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SLEEP 2018
This grew from being a file to a pamphlet. Here’s a Table of Contents to help you navigate through the topics.

TABLE OF CONTENTS

DISCIPLINE
  • The Importance of Discipline
  • Disciplined Life Style Choices: Basic Sleep Hygiene
  • Discipling the Mind
  • Unruly Mind
  • Lowering Stimulation
  • Attitude Is Everything
  • Wind-Down
  • Routines
  • Imagery
  • More On Occupying the Mind
  • Releasing Muscle Tension
  • Falling Asleep & Coping With Awakenings
  • The Need To Pee 
  • Naps
MANIPULATIONS
  • Light: Friend & Foe
  • Temperature Regulation
  • The Problem
  • Four Temperature Interventions
  • ..Cold Room
  • ..Terraced Blankets
  • ..Fans
  • ..A Cooling Foot
  • Getting Comfortable
  • Knee & Body Pillows
  • Mattresses & Pillows
  • Compression Socks
  • Devices
  • Audio Assists
  • Sleep Apps
  • Snoring & Mild Sleep Apnea Devices
  • Bruxism: Less is More
INGESTABLES & AROMATICS
  • Ingestables
  • Melatonin
  • Sleeping Pills
  • Kavinase
  • Valerian
  • Magnesium
  • Vitamin K2
  • Vitamin B3
  • Low Sodium Intake
  • Benadryl
  • Other Medications
  • Aromatics
CHALLENGES WHEN TRAVELING
  • Ambiance
  • Altitude
NEVER GIVE UP!

AND NOW THE CONTENTS  
  
DISCIPLINE
The Importance of Discipline
I believe that discipline is the key to aging well and being disciplined about sleep supports our personal goals of 'exceptionally successful aging'. If you are sleep challenged like me, being disciplined about your lifestyle choices and managing your mind when in bed can both be extremely effective. Being aggressively resourceful also helps in bagging more zzzz's.

Disciplined Life Style Choices:  Basic Sleep Hygiene
..keep regular sleep hours, allowing 8-9 hours of in-bed time for sleep whether you use it all or not
..limit your in-bed activities to sleep and sex
..exercise during the day, but not close to bedtime
..do gentle stretches in the evening but no big back bends, which may be overly stimulating 
..no caffeine after noon for most people
..no alcohol near bedtime because it may trigger awakening later in the night when the calming effects wear off
..avoid eating near bedtime (no less than 3 hours before bedtime if you have heartburn or GERD)
..avoid excess stimulation or emotional intensity in the evening
..allow 1-2 hours for wind-down
..keep the sleeping area cool and quiet (below 68 F degrees)
..sleep in a dark room or use eye covers
..acquire the skill of sleeping with earplugs (I prefer silicone)
..use white noise to smooth-out the background noise (ocean sounds from my phone)
..clear your mind on to a list while winding down & keep a bedside notepad if you need extra memory dumping

Discipling The Mind
Unruly Mind
For me, a significant impediment to sleeping well is my busy mind. I have a hyper-viligiant mind and nervous system. I would have been a great sentry on a medieval gate. I have an active, observing mind—I can’t not notice things. In the background, my mind is constantly interpreting the stream of incoming sounds, smells, and visual images—day and night. I’m a light sleeper and react to every change in my environment.

Eye covers and silicone ear plugs decrease the input stream into my insatiable surveillance system but there is still the parallel busyness of my internal environment. Quieting the internally generated disruptions requires different skills. To do so, I use a meditation model. I think of my busy mind as an unruly child constantly on the verge of tantrums that must be reined in. When I want to sleep, it wants to run off and play. I must be the adult that constantly insists that we have finished with play and problem solving for the day and we are all going to sleep, now.
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Silicone ear plugs are our favorites—any brand will do.

Lowering the Stimulation 
Diminishing the stimulation before bedtime is wildly effective in calming that rampaging child in my mind. Cutting off reading, TV viewing, and computer work at least an hour before bedtime helps my mind settle down. I avoid doing tasks, like looking at emails, that might be agitating. Problem solving and talking about difficult topics have to wait until morning. If I can, I prefer to have 2 hours of low stimulation to start the glide towards sleep. I focus on feeling deeply contented with my day without revisiting the details, which might be too enticing. I ignore what was left undone.

