Azure Jane Lunatic (Azz) 🌺 (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
azurelunatic) wrote2024-03-01 12:44 am
azurelunatic) wrote2024-03-01 12:44 am
Entry tags:
2024 sleep masterpost
Occasionally people on the internet ask for the community's collected wisdom about sleep. This is what I can think of for my own sleep routines, tips, and tricks, plus what I do about various confounding factors. Maybe one of these days I'll go through the paperwork from that wretched sleep class and write up my notes on that, too.
I have Delayed Sleep Phase Syndrome, primary insomnia, sleep maintenance insomnia, and ADHD.
Equipment/Apps:
Phone!
• Blue light & brightness filter (built in to Android)
• Timed Do Not Disturb turns on at 11pm and turns off when I unplug from the charger or when my first alarm goes off (built in to Android)
• long charger cable that reaches from the plug well off the bed to any side of my pillow (there is a horrifying experience someone had with an extension cord and a half-unplugged charger and a necklace)
• dim light I can turn on if I'm too tired to plug in my phone in the dark (F you Mr. Sherlock Holmes)
• sleep tracking app (helpful in spotting trends and logging disturbances); I use Sleep as Android, by Urbandroid
• smartwatch that integrates with sleep app enough to work as an additional logging sensor (I tried using it as the primary sensor but kept exiting the app on the watch in my sleep; my workaround is that I have it set up to use the watch but then click the "track without watch" button)
• multiple alarms when I need to wake up (F you Mr. Elementary Holmes); first alarm tries to wake me, snooze to attempt again, subsequent alarms in case I turn off the first instead of snoozing it
• Android automatically tells me how many hours until the alarm I'm currently enabling, which is less math that I have to do in my head when I'm calculating for driving safety
• white noise generator in sleep app, set to Ocean Beach, with random extra sounds turned on but fairly low volume. The extra sounds (seagulls, boat horns, etc) keep my brain from acclimating too well to the sound's loop such that random house sounds won't immediately snap me out of a doze
• calculatedly not-quite-boring game(s); I use a skip-bo on easy mode if I need to play a game, and I have the colors set to dark greys and reds so it won't be bright at me. It's engaging enough that I won't put it down to start doomscrolling, but not so engaging that I will keep myself awake to keep playing. I had a dice game on a previous model of phone that served the same purpose and had the same level of color control.
• priority filter on notifications: house chat, my child, and a few others get through Do Not Disturb so I won't miss important things (built in to Android)
• Twitter's implosion has kept the doomscrolling there to a minimum
• I'm better about not looking at email with Do Not Disturb on so I don't see incoming notifications, and there aren't emergency emails (either it's a phone call, or it's not an emergency)
• bedtime/sleep specific home screen with all the apps organized so I don't have to search through more distracting apps to get to what I need
• Libby app with audiobooks of cozy mysteries I've read before, audiobook speed at 65% & an hour timeout (and knowing that the heroine meets peril at about 90% of the book, so I can save that part for not-sleep and start the next book)
• IFTTT and/or Tasker powered emergency contact call filter: a single call from a specific list (IFTTT, set up per number) or a starred contact (Tasker) resets my ring/notification volume to Very Loud. A second call from that list will therefore ring; my emergency contacts have been instructed how to use it, and are less concerned about waking me up if they should happen to call during a nap. (This does mean that a single call from the emergency contact will allow the next non-emergency contact who calls to wake me up, but that's a risk I've accepted.)
• notepad app on phone so I can succinctly write out thoughts I absolutely have to save without turning on a light
Automated lights/etc!
