As a holistic psychiatrist practicing in NYC, one of the most common complaints I hear from patients is that they can’t sleep. Some people can’t fall asleep, some can’t stay asleep, others sleep eight-plus hours and still feel tired all day.
I tend to believe in the body’s ability to figure it out and heal...as long as we get out of the way. Our sleep wake cycle is cued by things like light changes, temperature changes, and routine. As you know, modern living comes with artificial light after sunset, consistent indoor temperatures whether the sun is at high noon or long gone behind the horizon, unpredictable schedules, and chronic low-grade stress. You can begin to see how modern living has messed with everybody’s clycles, leaving us all tired but wired at night and dragging ourselves through the day.
The good news is we can get strategic and recreate something that approximates the appropriate cues for sleep. After years of helping patients improve their sleep, I’ve distilled this down to a few basics. Here’s the crash course:
How to optimize your sleep-wake cycle.
The whole sleep-wake cycle is simple: Light makes us feel awake, and darkness makes us sleepy. This system was foolproof until the invention of the light bulb, and now the vast night sky dimly lit by stars and moonlight has been replaced by Netflix in bed. This constant stimulation tricks the brain into thinking it’s daytime, so is it any surprise we feel wired around midnight? Here's how you can take back control:
1. Prioritize outdoor time.
You can outsmart the system by ensuring you see bright light during the day and darkness at night. That means opening your shades as soon as you wake up in the morning and getting outside as much as possible during daylight hours. Then, once the sun goes down, switch your computer to night mode using an app like f.lux, start dimming the lights in your house, and avoid screens as you get closer to bedtime. If you have to look at a screen, consider wearing orange plastic glasses to block the blue spectrum light.
2. Go back to basics.
Finish your night with a bath or shower by candlelight. Bonus points for adding soothing Epsom salt and lavender essential oils. Then, I'd recommend reading a book by the light of a salt lamp. Salt lamps have a nice, soothing quality, and they emit warmer, red-hue light that’s less likely to wake up your brain.
3. Make your bedroom a cave.
We are also hard-wired to get sleepy when the temperature drops a few hours after sunset, so stimulate this by making your bedroom a little chilly. Around 65-67 degrees Fahrenheit is a sweet spot for your deepest sleep. Make your cave dark—like you-could-walk-off-a-cliff dark. If you have ambient light pollution, get blackout shades (easier than it sounds; go to Home Depot and ask for help).
If you have electronics in your bedroom, remove them. If they’re nonnegotiable, cover them with duct tape or translucent orange plastic tape. A good eye mask can also go a long way to blocking out light. And while there was no Amazon.com on the proverbial Savannah, you can avail yourself of modern luxuries and get a good white noise machine if you have noisy neighbors. I prefer the Dohm one.
What to ditch:
1. Your phone.
By keeping your phone in your bedroom, you're tempting yourself to make it the last thing you look at before you close your eyes. The trouble is, staring at the screen, even when it's on night-shift mode, is like taking a shot of espresso in that it cues your brain for wakefulness. Your phone is a gateway to the druglike rush of a text from your crush or a like on social media and the angst of work email and current events. None of this juju is conducive to sleep. Starting tonight, set your phone on do-not-disturb mode, allow calls from your favorites to get through for emergencies, and tuck yourself into bed outside the bedroom.
One of the main reasons everyone’s sleep is wack is that we’re all stressed out of our minds. The body does not want to drop into deep, vulnerable sleep if it thinks it’s sleeping in the middle of a war zone. Provided that you don’t actually live in a war zone, there’s a lot you can do to start communicating to your body that everything is OK. First, if your job or your relationship is pulling at you too hard, get proactive about it. Read Nonviolent Communication by Marshall Rosenberg, speak up for your needs, or make a change. If you stay up late working, shut it down. Realize that if you get a good night’s sleep, you’ll be so much more productive the next day, and it will likely make up for the time you missed working at night.
I don’t make many friends with this idea, but if you struggle to sleep and you consume any amount of caffeine, do yourself a favor and begin to gradually taper your intake. If you love the ritual, keep the ritual, but ditch the caffeine.
What to adopt:
1. An earlier bedtime.
This is an unpopular idea, especially in NYC, but we all need to get to bed earlier. I like to look to ayurvedic practices to guide my days. Under the ancient Indian health practice, there’s a "kapha" quality to the hours of 7 p.m. to 10 p.m. that makes us feel heavy and sleepy. If you get in bed early enough to catch that wave, it will ride you right into sleep. Starting around 10 p.m., a pitta, or fiery energy, takes hold. This can make us feel like we just got a second wind. If I’m still awake at this time, I suddenly want to do projects around the house or mindlessly scan Instagram. One of the best ways to set yourself up for falling asleep more easily and sleeping more efficiently is to get in bed by 10 p.m.
2. A holistic routine.
Finally, start exploring rituals that help you wind down. Right before bed, I like to put an essential oil blend called Bedtime Story from Living Libations, which contains chamomile, lavender, tangerine, and spikenard, into an aromatherapy diffuser. I'll also add a few drops in my bath or on an eye mask.
There are great aromatherapy diffusers available at various price points, and I personally have the VicTsing model at home. If I’m really wound tight, I’ll take a few minutes to do a breathing exercise called 4-7-8 breathing. I lie down on my bed, place my hands on my abdomen, then inhale for 4 counts, hold for 7, and exhale for 8. This hack can essentially trick the nervous system into believing you’re not stressed, even if you are. If all else fails, I’ll listen to a guided meditation or a yoga nidra track on an actual CD player. I don’t recommend meditation apps for sleep (see the above rant about getting the phone out of the bedroom!).
I hope these tips help you get out of your own way and start sleeping deeply every night. Sweet dreams!
Dr. Ellen Vora is a holistic psychiatrist practicing in NYC. She graduated from Columbia University Medical School, received her B.A. in English from Yale University, is boarded in psychiatry and integrative and holistic medicine, and she's also a licensed medical acupuncturist and certified yoga teacher. Vora takes a functional medicine approach to mental health–considering the whole person and addressing the problem at the root, rather than reflexively prescribing medication to suppress symptoms. She specializes in depression, anxiety, insomnia, adult ADHD, bipolar and digestive issues. In addition to seeing patients, Vora also writes, blogs, contributes to two healthcare startups, and does corporate wellness presentations.