Today’s Solutions: May 22, 2022

“Sometimes finding just one place to start, one thread to pull on, can shift the momentum in the other direction—sleep improvement leads to more sleep improvement.” -Diane Macedo

In today’s Optimist View, we’re delighted to share an excerpt from ‘The Sleep Fix,’ the newest book from ABC News anchor/correspondent, Diane Macedo.

As an early-morning reporter and overnight news anchor, Macedo learned the hard way how valuable sleep is. After struggling for years with sleep issues and eventually developing a tolerance to sleeping pills, Macedo decided to attack the problem as a journalist, interviewing sleep experts from all over the world to get to the bottom of what really keeps us from sleeping—and the various ways to fix those problems.

Up to sixty percent of the population is estimated to be living with insomnia, while many more unknowingly suffer from other sleep disorders. The Sleep Fix aims to flip the switch on common sleep advice and offering comprehensive, realistic solutions based not just on science and experts, but also Macedo’s own years-long struggle.

We also sat down with her this past week for a discussion about her book and her insights on adjusting and fitting solutions to a better sleep in our everyday lives on The Optimist Daily Update. You can listen to the interview on Apple Podcasts, Audible, Spotify, or any podcast catcher!

To read a chapter of Macedo’s excellent exploration of sleep – and how to get enough of it, please read on…

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From The Sleep Fix: Practical, Proven, and Surprising Solutions for Insomnia, Snoring, Shift Work, and More 
by Diane Macedo

Chapter 3: Quelling the Overactive Mind 

TRYING TO SLEEP WHEN WE have insomnia is like trying to sleep while someone is constantly pestering you with questions like “Are you asleep yet?” The obvious answer is “No, because you won’t SHUT UP!” And the obvious solution is to get that person to go away. The problem is we are both the person trying to sleep and the annoying person asking all the questions. So the first thing we need to do is turn the volume down on that voice by dialing back our arousal.

In other words, we need to learn to relax. But if you’ve ever had someone tell you to “just relax” or “calm down,” you know that’s easier said than done.

The extra-tricky part is when we have insomnia, it can feel like arousal shows up out of nowhere—and at the worst times. 

My routine, for example, would often play out like this:

  1. Start dozing off on the couch.
  2. Head to bed (just a few feet away).
  3. Suddenly feel wide awake.
  4. Lie in bed worrying about not sleeping and thinking about everything from my to-do list, to a conversation I had, to what I should be for Halloween . . . in five months.

Sound familiar?

I always thought the act of walking from the living room to my bedroom was giving me a second wind. In reality, it wasn’t the walk to the bed that was revving me up. It was something called conditioned arousal.

Conditioned Arousal

Conditioned arousal develops because our brain likes to anticipate and prepare. Eat something that makes you sick, and next time you’re near it, you might feel nauseated at just the smell of that food. This happens because your brain makes the connection between that food and your sickness, and triggers that response to prevent you from eating it again. On the flip side, walk into your favorite restaurant and your mouth may start to water before you’ve even looked at the menu. Your brain has made a connection between that restaurant and food and is getting you ready to eat as soon as you walk in the door. This is called classical conditioning, or as I like to call it, mental autopilot.

Unfortunately, our mental autopilot can also kick in if we repeatedly get into bed, then do something mentally stimulating, like check emails, peruse social media, have emotional conversations, or think about something stressful. After a while, our brain starts to associate our bed with this mental arousal, and the act of getting into bed becomes a cue to automatically enter that mentally active state. Once we put down the phone or the crisis passes, and there’s nothing else for our active mind to work on, it’ll create its own work: by rehashing the past or worrying about the future.

From that point, it becomes a growing and vicious cycle. Think- ing and worrying make it hard to fall asleep, which makes us worry about the fact that we’re not sleeping. Then THOSE worries keep us awake. Eventually you might not even have to be in bed—just knowing it’s bedtime can start to trigger those worries.