• The main LED lights in the living room start dimming and reddening a little before 11 pm (5 tentacled bulb lamp by the couch & strip of LEDs by the fireplace)
• All the living room lights, not just those, turn off at 11:30 pm after two verbal warnings (ok, except for some fairy lights, for safety)
• The TVs turn off about 30 seconds later
• The computer that runs the TV can be verbally or keyboard told to pause the current running media (video or audio) in a way that doesn't require turning the screen back on
• LED lights in the bedroom that turn on very dim red at 11:30 or when we say goodnight to the living room; it generally doesn't wake up anyone who is already asleep, and reduces the amount of loud blundering around in the dark
• widget on bedtime home screen to toggle bedroom lights (usually off) silently as well as by voice command or searching through the Home Assistant app to find the switch
This situation uses:
• Zigbee lights and a Zigbee dongle
• a few wifi lights and a secondary network, since we don't want to trust the makers of random wifi appliances to be sufficiently unhackable
• "Home Assistant", a software package and a dedicated mini-computer (will cheerfully run on a Raspberry Pi) in the living room and bedroom
• Some kind of infrared remote control dongle on the computer
• A wifi/infrared universal remote control puck that can be controlled by Home Assistant (the specific one is now discontinued)
• Several extremely clever little automations put together by Belovedest, some of which I requested
Alarms
• Different sound for routine alarms vs. single-purpose alarms
• Rotating the alarm sound if I get habituated
• maxing out the number of possible snoozes in settings, so if I automatically snooze it repeatedly, it keeps trying
• Multiple alarms: one for the first time I should attempt to be awake, followed by more so I can't accidentally snooze/stop through my doctor appointment; an additional alarm for the out the door warning
• calendar appointment to announce bedtime with a ding on the computer and a visible notification on the phone; this is also calculated to not wake me up because it won't get through Do Not Disturb
• f.lux bedtime reminder on computers
• Android (Fitbit?) bedtime reminder
• Scheduling sleep time as a block on my calendar so I don't schedule anything over it (more in use when I have to get up at a specific time)
Less technological items
Bed
• a mattress that is not actively injuring me & is rated for more than one heffalump
• body pillow
• various bedding that lets me sleep on my side without injuring my shoulder, including a buckwheat hull pillow and using rolled-up/wadded-up cotton blankets as pillows some of the time
• Separate blankets from Belovedest
• a range of cover options, from super warm to very light so I can add or subtract in the middle of the night without thinking too much about it
• tried a weighted blanket but it was a little too heavy for me so I rolled it up and put it in a pillowcase as one of the more structural pillows
• pillow to keep my knees from knocking together
Light control
• Blackout curtains and roller shade; have replaced the curtains more than once to get satisfactory results.
• The window facing east has curtains that go below my bed-based eye line. It doesn't have a cornice or valance, but that would be a next step if the light blocking became not enough.
• The window facing south has a roller shade and the rejected blackout curtains that weren't enough on the east window. This is about the right length there due to bed placement.
• using the corner of one of my heavy cotton blankets as an eye mask that doesn't set off immediate sensory hell & working on a weighted eye mask, since I will pull off masks that fasten at the back of the head, as well as pulling off hats in my sleep
• various LEDs in bathroom are bright enough so I don't have to turn on the big light when I make a midnight visit; also used to have a nightlight
• controlling the amount of light coming in from the hall
• the aforementioned living room light settings so we "buzz off to bed" as Dad used to phrase it
• F.Lux program on living room TV machine & my desktop, set to very strict blue light filter in most cases
• Android light filter
• the aforementioned bedroom LED bulb automation situation for low red light as a bedtime prep light
• adjustable color temperature desk lamp
• Used a sunrise lamp when I had the early morning job, which made mornings Less Terrible (unfortunately the LEDs started making a sound when not at full power, which took it out of consideration for a slow fade bedtime)
• bedside lamp with dimming and auto-off feature
• masking tape over the very bright blue LED on the Home Assistant microphone in the bedroom (it's re-purposed old equipment or we might have chosen something different); my exact words were approximately "make it Not" while sobbing. We initially used some cloth. It can still be seen for troubleshooting purposes but no longer keeps me up.
