Sleep Plan

Relearning how to sleep normally and naturally

Don’t ask how people are doing, ask how they are sleeping.
— Dr. Andrew Huberman

Sleep is a critical factor that influences our mental and physical health, yet it is regularly neglected today due to modern pressure and/or lifestyle. This often leads to significant impairments in how we think, concentrate, learn, remember, emotionally/physically feel, and perform, which usually creates even more problems (e.g., not sleeping > exhaustion > agitation > anxiety > not sleeping; repeat).

When we finally decide to start getting better sleep, we often end up restlessly awake, worrying, scrolling on our phones. We over-compensate with coffee and late naps that make it even more difficult to sleep the following night. This becomes a vicious cycle.

Primary Tasks to Improve Sleep:

  1. Improve overall sleep schedule, routine, and setting.

  2. Reduce activities that are not conducive to sleep.

  3. Incorporate supportive activities, lifestyle changes, and cognitive skills to improve sleep.

Sleep Setting

First, ensure where you are sleeping is:

  1. Dark (alternatively: use an eye mask).

  2. Quiet but not uncomfortably quiet or loud (use a fan, white noise machine/app, ear plugs).

  3. Cool but not uncomfortably cold or hot (a cooler room and heavier blanket promotes sleepiness).

  4. Comfortable (use a sleeping surface or mattress that is firm enough for your body).

Sleep Strategy

  1. Sleep and wake up around the same time every day (including days off) to establish a regular rhythm, but…

  2. Sleep only when sleepy: trying to sleep when you are not sleepy often leads to frustration, anxiety, and associating the “bed/bedtime” with being awake, making it even more challenging to sleep. You’re doing the right thing at the wrong time, so…

  3. Get up & try later (20-minute rule): if you have not been able to sleep for around 20 minutes, get up and away from the bed/bedroom, and do something quiet, calming, or boring until you are struggling to stay awake (nothing too interesting or exciting that it keeps you awake: reading, podcast, sleep story, guided meditation). Now, return to bed. If you don’t sleep for another 20 minutes, repeat this step until you fall asleep.

Acknowledge and accept the lack of control over how long this might take and that you will be pretty tired the first few days of doing this, but this is necessary and temporary! Making a real commitment to this will improve your ability to sleep the following night if you avoid the following

Sleep Disruptors

  1. Naps longer than 30 minutes past the afternoon.

  2. Waking/staying up late: unpredictable and irregular sleep patterns will make it unnecessarily difficult to improve sleep patterns.

  3. Intense exercise or physical activity 2 hours before sleep.

  4. Canceling activities and plans because you feel tired: this can reinforce insomnia.

  5. Being unproductive during the day: if you waste time during the day, you will later stress out about that and how behind you are getting overall. While you can distract yourself during the day, it’s pretty much just you and your mind at bedtime (and the mind has a lot to say about wasting time or being behind).

  6. Using the bed for things other than sleep, sex, or sickness: your mind will learn to associate “bed, bedtime” with activities like “working, thinking, worrying, social media, depression”. Your body will grow to stay awake for these activities when in bed + around bedtime.

  7. Eating too little/much 2-3 hours before sleep: feeling too hungry or full often leads to physical discomfort and subsequent difficult thoughts and feelings (frustration, regret, shame, anxiety). If you are hungry, drinking warm milk can aid sleep because of tryptophan.

  8. Using cool, bright lights and electronic screens/devices 30 minutes before sleep: bright lights at night disrupt our body’s natural light-dark cycle that cues our body to wake/sleep, suppressing our natural melatonin production. Our device usage also artificially induce emotions that are not conducive to sleep (media, news, content, conversation).

  9. Excessive use of phone, internet, or social media to deal with boredom, anxiety, and agitation during the day or trying to sleep: this creates a vicious cycle because while these things are very effective and keeping your attention and suppressing certain feelings, there is a rebound of those feelings once you stop using it. How do you deal with that? By using it more. Then you worry about lost sleep, try to force yourself to sleep but the pressure to sleep makes you so anxious and agitated you are back on your phone to numb that feeling.

  10. Excessive substances that prevent sleep or disrupt sleep architecture (typically reducing deep or REM sleep): forming habitual use and dependence can cause you to feel like you need to keep using it to sleep (even if your body only truly needs it occasionally, not daily), creating tolerance (needing to use more to achieve previous/desired effect). Avoid:

    • Alcohol 4-6 hours before sleep: although you fall asleep faster, alcohol disrupts sleep architecture, compromising quality of rest and recovery.

    • Caffeine (coffee, tea, soda, chocolate) and nicotine (tobacco, vape, gum, patch) 4-6 hours before sleep: both will prevent sleep. Do not consume more than 400mg (~4-5 cups of coffee, 7 shots of espresso).

