Tag Archives: Insomnia

Sleep and Dreams

  • All people dream when they sleep, including people who think they don’t (more…).
  • According to sleep and dream expert Rubin Naiman, good dreaming contributes to our psychological well-being by
    • supporting healthy memory
    • consolidating memories
    • retaining information
    • warding off depression
    • expanding our ordinary limited consciousness into broader, spiritual real
  • Sleep generally occurs in 90-minute phases repeated throughout the night. Each phase moves from non-REM sleep to REM sleep. At the beginning of the sleep cycle, the REM phase lasts only a few minutes, but in the last phase before awakening, the REM phase can last  up to 40 minutes, and these late-stage dreams often stay in our memories as we awaken.
  • Dreams are largely confined to the REM, or rapid eye movement, phase of sleep.  In REM sleep, we are also in a type of paralysis, and if this paralysis doesn’t occur for whatever reason, a deadly acting out of our dreams can take place.
  • The longer your REM cycle, the more intense your dreams (more…)
  • When someone is sleep deprived we see greater sleep intensity, meaning greater brain activity during sleep; dreaming is definitely increased and likely more vivid (Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center in Minneapolis.)
  • It has been observed that dream deprivation causes effects such as:
    • waking dreams (visual and auditory hallucinations)
    • interference with memory and learning
    • a loosening of associations
    • impaired waking ability to do tasks requiring focused attention
    • difficulty maintaining a straight line of thought
    • creating irritability and suspiciousness.
  • High dream recallers are more reactive to environmental stimuli [during sleep], awaken more during sleep, and thus better encode dreams in memory than low dream recallers. (more…)
  • Whatever people are exposed to during the daytime will have an impact on their dreaming at night.
  • You can have a negative impact on your dreams if you’re surrounded or getting exposed to negative things throughout the day. But, on the flip side, you can also have a positive impact on your dreams if the last things that you’re thinking about are positive things. (Dr. Shalini Paruthi)
  • How to have better dreams: While we can’t have 100 percent control over our dreams, there are things we can do to influence them in a positive direction, experts say. Among them:
    • exposure to pleasant smells and sounds while we’re sleeping
    • avoiding spicy foods
    • not smoking
    • eating healthy and exercising regularly
    • improving our daytime thought patterns
    • In simplistic terms, if you want good dreams, sleep well and think happy thoughts. (Dr. Shalini Paruthi)
  • In Dr. Naiman’s view, your complaint of feeling tired the day after dreams disturb your sleep is not usually the result of dreaming, per se, but of attempting to deny, resist or fight the dreams. It is this struggle that can leave you exhausted. He notes that occasional bad dreams and even nightmares are a normal part of one’s dream life, also to keep in mind that even a negative dream can have a positive effect on one’s life.



  • According to Antrobus, factors that can lead to poor sleep include:
    • consuming alcohol before bed
    • experiencing stress and having a disturbing day
    • keeping electronics like cell phones, televisions or computers in the bedroom
    • eating, exercising or consuming caffeine too late
    • having an uncomfortable bed or sleeping environment
    • keeping an inconsistent sleep schedule.
  • Dr Shalini Paruthi’s advice on getting a good sleep:
    • sleeping in a room that’s dark, quiet and cool (18 to 22 celcius degree)
    • taking a bath and reading a book before bed
    • practicing relaxation exercises
    • avoiding stressful or stimulating activities before sleep
    • napping early in the day (or not at all)
    • exercising earlier in the day
    • avoiding alcohol, sugar and large meals before sleep
    • maintaining a regular sleep schedule
    • going to bed when we’re tired.


想睡得更沉更好? 不妨先让自己醒着吧!


然而,根据科学文献 (scientific journal articles),对于长期失眠最好的治疗方法,却是大多数人都没有尝试过,而且听起来有些疯狂:睡得更好的秘诀就是(至少在一段时间里)故意减少睡眠时间。

这就是所谓的睡眠限制疗法 (Sleep Restriction Therapy),它是认知行为疗法专门针对失眠治疗(CBT-I, Cognitive Behavioural Therapy specifically for Insomnia)的其中一部分。这样做是为了减少你花在试图睡着的时间(比起你实际能睡着的时间)。

方法是这样的:用几个星期的时间,记录你真正得到的睡眠是多少个小时 – 比如说每晚可以睡五个半小时。下来,设定肯定必须起身的时间,通常是你最迟必须醒来又来得及去上班的时间 – 比如,早上6:30,所以,在睡眠限制疗法的原则下,你不让自己在凌晨1点之前上床。如果你在这段时间(1点多到6点半)成功地睡着了,你就可以开始渐渐地让自己早点休息,每次大约提早15分钟上床,直到你可以每晚熟睡完整的七八个小时。


当然 CBT-I 不仅仅是睡眠限制 – 它着重于改变失眠者有关睡眠的思想和行为,包括典型的建议,如在睡前一小时关掉手机等的电子设备,还有每天在固定的时间上床和起床。虽然这是一个优秀的治疗方法,但是患者一旦发现他们必须做的是特地的剥夺自己的睡眠时间,他们就选择放弃疗程。 这也是为什么这个已经被研究证明有效的方法没有得到充分利用的原因。当然这方法一点也不容易执行,尤其对失眠者来说要抵抗睡意,想睡时不去睡觉是非常困难煎熬的。失眠者往往非常在意他们睡了多少个小时,但是他们可能忽略了,睡了五六个小时不是问题所在,他们最应该驱除的,是躺在床上干看天花板辗转难眠的时间。



To Get Better Sleep, Maybe Try Staying Awake 


Insomnia & Poor Sleep

睡好眠清单 (.pdf)

The more you worry about having to take medicine, the more you need to take them

Yes, and that’s all the point I want to make in this post.

