Ssshh! Falling Asleep the Way You Like To

by Nina

"The shoe that fits one person pinches another; there is no recipe for living that suits all cases." Carl Jung

I've had more than one person ask me the same question about my post recommending practicing breath awareness or pranayama in bed for insomnia (see Yoga for Better Sleep: Workshop and Tip). The question had to do with the position you should take while you are practicing in bed:
Was wondering whether this breath practice was to relax you enough so that you can then turn over and fall asleep or to fall asleep while doing this practice? If you are to fall asleep while doing the practice and you happen to be someone who cannot fall asleep laying on your back, do you then do the practice in the position that you fall asleep in?

The simple answer is: it's up to you! The description I provided of practicing on your back with your hands on your belly just happens to be the way I do it, at least most of the time. It was never meant as a prescription.

Although breath awareness and pranayama are typically taught either in seated positions or supine positions (on the back), in this case your aim—the opposite of that for a formal breath practice—is to fall asleep. So you will need to experiment to see what works best for you. Maybe you'll practice on your back until you feel ready to turn over and fall asleep. Or maybe you'll practice in your typical sleeping position and fall asleep while practicing. As it happens, I've also been taught to practice pranayama in supported Child's pose, feeling my breath in my back body, so practicing in a prone position (face down) even turns out to be legit!

Supported Child's Pose

Or, if you practice on your back, you might, to your own surprise, find yourself drifting off to sleep in that position, maybe even turning over in your sleep. (To be honest, I'm pretty sure I've done all these things, at one time or another.) And what works one night (or one month) may not work at another time, for any number of reasons, including physical ones, such as having a cold or a physical problem that requires a change in your sleep position.

The point is: Ssshh! It's dark, no one is looking, and you can do whatever you want! 

Yoga for Better Sleep: Workshop and Tip

by Nina

Cairns by Nina Zolotow

I don’t teach workshops very often, but when I do, I focus on topics I really care about. My upcoming workshop on Saturday April 6th, 2-5pm at Brentwood Yoga Center focuses on one of my favorite topics: Yoga for Better Sleep. (to register, go to http://brentwoodyogacenter.com/workshops ) This is topic is dear to my heart because, well, it’s something I have to practice myself on a regular basis. Even small amounts of stress can disrupt my ability to fall sleep or to sleep soundly (interestingly, that’s something that seems to run in my family). Fortunately I’ve learned a number of techniques both for reducing my stress levels in general and for lulling myself to sleep while I’m in bed. And my feeling about teaching these techniques to others is that if I’ve helped just one person to achieve better sleep, than I’ve been successful!

I’ve written about this topic in general on the blog (see Day to Night and Yoga for Insomnia, Part 1). But the other night as I was lying in bed not sleeping, I realized that if I had to choose one single technique above all the others, it would be the breath practice I turn to almost automatically these days. And I decided then and there I wanted to share it with you all.

For most of us, what is happening when we’re lying in bed sleepless is that our minds are churning, thinking about the day’s events, ruminating about the past or worrying about the future, which stimulates our nervous systems. Turning our minds to a neutral focus, such as the breath, allows us to let go—at least temporarily—of those disturbing thoughts and helps calm the nervous system, switching on the relaxation response. And in my case, after 10 to 20 minutes of breath practice, I almost always end up drifting back to sleep.

Start by practicing simple breath awareness. This means focusing your mind on how your breath moves in your body, perhaps on how your belly rises and falls with your breath or, if it’s easier, how your chest moves with your breath. You could also focus on the more subtle sensations, such as the feeling of your breath moving in and out or your nostrils or, if you prefer, the sound your breath makes in your body. I actually like to lie on my back with my hands on my  belly because that makes it very easy for me to feel the movement in my abdomen.