    • Stimulants 12 hours before sleep (amphetamines: Adderall, Vyvanse, methamphetamine; non-amphetamine medications: modafinil)

    • Psychedelics in the evening (LSD, mushrooms, ayahuasca). It’s common to have difficulty sleeping even several hours after the experience and effects have worn off. When feeling sleepy, follow the 20-minute rule above.

    • Daily, high doses of THC (cannabis) to fall asleep: this might help you sleep faster but regularly using high amounts of THC will disrupt sleep architecture.

    • Excessive sleep medication/aids: while it is not a problem if used periodically out of true necessity (after following everything presented here), long-term use results in higher tolerance/dependence, rebound insomnia (the necessary days/weeks to adjust back to normal sleep without these substances), daytime drowsiness, problems with mood/stress, and cognitive/memory impairments (people 65+ years of age have double the risk of falling and hip fractures because excessive use of these drugs leads to confusion, memory problems, and changes in balance, including:
      A. Prescribed, controlled sleep medication (benzodiazepines: alprazolam/Xanax, diazepam/Valium, or lorazepam/Ativan; Z-drugs: zolpidem/Ambien, eszopiclone/Lunesta, zaleplon/Sonata)
      B. Non-prescription sleep aids (antihistamines: diphenhydramine/Benadryl, ZzzQuil, Tylenol PM, or doxylamine succinate/Unisom)

Sleep Supporters

  1. Create and commit to sleep rituals prior to bedtime to habitually remind your body that it is time to sleep soon (brushing teeth, stretching, journaling, reading, meditating, breathing).

  2. Get sunlight into your eyes as soon as possible after waking up. This cues the body to wake, providing energy that can reduce fatigue early in the morning. It can be even better to go outside and take a 10-30+ minute walk.

  3. At evening/night, use dimmer/warmer lights in the room. Set your devices/screens to automatically switch to a warmer light after sunset (Apple Night Shift; Windows Night Light; Android Night Mode; Samsung blue light filter; f.lux app for computers/phones).

    It is even better to use red lights in the room and red color filters on screens at night (dimmer the better). This effectively reduces blue light emission, minimizing the suppression of melatonin production and supporting our ability to sleep. Many smart lights or nightlight accessories are capable of this. On your phone or computer, you can turn on “color filters” to red and adjust to your needs.

  4. Be productive during the first few hours of the day, that way you have less to stress and worry about night (with a lot less to shame yourself with). This contributes to a sense of accomplishment, allowing your mind to feel like it can clock out for tonight. It also contributes to the necessary fatigue our mind/body needs to easily sleep. At minimum, be productive during the first few hours of the day.

  5. Move your phone and devices away from the bed. Whether you're bored, stressed, or agitated, stop making it so easy to just mindlessly and impulsively grab it… Strengthen your chances to avoid going on it during bedtime by simply keeping it out of reach. Remove stands, docks, or charging cables that encourage it to stay there.

  6. Regular exercise helps improve sleep quality (just avoid anything intensive 2 hours before sleep). Morning walks are a good way to start the day and get energy.

  7. Regular stress management or psychological work/support (therapy, mindfulness, meditation, prayer, support groups) can help in learning how to manage our problems and worries, things that are easy to get hooked by and contribute to rumination while trying to sleep (this can include therapy, mindfulness, reframing, radical acceptance).

  8. Reduce and balance overall consumption of content/information/news. While there is potential value to these things, you are always taking a risk of the long-term impact they may have on you later (e.g., your mind may dwell and focus on all of those things when you are trying to sleep > can’t sleep > go on phone to learn more > get more stressed and ruminate deeper > lose even more sleep). Minimize this risk by setting better boundaries around what content you consume.

  9. At some point during the day, spend at least 30-60 minutes with yourself where you are not mentally occupied (walking in silence, mindfulness meditation, journaling). This is critical for emotion regulation and stress management. We use this time to process our emotions and thoughts rather than playing catch up and processing them in the middle of the night when we would rather sleep.

  10. Stop trying to force yourself to sleep. Do what you can and let go of the rest. The more you stress about needing to sleep, the more you will stay awake, the more you will about how much sleep you will lose, right back to the more you stress about needing to sleep. If this stress gets bad enough, you will go on your phone or use substances only to fall back into the vicious cycle. Accept you won’t get as much sleep as you would prefer and focus on committing to the 20-minute rule above.

  11. As an extension of cognitive, mindfulness, or meditation work: practice defusion/non-judgmental noticing and acceptance with your internal experiences (“I notice I am having this thought/feeling… It will come, stay, go as it pleases. I can see that it is trying to be helpful by reminding me about… Thanks, brain”). Fighting with, trying to change or stop intrusive and unwanted thoughts usually results with becoming more frustrated or worried. Notice how and when your mind gives you the thought that “you must fall asleep, or else it will be the worst tomorrow!” That’s just it trying to be helpful but obviously not really changing much. It is what it is. Just notice the mind doing its job and go back to following the Sleep Plan. Practice this type of attention to your thinking during your waking time and bedtime to get better at not getting hooked by unhelpful thoughts or feelings. While making space for the thoughts and feelings to come and go, you can pay attention to your body or breathing as a physical anchor.