If at all possible, I putter before bedtime. Relatively mindless chores like kitchen clean-up, hand laundry, trimming nails and hair, lining up my gear for the morning, sewing on a button, and bathing keep my mind and body from becoming agitated or overly engaged. 

If I must do serious chores close to bedtime, I focus on minimizing my emotional reactiveness to the activities: no blame of self or others and no “if only’s”. I switch our music to relaxation pieces and lower the volume. I also start turning the lights down--I think of it as slowly turning a dimmer switch down on the stimulation to my nervous system until the lights literally go off.

Attitude Is Everything
Resist getting caught up in the drama of your non-sleep and sleep disruptions. Do not let the problem hog center stage in your mind or your life. Do not permit yourself to be agitated by your sleep difficulties—that only makes it worse. Dispassionately note “Hmmm, I’m not sleeping but I am relaxing and resting and that’s good.” The next morning, keep your assessment of the previous night’s effort at sleep as “It is what it is.” Don’t focus on it as a problem but note that it is a variable issue in your life.

I intentionally use relatively neutral language when talking about my sleep issues out loud, describing myself as “sleep challenged”, not an insomniac. It doesn’t help to dwell on it, to inflate it. Problem solve but don’t energize the frustration of your sleep difficulties. Avoid making it a part of your identity. It’s just one of many threads in your life that is a part of your day-to-day experience. Learn to set it down, to set it aside.

Wind-Down
Routines
Special jammies, Teddy bears, and lullabies—what happened to those lovely “time to sleep” routines? Less sweet and tender, establishing my own in-bed, sleep-inducing rituals has proved to be extremely helpful. Everyone is different, so you need to develop your own, but here is what works for me when I slip into bed.

I start with the low stimulation wind down described above. Abruptly going to bed after having been out or breaking from an intense project dooms my sleep. For me, it is all about transitions, so I am attentive to my wind-down.

The most restful position for my body is on my back without a pillow. Unfortunately, I have mild apnea and quickly choke when I doze off so I cannot sleep in that beloved position. I do however use that choking sensation to signal me that I’ve arrived at the door of sleep. I lie on my back until I hit that point. If I become impatient and roll into my side sleeping position prematurely, I rarely fall right to sleep. I’m far ahead if I spend a bit more time on my back.

These days, 5 to 15 minutes on my back is usually enough time to coax my brain to the doorway to sleep. When I abruptly wake from a choking spell, I carefully roll on my side to sleep and usually quickly drift off.

Several years ago, a bodyworker advised me to place my open hands on my upper belly, just below my ribs, with my elbows resting on the mattress while on my back. It is an energy practice intended to synchronize some of the internal organs to sooth my hypersensitive gut. The subtleties of the GI effects elude me, but I’ve come to enjoy it as a comforting “it’s time to sleep” message and faithfully use the position every night.

A busy mind is the bane of the sleep challenged and I am very strict with my mind at bedtime. I intentionally select substitute imagery each night to displace whatever is occupying my mind when I slip between the sheets. I’m always trying out new mental exercises that go nowhere, that aren’t too hard, that aren’t too stimulating. The idea is to occupy the mind with some little task so that it lets go of the intensity of the day without introducing new tension. 

Reading at bedtime is too stimulating for my mind, though writing in which I’m doing a memory dump can be fine. Sudoku is a disaster for my sleep because I go around and around with segments of those challenges all night.

Bill finds that focusing on his widely spaced heart beats does the trick for him. Paying attention to one’s breath is magic for many and is highly recommended. I however am highly visual and so images are more effective than feeling sensations to entrain my mind.

Imagery
I apply myself at creating an image of what it’s like to drift off into sleep. Doing so helps me recognize when sleep is on its way so I can enhance it. My favorite image is that my body softens and that I’m slipping into a groove when I fall asleep. If disruptions occur to agitate me, it is as though I become slightly inflated and no longer fit in the groove. That reinforces that my task is to stay calm and tension-free.

Search for an image that resonants for you. Floating in water might work, giving you that sensation of being comfortably warm (or cool) and suspended. Or maybe a Star Wars/Trek theme would help: the shields or doors slam shut, protecting you from disruptions. Or perhaps imagining that you enter a futuristic sleeping pod could aid you in drifting off.