For some of you, this simple practice may be enough. For myself, I like to use a more structured technique of extending my exhalation. Extending the exhalation in particular helps calm the nervous system (your heart rate slows on your exhalation) but I also find it engages my mind more completely. To do this, when you reach the end of your exhalation, simply add a beat or two—without straining—before turning on to your inhalation. Keep it relaxed and easy. And if the practice aggravates you, simply return to your natural breath.

If at any point you realize your attention has wandered from your breath (it will, of course), simply—and without self judgment—bring your attention back to your breath.

I confess that, in addition to all that, I also count my breaths. I got the idea from Baxter who showed me a technique using your fingers that he learned when he studied at the Krishnamacharya Yoga Madiram. This really helps me keep my mind engaged, and when I start to really lose track of where I am, that’s when I’m starting to fall asleep. However, this may be, well, too anal for you. (Hey, I’m just trying to be honest about what I really do—and what really works for me.) Basically, you need to experiment and see what works for you. Maybe you’ll even come up with new variations. If whatever you are doing is working, then it’s right for you.

You can do this breath practice every night when you get into bed or just on those nights when you start to realize—it sometimes takes a while catch yourself—that you’re having trouble falling asleep or are wide awake in the middle of the night.

I have more tricks up my sleeve and hope to share them with some of you in person at my April workshop, but in the meantime, if I help just one person.....

Day to Night: Yoga for Better Sleep

by Nina

This morning I was talking with Bonnie Maeda, RN and Shari Ser, PT about the workshop we’re going to be teaching on yoga for sleep disorders at the Berkeley Yoga Room, Saturday, June 16, from 2 to 5 (see here for registration information). When I described my 24-hour approach to practicing yoga for better sleep to them, they were very enthusiastic. So I'm going to share it with you today.

Yes, yoga in general is relaxing, but some poses are more relaxing than others while some poses and practices are actually quite stimulating. So if you’re having trouble sleeping, I recommend you plan out your day regarding which poses you do when. I mean, if you’ve been suffering from insomnia, you wouldn’t drink a double espresso right before bed, would you? Standing poses, backbends and vinyasa flows can be almost as stimulating, so a strong practice including those poses done just before bed can keep you awake (trust me, I've tried it). But those poses help keep you strong and flexible, as well as reducing stress by releasing physical tension from your body, so you wouldn’t want to eliminate those poses entirely from your practice. On the other hand, there are relaxing practices you can do right in bed either before sleep or in the middle of the night that will help you fall asleep more quickly and sleep more deeply.

Buddha in My Garden by Michele Macartney-Filgate

Here's how to plan out your day:

Day Time
Getting exercise is important for improving your sleep. So during the day, walk, run, swim, cycle, or do a strong yoga practice that includes forceful, stimulating poses, including standing poses, backbends, twists, and/or Sun Salutations and vinyasa flows.

Early Evening
After work or in the early evening, if you’re up for practicing, it’s best to do poses and practices that calm your nervous system, such as forward bends, inverted poses, and restorative yoga. Meditation, Relaxation pose with a mental focus, and yoga nidra (yogic sleep) are also good stress reducers. If you want to use a guided relaxation, see the Relaxation Tracks tab on at the top of the blog. From this point on it’s best to avoid the simulating poses and practices.

Before Bed
Turn off the TV early or put your book down, and take some time before you get into bed for conscious relaxation. Switching your nervous system from fight or flight to relaxation mode before getting into bed will help you fall asleep more quickly and sleep more deeply. Supported inverted poses, such as Legs Up the Wall pose, Easy Inverted pose (see here), and Bridge pose with straight legs, will calm your nervous system. Some people also like to meditate or practice seated breath awareness before getting into bed.

In Bed
For people suffering from insomnia, just getting into bed can trigger a new bout of stress. If you find your thoughts are racing and you are worrying about falling asleep, you can practice a body scan (Relaxation pose with a mental focus), where you conscious relax various parts of your body. Or you can work with your breath, either practicing general breath awareness or any form of pranayama that lengthens or emphasizes the exhalation. Practicing conscious relaxation before falling asleep will help you sleep more deeply. See my post Yoga You Can Do In Bed for more information on yoga you can do before falling asleep.