•
Other Infrastructure
Cats & miscellaneous noise
• Yellface no longer starts begging for breakfast at sunrise, after her thyroid treatment
• Yellface does start begging for breakfast at Belovedest's first alarm, and resumes begging at every snooze-based reactivation (she's very smart, at least around things related to food) but once they've visibly stopped stirring she shuts up and sits on them and waits for them to move/the alarm to go off again
• Belovedest has lengthened their snooze interval from 10 minutes to 30 so I can often sleep through this portion of the morning
• Closing the bedroom door at cat-feeding time, to keep Roomba-pet (a Roomba, not a cat) out and not accidentally closing Yellface in with me
Temperature regulation: I'm fat and in surgical menopause. I overheat at the drop of a thermometer. One of the useful things I did get out of that wretched Sleep Hygiene class was that you shouldn't be a hero about temperature, you do need to be the right temperature for sleep
• Heat pump with a pretty good thermostat
• (retired the portable air conditioners that kept the bedrooms cool even if the rest of the house was Very Hot)
• (retired the smartish window fan that would turn off/on at a certain temperature so we wouldn't wake up freezing)
• tiny positionable personal fan with three speeds: allows me to cool off even during the cold season without disturbing my bedmate; it's hanging by one of its bendy tripod legs from a repurposed tension rod shower shelf so it won't confuse the sleep trackers
• personal heat/cold jobbies:
- hot water bottle for feet when cold
- towel-wrapped ice pack when hot; I have sewn an old towel into a long sack so I can drop the ice pack into the bottom and wrap the rest around so even if it comes somewhat unwrapped it won't necessarily get fully loose and cold me awake
• sometimes a shower before bed
• drinking water bottle in bed, sometimes with ice or hot, optionally hot with peppermint herb tea
Medical/Meds:
• Treatment of miscellaneous medical problems that can cause discomfort
• pre-medicating certain things and medicating at the first sign of An Problem for others
• Surgical correction of deviated septum & excessively large turbinates. Those had caused chronic nasal congestion.
• Treated chronic nasal congestion aggressively
- antihistamine regulated to not dry out too badly
- steroid spray
- saline spray
- neti pot
- swabs easily accessible in bathroom to manually clear nose
- dedicated Vaseline by bed, to make swabbing out easier
- therefore was possible to sleep with mouth closed most nights
• Sleep apnea screening
- lowest diagnosable level; medical outcome not actually improved with CPAP & I didn't notice improvement that couldn't be explained by other means
- it kept blowing snot towards my lungs
- side-sleeping is a legit treatment for sleep apnea
- pillows to position jaw Just So
• Reprogrammed my brain about sleep schedule guilt (morality should not attach to sleep schedules! In a pre-industrial agricultural society it is definitely inconvenient for someone to be asleep after first light but somebody also needs to be able to stay up with the sick cow!!)
• got a sleep neurologist
• fired the bad sleep neurologist who believed in CBT-i
• melatonin in dinner pills at 0.5mg, not at bedtime at 3-5+ mg, per the good sleep neurologist
• some people can sleep dep and gaslight themselves into a new sleep schedule (CBT-i) but it makes some other people suicidal and generally unstable. Guess which I am.
• bedtime meds stored by bed, not somewhere else in the house
• bedtime meds in a weekly case, not counted out manually every night, so it's fewer actions to take them and so I will see if I have or haven't taken them
• my friend swears by timer caps for any scheduled meds, to see when you last opened the container
• Meds with a stimulant effect taken in the morning
• sleep & sleep-promoting meds
- trazodone is a sedating antidepressant which doesn't have all of the same problems as many other categories of sleep med
- anxiety meds help with not getting to sleep/waking up in the middle of the night thinking obsessively about distressing topics or things I need to do
- Gabapentin (sedating nerve pain med) taken at night, & nerve pain WILL wake me up (thanks, Taxol!)
- Naproxen for miscellaneous aches and pains, as it's supposed to be for 12 hours rather than 8-ish like ibuprofen
- my "as needed" IBS antispasmodic med in the nightly box because spasms will wake me up and I should pre-medicate
• Additional compartmented pillbox with single day/night amounts of all the digestive/additional pain remedies I'm likely to need, pre-cut if necessary. This means I can't (badly) over-medicate by accident, am unlikely to grab the wrong ambiguously shaped pill, and don't need to get up in order to access meds
• travel bottle for approximately 24 hours +1 of my srs bzns pain meds
• A small hard case & bag to carry my digestive emergency & srs bzns pain meds with me at all times, so I don't have to maintain as many separate bottles as I do for the Ritalin
• Storing the necessary amount of my Ritalin by bed and taking it at my first alarm if I absolutely positively have to be awake (this is why we don't de-label those bottles for ordinary reuse for Several Months: main bottle, purse bottle, and bed bottle, with the two other bottles getting a very limited supply that it won't kill me to lose in case I misplace one.)
