted to put me on prescription sleeping pills. I said no to that. Sleeping pills are addictive and you have to take them for the rest of your life. As a software developer, I am used to finding and fixing the underlying problem as opposed to the quickfixes these doctors were offering me.

After much research I figured out the underlying problem, and the fix for it. The underlying problem is magnesium deficiency. As a software developer I am using my brain more intensely than most people. This is the stress the doctors are talking about. Stress depletes magnesium. The cells in our body depend on two essential minerals for normal function: Calcium and magnesium. Cells go into ON state when calcium goes in, and OFF state when calcium goes out. Calcium doesn't go out on its own: magnesium has to go in and displace the calcium. When you are low on magnesium, cells can't go into OFF state. When that happens your muscles become stiff and you need massages, and your brain can't turn off and you can't sleep. The solution is magnesium supplements. This fixed my muscle stiffness issues and my sleep issues. A special compound of magnesium called magnesium l-threonate is especially helpful for sleep because it can penetrate what is known as the "blood brain barrier".

Scientific sources for this are hard to come by. I had to piece together all this from multiple sources. Here are some:

https://www.westonaprice.org/health-topics/abcs-of-nutrition...

http://www.drsinatra.com/benefits-of-magnesium-supplements-f...

http://paleoforwomen.com/soul-crushing-stress-and-the-miracl...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637834/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/

https://www.ncbi.nlm.nih.gov/pubmed/23853635

https://www.ncbi.nlm.nih.gov/pubmed/8232845

Your mileage may vary. Magnesium deficiency turned out to be the cause of my insomnia but may not be the cause of yours.

Same for me. Two things worked wonders. Magnesium supplements and a Vitamin D lamp.

There is a massive difference between taking D3 and using a lamp. While relatively expensive they are worth every penny.

Interesting. I never across Vitamin D during my research on insomnia. What is the theory behind this? I'd like to try this--what brand of Vitamin D lamp worked for you?
Dermfix 3000. It seems it is discontinued. They are selling a handheld model now: https://www.dermfix.eu/1000mx-psoriasis-uvb-lamp.html

Using just magnesium never fully fixed my insomnia issue. It helped immensely in the beginning, but eventually the issue deteriorated and I again could not sleep even while taking large doses of magnesium.

Using a lamp was a world of difference within days. With a combination of both I have absolutely no insomnia issues anymore.

> Well, it’s often due to a phenomenon called sleep state misperception. When you’re in lighter stages of sleep, it can sometimes feel like you’re still awake, because there’s still thought activity occurring in the brain.

I learning about this, uh, experientially. My wife snores. Many times, once she starts sawing wood, I will poke her and tell her to roll over. Very often, she'll tell me "I'm not snoring, I wasn't even asleep." Hmm...

> There are so many horror stories out there about people who developed a benzo addiction or did crazy things while they were on Ambien.

One of the real challenges about being inundated with information on the Internet 24/7 is that there is a fundamental bias that we have a really hard time compensating for: No one writes down boring stories. If you judge the world based on what you read online, every Ambien pill summons a visit from the Ambien walrus and setting your kitchen on fire. Every trip to Central America ends in horrid digestive disease, bot fly infections, or both. Every politician all the way down to your local city council member is a corrupt sociopath, and every cop a malevolent scumbag.

The reality is that all of those stories get written down because they are interesting, which tends to imply that they are unusual, which means they are the exact opposite of being representative. But it's really hard to internalize that fact.

> No one writes down boring stories.

Millions of people on Facebook and Twitter are doing this right now.

One counterintuitive piece of advice I can offer is to take a cold shower right before bed. Some might think a cold shower would shock the system so much that your body would be on high alert... but that's very temporary... and when you slip into your warm bed sheets afterwards, you feel like your in a safe place.

Your milage may vary. I've seen conflicting science on this. Here is the positive case: https://www.sleepadvisor.org/showering-before-bed/

> To keep reading this story, create a free account.

Seriously medium? I just wanted to read

I want to chime in here and say the number one thing that helped me sleep better: less stress. Everything else didn't do shit. I tried pills, breathing exercises, routines, food, etc... Didn't work.

I went from barely being able to pay bills month to month with no luxuries (people look at what I lived in at the time as a prison jail cell), working on a degree I hated at a university I hated, living in a city I hated, no physical affection or love, and overall very lonely ... to perpetually having a job I hate, being in a decent relationship, not making anywhere near enough to afford the area but can afford the bills I do have, and still pretty lonely. Region isn't great either but mostly cause it's so expensive. Life still sucks but it's not the pure hell I was in before.

I don't fall asleep super fast. But I don't wake up as much in the middle of the night. (And I can fall back asleep) I don't deal with it taking 3-4 hours on the regular to fall asleep - about 30 minutes to an hour now. (I watch random educational YouTube videos) I don't deal with my mind racing and trying to figure out how to solve every problem... Even if I wish sometimes I did have that fire under my ass to keep me moving. I don't have more stressful periods where I sleep maybe 30 minutes to an hour a day and a week feels like a month or more. I'm less stressed. It was the number 1 thing that helped me and I noticed it immediately. And I always knew that was the issue.

Because of that, there was no cure except to get rid of the stressors. So I finally graduated, I got a job after many months of toil that ended up paying me, I finally met someone who would be in a relationship with me (took 26 years), and I got out of Seattle. It took forever.

Going to be 30 soon enough. I feel like when I do have my birthday, the stress will come back thanks to feeling wildly underaccomplished. Woo... But I'll manage as long as I don't live in Seattle again.