Imagine being exhausted all day yet being filled with dread the moment you realize you can finally go to bed! This was me. Of course it wasn’t sleep I was dreading, but the act of lying in bed awake, frustrated, and endlessly cycling through negative thoughts.

So I handled this in the most mature and sensible way possible: avoidance. As soon as bedtime hit, I’d convince myself that I had to watch that TV show or organize my kitchen cabinets or shop for something online or research an idea—anything to avoid going to bed. It’s worth noting that I didn’t realize this was an avoidance tactic at the time. I genuinely felt I had to do these things urgently. Also, at least some of these activities could make for a good way to unwind before bed, but I wasn’t doing them in a relaxing way. I was clinging somewhat obsessively to them, trying to keep my mind as active and occupied as possible so I wouldn’t have to think about my bedtime anxiety. When I would finally give in and go to bed, I was exhausted, but my mind was racing. The later it was, the more anxiety I would have about how I wasn’t going to get enough sleep.

Another reason for our barrage of often-repetitive bedtime thoughts has to do with memory. If I dictated an important phone number to you and you couldn’t write it down, how would you remember it? You would probably repeat it to yourself over and over again. This is how our brain remembers things when it’s given no better alternative. By repeatedly running over our to-do list and other thoughts, our mind is simply trying to ensure we don’t forget these things. Unfortunately those reminders often keep us from sleeping, and what’s one of the side effects of poor sleep? Forgetfulness. Thanks, mind!

No Mental Break

There’s all sorts of complicated research that explains the benefits of mental downtime, but you don’t need to be a scientist to understand why lack of downtime was hurting my sleep: my mind was cycling through thoughts in bed because I gave it no other option.

At the height of my insomnia, I was working ten p.m. to roughly nine a.m. for World News Now, America This Morning, and Good Morning America. I was so busy during those hours, on most days I wouldn’t even stop to use the bathroom. In addition to that, I would often do shoots during the day for one of the above shows or Nightline. If I wasn’t in bed or working, I’d be doing research, cooking, fixing something around the house, and/or devising my latest life hack (I’m obsessed). Even when I found time to get my nails done, I would listen to podcasts at the same time in hopes of getting a story idea. There wasn’t a minute in which I wasn’t actively thinking about or consuming information. No wonder my mind would start rehashing and analyzing when I finally tried to sleep—it was the only opportunity available.

Jason Karp had a similar experience. After his eight-week stint of forced sleep deprivation, it took him about six months to be able to sleep well again. He says part of the problem was his obsession with being productive. He would take notes while reading the newspaper, he barely made time for friends, and the only movies he’d watch were documentaries he wanted to learn from. “Everything was about self-advancement and self-improvement,” he says.

In other words, Jason was driving himself to be mentally aroused all the time. And remember how he had super-high cortisol levels? Guess what fuels arousal? Cortisol, which is kind of like the slow- release form of adrenaline.

Jason eventually started seeing a therapist who described him as an “engine that’s redlining constantly.” And just like you can’t throw a redlining engine into park, you can’t expect a mind that’s so aroused to suddenly fall asleep. First, you have to learn to slow down.

The Threat of Wakefulness

Unfortunately for insomniacs, our conditioned arousal often goes beyond just cycling through to-do list items or processing our day. Instead, our fear of being awake kicks our arousal into overdrive. We spin scary narratives as we lie in bed about how terrible our day will be without sleep, how we won’t be able to function, how we might get sick. Sometimes I even worried I would die from sleep deprivation.

This might sound extreme, but we’re actually more prone to catastrophic thinking after bedtime.

 As Dr. Jason Ellis explains in his book, The One-Week Insomnia Cure, some parts of the brain that downregulate while we sleep will still downregulate at their usual times even if we’re awake— including “the part of the brain that covers rationality, reasoning and logic.” So we may be awake overnight, but our reason and logic are basically still asleep. Notice a new freckle during the day, and you might make a note to see the dermatologist. Start thinking about that freckle overnight and you could find yourself planning your own funeral . . . even though there’s no evidence it’s anything more than a freckle.