• Separating my AM pills into before meal / after meal on a weekly basis, so I don't have to think about what pills I'm taking before I'm coherent
• Lip balm by bed for chapped lips
• an unventilated surface under my ear results in an ear infection if there's any dampness. This is bad news because I'm a side sleeper. Worse news when I've taken a night shower or happen to live in Arizona and my ears generate sweat. My pillow situation is set up carefully to avoid this.
• Psyllium fiber capsule taken with water around 4-5 am to combat "mechanical hunger" -- my blood sugar is fine (chemical hunger) at that time but my digestive system sometimes thinks it should have something with some bulk to it, and reacts painfully if it doesn't. Unfortunately this is because I have slept through my natural dinner time, not overshot my breakfast. Ideally mechanical hunger and chemical hunger will line up, but Not Always.
Thirst, etc.
• Belovedest has a nice body (heh)
• water bottle in bed, always topped off before bedtime
• bathroom before lying down, and then again a little before I think I might be able to sleep
• dehydrating meds mostly moved to morning
• blood sugar control
• vitamin c helps me combat the ravenous thirst I get after too many preserved meats; taking it with my evening meal or at bedtime means I don't have to drink a ridiculous amount that has me peeing every hour
• No chance of becoming pregnant and therefore nobody tap-dancing on my bladder
- learning how much sleep deprivation was involved in traditional biological parenthood was the second major driver of deciding to never become pregnant. Learning about morning sickness was the first.
• if I have to poop I can't fall asleep so I get up promptly for that rather than thinking I can fall asleep and wait until later
• getting my nose fixed reduces the amount of water I need to drink to keep my airway free of glue, which means less for my bladder to think about at night
Procedure/Schedule:
• Never again taking a job that means I have to be awake too early on a daily basis
• my executive function goes to bed relatively early; if there are any tasks standing between me and bed, get them done well before that point
• my executive function doesn't wake up early either; laying out necessary morning objects lets me fake functionality before I can think through things
• conditioning any necessarily immediately pre-sleep tasks in a chain where it takes more energy to break the chain than to carry it out (fill water bottle, visit bathroom, shower, brush teeth with the toothbrush that lives in the shower)
• laying out clothing not just before bed, but as early as possible
• laying out bag for morning not just before bed, but as early as possible
• detailed morning checklist that details every departure from routine, prepared again as early as possible and assuming I can read and follow simple instructions but cannot necessarily break down complex tasks or optimize their order
• demi-permanent signs detailing repeating complex tasks in their optimized order in the place where Morning Me or Bedtime Me will have to think about them. (example: a sign taped on the mirror, saying bedtime pills and water first, then floss, then inhaler, then rinse mouth, then and only then the special toothpaste that needs to be followed by half an hour of no drinking or rinsing)
Convenience & comfort
• If any little thing makes me go "oh but that's effort" or "I can power through this", what if ... Not?
• duplicate phone and watch charger by bed (also ADHD place-bound item strategy)
• should also have a headphone cord
• fresh underwear, cotton (I recognize that some experts say that none underwear is best for overnight, but that doesn't work for me)
• ideally I would put the bed into a sleepable state immediately upon leaving it; this is different than "making the bed" as that implies an aesthetic that appeals to authoritarian regimes like some parents and all drill sergeants. This is strictly functional but probably should include layering the blankets correctly, finding all the necessary pillows, and applying a top layer resistant to cat yak and other unpleasant surprises.
• I cannot sleep with pants on. If it has enough elastic to keep a pair of pants worth of cloth from slithering down around my knees, it's too tight for me to sleep in.
• change positions regularly throughout the night so things don't start hurting and don't get injured from staying in one bad position too long
• f you Mark Zuckerberg for saying that you should keep still in spite of pain because that's your body trying to distract you from meditation. Sometimes it's your body warning you about the horrifying injury you're about to get.
