NOTE: I published this elsewhere 10 years ago, on a platform that is now mostly defunct, so thought I would share it again here. I’ve updated it a little, but generally all this advice still holds!

I suffered from terrible insomnia for most of my adult life. This topic came up again recently, so I decided I’d finally take the time to write a post about it in hopes that it may help someone. First and foremost, let me note that insomnia is often a symptom of depression and anxiety — and can be related to undiagnosed medical conditions like thyroid dysfunction — so it’s important to talk to a doctor and make sure any underlying conditions are being properly treated first.

That being said, I suffered for decades trying to get help from more than one doctor and I always got the same condescending nonsense like “try drinking warm milk” and everything else that someone who has been researching this issue for years would’ve already tried. To be clear, this piece isn’t intended for people with occasional sleeplessness, for whom “have you tried taking melatonin?” is a reasonable suggestion and not the sort of question that makes you want to scream. This is for people like me who have suffered from serious insomnia for so long that they have become willing to make meaningful life changes to address it.

This is what worked for me. Your mileage may vary. I think it’s important to know that over the past decade or so, I have significantly changed my life in order to manage both my anxiety and insomnia. I’ve made a lot of changes that will probably seem like too much work for most people. But for me, feeling calm, rested, and energetic most days — I have more energy than I did in my 20s and 30s, even though I’m 50 now — is worth the attendant sacrifices. I also made these changes gradually over the years, not all at once, which made things easier.

Here are the strategies I employ today:

Exercise-related strategies:

I wake up at the same time every morning (5:30am) and do an hour of intensive cardio or strength training. This is, by far, the most important part of my strategy. Forget excuses like “I’m not a morning person” (no one is, at 5:30am), “I just can’t” (yes you can), etc. I’ve been doing it for years and it’s still not easy, but what makes it easier is (1) making sure I’m strict about going to bed when I intend to (10pm), (2) going the gym every day rather than just a few times a week (your body eventually gets used to waking up at the same time every day), (3) belonging to a gym right near my work (so I’m able to fully wake up while I’m on the subway) (Update: During COVID I took the opportunity to build out my home gym, and that makes it even easier!), and (4) setting everything up the night before (lay out my gym clothes, pack my work clothes in my gym bag for the next day) so that all I have to do is wake up, throw my gym clothes on, chug some coffee, and walk out the door. Getting my exercise in early ensures that by the end of the day, my body is physically worn out and ready to sleep. If you have to bring kids to daycare or have other reasons morning workouts are impossible for you, try doing it at lunch — any time other than after work, which tends to keep my system “revved up” beyond my intended bedtime.

I walk the dogs in the evening after work. Unlike my intensive morning workout, this is just a relaxing 15–30 minute stroll around the neighborhood. This helps tire my muscles out just a little bit more and make the transition between work and home. Seeing my pups so excited to get outside helps me shake off whatever minutiae was stressing me out during the workday and focus on what’s important.

I do a few minutes of yoga before bed. Just before I get into bed to read, I do a few yoga poses that require strength: chair pose, warrior 3, side planks, etc. It helps relax my muscles one final time. I am a person who gets very “fidgety” when I can’t sleep, so tiring myself out physically is key to managing my insomnia.

Light-related strategies:

I use a SAD light every morning while I drink my coffee. You can use any light that’s intended to treat SAD (just Google “seasonal affective disorder light therapy” and you’ll get a ton of options). Not as essential in the summer, but key for me in the winter.

I get natural light during the workday. I make sure I’m experiencing natural light as much as possible during the day. I have my desk next to a window now, but I’ve had to work in cubicles where there was no natural light whatsoever, which made it all the more important to get outside for a walk at lunch. Even 20 or 30 minutes of daylight makes a difference.

Strategies related to my bedtime habits:

I have a bedtime ritual that starts 1–2 hours before the time I want to be asleep. During this time I focus on things that are calming or otherwise part of my evening routine: Chatting with my partner about our days, noodling with the guitar, packing my gym bag for the next morning, playing with our dogs. I try to avoid doing anything stimulating or stressful like making phone calls, paying bills, etc.

I write things down before bed. I keep a gratitude journal on my nightstand and, every night, write down at least 5 things I was particularly grateful for that day. That helps put me in a relaxed, positive frame of mind for sleeping. I have a separate “worry journal” where I write down everything I need to do or am otherwise fretting about that might keep me awake. I tell myself that I can open the notebook and resume worrying about these things in the morning, but for now, I am closing the notebook and putting them aside. These are both just mindfulness rituals that work for me, but different things work for different people. Other rituals that work for people I know: Writing down their worries on little pieces of paper and burning them with a candle, saying a prayer out loud, meditating, drawing a picture that sums up their day.

I read in bed for up to an hour, in the dark, using either the Instapaper or Kindle apps on my phone with the white-text-on-black-background setting engaged. I hate how some people insist that ALL DEVICES must be verboten before bedtime, or that doing anything in bed — including reading — is a problem. Here’s what I DON’T do for an hour before sleep time (I get in bed at 9pm with the goal of being asleep by 10pm): Surfing the web on my phone or a computer, replying to emails, watching TV, doing anything under bright lights. Here’s what I DO do: Get into bed, turn off the lights, turn off all notifications on my phone, and read a book on my Kindle app with the white-text-on-black-blackground setting engaged. For me, it’s critical to turn off any banner notifications or other distractions that might pop up while I’m reading. All I have access to is the book or article in front of me. I find this helps me fall asleep even more quickly than reading a paper book (or non-backlit Kindle) under dim light. Somehow the total darkness is what signals to my brain that sleep time is coming. I give myself an hour, though, so I am able to relax and lose myself in the story before I start getting anxious that I’m not feeling sleepy yet.

