Apologies for giving you a boring canned answer when you are sleep-deprived and looking for help. But I swear these things really helped me.

Number one: think about getting a sleep study done by an actual sleep doc (pulmonary doc or neurologist). This was life changing for me. Don’t go to a chiropractor or whoever the fuck and get a CPAP machine.

Also, and this is important: Have you looked into tips for “sleep hygiene”? None of them are a quick fix like Xanax, but they can be powerful when used together.

These include things like:

• going to bed and getting up at the same times every day. this means getting up at your normal time, even if it’s a weekend, even if you didn’t sleep well that night, just make yourself do it
• when sleeping…making sure the room is dark, cool, and quiet (ear plugs are a big help here). by cool, I mean 68-69F (about 20C).
• cutting way back on caffeine and/or eliminating it…and absolutely no caffeine after lunch (the older we get, the longer it takes to metabolize caffeine)
• not looking at any glowing screens (TV, phone, computer, tablet, etc) before bed time… for at least 15-30 minutes
• avoid eating / drinking a couple of hours before bed time
• using your bedroom only for sleeping and for sex

And when you have trouble sleeping, it’s a very good idea to get out of bed, go to a different room (one that is not too bright) and do something boring like read a text book for 15-20 minutes then go back to bed and try again.

When we stay in bed and aren’t sleeping, we’re training our brain that it’s OK to do that. You want to beat it into your subconscious brain that the bed / bedroom is for sleeping.

Yeah Xanax is literally the worst thing possible for this, especially as a frequent thing. It’ll significantly worsen your sleep quality in the long run. (Hi I’m a psych nurse and I meet a lot of people stuck in insomnia hell because they’ve been slapping a Xanax bandaid on it for a few years while it just continued to devolve and now they’re basically psychotic because they never actually fixed the root issue.

I’m also hearing a lot from you about medications and next to nothing about any lifestyle changes. No medication will ever actually fix this kind of problem. Medications just give you a leg up on fixing yourself.

First of all what stimulants do you use, especially caffeine and nicotine? (I would also hope you already know to avoid meth and cocaine and not take stimulant ADHD meds at bedtime.) Are you avoiding them in the last 6 hours before bed? A lot of people (especially with ADHD) will say stimulants calm them down but what they’re actually feeling is a change from their baseline restless anxious awake to a focused, productive awake. The second one feels more settled, and can actually help you fall asleep briefly if the specific problem is difficulty holding still long enough to sleep, but it’s going to completely fuck up your circadian rhythm in the long run.

Speaking of circadian rhythms, are you trying to keep your body in a steady daily routine? This includes a consistent bedtime, but your mealtimes and daily physical activity are part of your circadian rhythms too. There’s a lot of different schools of thought on how to time meals and exercise to best support sleep, but the general consensus is just don’t do either right before bed. I would also recommend adding a structured “wind-down” period to your nightly routine that takes 15-30 minutes where you do one of like three basic things:

• something mind-numbingly boring

• something you’ve always found soothing/comforting

• Journaling about the day to give your brain a head start on the memory processing it’s about to do.

It’s also very helpful to create full sensory environments that you use to trigger pavlovian responses. You know how pavlov’s dog drools when the bell rings because it’s used to food showing up when the bell rings? The biggest difference between you and a dog is that you get to decide what you want to be trained to do. The downside to this is that it can take a while to train these responses into your body, so be patient and don’t just give up after like a week. So you’ll want to create at least two full and distinct sensory environments. The specifics don’t matter as much as creating a consistent routine for yourself, but here’s some examples of things I’ve tried or seen people try:

Alert

• Sight: Curtains open / sunlight / full spectrum white light is the input that aligns most closely with most people’s existing natural rhythm.
• Sound: Music, white noise of people talking in the background.
• Smell: Essential oils are actually really good for training pavlovian responses in yourself because of how powerful scent memory is. A lot of people like to incorporate citrus-y smells for alertness, but personally I actually really enjoy just keeping my used coffee grounds from the morning in a cup on my desk. That also brings us to the next one…
• Taste: Coffee has a pretty distinct taste that most people associate with alertness, and you can get a similar taste from chicory root and/or decaf coffee, but one real cup right after waking up shouldn’t mess you up too bad. Chewing gum is also an option, however.
• Touch: The big one for me doing classes from home during COVID was still getting up and putting on “outside clothes” even if I was just sitting at the computer at home.

Rest

• Sight: usually red-yellow spectrum light, and much lower brightness around bedtime. You can turn on a red-shift filter for most electronic devices these days, and LED bulbs also often come in a yellow-orange incandescent style color (and a lot of hobby/makeup lights have multiple color settings for this reason as well, white for when you’re working, orange/yellow for resting/relaxing.
• Sound: some people listen to soothing music, I conditioned myself to fall asleep to the sound of a raging thunderstorm because I sleep during the day and work at night, and the thunderstorm sounds easily block out daytime noises.
• Smell: Lots of options here too for essential oils or other scented products. You could also use a specific lotion or wash your sheets in a specific scented detergent. A lot of people say they find lavender scents to be particularly soothing, but again, the exact sensory trigger isn’t important as much as you picking one to use consistently.
• Taste: Herbal tea is my biggest recommendation here, but you could also go with a small snack/sweet as part of your nightly routine.
• Touch: We already covered wearing different clothes, but some additional options include a weighted blanket or one of those compression sleep pods (I just got one to try out recently and like it so far!)

Anyway like I said, these can take a while to train your body to do, so pick things that will be easy for you to do, set up your space to make it as easy as possible to keep doing them, and keep at it. The most important thing is consistency and routine.

doc doesn’t want to perscribe you xanax because xanax will stop working and this fucks up many other things in the process