More On Occupying the Mind
Providing a substitute behavior or topic for my busy mind is something I do almost every night to quickly fall asleep and for “re-sleeping,” or falling back to sleep. Counting backwards from 100 usually works unless I’m really wound up but I save it for my easy-to-remember, last resort on especially rough nights. I’ve recently added saying each number twice, sequenced with my breath, to further slow my mind for those ‘resistant’ situations. 

I am careful not to use the same subject to trick my mind every night because the tricks lose their effectiveness. I always have 2-3 current favorite strategies and am always trying out new twists. Some work better some nights than others.

A current favorite ‘toy’ for my mind is recalling 2 conjugations of an Italian verb. I currently have a favorite pair and I have forgotten the right answers for some of the slots on my visual blackboard, which makes it even more engaging. Rather than look up the forgotten words during the day, I keep my mind focused on filling in the missing puzzle pieces at night, pieces I never find.

I begin by recalling one word in the chart and then spelling it out painfully slowly: one letter at most for each inhale/exhale cycle. I see each letter in my mind and linger while I slowly breathe, then I go on to the next letter. My mind wants to jump between the charts for the 2 verbs and I let it, but the spelling out of the word it always timed with my breath. For me, I believe that the scattered, non-linear word selection of my mind is an early sign of approaching sleep: its no longer alert enough to follow a straight line. Of the dozen possible words for the 2 verbs, I believe I often get to about 3 before I fall asleep.

The trick is to find a toy for the mind that fully occupies it, a task that you can drag your busy mind back to when it wanders off to solve the problems of the day. Forcing the pace of spelling-out a word down to the pace of my breath and seeing the word in my mind occupies the major stimulation channels so there is little left for my unruly mind to run away with. If my mind wanders off, I drag it back to my visual conjugation chart, which is all it is allowed to see.

Spelling and working with words is a very effective way for me to distract and manage my busy mind. Even matching each letter of a word to my breath for items on my grocery list will do. Two nights in a row, I fell asleep before I could finish spelling “artichoke”. Bringing up images of wildflowers in our photo album and playing the spelling game there works too. Sometimes I’ve painstakingly revisited a hike, “seeing” the scenery with almost each changing step. Focusing on the breath or heart beat alone will induce sleep for many, but insisting on a visual image and coordinating it with my breathing is much more powerful for me.

I constantly experiment with new tasks for my mind. Some work better some nights than others and some work better for initially falling asleep or going back to sleep. I do best with tasks that require concentration but are circular: I only get to work with 2 verbs or only wildflowers, which boxes in my brain. I seek tasks where there is no pay-off for rushing through or getting to the end. I am a great list maker, but that is too stimulating for me, as is thinking about the chores for the next day. 

Another technic is called dream remembering. When you awaken too early, try hard to catch fleeting bits of your current dream. It gets easier with practice and you only need a few threads. Instead of letting your mind wander off, force it to work with the remnants of this most recent dream. Coax it back into the old story line to let it help you return to sleep where you last encountered it. Like all of the technics, it works better some nights than others.

Some nights my mind absolutely balks at these games: its way too busy dashing around doing important things to be distracted by a stupid few words or sappy flower images. If I scan my body on those nights, I usually discover excess tension throughout my body. The tension could be from a big athletic exertion that day or residual gripping triggered by bad news or a difficult problem from the evening.

Releasing Muscle Tension
The best way to deal with sleep disrupting muscle tension is to address it before you get in bed, perhaps with a hot shower or some light stretching, but that doesn’t always happen. 

What works best for releasing my tension once in bed is a systematic contraction and release of my major muscle groups. It takes a minimum amount of effort and movement and is something I can coax myself into doing if my body is too uncomfortable for sleep.

On my back in bed, I strongly contract all of my major leg muscles and hold that contraction for about 10 seconds. Usually there is one or more muscles that don’t engage and I just note that. After 10 seconds, I release the tension. Usually several muscles threaten to cramp and I play that edge to keep them from cramping by releasing early. Quickly backing off the intensity of the contraction will often interrupt the cramp and then I proceed but more lightly engaging that muscle.  