Recently I spoke to a woman in her late 50s who has problem sleeping. She has been a patient since 15 years ago, but was never regular with medicination.

She has used all possible means to make herself sleep, taking wine, using chinese herbs, exercise etc. She just doesn’t want to depend on medicines. But she always comes back to see doctor and collect medicine when all other methods fail and she really needs some sleep.

So yes, she came back again last week. And since that visit she has called up the clinic several times. Every time asking about

  • When can I stop taking these medicine?
  • Can I start to reduce them now?
  • Will they harm my body?
  • What are the side effects and possible side effects?
  • What’s going to happen in long-term taking these tablets?

These are just some examples, under one topic/question she can ask in so many different ways and for so many times. (Eh? OCD?!)

At the end everyone couldn’t stand answering her questions repeatedly. So I’ve got the job. I told her that through our experience with many patients with either anxiety-related problems or with insomnia, the more she worries about needing to take medicine, the more she has to take it, it’s always like that. I asked her what has the focus of life becomes now?

All kind of worries about taking medicine.

The medicine is not likely to help her much if she continues to worry this way. So she won’t get well, so she’ll have to continue taking them. So she will continue to worry about taking them… … See the vicious cycle here?

So I asked her back why not continue with medicine, but shift her focus of life in something more meaningful, to how to live more healthily and happily? How about developing new interests, learning yoga, going swimming, forming new social relationships, improving familial relationship etc etc.

When she’s able to shift the focus and live more meaningfully and healthily, she may not even need the medicine without herself realising that.


越是担心吃药, 越是需要吃药?

当这过去十几年来一向难入眠的女士, 用尽方法却还是不能好好睡一觉, 她就会回来看医生, 通常每一两年至少来一次. 而这次拿了药回去后, 就开始不断地”电话轰炸”诊所, 问什么时候可以停药? 现在就停可以吗? 停了马上复发吗? 这些药有什么副作用? 对身体有什么害处? 一定要吃这些要吗? 等等等等. 每两到三天就来一通电话.

详细解释许多次后, 她却不见得可以明白. 下次打来, 还是问回这些问题.

所以我告诉她, 经验告诉我们, “越是担心吃药的人, 越是需要吃药, 往往也得吃得越久” 想想这么个担心忧虑法, 你的生活中心全是什么? 生活还剩下些什么?

本来吃药可能很快有效, 但是你这么一直担心, 东想西想, 日想夜想, 人可能反而更不舒服更忧虑, 结果要吃更多药, 然后又更担心忧虑, …恶性循环, 对吗?

何不就相信医生, 继续吃药, 同时好好地, 健康地生活, 培养新的兴趣, 做些运动, 建立社交生活, 改善与家人的关系等等, 在这情况些, 也许不知不觉中已经不需要再依赖药物了.

Insomnia & Poor Sleep

This is a patient with longstanding sleeping problem, not that he isn’t able to fall asleep, but he can’t sleep for many hours, is usually awake at about 2-3am, then has to lie on his bed till 6-7am.

He struggles so much with sleep for the past 30+ years of his life, now in his 60s. With medication his problem improves, but when his body starts to tolerate with the medicine, he will struggle to sleep longer again. To him having a good sleep and being able to sleep till morning is the most important thing. He’d rather over sleep and be late for work. He’d exchange anything for a good sleep till morning.

To make sure he’s able to sleep, he stays away from coffee, tea and anything that may lead to restlessness or insomnia for all these years. Sometimes he does feel too tired able and blurred in the day so he’ll have a lie in. But he doesn’t fall asleep, isn’t taking nap.

Advice given that he shouldn’t even have a lie in, as sometimes people are resting and they fall asleep without realizing it. Secondly, to learn one important fact that “if you can’t fall asleep, then just let it be”. In fact lying down on a bed is also a type of resting, you get to relax your muscles, body, and eyes. The only part that doesn’t really rest is perhaps your brain, but it doesn’t and will never rest completely anyway, whether you are sleeping or not. So accept the fact that your brain doesn’t want to fall asleep, let it be, just relax yourself. Do more exercise in the day, engage in more physical and mental activities in the day, get yourself tired.


What to do if I can’t sleep (well)?

  • Make sure you don’t sleep during the day, not even lying down and rest
  • Engage in more mental and physical activities in the day
  • Avoid tea, coffee and anything with caffeine in it. You may have tolerated it well in the past, but no longer now.
  • Accepts that lying down is also a type of rest, your muscles, body, eyes are all resting.
  • Accepts that it really doesn’t matter if you can’t fall asleep. Just continue lying down, relax and enjoy the sense of it.
  • Don’t be afraid and worried that you won’t fall asleep. The more you worry the harder you fall asleep.
  • You’re not alone. About every 4 out of 5 patients who visit our clinic has problems with sleeping. Some have not slept properly for few weeks. Some have not slept at all for 3-4 days.