• avoid bad positions in case I fall asleep in them
I have Delayed Sleep Phase Syndrome, primary insomnia, sleep maintenance insomnia, and ADHD.
Equipment/Apps:
Phone!
• Blue light & brightness filter (built in to Android)
• Timed Do Not Disturb turns on at 11pm and turns off when I unplug from the charger or when my first alarm goes off (built in to Android)
• long charger cable that reaches from the plug well off the bed to any side of my pillow (there is a horrifying experience someone had with an extension cord and a half-unplugged charger and a necklace)
• dim light I can turn on if I'm too tired to plug in my phone in the dark (F you Mr. Sherlock Holmes)
• sleep tracking app (helpful in spotting trends and logging disturbances); I use Sleep as Android, by Urbandroid
• smartwatch that integrates with sleep app enough to work as an additional logging sensor (I tried using it as the primary sensor but kept exiting the app on the watch in my sleep; my workaround is that I have it set up to use the watch but then click the "track without watch" button)
• multiple alarms when I need to wake up (F you Mr. Elementary Holmes); first alarm tries to wake me, snooze to attempt again, subsequent alarms in case I turn off the first instead of snoozing it
• Android automatically tells me how many hours until the alarm I'm currently enabling, which is less math that I have to do in my head when I'm calculating for driving safety
• white noise generator in sleep app, set to Ocean Beach, with random extra sounds turned on but fairly low volume. The extra sounds (seagulls, boat horns, etc) keep my brain from acclimating too well to the sound's loop such that random house sounds won't immediately snap me out of a doze
• calculatedly not-quite-boring game(s); I use a skip-bo on easy mode if I need to play a game, and I have the colors set to dark greys and reds so it won't be bright at me. It's engaging enough that I won't put it down to start doomscrolling, but not so engaging that I will keep myself awake to keep playing. I had a dice game on a previous model of phone that served the same purpose and had the same level of color control.
• priority filter on notifications: house chat, my child, and a few others get through Do Not Disturb so I won't miss important things (built in to Android)
• Twitter's implosion has kept the doomscrolling there to a minimum
• I'm better about not looking at email with Do Not Disturb on so I don't see incoming notifications, and there aren't emergency emails (either it's a phone call, or it's not an emergency)
• bedtime/sleep specific home screen with all the apps organized so I don't have to search through more distracting apps to get to what I need
• Libby app with audiobooks of cozy mysteries I've read before, audiobook speed at 65% & an hour timeout (and knowing that the heroine meets peril at about 90% of the book, so I can save that part for not-sleep and start the next book)
• IFTTT and/or Tasker powered emergency contact call filter: a single call from a specific list (IFTTT, set up per number) or a starred contact (Tasker) resets my ring/notification volume to Very Loud. A second call from that list will therefore ring; my emergency contacts have been instructed how to use it, and are less concerned about waking me up if they should happen to call during a nap. (This does mean that a single call from the emergency contact will allow the next non-emergency contact who calls to wake me up, but that's a risk I've accepted.)
• notepad app on phone so I can succinctly write out thoughts I absolutely have to save without turning on a light
Automated lights/etc!