In the Middle of the Night
All of us insomniacs are familiar with the terrible moment in the middle of the night when we realize we’re wide awake and the possibility of returning to sleep feels hopeless. However, the worst thing you can do is lie there worrying about not falling back to sleep. Instead, return to the same practices you do before falling asleep, such as Relaxation pose with a mental focus, breath awareness, or extending the exhalation. Although it takes some discipline to focus on these practices (for some reason, worrying seems so much easier in the middle of the night), many people, including me, find that 10 to 20 minutes of practice allows us to fall back into a deep sleep.

Some practitioners I know do soothing poses in the middle of the night, such as supported forward beds (in bed with pillows) or even Legs Up the Wall pose. You can try this if seems appealing; just make sure you move slowly, stay warm, and keep the lights as low as possible. You could even play a guided relaxation track at this point. Again, see my post Yoga You Can Do In Bed for more information.

Morning
Good morning! I hope you slept better last night. Now, if you feel like gently stimulating your nervous system by moving with your breath, doing a few standing poses, or even doing a full yoga practice, go for it!

Three Happy Endings: Yoga for Better Sleep

by Nina

My friend Liz has a chronic disease but she takes great care of herself. She eats a healthy diet, and, when she is up to it, takes long walks and yoga classes at her neighborhood yoga studio. Because she has sleep problems, she recently decided to start practicing yoga at home as well, after she comes home at night. “It works!” she told me happily. “I sleep like a baby after doing yoga.” Today I decided to ask her what kind of yoga she does, and she said something very interesting. “It depends on what time I get home.” She went on to explain, “If I get home around 6:00 pm, I’ll do some flow yoga, with poses like Warrior 1, 2, and 3, and Half Moon pose. But If can’t practice until 8:00 or 8:30, that’s counter productive.”

“That makes perfect sense to me,” I said.

“Really?” Liz looked intrigued.

“Yes,” I explained. “Standing poses and vinyasa yoga are stimulating to your nervous system. When you stand up, your blood pressure has to rise to keep the blood pumping up toward your head. So if you do stimulating poses too close to bedtime, it’s going to be hard to go to sleep soon afterward. It’s like drinking a cup of coffee too late in the day.” Then I asked her what kind of poses she does if she can’t practice until 8:00 or 8:30.”

“Legs Up the Wall pose,” she replied. “And Shoulderstand and Plow pose. I also like to do that restorative yoga pose where you lie back on a bolster with your knees apart and the soles of your feet touching.”

“That’s perfect!” I said. “The first three are inverted poses, which automatically trigger the relaxation response. These are exactly the poses that are best to do right before bed to help you to sleep better. And that restorative pose is Supta Baddha Konasana or Reclined Bound Angle Pose, and it’s one of the most soothing and relaxing restorative poses.”

Flowers in the Shade by Brad Gibson

I went on to tell her that this is exactly the way I teach yoga for better sleep. It is important to get exercise during the day, but any vigorous exercise, including yoga, too late in the day can be over stimulating. So if you are having sleep problems, this is something you should consider when you are planning your day. Do your vigorous exercise, including standing poses, flow yoga, and backbends, earlier in the day. And try doing inverted poses, forward bends, or restorative yoga in the evening before bed to see if they help improve your sleep.

There’s no hard and fast rules, however. Liz discovered the best times for herself to practice vigorous versus relaxing yoga by experimenting. And the only way for you to find out the best times for yourself is by going through a similar process. However, I can tell you that if you take a nighttime yoga class and have difficulty sleeping afterward, when you come home, instead of getting right into bed, try practicing your favorite calming pose first and see if that helps.