I continue with a half dozen more cycles of contract-release, gradually coordinating it with my breath, recruiting more and more muscles with each round. I do it both with my feet flexed and pointed and engage my buttock muscles as well. I’ll sometimes move on and repeat the exercise with my upper body but most of the time working my low body is enough to ready it for sleep.  Should some muscles be real troublemakers, I get out of bed in the dark and do more intense stretches for my calves, quads, or hamstrings as needed.

Falling Asleep & Coping With Awakenings
I suffer from sleep fragmentation, which means I am at risk for abruptly awakening multiple times an hour throughout  the night. I awaken like a fire alarm had gone off. My impeccable sleep hygiene helps but when the abrupt wake-ups occur, I am still stuck with getting back to sleep over and over through the night, the thought of which in itself, can be distressing.

The universal recommendation is that, if you aren’t sleeping, to get out of bed and doing something, like read. I NEVER do that. I think it is terrible advise. If I have an extreme hot flash or a horrific dream or leg cramps, I’ll get up and pee whether I need to or not, then shuffle around in the dark until the issue fades, which may take 10 minutes.

I insist on staying in the dark the entire time and promptly returning to bed for a number of reasons:
..most troubled sleepers, like Bill and I, sleep a lot more than we think we do and if we don’t stay in bed, that can’t happen 
..the rest from other than deep sleep keeps me from increasing my sleep deficit
..the stimulating effect of light sabotages my capacity to return to sleep
..getting up to read or do some other activity risks becoming a reward for not sleeping

For me, a critical part of managing my sleep challenges is not being upset by the awakenings during the night. I work extremely hard at not getting caught up in the drama: “I need to sleep tonight because of what I have to do tomorrow.” "I can’t keep doing this night after night”. “Not sleeping is bad for my health”. Instead of taking the bait on these unruly mind antics, I stay relaxed and I discipline my mind not to go off and ‘make good use of the time’. I absolutely believe that I get more sleep than I perceive and I’ve convinced myself that staying in bed to rest and relax is in itself a worthy activity.

The Need to Pee
Bill’s sleep patterns immediately improved when he stopped deliberating whether to get up to pee or not and instead, he just got up and peed. It was the “should I/shouldn’t I” debate, interpreting the sensations, and factoring in when the alarm clock would be going off, that disrupted his sleep more than getting up. Now, if the question arises in the night, he immediately gets up and pees with the least amount of light as possible and quickly goes back to sleep.

I emphasize being well hydrated early in the day so I’m not catching up on my fluid intake in the evening. Doing so increases the odds that I will sleep through the night without any urgency.

If your need to pee at night fluctuates a lot, you might read about foods that are bladder irritants. They can increase your urgency even though you don’t have much volume to release.

Naps
I tend to avoid naps, being concerned that the midday rest will decrease my odds of sleeping that night. However, we have a friend who regularly includes them in her week. Her rules are to limit her naps to 20 minutes and to use them no later than early afternoon. Taking her lead, we’ve both successfully used her strategy to improve our driving endurance on drowsy days with cat naps.

MANIPULATIONS
Light: Friend & Foe
Since childhood, Bill’s internal clock was set a little over 24 hours, which had him perpetually and uncomfortably out of sync with the rest of the world. In our 30’s, light boxes, or seasonal affect disorder lamps, became available. Eating breakfast in front of our special wavelength lamp did the trick for getting him on a 24 hour clock, which made sleeping easier.
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Our new 11” high Verilux LED light box has a delightfully small foot print.

Also affecting our melatonin levels, are blue light emitting devices, like computer screens, TV’s, and LED lights. They degrade sleep if there is too much exposure near bedtime. We have yet to tackle this problem in a meaningful way. I’ve only gotten as far as buying clip-on lenses for my glasses to filter out the offending wavelength. The lenses are heavy enough to make my glasses slide down my nose, so I don’t like wearing them.

Both adding the proper wavelength of light in the morning and reducing blue light exposure in the evening might be worth exploring in your search for your best sleep interventions.

Temperature Regulation
The Problem
It’s a fact: as people age, their body’s temperature regulation system degrades. Intense menopausal hot flashes are the most obvious manifestation. But more minor hot flashes can disturb sleep without being recognized as such.  And of course, aging men experience hot flashes too, especially after prostate cancer interventions, like surgery and anti-testosterone treatment. There are also other age-related changes that affect temperature regulation which contribute to scores of urban elderly dying during extreme heat waves.