• The main LED lights in the living room start dimming and reddening a little before 11 pm (5 tentacled bulb lamp by the couch & strip of LEDs by the fireplace)
• All the living room lights, not just those, turn off at 11:30 pm after two verbal warnings (ok, except for some fairy lights, for safety)
• The TVs turn off about 30 seconds later
• The computer that runs the TV can be verbally or keyboard told to pause the current running media (video or audio) in a way that doesn't require turning the screen back on
• LED lights in the bedroom that turn on very dim red at 11:30 or when we say goodnight to the living room; it generally doesn't wake up anyone who is already asleep, and reduces the amount of loud blundering around in the dark
• widget on bedtime home screen to toggle bedroom lights (usually off) silently as well as by voice command or searching through the Home Assistant app to find the switch
This situation uses:
• Zigbee lights and a Zigbee dongle
• a few wifi lights and a secondary network, since we don't want to trust the makers of random wifi appliances to be sufficiently unhackable
• "Home Assistant", a software package and a dedicated mini-computer (will cheerfully run on a Raspberry Pi) in the living room and bedroom
• Some kind of infrared remote control dongle on the computer
• A wifi/infrared universal remote control puck that can be controlled by Home Assistant (the specific one is now discontinued)
• Several extremely clever little automations put together by Belovedest, some of which I requested
Alarms
• Different sound for routine alarms vs. single-purpose alarms
• Rotating the alarm sound if I get habituated
• maxing out the number of possible snoozes in settings, so if I automatically snooze it repeatedly, it keeps trying
• Multiple alarms: one for the first time I should attempt to be awake, followed by more so I can't accidentally snooze/stop through my doctor appointment; an additional alarm for the out the door warning
• calendar appointment to announce bedtime with a ding on the computer and a visible notification on the phone; this is also calculated to not wake me up because it won't get through Do Not Disturb
• f.lux bedtime reminder on computers
• Android (Fitbit?) bedtime reminder
• Scheduling sleep time as a block on my calendar so I don't schedule anything over it (more in use when I have to get up at a specific time)
Less technological items
Bed
• a mattress that is not actively injuring me & is rated for more than one heffalump
• body pillow
• various bedding that lets me sleep on my side without injuring my shoulder, including a buckwheat hull pillow and using rolled-up/wadded-up cotton blankets as pillows some of the time
• Separate blankets from Belovedest
• a range of cover options, from super warm to very light so I can add or subtract in the middle of the night without thinking too much about it
• tried a weighted blanket but it was a little too heavy for me so I rolled it up and put it in a pillowcase as one of the more structural pillows
• pillow to keep my knees from knocking together
Light control
• Blackout curtains and roller shade; have replaced the curtains more than once to get satisfactory results.
• The window facing east has curtains that go below my bed-based eye line. It doesn't have a cornice or valance, but that would be a next step if the light blocking became not enough.
• The window facing south has a roller shade and the rejected blackout curtains that weren't enough on the east window. This is about the right length there due to bed placement.
• using the corner of one of my heavy cotton blankets as an eye mask that doesn't set off immediate sensory hell & working on a weighted eye mask, since I will pull off masks that fasten at the back of the head, as well as pulling off hats in my sleep
• various LEDs in bathroom are bright enough so I don't have to turn on the big light when I make a midnight visit; also used to have a nightlight
• controlling the amount of light coming in from the hall
• the aforementioned living room light settings so we "buzz off to bed" as Dad used to phrase it
• F.Lux program on living room TV machine & my desktop, set to very strict blue light filter in most cases
• Android light filter
• the aforementioned bedroom LED bulb automation situation for low red light as a bedtime prep light
• adjustable color temperature desk lamp
• Used a sunrise lamp when I had the early morning job, which made mornings Less Terrible (unfortunately the LEDs started making a sound when not at full power, which took it out of consideration for a slow fade bedtime)
• bedside lamp with dimming and auto-off feature
• masking tape over the very bright blue LED on the Home Assistant microphone in the bedroom (it's re-purposed old equipment or we might have chosen something different); my exact words were approximately "make it Not" while sobbing. We initially used some cloth. It can still be seen for troubleshooting purposes but no longer keeps me up.
