WELLNESS WEDNESDAY

Hey folks, Sally Riggs here, psychologist, fellow long hauler, and your Long COVID. Coach, welcome to another Wellness Wednesday.

Today, I wanted to talk about an issue that is huge in Long COVID. And really not talked about enough or sometimes talked about in the wrong way. And that is insomnia. I had insomnia for about 18 months straight. And for me, as for many of us with Long COVID, that meant that I was able to fall asleep, although that wasn't super easy. But I would not stay asleep past about 1:30 am. And then I could not get back to sleep again, I would wake up to use the restroom, one o'clock 1:30, 2 o'clock, and then be awake for the rest of the night. And if you are experiencing this, I want to go through today's 10 Surprising tips for overcoming insomnia in Long COVID. Because there's a lot of misinformation out there, particularly from GPS and primary care physicians that I just want to talk a little bit more about and correct.

So the first thing that is important for us to establish is why we're experiencing insomnia. And it may not be what you think, or you've been told it is not because of anxiety. Now, anybody who cannot stay asleep past 1:30 am for 18 months, sure, the minute they wake up, they're going to be anxious. But it's not anxiety that's waking you up in the first place. And with so much of Long COVID anxiety as a secondary symptom. Rather than what is causing our issues in the first place. What is actually causing insomnia is nervous system dysregulation. If you are stuck in a fight or flight, or even in shutdown, your body cannot rest. In order to sleep, you need to be in rest and digest. Which if we're thinking about the polyvagal ladder is right up there at the top. If we are in sympathetic activation, fight or flight, our body is all antsy and agitated and full of emotion that needs to be worked through and we cannot sleep. And if our body isn't shut down, even though we feel fatigued, we're not tired, the body has just turned things off to protect itself. Again, it's not sleeping.

So I cannot stress enough, and you will hear me talk about this a lot on this channel. As you work through your nervous system and start to calm it down, start to understand it and start to befriend it. Ultimately, as you get back to rest and digest more, your sleep will slowly start to improve, I absolutely promise and so please hang in there until then, the rest of the tips that I'm going to go through will help you with some things in the meantime. But I cannot stress enough working on your nervous system.

So the second thing that I want to talk about is that as we work on our nervous system, if we are remembering again that it's a ladder, so rest and digest are at the top fight or flight is in the middle and shutdown is at the bottom. If you aren't working your way up the ladder, you have to go through fight or flight to get to rest and digest. So probably as you work on calming your nervous system, your insomnia will get worse before it gets better. And that is the same with a lot of nervous system work. Because we have to push through that ceiling of fight or flight to get back to rest and digest. And that means that we will temporarily be in that state more and it will be harder to sleep. So again, it's not a simple fix with nervous system work. It takes us a while to work through all of this. If you are noticing that your insomnia has gotten worse, hang in there. It will get better again, but it will just take time to move through that fight or flight.

Now the third thing I want to talk about is that the majority of traditional things that people suggest for insomnia, often referred to as sleep hygiene are not going to work for us. And you may have had a very helpful Doctor's GP Long COVID clinic give you a sheet with sleep hygiene rules. I've been a psychologist for a very long time we have used that stuff a lot. It is evidence-based, it is incredibly effective. And now I'm going to talk you through why it doesn't work for us. And so if you have been struggling with that, you're not alone, it doesn't work for us feel free to rip up the sheet or put it in the trash or whatever makes you feel the best. I'm gonna give you some other things that are more helpful.

So the fourth point is that one of these things from that sleep hygiene list that is most frequently cited is that if you're awake for more than 20 minutes, don't lie in bed, get up and do something else. And I'm here to give you permission to ignore that we have dysautonomia, and or pots, the vast majority of us, and getting up and moving from lying down to setting up is going to make those symptoms 10 times worse.

Even if you are lying in bed 24/7 And you do not ever sleep. If you have pots or dysautonomia for a certain period of time, that is the best place for you to be. So again, please, if you've been told to get up, just ignore that one.

The next one that people very frequently get told, and is Top tip number five, is to go to bed and get up at the same time. Even if you haven't slept. That is not going to work for us. We need to sleep when we can. If that's 2 am to 10 am, then so be it. Move your life around so that you can sleep at that period of time. We can not be trying to force our body through sleep deprivation to try and sleep because we are stuck in a fight or flight. If you're someone who has a circadian rhythm problem, then sure that's going to be incredibly effective. But that's not our issue. Our issue is nervous system deregulation. And so that's not going to work.

By the same token, Top Tip number six will say don't nap during the day. But we definitely should be napping in the day. If we can. Our mitochondria are broken, and we can't make enough energy to get through the day in the state that we're in. And so if you can fall asleep on the couch in the afternoon, that's going to give your mitochondria a break and help you to produce a teeny bit more energy to get through your day. Again, you don't have a circadian rhythm problem, you have a nervous system problem and many other physiological things happening in your body. So if you can nap from 6 am until eight, and then you have to get up for work, then you do that. And if you are having to work again, it's really important to talk about accommodations at work, so that you can take a break every so many hours, and part of that may be taking a 28-minute power nap.