Now consider that insomniacs have a general tendency to be awake after bedtime and to obsess over the consequences of not sleeping, and you can start to see how this plays out. As we repeatedly lie in bed catastrophizing about how doomed we are, we send our brains a clear message: being awake after bedtime is a serious threat. After a while, as bedtime approaches, our brain prepares us to face this threat, the same way it helps us face any threat—by triggering hyperarousal, aka our fight-or-flight response. Our heart rate and breath might speed up, our muscles get more tense, our pupils dilate to take in more light. This is all helpful when we need to be alert in the face of danger, but it’s very unhelpful if we’re trying to sleep.

To make matters worse, typical sleep advice often reinforces this. I can’t tell you how many times I’ve heard that if I have trouble sleeping, I should read a boring book. Some even advise reading an instruction manual. Since boredom generally facilitates sleep, the logic is that you can basically bore yourself to sleep. But this approach ignores an alternative reaction to boredom: frustration.

ABC News correspondent Trevor Ault says he tried this strategy by listening to deliberately boring podcasts aimed at lulling the listener to sleep. “That was a horrific failure,” Trevor says. “I just kept thinking about why it was a terrible story. Because we’re professional storytellers, so I’m like, oh, man, you got to cut this out and trim the fat here.” Instead of feeling sleepy, Trevor said he ended up feeling frustrated over the crappy story and even more awake, thinking of all the ways he could fix it.

My friend Brad had a similar experience when he tried his doc- tor’s suggestion to fold laundry when he couldn’t sleep. Since Brad hates folding laundry, it just made him feel pissed off. “For me folding laundry isn’t calming . . . it would fully wake me up. Because I’d be like, okay, this is something that I have to do.”

Dr. Jason Ong, a clinician and researcher with Northwestern University’s Center for Circadian & Sleep Medicine, recalls a patient who said he read a phone book anytime he woke up overnight. Unlike Trevor and Brad, this patient felt the boring task did help him to fall back asleep, but when Ong asked if he found the activity soothing and relaxing, the guy replied, “No, I hate myself for having to read the phone book to fall asleep.”

So even if it works in the moment, if the boredom strategy leaves you frustrated, it can still backfire. Because now you have yet another source of sleep anxiety: “I have to sleep, otherwise I’ll have to read the effing phone book!”

The more reasons we give ourselves to fear wakefulness, the more we see it as a threat, and the more likely we are to go into a state of hyperarousal as we prepare for sleep.

The Sleep Through the Night Myth

While we’ve been led to believe that a good night’s sleep means sleeping straight through from bedtime to wake-up time, that’s actually not how human sleep works. Instead, we sleep in cycles, going through sleep stages that get increasingly deeper, followed by REM sleep, in which we do most of our dreaming. After 70 to 100 minutes (not exactly 90, as many articles and books claim), one cycle ends and a new one begins. But here’s the interesting part: in between the cycles we usually wake up. And I don’t just mean we insomniacs, I mean everybody.

Most people just fall right back asleep so quickly they don’t even remember these awakenings—hence the feeling that they “slept through the night.” Insomniacs, on the other hand . . . we basically freak out.

As sleep physician Dr. Daniel Erichsen explains, “When somebody with insomnia wakes up for whatever reason, they become aware of being awake, they react to being awake, they go, ‘Dang it, I’m awake!’ Then the thoughts go into ‘Why am I awake? What happened? How can I change this? I need to sleep!’ And then you become fully awakened.”

It’s not the fact that we wake up throughout the night that’s the problem. It’s the fact that our worries create arousal, which in turn keeps us awake. So the next time you hear the term sleep through the night, including in this book, please know it’s a loose expression. And the next time it’s two a.m. and you’re wondering why you’re awake, it might be helpful to remember the answer is probably because that’s completely normal.