Liz improving her sleep by practicing yoga at home is just one of the happy endings to this story. The second happy ending is that she made her home yoga practice her own by experimenting, observing, and coming up with her own yoga solutions that suited her particular needs and concerns. That, I told her, is advanced practice.

The third happy ending is that I asked Liz for her permission to write about her today, and she said yes. Thanks, Liz!

Never go to bed angry

by Nina

On Tuesday I read a short little piece in the NY Times questioning the adage “Never go to bed angry” (see here). It was one of those bottom line pieces, and the bottom line was this:

“Going to sleep upset or disturbed preserves the emotion, research suggests.”

In the cited study in The Journal of Neuroscience, scientists exposed 106 men and women to images that elicited various emotions. In some cases the emotions were negative and in other cases the emotions were positive or neutral. The researchers then looked at what happened 12 hours later when the subjects were shown both new images and the previous ones, either in the morning after a night of sleep, or at the end of a full day of wakefulness. The conclusion was:

“The scientists found that staying awake blunted the emotional response to seeing the upsetting images again. But when the subjects were shown the disturbing images after a night of sleep, their response was just as strong as when they had first seen them—suggesting that sleep “protected” the emotional response.”

That doesn’t sound good, does it? Going to bed angry and waking up angry is not only an unpleasant experience for you, but it probably doesn’t enhance your relationships with the people around you. Besides, it's also not a good idea to go to bed angry if you are concerned about getting a good night's sleep. Your stress levels will be high and your sleep, if you can sleep, will be restless—maybe filled with upsetting dreams—and you won’t feel rested in the morning.

But very probably you—unlike the people in the study—can’t just put away an “upsetting image” when you are very angry. In fact, the chances are you’ll keep having one angry thought after another, and with each angry thought you’ll get another jolt of adrenaline (that’s why they call it the “fight or flight response,” people), keeping your stress levels as high as they were before.

Santa Barbara Botanical Gardens: A Detail by Joan Webster

The good news is that Baxter says it takes only about 90 seconds to clear the adrenaline released in your system by an angry thought if you switch to a more neutral topic. So to put away your anger, he recommends a structured breath practice, in which you measure your inhalations and exhalations, and count your breaths to engage your mind. If you combine this type of breath practice with a supported inversion (such as Legs Up the Wall pose) or a supported forward bend (if you find those soothing), both of which help switch your nervous system to relaxation mode, you’ll get a double dose of calm.

You could also use a guided relaxation (see here) as a way to engage your mind and relax your nervous system at the same time.

Yoga You Can Do In Bed

by Nina

Did I say “in bed? Yep. It’s normally not a good idea to fall asleep when you are doing yoga (you can overstretch your muscles if you fall asleep in a restorative pose and if you’re practicing conscious relaxation, well, being unconscious pretty much negates the positive effects you’re aiming for). However, there is one exception to this rule of thumb: when you’re lying in bed sleepless due to insomnia.

Whether you have trouble falling asleep initially or can’t fall back to sleep after waking in the middle of the night, instead of working on your To Do list (it’s tempting, I know), try a little yoga. There are a number of yoga practices that just might help you relax enough to finally drift off to sleep and/or improve the quality of your sleep.

Patterns in a French Garden by Brad Gibson

While practicing any of these techniques, be sure to stay warm and keep the lights off to keep stimulation down to a minimum.

Breath Awareness. This is the simplest yogic breath practice and one of the most basic forms of meditation. Simply bring your awareness to the sensations of your natural inhalations and exhalations. When you notice your mind wandering to your To Do list or elsewhere, gently return your mind to your breath.

Extending Your Exhalation. After observing your natural breath for a few minutes, you can try extending your exhalation (while inhalations are slightly stimulating, exhalations are naturally relaxing). When you reach the end of your exhalation, instead of immediately inhaling, lengthen your inhalation by one or two beats. Keep it relaxed, and if at any point you find the practice irritating, return to your natural breath.