Four Temperature Interventions
..Cold Room
There is nothing better for a good night’s sleep for me than an icy cold bedroom. We let our trailer temperature drop into the 40’s on freezing winter nights. Ahhh, that is a prescription for great night’s sleep for me. Given we don’t favor driving in snow, we don’t experience too many of those nights, though we do what we can to have our sleeping space in the low 60’s or below.

If it is really cold in our trailer, I like to drape a finely woven, soft scarf  over the top of my head instead of adding another blanket. And it’s easier to fine-tune its effect when I’m half asleep than a cap. I also find that a cap results in oilier hair in the morning compared with a draped scarf. 

..Terraced Blankets
Our latest refinement for regulating our temperature through the night is using 3 blankets, unless we are in hot weather. We found a $10 summer blanket to be a game changer for us. The summer blanket is placed against the top sheet. Ours happens to be for a single bed, so it doesn’t drop down below the top of the mattress, which makes it even a little cooler.

Next, we put on a more substantial, medium weight blanket, and fold it back so it covers the feet but only comes about 2/3’s of the way up towards our shoulders. The 3rd blanket is folded back to cover the lower 1/3 of us or less. With our terraced layers of relatively light blankets, we can each quickly and easily adjust our covers through the night to match our changing needs. In cold weather, we’ll still use 3 blankets, but select 1 or 2 heavier ones for the upper layers.

Though counter intuitive, sometimes in hot weather, we actually prefer to keep the flannel sheets on the bed and use no blanket at all, or perhaps have the summer blanket ready at the foot of the bed to pull up half way through the night.

Duvets that are so popular in Europe are lovely but they are a disaster for my sleep. They are too insulating. I love the cozy feel for an hour or two, and then I totally overheat. At that point, I’ve got to get out of bed to let the mattress and duvet cool, as well as me. 

To cope with duvets, we either gut the duvet from its sheet bag before retiring or redistribute it within the bag. I stand on the side of the bed, grip the sheet portion by the edge, lift it, and shake it until the full length of the duvet filler occupies no more than half the width of the bag. Once back on the mattress, I have a tube of duvet stuffing flanked by doubled sheet. I start out under the sheet portion and if I get too cool, I burrow under the duvet tube. 

..Fans
I know that most people dread having a fan blowing on their face at night but when nuclear-grade hot flashes became a part of my reality, having a fan blowing directly on my head became the only way I could get any sleep if the room temperature crept over the mid-60’s, or if the room was stuffy. Consider it an acquired taste and give it a try; fiddling with the angle of the airflow helps immensely.
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My almost 5” & 6” fans, both with USB plugs.

I carry a small fan, the diameter of a small saucer, on my bike when we travel overseas. It has a USB connecter and the adapter we use to plug into the socket adjusts for the local voltage. In other words, I can buy any cheap, little fan in the US and plug it in anywhere in the world. I use my large, first-purchase of a bedside fan in our trailer and apartment. It’s impossible to test fans for their noise level before you buy and I am noise-sensitive. My fans are a good source of white noise but silicone ear plugs are a must for me when my fan is on. Sleeping with earplugs takes time to adapt to but they help with other distractions as well. 

When we bought our trailer, we choose the less upscale layout of a studio apartment instead of the more refined 1 bedroom look, to support our sleep. “Big air” is the watchword—having a bigger volume of air keeps it from feeling stuffy, which aids my sleep.

..A Cooling Foot
Another way I module my temperature while under the covers is by sticking a foot out into the air. As long as I’m not chilled, having one foot (or both) colder than the rest of me doesn’t make me uncomfortable and it gives me yet another way to regulate my temperature.

Getting Comfortable
Knee & Body Pillows
Try a knee pillow if you have sacro-illiac (upper buttock) pain when side sleeping. Keeping the upper knee roughly at the same level as the upper hip when side sleeping can reduce strain on the joint, the associated pain, and the subsequent restlessness. Full body pillows aren’t an option in our nearly-fulltime travel lifestyle but I know of people that find them indispensable for relieving SI and other discomfort when sleeping. 

My compromise is to use a foam knee pillow when at home and in our trailer and I carry an inflatable pillow when cyclotouring to ensure I have a knee pillow every night.

