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Your Sleep Questions, Answered | Donn Posner

Jul 19, 2023 1h 18m 23 insights
<p><em>New episodes come out every Monday, Wednesday, and Friday for free, with 1-week early access for Wondery+ subscribers.</em></p> <p>---</p> <p>In today's episode, Dr. Donn Posner proposes a whole new way of thinking about sleep. First, he normalizes the sleep problems many of us experience. If you're sleeping poorly right now, he says, don't freak out; it's natural and normal. Second, he has a bunch of tips for how to deal with insomnia, some of which you may have never heard before. </p> <p>Dr. Donn Posner is one of the leaders in the field of Cognitive Behavioral Therapy for insomnia. Dr. Posner is the Founder and President of Sleepwell Consultants, and Adjunct Clinical Associate Professor in the Department of Psychiatry & Behavioral Sciences at Stanford University School of Medicine. </p> <p><strong>In this episode we talk about:</strong></p> <p><br /></p> <ul> <li>The difference between chronic and acute insomnia</li> <li>How we can adapt to things that can mess up our sleep, like remote work</li> <li>Sub-chronic sleep conditions </li> <li>What to do if we're experiencing acute insomnia so that it doesn't become chronic insomnia </li> <li>The importance of structure when it comes to good sleep</li> <li>What social jet lag is </li> <li>Dr. Posner's take on napping</li> <li>Why wake time is so important when it comes to good sleep </li> <li>Why we shouldn't try to compensate for a bad night's sleep</li> </ul> <p><br /></p> <p><strong>Full Shownotes:</strong> <a href="https://www.tenpercent.com/tph/podcast-episode/donn-posner-268-rerun" rel="noopener noreferrer" target="_blank">https://www.tenpercent.com/tph/podcast-episode/donn-posner-268-rerun</a></p>
Actionable Insights

1. Prioritize Consistent Wake Time

Establish a consistent wake time, at least five days a week, as it is the single most important input for entraining your internal biological circadian rhythm and maintaining healthy sleep. This also ensures consistent first exposure to daylight.

2. Avoid Compensating for Poor Sleep

Do not compensate for a bad night’s sleep by waking up later, going to bed earlier, or napping during the day. Stick to your regular wake time and sleep duration to allow your internal sleep regulation mechanism to self-correct.

3. Don’t Try to Force Sleep

Recognize that sleep is an automatic, autonomic process, similar to digestion or heart rate, and you cannot consciously force yourself to sleep. Trying too hard to sleep in bed is counterproductive and will make it more difficult.

4. Leave Bed If Awake At Night

If you wake up in the middle of the night and cannot fall back asleep, get out of bed immediately. Go to another room, do something fun or relaxing, and only return to bed when you feel sleepy again to avoid associating your bed with wakefulness and rumination.

5. Normalize Sleep Problems

If experiencing poor sleep, don’t panic or freak out, as it is a natural, normal, and fixable reaction to stress. This mindset helps prevent acute insomnia from becoming chronic.

6. Assess Sleep Need by Daytime Function

Determine your individual sleep need by how you feel and function throughout the day, rather than fixating on a specific number of hours. If you feel fine, are not excessively tired, and can concentrate well, you’re likely getting enough sleep.

7. Avoid Sleep Fixation

Do not become overly fixated or anxious about your sleep, as this can undermine the natural sleep process and perpetuate insomnia.

8. Implement Pre-Bed Wind-Down Routine

Transition to lower light levels and quieter, more relaxing activities at least an hour or two before bedtime, avoiding work or stressful calls right up until sleep. This prepares your body for sleep.

9. Get Morning Light Exposure

Upon waking, expose yourself to as much natural light as possible by opening curtains, sitting by a window, or going outside. This helps entrain your circadian rhythm, especially if you are experiencing sleep problems.

10. Ensure Dark Bedroom Environment

Keep your bedroom as dark as possible, especially before your desired wake time, using sleep masks, room-darkening shades, or shutters. Minimizing light exposure helps prevent early awakenings and maintains circadian patterns.

11. Add Daily Routine Regularity

Enhance circadian entrainment by maintaining regular meal times, consistent exercise schedules (e.g., a walk at the same time daily), and overall daytime activity. Being active during the day promotes better sleep.

12. Align Bedtime with Wake Time

Determine your desired wake time, set an alarm, and then backtrack the necessary sleep hours to establish an appropriate bedtime. Avoid going to bed before you feel sleepy.

13. Practice Power Napping

If napping, aim for a short 20-minute power nap, ideally seven to nine hours after waking, and set an alarm to avoid sleep inertia. This helps compensate for lost sleep minimally without disrupting night sleep.

14. Avoid Alcohol as a Sleep Aid

Do not use alcohol as a sleep aid, as it may induce initial drowsiness but can lead to fragmented sleep and awakenings in the middle of the night as its effects wear off.

15. Manage Device Blue Light

If using devices (phones, tablets) during night awakenings or before bed, activate blue light filters to reduce the impact on your circadian rhythm. For general use, prefer screens at a distance (like TV) over handheld devices close to the eyes.

16. Set Bedtime Alarm

To combat “doom scrolling” or delaying bedtime, set an alarm on your phone for the time you intend to start your wind-down routine and prepare for bed.

17. Seek Professional Help for Chronic Insomnia

If you’ve experienced insomnia for more than three months (chronic insomnia), seek professional help from a behavioral sleep medicine specialist, as targeted non-pharmacological treatment like CBT-I is often necessary to resolve the issue.

18. Prioritize CBT-I for Insomnia

For chronic insomnia, prioritize Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first-line treatment, as it is a non-medication therapy recommended for long-term solutions, unlike medications which are better suited for short-term problems.

19. Utilize Telehealth for CBT-I

Seek treatment for insomnia through telehealth, as Cognitive Behavioral Therapy for Insomnia (CBT-I) can be effectively delivered exclusively online, making professional help more accessible.

20. Insomnia Diagnosis Doesn’t Need Sleep Study

Understand that diagnosing insomnia typically does not require a sleep study, unless other occult sleep disorders are suspected, making online diagnosis and treatment feasible.

21. Use Sleep Meds for Acute Insomnia Only

Use sleep medications, including over-the-counter options, only for short-term or acute insomnia under medical guidance, as they are not designed to fix the underlying perpetuating factors of chronic insomnia and can lead to dependency.

22. Use Marijuana for Short-Term Sleep Aid

If using marijuana as a sleep aid, treat it like any other sleeping pill and use it only for short-term issues, as long-term use can lead to tolerance and difficulty sleeping when discontinued.

23. Maintain Sleep Structure (Well-Sleeper)

If you’re already sleeping well, aim to get up at the same time five days a week and largely go to bed at the same time or after you’re sleepy five days a week to maintain good circadian entrainment.