The Myth of the “Quiet Mind”

When I was dealing with conditioned arousal, I had no idea what it was, so I described it like so many insomniacs do: “I can’t sleep because I can’t shut off my brain.” This is an accurate description of what conditioned arousal feels like. But it highlights a major misconception we insomniacs seem to share: that the rest of the world somehow turns off their thoughts in order to fall asleep.

For me, it didn’t help that mindful meditation had just become the new it trend. I was constantly seeing articles and TV segments touting how meditation “quiets the mind.” That’s exactly what I needed! So I downloaded a meditation app and, as always, kept my expectations super realistic: after one session I would be like Neo from The Matrix, stopping my thoughts like slow-motion bullets. 

The reality went more like this:

Meditation app narrator: Focus on the breath. Feel your stomach expand and relax . . .

Me: Got it. The breath, focusing on the breath. Breathe in, breathe out. Man, I am nailing this!

App dude: Now bring your attention down to your feet. Observe any sensations in your toes . . .

Me: Focusing on my feet. Do I feel any sensations in my toes? I don’t think so. But that reminds me, I forgot to get those gel insoles I wanted for my sneakers again. Damn it, I suck! Maybe they sell them at the pharmacy and I can just grab them on my way to work.

App dude: Slowly move your attention to your ankles . . .

Me: Idiot! Stop thinking about insoles! Ankles . . . focus on the ankles. Breathe in, breathe out. Ankles feel fine. Breathe in, breathe out. My shins are tight, though. Breathe in, breathe out. They always feel a bit achy. Wonder if the insoles would help with that? Maybe I should just order them online so I don’t forget. I wonder if they have them on Amazon Prime?

App dude: Observe any sensations throughout the leg . . .

Me: Amazon Prime? Seriously, Diane?! You’re supposed to be meditating and you’re thinking about Amazon PRIME?!!! Get it together!

I’m not sure I even made it to the torso before I finally gave up. I was hoping to find this peaceful place of quiet, sleep-filled Zen. Instead, I was even more awake than usual and super mad at myself. Not only was I a crappy sleeper, with crappy uncushioned sneakers—now I was also a crappy meditator.

But the real reason I failed was because I was trying to achieve the impossible. As my colleague Dan Harris, author of 10% Happier and Meditation for Fidgety Skeptics, explains, “This is the most pernicious misconception around meditation . . . drop the idea of clearing your mind. That is impossible unless you’re enlightened or you have died.” (More on meditation in chapter 20.)

And just as meditators don’t clear their minds, neither do good sleepers. As clinical psychologist Dr. Nick Wignall explains, “Your brain is always incredibly active, even when you’re sleeping.” Wignall says when we do fall sleep, it’s not because our thoughts go quiet. It’s because “your sleep drive outcompetes your level of arousal.”

But when we buy into the myth of the quiet mind, we create our own problem. Our worries about thinking and our efforts to stop thinking just increase our mental arousal and make it harder for our sleep drive to compete.

THE “ARE YOU SERIOUS?” FIX:

CONSTRUCTIVE WORRY

My first sleep breakthrough came when I realized I didn’t need to distract myself or silence my thoughts and feelings. Instead I needed to embrace and process them in a productive (and idiot- proof) way. Enter constructive worry. It’s just a simple practice of writing all your worries on one side of a page and the next steps to solving them on the other, and I have to admit, when I first read about it, I couldn’t help but roll my eyes. Ambien didn’t put me to sleep anymore, but a dressed-up to-do list was going to help?      

Now when people ask how I beat insomnia, constructive worry is the first thing I mention. I love this technique for so many reasons: It’s cheap (just need a notebook and a writing utensil), it takes only a few minutes, it’s super straightforward, so you don’t have to worry about “doing it wrong,” and most importantly, it works! 