Mattresses & Pillows
I assume everyone has experienced sleep disruption from uncomfortable mattresses and pillows. And the obvious solution is to replace them until you get it right. But another viewpoint is to consider if you are part of the problem.

We had a high quality but old mattress that was beyond its ‘use by date’ and Bill was sure it was the cause of his back problems. With time, he discovered his discomfort when on the bed correlated with the health of his back. If he tended to his back care, then he had no complaints about the mattress. Of course, it doesn’t mean that we shouldn’t have replaced the mattress sooner but as travelers with little control over the quality of our beds from night to night, it behoves him to keep his back tip-top for his best chance at a good night’s sleep anywhere.

Compression Socks
I have both medical grade, toeless compression socks and athletic grade calf sleeves. Both can help settle down my feet and calves when they are swollen from the heat or air travel or from athletic activities. I find that they can reduce calf discomfort just enough to make the difference in getting a good night’s sleep or not.

Devices
Audio Assists
I’m a huge believer in audio support for sleeping, but its got to be just right. Some pieces that help send me off to sleep will awaken me in the night if I’ve left the player on “Repeat” mode.

Years ago we used a guided imagery audio recording by Belleruth Naparstek that seemed to literally rewire our brains for sleep. Her jarring accent and peculiar imagery were off-putting at first, but it worked. Listening to her night after night seemed to teach our brains how to find sleep. I suspect it was a clever mix of the timing of tones and imagery that did the trick. We no longer use it, but I’m convinced it has had a lasting effect in reprogramming our sleep process.

Now we use white noise at the bedside, like ocean sounds pieces, that are designed to aid sleep. Pieces like that can be on repeat mode to lull me back to sleep when I awaken in the wee ours. They help diminish the jarring effect of environmental noises as well as reinforce the message “It’s time to sleep”. 

I always set an alarm, even if I am allowing myself to sleep in. Knowing that the time is being monitored elsewhere allows my internal manager to go off duty. Even if I’ve been up late or had a bad night, I don’t usually sleep much past my typical wake-up time but turning over the clock-watching responsibility to the alarm improves my odds of getting extra sleep.

Sleep Apps
We recently began wearing our Apple watches to bed and using the Auto Sleep app to track our sleep. It provides another opinion on the total amount of sleep we are getting and reports on the amount of deep sleep as well. 

Only a sleep lab can truly measure deep sleep and unfortunately, the app's algorithm using heart rate and restlessness doesn’t seem to be a good indicator of deep sleep for either of us.  Whether I register almost 4 hours of deep sleep or zero, my impression of my night’s sleep and how I feel during the day can be the same. 

Even when Bill is very frustrated with the previous night’s sleep disruption, he often retorts that “I wasn’t awake THAT much.” On net, we find the app interesting and it did motivate us to budget 8.5 hours for sleep instead of 8, but it also leaves us with more questions than answers. 

Snoring & Mild Sleep Apnea Device
Snoring and mild sleep apnea have been the bane of my adult life. You can’t live well if you can’t sleep and you can’t sleep if you are constantly waking yourself because you can’t breath. In addition to the tremendous sleep loss, professionals pile on dire warning of heart damage and shortened life span to add a bit more angst to the mix. 

I’ve had 2 sleep studies, have been sleeping only on my sides for 30 years (and still snore and choke), and tried prescription and non-prescription nostril tape devices with no improvement. But in December of 2017, I punted for the $100 Good Morning Snore Solution “tongue retention device” (TRD) after reading an online blog of a fellow sufferer. He was right, it works, at least for the 2 of us.

My usual sleep routine is to start on my back to invite muscle relaxation throughout my body. As I settle and drift towards sleep, I’m delighted if I start gasping for air. That gasping means I am falling asleep and don’t know it. I let that happen 2-3 times to allow that drift become well anchored, then I ever so carefully move onto a side to sleep. On my first use of the TRD, I slipped it into place when I sensed I would soon be drifting off and the snorting and gasping for air never occurred, I simply fell asleep.
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Two different styles of tongue retention devices.

I slept with the device in place for about 4 hours and removed it when the disruption it was causing to my sleep was greater than its benefit. The discomfort was too much for my now more shallow sleep cycles but I was thrilled. Clearly my best treatment for my snoring and mild sleep apnea was the simplest, which was forcing a repositioning of my tongue. I didn’t need surgery, CPAP, jaw manipulation, or nasal devices. A simple suction-based repositioning of my tongue was highly effective. 