•
Other Infrastructure
Cats & miscellaneous noise
• Yellface no longer starts begging for breakfast at sunrise, after her thyroid treatment
• Yellface does start begging for breakfast at Belovedest's first alarm, and resumes begging at every snooze-based reactivation (she's very smart, at least around things related to food) but once they've visibly stopped stirring she shuts up and sits on them and waits for them to move/the alarm to go off again
• Belovedest has lengthened their snooze interval from 10 minutes to 30 so I can often sleep through this portion of the morning
• Closing the bedroom door at cat-feeding time, to keep Roomba-pet (a Roomba, not a cat) out and not accidentally closing Yellface in with me
Temperature regulation: I'm fat and in surgical menopause. I overheat at the drop of a thermometer. One of the useful things I did get out of that wretched Sleep Hygiene class was that you shouldn't be a hero about temperature, you do need to be the right temperature for sleep
• Heat pump with a pretty good thermostat
• (retired the portable air conditioners that kept the bedrooms cool even if the rest of the house was Very Hot)
• (retired the smartish window fan that would turn off/on at a certain temperature so we wouldn't wake up freezing)
• tiny positionable personal fan with three speeds: allows me to cool off even during the cold season without disturbing my bedmate; it's hanging by one of its bendy tripod legs from a repurposed tension rod shower shelf so it won't confuse the sleep trackers
• personal heat/cold jobbies:
- hot water bottle for feet when cold
- towel-wrapped ice pack when hot; I have sewn an old towel into a long sack so I can drop the ice pack into the bottom and wrap the rest around so even if it comes somewhat unwrapped it won't necessarily get fully loose and cold me awake
• sometimes a shower before bed
• drinking water bottle in bed, sometimes with ice or hot, optionally hot with peppermint herb tea
Medical/Meds:
• Treatment of miscellaneous medical problems that can cause discomfort
• pre-medicating certain things and medicating at the first sign of An Problem for others
• Surgical correction of deviated septum & excessively large turbinates. Those had caused chronic nasal congestion.
• Treated chronic nasal congestion aggressively
- antihistamine regulated to not dry out too badly
- steroid spray
- saline spray
- neti pot
- swabs easily accessible in bathroom to manually clear nose
- dedicated Vaseline by bed, to make swabbing out easier
- therefore was possible to sleep with mouth closed most nights
• Sleep apnea screening
- lowest diagnosable level; medical outcome not actually improved with CPAP & I didn't notice improvement that couldn't be explained by other means
- it kept blowing snot towards my lungs
- side-sleeping is a legit treatment for sleep apnea
- pillows to position jaw Just So
• Reprogrammed my brain about sleep schedule guilt (morality should not attach to sleep schedules! In a pre-industrial agricultural society it is definitely inconvenient for someone to be asleep after first light but somebody also needs to be able to stay up with the sick cow!!)
• got a sleep neurologist
• fired the bad sleep neurologist who believed in CBT-i
• melatonin in dinner pills at 0.5mg, not at bedtime at 3-5+ mg, per the good sleep neurologist
• some people can sleep dep and gaslight themselves into a new sleep schedule (CBT-i) but it makes some other people suicidal and generally unstable. Guess which I am.
• bedtime meds stored by bed, not somewhere else in the house
• bedtime meds in a weekly case, not counted out manually every night, so it's fewer actions to take them and so I will see if I have or haven't taken them
• my friend swears by timer caps for any scheduled meds, to see when you last opened the container
• Meds with a stimulant effect taken in the morning
• sleep & sleep-promoting meds
- trazodone is a sedating antidepressant which doesn't have all of the same problems as many other categories of sleep med
- anxiety meds help with not getting to sleep/waking up in the middle of the night thinking obsessively about distressing topics or things I need to do
- Gabapentin (sedating nerve pain med) taken at night, & nerve pain WILL wake me up (thanks, Taxol!)
- Naproxen for miscellaneous aches and pains, as it's supposed to be for 12 hours rather than 8-ish like ibuprofen
- my "as needed" IBS antispasmodic med in the nightly box because spasms will wake me up and I should pre-medicate
• Additional compartmented pillbox with single day/night amounts of all the digestive/additional pain remedies I'm likely to need, pre-cut if necessary. This means I can't (badly) over-medicate by accident, am unlikely to grab the wrong ambiguously shaped pill, and don't need to get up in order to access meds
• travel bottle for approximately 24 hours +1 of my srs bzns pain meds
• A small hard case & bag to carry my digestive emergency & srs bzns pain meds with me at all times, so I don't have to maintain as many separate bottles as I do for the Ritalin
• Storing the necessary amount of my Ritalin by bed and taking it at my first alarm if I absolutely positively have to be awake (this is why we don't de-label those bottles for ordinary reuse for Several Months: main bottle, purse bottle, and bed bottle, with the two other bottles getting a very limited supply that it won't kill me to lose in case I misplace one.)