Silently Reciting a Mantra. Just as you would when you are meditating, you can use a silent mantra or any word or phrase in bed to keep your mind from drifting into anxious thoughts. This is helpful for those of you who don’t find focusing on the breath effective (or when you have a cold!). When you notice your mind wandering from your mantra to your To Do list or elsewhere, gently return your mind to your mantra.

Guided Relaxation. Following the instructions for a guided physical relaxation (see here), with or without ear phones, allows you to focus your mind on a soothing voice and your physical sensations, enabling some people to drift off to sleep.

Self-Guided Relaxation. When you are familiar with the basic instructions for deep physical relaxation, it’s simple enough to skip the relaxation track and just gradually relax your body by following your own instructions. Many years ago, my first yoga teacher recommended this as insomnia practice.

Slight Inversion. Take the pillow out from under your head and lie on your back with your knees bent. Lift your pelvis up and place the pillow underneath it. You’re now in a very low version of Supported Bridge pose, a gentle inversion that naturally triggers the relaxation response. Try to stay in the position for five to ten minutes.

Supported Forward Bend. If you sleep alone or aren’t worried about disturbing your partner and you find forward bends soothing, you could try a supported bend in your bed. Sit with your legs straight or in crossed-legs position (whichever is more comfortable and allows a deeper forward bend) and place a stack of pillows on top of your straight legs or in front of your crossed legs. Then lengthen your spine forward and rest your forehead and arms on the pillow and relax. Try to stay at least three minutes. If you can’t get comfortable in the pose, then this one isn’t for you.

If you suffer from insomnia, I sincerely hope you’ll something on this list that will help. Most of these are techniques are ones I’ve found useful myself (I'm a bit too lazy to sit up and try an actual pose, however). Readers, if you have any additional suggestions, please chime in!

Yoga for Insomnia, Part 1

by Nina

Paul Weston and his new therapist from "In Treatment"

There I was on Saturday night, doing that thing where you talk out loud to a fictional character on your TV screen. But, really, Paul Weston in Season 3 of “In Treatment” was asking his new therapist for another Ambien prescription. And when he told her that he’d been taking Ambien every night for over a year, I just lost it. I said, “That’s addiction, not a solution! You need to help him wean himself off the pills!” But his therapist wouldn’t listen to me. And then Paul told her that even with the pills he didn’t sleep through the night, but always woke from a nightmare after several hours, and then had trouble going back to sleep, often taking another Ambien to get himself through the second part of the night. He was worried that he might have Parkinson’s Disease. But even though I begged her to offer him an alternative, in the end his therapist wrote him another prescription and said he could come back and talk to her if he wished, so besides the pills all she had to offer him was long-term talk therapy.

Then on Sunday morning I was doing it again because I read an article in the NY Times “Sleep Medication: Mother’s New Little Helper” (see here) about mothers who can’t sleep because they are too stressed out about all the little things they had to do, and instead spend hours in the middle of the night fretting over their “To Do” lists. Both the author of the article and the women themselves seemed to think the only options these women had were sleeping pills or lack of sleep. “Conscious relaxation!” I shouted to the author and the women in the article, but to no avail. It is just part of being a mom these days, they claimed. Some of them even talked about how useful it was to have time to themselves in the middle of the night, when they could get even more work done.

It’s a good thing I can rant in this post today! I do think sleeping pills can be useful on a short-term basis to get you through a short, difficult spell, but they are not a long-term solution because they do not solve the underlying problems (and you do, in fact, become addicted after just two weeks). If you read my first post on chronic stress (see here) you will know that what’s keeping both Paul and the women in the NY Times article from sleeping well is chronic stress. And a different solution to their insomnia could be practicing yoga stress management techniques. So what would I prescribe for Paul Weston?