After several months of use, I still am not able to use the device the entire night because of the discomfort to my gums and tongue. I’ve done the forbidden and trimmed the Good Morning product so it is less irritating to my gums. I finally took 3 nights off to let my chronically sore tongue recover, which definitely helped. I now only expect to use the device for about half of the night and alternate between 2 products to vary the nature of the discomfort.

Interestingly, I believe that using the devices has either stretched the ligament under my tongue or re-patterned my tongue positioning. Often during awakenings after I’ve removed the device, I’ll notice that my tongue is still drawn forward between my teeth and feel like I now rarely get into the gagging spells. I also believe that my sleep quality is vastly improved since I began using the devices.

I will continue using the TRD and keep looking for yet a new model hoping it will be an ‘all-nighter’ for me.

Bruxism: Less Is More
Grinding and/or clenching your teeth is painful day and night and the pain can easily interfere with one’s sleep, as I well know. My dentist emphasized that it can result in “excruciating, irreversible pain.” His treatment plan was to cinch everything in my mouth down tight with his repairs and give me a bite guard to wear at night. That prevented chipping my teeth but it didn’t give me relief from the sleep-disrupting pain. Equilibrating my teeth so my jaw movements were smooth was good, but again, fell short of solving my problem.

A massage and cranial-sacral therapy friend had an opposing strategy: get rid of the splint and instead loosen the cranial bones so they could freely make the little moves they are supposed to make. He supported that with intra-oral massage behind the last teeth to relax overly tight muscles. The former was painless, the later was nasty, but his ditch-the-device strategy worked. My bruxism mostly abated and my pain disappeared. 

Another massage therapist used a slightly different model for the inside-the-mouth work, but it too was effective. From them, I learned how to do it myself. After several years, I was able to discontinue my daily interventions and go with a couple of ‘tune-ups’ per year from them. For me, it was absolutely a solvable problem and one I consider in my past.

INGESTABLES & AROMATICS
Ingestables
Melatonin
I believe that melatonin aids my sleep only when dealing with jet lag but another woman I know says it affects her like a sleeping pill. It’s generally not consider effective as a sleep aid unless your circadian rhythm is disrupted by jet lag or shift work. And it’s not recommended for long term use. Melatonin is sold as a nutritional supplement but it is a hormone and sustained use can cause other problems, including insomnia.

Sleeping Pills
We only use a few sleeping pills between us a year, and only for jet lag recovery. The best sleep is the sleep you give yourself and we work hard at doing that as well as we can. Sleeping pills of course can be addictive and can disturb your sleep architecture. In addition, they can be detrimental to your health.

Kavinase
Kavinase is one of several brand names for a nervous system depressant called phenibut that is not approved for use in the US. It’s sold online as a nutritional supplement and is often abused as a recreational drug. People can develop a tolerance to it, which can lead to taking larger and larger amounts. And we’ve read that withdrawals from it can be nasty.

We bought it from an acupuncturist who learned of it from a naturopath. We both found it useful for jet lag. We often used a prescription sleeping pill for 3 nights and then switched to Kavinase for 3 more nights and then went it alone. We’ve gradually stopped using Kavinase since our sleeping skills have continued to improve.
 
Valerian
Valerian is an herb often recommended as a sleep aid but I didn’t find that it helped me when I tried it some years ago. 

Magnesium
Magnesium supplements do aid my sleep a bit and they can reduce leg cramping as well. Magnesium oxide is the cheap, readily available form but it can loosen stools because it isn’t readily absorbed, so the magnesium doesn’t do much good in that form. 

I’ve used magnesium chloride for years, though there are other well-absorbed compounds available. I use about 150-300 mg of elemental magnesium, not the compound, but just the magnesium, at bedtime. I’m currently experimenting with the boutique product, magnesium threonate, that is supposed to be even more bioavailable than magnesium chloride.

Vitamin K2
I’ve read that taking vitamin K2 at bedtime can aid sleep, but that hasn’t been true for me. I was already taking it for bone health and switched from ingesting it in the morning to the evening with no effect.