I sleep with earplugs, a white noise machine, and have very dark window shades. I said at the beginning how this was one of the annoying suggestions, but really: Try keeping the room dark and silent or with white noise only. If you close your eyes at night and find it’s darker than when you had them open, then you need to cut off some sources of light. I have shades that block out the streetlights and neighbors’ backyard lighting, and put black electrical tape over chargers and other devices with lights on them. Other people I know use white noise machines in addition to the earplugs.

Diet-related strategies:

I don’t drink alcohol. When I was younger I relied on having a glass or two of wine before bed to help me sleep, but the problem with that is that, like any addictive substance, the amount I “needed” kept increasing. Plus, alcohol disrupts your REM sleep and can wake you up in the middle of the night when the effects wear off. I quit drinking for a variety of reasons, but was surprised to find that one of the benefits was how much better I started sleeping (not at first, but after about 6 months).

I make lunch my big meal of the day. This helps me avoid eating a large, high-calorie meal right before bed, which can also interfere with sleep. I look forward to a filling and flavorful lunch as my “big meal.” I also block out my work calendar from 12p-1p weekdays, so people don’t try and schedule meetings during that time, forcing me to just grab something on the run.

Caffeine? This doesn’t apply to me, personally (I drink plenty of coffee!), but some people are particularly sensitive to caffeine due to genetic differences in how they metabolize it. My partner is one of those (I’m not, thank goodness!). He can have a cup of coffee at noon and it will keep him awake 10 or 12 hours later. If you’re reading this, you might try cutting out caffeine temporarily to see if you are one of these people.

Strategies around medication:

I took drugs at first, but not Ambien. The two groups of commonly-prescribed drugs, (1) Ambien-type drugs and (2) prescriptions classified as benzodiazapenes (i.e. Xanax, Ativan, Klonopin, etc.) are intended for short-term use and quickly lose effectiveness — and the latter are dangerously addictive. Once I finally found a doctor who took my sleep issues seriously, we set about trying to find a non-addictive medication that could help over the long term and was safe for me to take for months at a time. People I know have found success with a first-generation antidepressant called trazodone, but it gave me terrifyingly realistic nightmares that felt like hallucinations (a known side effect). What worked for me was quetiapine fumarate, which is an anti-psychotic that’s used off-label for insomnia. It comes with significant side effects and requires monitoring, but it was worth the risks for me. I was eventually able to taper off of it, but I took it while I was working on other lifestyle changes to get my insomnia under control. My point is that there are non-addictive, non-Ambien options that are available, but the tough part is finding a doctor who takes you seriously and doesn’t give you the same “try taking a warm bath!” nonsense.

I take melatonin, but I don’t actually know if it does anything. From what I’ve read, melatonin gets destroyed in a person’s stomach, so taking it as a pill that you swallow is much less effective. I get the kind that dissolves under your tongue and take 5mg of it about an hour before bed. I actually don’t know that this helps, but it doesn’t seem to hurt.

(Update: At 50, I’m now on hormone replacement therapy (HRT), and the 200mg progesterone I take at night really helps with falling asleep quickly too!)

Strategies related to my lifestyle and way of thinking:

I have a meditation practice and I make it a priority. Mine is part of a larger Buddhist practice focused on letting go of trying to control the world around me and accepting things as they are, which is helpful in reducing general anxiety and, as a result, insomnia. But even on its own, I think meditation is helpful. I try to meditate every day, even if only for 10 minutes, which helps me practice getting my mind into the place of stillness that is helpful when trying to fall asleep. Meditation is great for learning how to quiet the “noisy voices” that would not stop reminding me of everything I needed to do the next day when I was trying to fall asleep. I find the Buddhify app useful for guided meditation.

I remind myself that not sleeping is not the end of the world. I was raised to think that there were certain rules that had to be followed, and if you followed them all to the letter, your life would be perfect and nothing bad would ever happen to you (that’s how it works, right)? For me, that also applied to getting 8 hours of sleep. If I wasn’t sleeping, I began to have meta-anxiety about getting into bed, and worrying about my insomnia kept me awake. That would’ve been funny if it weren’t so frustrating! Now, when I have the occasional sleepless night, I keep in mind that people with infants, those living in war zones, people who have to work multiple shift jobs, and many others are able to survive on surprisingly small amounts of sleep. Not sleeping for a few nights might make me tired and irritable, and isn’t great for my health, but I will survive, and I will eventually go back to normal sleep patterns. It’s not the end of the world.

I check the calendar. It took me an embarrassingly long time to realize that my occasional bouts with intense anxiety always came 1–3 days before my period was scheduled to start. I still typically only get 4 or 5 hours of very light sleep, waking every hour or so, for at least one night during that time. Knowing that it’s just a hormonal issue and that it will pass in a night or two — and being able to anticipate that it was going to happen — made it easier to tolerate.

I undertook other life changes to address my depression and anxiety. This would be a whole ‘nother post, but I have made many other changes to improve my mental health and which contribute to my feeling more relaxed and less stressed overall, which I have to assume contributed to relieving my insomnia. These include engaging in talk therapy, volunteering, choosing jobs that are not as high-pressure as many in my field, investing in my social safety net by prioritizing making time with old and new friends, and taking steps to simplify my life.

I hope this helps someone. Good night and good luck.