I keep waking up at 4am. Here’s what I am doing to sort that out, as a therapist and as someone who always struggles with sleep.

I’m in a bit of a 4AM waking pattern again.

So annoying, but I am on my way out of it, which is nice. Not there yet, but still.

As a therapist, sleep is one of the things I was taught about and have helped people with. As a person, it is also one of the things I relate to the most.

So, I thought I would share what I am doing to sort my sleep out.

Firstly, why is this happening?

I have struggled with my sleep on and off since I was in my early 20s, and I moved into a tiny little flat of my own. There was a skylight in the bedroom for which the blind didn’t work, and in the summer I would be woken by both sunlight and the seagulls that perched on the roof (I was in Scarborough).

Some of it was that, and some of it was that I was in an unfamiliar place, living on my own, learning a new job that I was nervous about and doing a course that was pretty stressful too.

It got to the point, eventually, that I couldn’t really get to sleep either, even when I moved somewhere else without the skylight or seagull issues. Luckily for me, it was around this time that I started learning more about sleep for my job.

Since then, I have learned a few things about myself that are relevant:
• I am a light sleeper. It doesn’t take much noise, light or discomfort to wake me or keep me from sleeping. My wife can sleep anywhere, any time, and I envy that.
• I over-hydrate myself. I always need a wee in the night because I am the world’s most hydrated man.
• When I am stressed or anxious, my sleep is worse. I wake up and have things going through my mind and tension in my body.

What are you supposed to do about all that?

If you are struggling with your sleep, the first thing you will come across when you look for help is “sleep hygiene”, which is a term that is used to describe the basics of giving yourself a chance for a good night of sleep:
• Temperature: not too hot, not too cold
• Light: make it dark, don’t look at screens for at least 20 mins before you go to bed
• Noise: make it quiet, or white noise sounds can help
• Caffeine and water: don’t drink for a couple of hours before bed, and don’t have caffeine in the afternoon

Fair enough, right?

However, sometimes that’s not enough. For me, the thing that really helps is actually something called sleep restriction.

Again, I don’t know why we need a fancy term for it. Basically, it is about making sure that you are only in bed when you are either asleep or relaxed (or being intimate, that’s allowed). Here’s how it works best in my head, and how it relates to why I was having a period of bad sleep recently.

It’s all based upon association: the fact that your brain creates links between things that come together. A smell that reminds you of a specific person. A song that takes you back to a particular time. The same applies to bed: is it associated with feeling relaxed and sleepy? Or tense and awake?

When you are sleeping well and you are generally relaxed, you go to bed relaxed, you sleep soundly, you wake up. So, your body builds this association: Bed = relaxed and sleepy.

When you have a period of time where you are stressed, ill or there is something else disturbing your sleep, you might end up having a few nights where you are lying in bed feeling tense, tossing and turning. The annoying thing is, if the general stress starts to go away, your sleep might not automatically improve. This might be because your body has built this association: Bed = tense and awake.

How do we rectify this association? We purposefully try to only get into bed or stay in bed when we are feeling relaxed or sleepy. We purposefully try to build the association that Bed = relaxed and sleepy, simply by staying away from the bed when we are tense and awake.

That means that if you are tossing and turning and not getting to sleep, you get out of bed rather than staying there. You go and do your wind-down routine for a bit. You read, listen to something, you breathe. Sometimes that means I am lying on the sofa for a couple of hours or even until morning.

That’s OK. That’s one night where I was mostly in bed when I was either relaxed or asleep. I haven’t banked a load of hours in bed being tense.

It also means that for a few nights, you might purposefully stay up later. If you keep going to bed at 10 and waking at 4, try going to bed at 12 instead for a few nights. The idea being that if right now 6 hours is what you are getting, you are better off getting that 6 hours without the tossing and turning afterwards.

Once you have had a few nights of that, you can start making bedtime a little earlier again, bit by bit.

I’ve done this enough times over the years that actually I do have faith that it will work. When you first try it it feels brutal (because there are some nights where you go to sleep later but still wake up at 4), but it is effective, so that helps me hold the belief that it won’t be for many nights, this.

So, this is what I have been doing the last few nights, and what I will be doing going forwards:
• I am being stricter with myself about screens before bed. I like to watch comedy shows before bed, but 20 mins before I intend to go to sleep, no screens at all. I also like to move from big light to small light – a lamp or a candle – because I feel that helps my body get the message that it’s time for bed.
• I write what I am anxious about. I take a little pad and pen and I write some of my stress or worries down, so they are out of my head and slightly less likely to wake me up at 4.
• I read a book or listen to a podcast, but then I switch to a magazine (about Warhammer, if you must know) – something I can flick through but don’t have to get hooked into. It works like a charm. I’m yawning after 2 pages.
• If I wake up, I go for a wee and then try to get back to sleep, but if it’s not working, I get up and go downstairs. I read, I listen, and I try to relax. Sometimes I fall asleep on the sofa.
• After a few nights, the waking stops, or it carries on but I can get back to sleep easily.

That’s the plan. Tried and tested. If you struggle with your sleep, I hope there’s something helpful in there for you.

Thanks for reading. Until next time,

Ted

P.S. Honestly, those seagulls. There was also a day when I went out to my car in the morning and one was sitting on top of my car. I didn’t know what to do because the things are absolutely huge, so I just had to wait until it decided to go.