  12. Hot bath 1-2 hours before sleep can raise body temperature and cause you to feel sleepy as your body temperature drops again (associated with transition into sleep).

  13. Certain supplements are known to promote relaxation or sleepiness, including melatonin, valerian root, L-Theanine, tryptophan (5-HTP) or warm milk, magnesium glycinate, chamomile, lavender, CBD.

  14. Worry list: if you notice something and are worried about forgetting it, write down things you need before sleep.

  15. Keep track of all these behaviors, what you are adherent to and when you are not, and notice the impact it has on your sleep. This data is very helpful when working with a healthcare professional.

Sleep Architecture

This is our basic pattern of normal sleep:

  1. Light sleep (non-REM Stage 1): body transitions from “awake” to “asleep”, decreasing body temperature and relaxing muscles. It’s easy to be awakened at this stage!

  2. Transition to deep sleep (non-REM Stage 2: body prepares for deep sleep by continuing to decrease body temperature and stabilize breathing and heart rate.

  3. Deep sleep (“slow-wave sleep”, non-REM Stage 3): the most restorative phase, crucial for physical and psychological recovery and growth, muscle development, feeling energized and refreshed.

  4. REM Sleep: dreaming, memory consolidation, learning, cognitive/emotional processing and regulation.

Sleep disruptors:

  1. Prevent you from getting into light sleep (stage 1) at all (e.g., agitation, anxiety, coffee, ADHD medication, street noise) or

  2. Help you get to sleep quickly (Xanax, Benadryl, alcohol) but disrupt sleep architecture, reducing deep and/or REM sleep, affecting overall sleep quality, energy, recovery, memory, learning, cognition, and mood.

Daily Sleep Log

If you are serious about working on your sleep, it is important to monitor patterns and progress of sleep while doing your best to adhere to the Sleep Plan. This gives you better insight to what things you need to sustain and what needs to change. This information is also helpful for your healthcare providers. You can copy and paste this into your preferred notes app, create a spreadsheet, or use a journal/paper. A completed example of a common scenario is included at the bottom:

Complete Before Going Into Bed:

Today’s date:

Caffeinated drinks & time consumed:

Stimulants (nicotine, medications, etc) & time consumed:

Alcohol & time consumed:

Cannabis & time consumed:

Nap lengths & times:

Exercise lengths & times:

How sleepy did I feel during the day today (1-4):

  1. So sleepy I struggled to stay awake most of the day

  2. Somewhat tired

  3. Fairly alert

  4. Alert

Complete in the Morning:

Today’s date:

Time you went into bed last night:

Time you got out of bed this morning:

Hours in bed last night:

Number of awakenings and total time awake last night:

How long it took to fall asleep last night:

Medication/drugs used last night:

How alert did I feel when I woke up this morning (1-3):

  1. Alert

  2. Alert but a little tired

  3. Sleepy

My Current Sleep Disruptors:

  • Complete Before Going Into Bed:

    Today’s date: June 1

    Caffeinated drinks & time consumed: 3 cups of black coffee (7am - 6pm)

    Stimulants (nicotine, medications, etc) & time consumed: ADHD meds (10am), nicotine on/off every other hour until 11pm

    Alcohol & time consumed: 2 beers (9pm)

    Cannabis & time consumed: 3 hits of THC vape (11pm)

    Nap lengths & times: 2 hours (6pm)

    Exercise lengths & times: none

    How sleepy did I feel during the day today (1-4): 1 - so sleepy I struggled to stay awake most to the day

    Complete in the Morning:

    Today’s date: June 2

    Time you went into bed last night: 1am

    Time you got out of bed this morning: 8am

    Hours spent in bed last night: 7

    How long it took to fall asleep last night: 1 hour

    Number of awakenings and total time awake last night: woke up once for 45 minutes

    Medication/drugs used last night: Xanax + 3 hits of THC vape around 2 when I was getting frustrated I could not sleep

    How alert did I feel when I woke up this morning (1-3): 3 - very sleep still

    My Current Sleep Disruptors:
    - sleeping too late, never the same time
    - napping too long and late (after work before going out to bar)
    - staying in bed too long when I cannot sleep and then going to social media - not following 20-minute rule
    - using too many substances at the worst times, keeping me up longer than I need (nicotine, coffee) or keeping me dependent just to be able to get drowsy (Xanax, concentrated THC) but working less and less the more I keep using them
    - eating poorly and late, not exercising
    - not practicing cognitive strategies, mind keeps racing and just engage with unpleasant thoughts, worries, frustration, regret
    - keep canceling plans with people during the day and putting off activities and goals I have scheduled, not getting anywhere with goals - not living toward values or addressing many of my needs, making it harder to sleep or be more productive during the day

Once our sleep is improving (even if we are just starting the process of improving our sleep), we can use reflective journaling to examine and redirect our day-to-day patterns.