• Separating my AM pills into before meal / after meal on a weekly basis, so I don't have to think about what pills I'm taking before I'm coherent
• Lip balm by bed for chapped lips
• an unventilated surface under my ear results in an ear infection if there's any dampness. This is bad news because I'm a side sleeper. Worse news when I've taken a night shower or happen to live in Arizona and my ears generate sweat. My pillow situation is set up carefully to avoid this.
• Psyllium fiber capsule taken with water around 4-5 am to combat "mechanical hunger" -- my blood sugar is fine (chemical hunger) at that time but my digestive system sometimes thinks it should have something with some bulk to it, and reacts painfully if it doesn't. Unfortunately this is because I have slept through my natural dinner time, not overshot my breakfast. Ideally mechanical hunger and chemical hunger will line up, but Not Always.
Thirst, etc.
• Belovedest has a nice body (heh)
• water bottle in bed, always topped off before bedtime
• bathroom before lying down, and then again a little before I think I might be able to sleep
• dehydrating meds mostly moved to morning
• blood sugar control
• vitamin c helps me combat the ravenous thirst I get after too many preserved meats; taking it with my evening meal or at bedtime means I don't have to drink a ridiculous amount that has me peeing every hour
• No chance of becoming pregnant and therefore nobody tap-dancing on my bladder
- learning how much sleep deprivation was involved in traditional biological parenthood was the second major driver of deciding to never become pregnant. Learning about morning sickness was the first.
• if I have to poop I can't fall asleep so I get up promptly for that rather than thinking I can fall asleep and wait until later
• getting my nose fixed reduces the amount of water I need to drink to keep my airway free of glue, which means less for my bladder to think about at night
Procedure/Schedule:
• Never again taking a job that means I have to be awake too early on a daily basis
• my executive function goes to bed relatively early; if there are any tasks standing between me and bed, get them done well before that point
• my executive function doesn't wake up early either; laying out necessary morning objects lets me fake functionality before I can think through things
• conditioning any necessarily immediately pre-sleep tasks in a chain where it takes more energy to break the chain than to carry it out (fill water bottle, visit bathroom, shower, brush teeth with the toothbrush that lives in the shower)
• laying out clothing not just before bed, but as early as possible
• laying out bag for morning not just before bed, but as early as possible
• detailed morning checklist that details every departure from routine, prepared again as early as possible and assuming I can read and follow simple instructions but cannot necessarily break down complex tasks or optimize their order
• demi-permanent signs detailing repeating complex tasks in their optimized order in the place where Morning Me or Bedtime Me will have to think about them. (example: a sign taped on the mirror, saying bedtime pills and water first, then floss, then inhaler, then rinse mouth, then and only then the special toothpaste that needs to be followed by half an hour of no drinking or rinsing)
Convenience & comfort
• If any little thing makes me go "oh but that's effort" or "I can power through this", what if ... Not?
• duplicate phone and watch charger by bed (also ADHD place-bound item strategy)
• should also have a headphone cord
• fresh underwear, cotton (I recognize that some experts say that none underwear is best for overnight, but that doesn't work for me)
• ideally I would put the bed into a sleepable state immediately upon leaving it; this is different than "making the bed" as that implies an aesthetic that appeals to authoritarian regimes like some parents and all drill sergeants. This is strictly functional but probably should include layering the blankets correctly, finding all the necessary pillows, and applying a top layer resistant to cat yak and other unpleasant surprises.
• I cannot sleep with pants on. If it has enough elastic to keep a pair of pants worth of cloth from slithering down around my knees, it's too tight for me to sleep in.
• change positions regularly throughout the night so things don't start hurting and don't get injured from staying in one bad position too long
• f you Mark Zuckerberg for saying that you should keep still in spite of pain because that's your body trying to distract you from meditation. Sometimes it's your body warning you about the horrifying injury you're about to get.
• avoid bad positions in case I fall asleep in them
thanks
Thanks. Linked from MetaFilter.
Re: thanks
I wrote a comment with responses to some of the discussion there.