If you've ever suffered from insomnia, and especially if it's chronic, then you've probably been drawn to all the social media posts and news articles from specialists, and others, telling you what it is that you must be doing wrong.
You eat too much for your last meal and, or you eat too late in the evening, you drink caffeinated drinks after midday, you drink alcohol at night, you expose your pineal gland to blue light from mobile phones and other screens, your bedroom is too warm, it's not dark enough, there are electronic devices in your bedroom, and on it goes including your tendency to take your worries to bed with you.
Make no mistake, nothing on this list is irrelevant if you're doing it and it impacts on your sleep, but more often than not, there's nothing for the seasoned insomniac to learn from it. In fact it's all so familiar to you, you could fluently advise others.
And it gets worse. Bearing in mind that those who are drawn to such advice are generally those who cannot sleep, rather than those who simply don't sleep long enough and even wear their short sleeps as a badge of honour. They will not be the ones who read about the horrors that can befall those who don't sleep long enough: Low immunity! Greater risk of Alzheimers! Heart disease! Premature death! Those who read this, and the rest of the list that I don't care to add to here, are those of us who are searching for solutions, for the missing bit of the puzzle. The list of horrors does nothing for us, other than to add to the anxiety that poor sleep will have already initiated.
Why has it taken me a couple of decades to uncover what seem like secrets for coping with the horrors of insufficient sleep? Why are the experts only highlighting a well-worn list of sleep hygiene tips when the reasons for insomnia are as diverse as the people who experience it? And most importantly, why do they issue the litany of horrors, but never any recommendations beyond the glaringly obvious: YOU NEED TO SLEEP?!
The answer may be that they simply don't know. Medical training doesn't include such information, so why would they? But as more people experience insomnia, as a symptom of Long Covid, other viruses and illnesses, or simply a consequence of aspects of modern life not suiting our physiology, we need to know that we can go at least some way to addressing the horrors of sleep deprivation. And we can.
It's remarkable that so little attention in this context is given to the positive effects of meditation. If I started listing relevant references I could be here all day, so I strongly recommend you take a quick look at the number of studies in PubMed linking any of the above, e.g. Alzheimer's, immunity, and heart disease with meditation. The overlap between sleep and meditation is significant. Of course, they're not the same, both sleep and meditation have their own unique strengths, but any Venn diagram showing the commonalities would need a very large central overlap section. In other words, whilst many people do promote meditation as a way of sleeping better, few think of recommending it as an intervention for managing an inability to sleep adequately. If you already meditate, you are supporting your health whether or not sleep eludes you.
Of course, meditation seems challenging for some and it can be particularly so whilst lying awake, unable to get to sleep or get back to sleep…the world can feel more daunting in the small hours of the morning such that trying to meditate may not be easy. But there's something else. I've referred to it previously as the elephant in the room because discovering it and responding to it has helped me to sleep better, but I'm still not a world class super sleeper so I really appreciate what I've learnt about the 'elephant': my own breathing!
I had no idea that my breathing was dysfunctional. I wasn't much of a mouth breather, so I assumed I was doing the simple and instinctive job of breathing rather well. I wasn't. For a start I often breathed too shallowly and too quickly although not obviously so, which is why I didn't notice it, but I was breathing faster than my body needed which is one of the easiest ways on the planet to induce stress… no external stressor required. Daytime breathing patterns don't transform during sleep so I was also breathing too quickly in my sleep. I only knew this because when, having woken in the small hours one night, I decided to do some slow breathing practice, and found I couldn't. I was breathing rapidly and I couldn't slow it down which is a clear example of out-of-control breathing. So, not only was I not sleeping, there was also no chance of me getting back to sleep or even being well rested with my breathing telling my body and brain that there was a threat, (breathing speeds up when we're dealing with danger) for which I must remain alert.
So what did I do? I switched to a slow body scan type of meditation to try to relax and influence the speed of my breathing. I did eventually manage to slow it down and I certainly felt more at ease.
As with meditation, there's research (albeit much less of it) pointing to some really exciting outcomes of slow, deep (not 'big') breathing. You may be familiar with the sleep hormone melatonin, but did you know it has health benefits beyond sleep? Improved immunity and slowing the effects of ageing being just two of them.¹ But what does this have to do with breathing? Research has shown that slow breathing prompts the production of melatonin.² This being the case, there's cause for some optimism as levels of this hormone are low in people with insomnia and further reduced when the insomnia is chronic. And whilst it's available in over-the-counter supplement form in some countries, in others, such as the UK, it is not. How wonderful then to know that we have a chance of producing our own!
And the practice of slow, deep (not 'big') breathing has yet more to offer the insomniacs of this world. You may have hurriedly glossed over the above reference to Alzheimers in the list of horrors as it really is one of the most daunting for many of us. It seems our brains get effectively cleaned by Cerebrospinal fluid when we sleep, and this appears to be key in keeping Alzheimers at bay. But it doesn't exclusively happen during sleep. Our heartbeats influence the flow of this fluid, too, but not as much as slow breathing which moves about 4 times as much volume! This was the fascinating finding of a Norwegian study from 2019³ giving hope to those of us who feel our brains may be missing out on a good clean as a result of our sleep deprivation.
So, there is something you can do if you can't sleep. Slow breathing exercises will always be advantageous whether or not you suffer from insomnia, and if you practise mindful slow breathing, in other words, paying attention to your breathing a) you will likely make a better job of keeping it slow, and b) doing anything mindfully is effectively a form of meditation… Did you check out the list of meditation references on PubMed? I recommend practising during the day as well as during any wakeful hours in bed.
If your breathing needs some attention, as has certainly been the case with me, then breathing re-education may well be relevant to ensure good daytime breathing habits and thus functional breathing at night. We can help with this and it would be a privilege to do so. If it does apply to you, you have some work to do, but the rewards can be significant and the side effects thoroughly desirable. May you experience better health and a little more peace of mind whether or not your sleep gets back on track.
~ Annette Henry
PS There's now a 'part 2' to this post. The new post, Do Your Genes Influence Your Sleep? delves into more of what breathing can do to promote sleep and, crucially, how it can help when sleep just doesn't happen.
References
¹Srinivasan V, Maestroni GJ, Cardinali DP, Esquifino AI, Perumal SR, Miller SC. Melatonin, immune function and aging. Immun Ageing. 2005;2:17. Published 2005 Nov 29. doi:10.1186/1742-4933-2-17
²Jerath R, Beveridge C, Barnes VA. Self-Regulation of Breathing as an Adjunctive Treatment of Insomnia. Front Psychiatry. 2019;9:780. Published 2019 Jan 29. doi:10.3389/fpsyt.2018.00780
(See the section on Slow Deep Breathing).
³Breathing can affect the cleansing of the brain.
Additional Reference Material
The Breathing Cure by Patrick Mckeown
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