Vitamin B3
Vitamin B3 in the form of niacinamide or nicotinamide, not niacin, can diminish anxiety and rumination. We use it and love it for the subtle calming effect during the day that must result in us being a little less ruffled at bedtime as well. There is no drowsiness with it. Check out the link to find a more detailed description of it: INSERT LINK  http://detail.travelfit.us/page19/.

Low Sodium Intake
Being too low in my sodium intake can trash my sleep. Optimal sodium intake is hotly contested with the loudest voices admonishing us all to keep our intake as low as possible. Our physician doesn’t agree with that strategy and neither do we. If my intake is low, I get dizzy, depressed, have headaches, and get caffeine-like jitters in the night—none of which is good for my sleep.

Benadryl
The drowsiness caused by Benadryl leads some people to use it as a sleep aid, though it is not recommended for sleep. Many people develop a tolerance to it rather quickly and it doesn’t deliver the best quality of sleep. There is a special caution in the elderly as well and we know of one older woman who landed in the hospital because of taking too much Benadryl as a sleep aid.

Other Medications
Check every medication you use for side effects that might be interfering with your sleep, both prescription and over the counter.

Aromatics
I haven’t found lavender or other herbal essences in the bedside air to be of any help for my sleep challenges.

CHALLENGES WHEN TRAVELING
Ambiance
When we travel, which is most of the time, we always are thinking about how best to get a good night’s sleep in our new circumstances. In RV parks and campgrounds, we request slots away from the road, the office, and the toilets to decrease the incidence of jarring noises. We prefer RV parks to campgrounds because people often run generators if there is no electricity and many do not obey the authorized operation hours. We do our part to keep the noise down by having extra solar panels and no generator. 

In hotels, we ask for quiet rooms and we agitate for rooms away from the road and the elevator. Top floor rooms with an attic ceiling can be hot and stuffy; ground floor rooms may get auto exhaust and crawling bugs. I’ll ask for a room fan if there is a hot spell and no air conditioning. We love overseas tourist apartments because they generally are more spacious, have more windows, and have better air flow. We scout online and in person for the best sleeping situation we can get every night.

I carry a small fan with a USB connector, even when cyclotouring abroad. Setting my fan up on a nightstand or hanging it on a headboard can make the difference between sleeping well and not. I also pack an inflatable knee pillow for my vulnerable SI joint. And of course, having ear plugs and eye covers within easy reach may save my night’s sleep.

Altitude
A rapid increase in your elevation can degrade your sleep. If you are acclimated to sea level, whether hiking or sleeping, you’ll likely begin having difficulties at 5,000'. The obvious solution is to only gradually increase the elevation at which you are sleeping but that is rarely an option. Support your body with good sleep hygiene and a perhaps increase your hydration and salt intake a bit and be patient. Your body will need a few days to adjust and there is no way around it. The higher you go and the more rapidly you ascend, the more your sleep will be degrade.

WHAT IS A "GOOD NIGHT’S SLEEP”?
Ultimately, you need to decide what is for you, a good night’s sleep. My idea of a great night’s sleep is to conk out within minutes of my head hitting the pillow, sleep with zero awakenings through the night for 7-8 hours, spontaneously awaken minutes before the alarm; and be clearheaded within 10 minutes of arising. That would be lovely.

However, my definition of a good night’s sleep is to drift off to sleep in 10-15 minutes with little effort; only wake-up 2-3 times during the night and immediately fall back to sleep each time; and readily awaken with the alarm. If that’s not happening, I’m content if I wasn’t uncomfortable and didn’t have to work hard at getting to sleep and getting back to sleep multiple times. 

The real sleep low point for me was in my 30’s when I dreaded going to bed because of the high level of stress from excessive awakenings, discomfort, and angst about sleep deprivation. My #1 goal these days is to not get back to that downward spiral of dreading bedtime because sleeping is so frustrating.

NEVER GIVE UP!
I’ve struggled to get a good night’s sleep since college and it got worse before it got better. My improvements haven’t come so much from professional support but from my own research and experimentation. 

Progress has been painfully slow but real. I keep trying. I keep making small improvements. Getting enough sleep is no longer a crisis but it is still a challenge. I am extremely pleased with the progress I’ve made and keep searching for ways to do even better. I hope that some of my experiences will move you to the next level in your sleep satisfaction.