During the afternoon or evening, Paul should practice calming yoga poses, such as restorative poses, supported forward bends or supported inversions (such as Legs Up the Wall Pose). Seated meditation is another good option for this time of day. If Paul can do Savavana or yoga nidra without falling asleep, these practices would also be effective, but taking a nap won’t be effective. The idea is for him to switch his nervous system from chronic stress to the relaxation response, providing him with time in a state of conscious relaxation. (See here for info on the difference between conscious relaxation and sleep.)

Then when Paul is in bed trying to fall asleep, I’d recommend either yogic breath awareness (or extending the exhalation) or a self-guided Savasana (such as progressive physical relaxation of different body parts) so that when he falls asleep he will be more relaxed (and will hopefully sleep deeper and longer). Even though he has important things to worry about, the key is to keep his mind on neutral subjects when he is going to sleep (he can always do his worrying the next day!).

Finally, if Paul wakes in the middle of the night, rather than getting up and turning on the light to read a book, work on the computer, or watch TV (these activities are mildly stimulating), I’d recommend that Paul stay in bed in the dark, and again do a yogic breath practice or a self-guided Savasana. There is a good chance this will help him get back to sleep again. Granted, worrying is very tempting; in the middle of the night it feels like important work. But like any other practice, moving the mind away from worry to a more neutral subject gets easier and easier with experience.

“Paul,” I’d say, “I’ve been there, too. And these are all practices that have helped me learn to sleep better, even during stressful times.”

CHRONIC STRESS: AN INTRODUCTION

by Nina

An ongoing theme that we’ll be exploring in depth on this blog is the negative effects of chronic stress on long-term health and the need for stress management as an important aspect of healthy aging. So perhaps it’s a good time for me to define exactly what we mean by “chronic stress” and to let you know a little about why it is such a serious problem.

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. It took a year and half of therapy, medication, and lifestyle changes to recover completely.

Wounded Bird by Brad Gibson

Feeling stressed is not always a bad thing, however. It’s your body’s normal response to perceived danger or extreme physical activity (often called the “fight or flight response”), which is vital in keeping you safe and active. When you encounter a stressful situation, whether it is a grizzly bear or a stack of tax forms, your body releases hormones (adrenaline and noradrenaline) to provide you with the energy and alertness needed to cope with the situation. And anyone who has almost been run over an SUV knows the feeling: heart racing, rapid breathing, gut clenching. This is because in stress mode, your nervous system stimulates your organs and mobilizes energy by:

• raising your blood pressure
• increasing your heart rate and the blood supply to your skeletal muscles (and away from your gut)
• dilating your pupils and bronchioles, providing improved vision and oxygenation
• generating needed energy by breaking down sugar and fat stores for immediate use

Between stressful situations, your body needs to rest, recover, and acquire new energy, so your nervous system responds by:

• lowering your blood pressure
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract
• contracting your pupils and your bronchioles for reduced oxygenation
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut

But what if the stress is long term? When you almost get hit by a car, escape from a bear or finish your taxes, the incident is over quickly and you bounce back to normal soon after. But if the stress is ongoing or “chronic,” maybe because of continuing job pressures (like mine at the software company), marriage problems, health problems, and so on, your nervous system is continuously on the alert and this can overtax your body potentially causing:

• heart disease
• hypertension (high blood pressure)
• insomnia and/or fatigue
• digestive disorders
• headaches
• chronic anxiety or depression
• weakened immune system

(Hmm, I just counted, and it seems I developed almost half of those symptoms, rather impressive in a weird sort of way.)

Of course, these symptoms are not only unpleasant but will seriously compromise your long-term health if you can’t manage to bring them under control. In addition, several age-related diseases, such as Alzheimer’s, Parkinson’s, and Diabetes are exacerbated by stress, and some theories of aging itself (such as the telomere theory I discussed last week) propose stress as a factor in the aging process itself.

I hope you’re not getting too stressed out by reading all of this! I credit yoga with helping me stay well since that breakdown. And in the coming weeks, we’ll be offering many different alternatives for managing your stress even as you take on the many challenges that life has to offer.