When Sleep Doesn’t Come, By Dr Ruff

Coralease RuffRN, PhD

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Contact Information: cruff@howard.edu +1 703 863 3164

Read article in pdf form here: health-promotion-in-grief-coralease-ruff

The feelings of tiredness, exhaustion, lack of energy, inability to get things done, and feeling overwhelmed are common characteristics of normal grief following the death of a child. These feelings tend to lessen over time. Slowly the energy and focus return. In the meantime, exercise is very helpful in increasing energy, elevating the mood, and enhancing sleep. Complete the exercise workout 3-4 hours before bedtime, to prevent any interference with sleep.
Sleep disturbances, common in early grief, can also leave us feeling exhausted.

Here are some strategies to enhance sleep. Begin with preparing the sleeping room.

First, remove the TV, laptop, smart phone and other work related items. The light from these items interferes with the production
of melatonin, the sleep hormone. If you use the laptop or watch TV in the evening, be sure to turn it off at least an hour before bedtime. The room should be cool, dark, and quiet. Some grieving individuals may feel chilly. A warm cup of herbal tea or a warm bath will warm the body and socks will warm cold feet.

Second, establish a sleep routine that begins with a consistent awake time and sleep time. Strive for going to bed no later than 10 pm daily. It is helpful to wind down for sleep, physically and mentally. Separate the busy day from sleep time, by clearing your mind of thoughts, worries, pent up feelings and the common “To Do List,” by writing all of it, on paper. Don your favorite sleepwear, play relaxing music, light a candle, or use an essential oil such as lavender for added ambiance.

The second part of winding down is to relax the body physically. Contract and relax each body part from head to toe. Slow deep breathing calms the heart and further relaxes the body for sleep. Gentle mind-body exercises, like yoga or tai chi, are great sleep enhancers. This established sleep routine must be practiced on weekends as well as during the week.
Dietary intake of caffeine, nicotine, and alcohol can disrupt sleep. When used during the day, consume these stimulants before the 5 pm evening meal. Consider also that many medications may cause sleep disturbances especially antihistamines, cough preparations, and some prescription drugs. If using them try to take them early in the day.
Some of us get to sleep easily but awaken in the middle of the night, unable to get back to sleep. It is common to awaken at least once during the night. Just relax, turn over and go back to sleep. The addition of white noise (sounds introduced via a recording or other instrument like an electric fan) helps keep silence or noises from becoming disruptive. Earplugs can also lessen these distractions. If you awaken and cannot get back to sleep in 10-15 minutes, do not try to force it. Just rest in bed and enjoy the feel of your soft pillow and bed covers around you. To keep from
watching the clock, turn the clock face away from your line of vision. Give yourself the gift of time out, awake or asleep. Some of the tried and true anecdotes to induce sleep include warm milk, herbal teas, and counting sheep from 100 backwards. Another technique is the use of specialized sleep DVDs, which use head phones to enhance the sound.
Avoid naps during the day to help ensure better rest and sleep at night. If you need a nap to get through the day, do so in the early part of the day and keep it to 20 minutes or less.

When sleep deprivation threatens your ability to perform activities of daily living, it may be necessary to consider sleeping pills as a short-term solution. Remember most sleep medicines have side effects and can become habit forming.
It is helpful to use natural behavioral strategies first, and give them several weeks to work. Finally, try not to fixate on sleep. This draws attention to the sleep issue, resulting in a self-perpetuating problem.