Here’s why:

  • By thinking through your worries before bed, you decrease the need to think about them in bed.
  • By doing this regularly, you create a new association: your brain starts to realize this is the time for worry, not when you’re in bed.
  • The nature of the exercise helps to shift your focus to solutions, rather than ruminating on problems. This can help with sleep and also ease general feelings of anxiety or depression and make you feel less stuck.
  • By writing your worries down, you remove the need for your brain to remind you to deal with them. You can relax knowing you won’t forget—because they’re right there on the page.

Jason Karp does an abbreviated version of this which he calls his brain dump. “I write every single thing down that’s in my head. Whether it’s ‘Remember to call this guy in the morning, remember to do this, remember to do that,’ or it could be just an idea that’s percolating,” he says. Since Jason’s biggest problem was waking up in the middle of the night, firing on all cylinders, he wanted to ensure any thought that might occur to him at two a.m. was already on the page. He says, “When I started doing that religiously, I started sleeping so much better.”

But, as with any other tool in this book, it’s important to enjoy constructive worry for its own benefits. Doing anything with the intention of making sleep happen usually results in us putting more pressure on ourselves to sleep, which backfires. So avoid getting in the mindset of “Okay, I did constructive worry. Now let’s see if I sleep.” Instead, try to think to yourself, “I did constructive worry. Now I feel less anxious.”

How-to: Constructive Worry

Pick a time when you can do this every day—ideally a few hours before bed.

  1. Get a notebook and draw a line to divide the page into two columns or use two pages side by side.
  2. On the left side, list anything that’s worrying you. On the right side, next to each worry, write the very next step to resolving that problem.
  • If you don’t know the fix, the next step might be to call someone for advice or research how to resolve it.
  • If the problem has no resolution—because it can’t be resolved, is out of your control, or because you’re worried about something hypothetical—the next step might be to accept and move on. Write that too.
  1. When you go to bed, keep the notebook nearby. If your worries return, remind yourself that you’ve figured out how to deal with them, and there’s nothing else you can do for the day.
Adjustments

As with any technique in this book, you do not have to do constructive worry perfectly for it to work. The best sleep solutions are the ones you’ll actually do, so make them work for you!

For example, I did not do this a few hours before bed as is recommended. My work schedule varies dramatically from day to day, so remembering to consistently block off time for constructive worry hours before bed is not happening. Instead, I store the notebook in my nightstand and do my constructive worry sitting on the bed, just before I brush my teeth and otherwise get ready to go to sleep. This technically betrays the cardinal rule: bed is for sleep and sex, nothing else. But I make sure I’m sitting on top of the covers, my back’s against the headboard, etc. This is different enough from when I’m lying in bed, under the covers, head on the pillow, lights out, that my mind is able to differentiate between constructive worry time and sleep time. Jason says he did the same, and it still worked for him too.

After two weeks I no longer needed the daily constructive worry routine. My brain got the message: head on pillow does not mean it’s time to think—it means it’s time to sleep. But that notebook is still in my nightstand, and if I have a lot on my mind before bed or if I wake up stressed in the middle of the night, I still use it. If the hubs is already sleeping, I just slip out to the living room and write my list there. Usually just a few short minutes of jotting things down and I’m able to relax, let those thoughts go, and drift off to sleep.

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to read more of The Sleep Fix, visit the book’s main page HERE.

  • Publisher: Harper Collins (2021)
  • Length: 373 pages
  • ISBN: 978-0-06-304002-1

About the author, Diane Macedo

Diane Macedo

Diane Macedo is currently an anchor and correspondent for ABC News, appearing on Good Morning America, World News Tonight, Nightline, World News Now, and America This Morning, as well as breaking news reports. She’s also an anchor for ABC News Live, where she hosts ABC New Live Update, The Breakdown, and covers breaking news and special events. An alum of Boston College, she lives in New York City with her family. Learn more at thesleepfixbook.com and follow Diane on social media on Instagram (@dianermacedo), Twitter (@dianermacedo) and Facebook (Facebook.com/DianeRMacedo).

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