If you are awake at 2 am and I hear this from so many people, definitely having something to listen to at that time to take your focus off just trying to fall asleep is going to be beneficial. So top tip number seven podcasts, the calm app, headspace, yoga, Nidra, audiobooks, anything that you can listen to comfortably, that will take your brain focus off of, oh my goodness, I need to sleep, oh my goodness, I need to sleep and just be putting it back on to something else. And ultimately, that may help you drift off. But that's not the point of it. We're not trying to put you back to sleep. We're just trying to help you tolerate that time and hang in there.

I would listen to podcasts as hard as I could and usually around six o'clock I would just kind of drift into some sleep and get about another hour or an hour and a half. And that was quite useful to me.

Top tip number eight and I'm not a physician. So obviously I can't prescribe meds and obviously, on YouTube, I can't give you meds recommendations. But many, many MECFS Doctors do recommend using Ambien including people like Jacob Teitelbaum, and some of the others that are very frequently presenting at summits about lung COVID or MECFS. The reason they recommend it, obviously, you need to talk with your physician about whether it's appropriate to you, but it has a short half-life. So unlike benzodiazepines, you're not going to wake up feeling groggy, when you do have to get up at whatever time. And you can take it. Typically, if you take a whole tablet, it's going to give you eight hours of sleep, you can take a half tablet, and it will give you four. So if you're awake at 2 am, and you want to get four more hours, you can take a half tablet, or if you're awake, I'm sorry, if you're awake at 2 am, you can get four hours, if you're awake at 4 am, you could take a quarter tablet, and get two hours. And what this does, knowing that you have something that will help you fall asleep, reduces the anxiety that reduces the vicious cycle that compounds insomnia. Now, I also want to caveat this, and this is solely also based on personal experience. I this for me was a game changer. I did use Ambien for a long time. And I do still have a stash in case I have a night where I can't sleep.

Ambien is unfortunately addictive or habit-forming as they say. And so when you are doing better with your nervous system, and you do wean yourself off, there will be a small rebound effect where you will get insomnia again momentarily. And again, you just have to hang in for a couple of weeks knowing that you've done the nervous system work, and it will resettle. And I did have that experience. And it did resettle. And most of the clients that I work with individuals who have also used Ambien have had that experience. And again, just hang in there at that point, and maybe go back to point seven, using your podcasts and your apps to do yoga, Nidra, et cetera, at that point,

Top Tip number nine. And this is a huge one. Most of us have PTSD from our experience of acute COVID and Long COVID. And so as you begin to improve your nervous system, and insomnia might be improving, you're still going to have some triggers around having spent so much time in bed, feeling awful, not being able to sleep in that space and all of the kind of associated sensations in our body and feelings that go along with that. So something that I would recommend, as you're in that stage, your insomnia is just starting to improve your nervous system is doing much better, you may need to do a little bit of a home makeover in your bedroom.

I threw out all of the pajamas that I had ever worn when I was sick, they were all associated with a very uncomfortable time and treated myself to some brand new ones that made me feel good. And kind of starting a new era of feeling better. I also got new sheets and duvet covers. And I also got new pillows. My pillows had gotten very old and we were not very uncomfortable. And I know that one thing that many of us deal with especially those who have M casts is that we can't sleep totally flat anymore. And we need three or four or five pillows. And mine we're not cutting it so I bought a bunch of new pillows. One thing I do still need to get probably is a new mattress protector.

Again, those of us who were waking up in hot sweats in the middle of the night. With that experience have sweating through your pajamas sweating through your sheets. I imagine that has probably done some damage to my mattress and at some point, I may invest in a new mattress as well. But whatever you can do to change that environment in your bedroom is maybe moving the furniture around. It may be doing a new painting to put on the wall. Whatever it is for you that can refresh that space and make it feel new and not associated with the previous experience of chronic insomnia and chronic COVID symptoms.

And top tip number 10. The thing to remember with insomnia is that this is tricky, and this is where physicians get confused. It definitely is that chicken and egg situation, that the fact that we're not sleeping does contribute to our symptom maintenance. And many physicians will say, you're not sleeping, that's why you're sick, you need to fix your sleep in order to get better. Well, unfortunately, it isn't that way around. As our nervous system begins to get better and we can start to heal, then the sleeping will get better and then we can heal even more.

But we do have to hang in there. In the meantime, knowing that not sleeping isn't helping us and trying not to panic about that, trying to remember that people have been through this too and that we all got better. We all made it out to the other side. I do not have insomnia anymore. In fact, I sleep incredibly well. Sometimes I don't even wake up to use the restroom.

So ignore any doctor who tells you to follow a strict sleep hygiene protocol.

Your sleep will slowly recover.

And most of the things on that list are not relevant to us and may actually make things worse. And if you are looking to learn more about how to heal your nervous system, take a look at my video from a couple of weeks back where I talk you through my new online course that is coming out very soon and it will help you do exactly that. I hope you have a tolerable week and I will see you again on another Wellness Wednesday.

Take care!