Why do I want to write about insomnia as a gastroenterologist?

As it turns out, many of my patients who complain about abdominal symptoms often also complain about insomnia. Sleep problems often manifest as abdominal symptoms. Some researchers suggest that our brains may develop gravity-induced ischemia when our bodies are in a prolonged upright position. Sleeping in a supine position allows the brain to be relieved of pressure from gravity. So, sleep is important for our brain – our mind.

Many people have problems actually falling asleep once lying down. Below is my take on why we have problems falling asleep. Using this method, I’ve found success in falling asleep without reliance on sleep medication.

Before getting into my insight on falling asleep, I presume that you are already observing the basics of sleep hygiene (See Sleep Hygiene by the Sleep Foundation).

Let’s examine what sleep is: sleep is when your voluntary muscles are relaxed, and your mind is rested – not wandering with random thoughts. When you can’t fall asleep, you will find that your muscles are tense. During sleep our voluntary muscles are relaxed. That is why we won’t hurt ourselves during vivid dreams. We can reverse engineer this process – by first consciously un-tensing our muscles. This will allow us to fall asleep. Just like that. Of course, this sounds very easy (and hopefully it is), but the reason so many people have problems sleeping is that we often are not even aware of how tense we are. Yet, achieving this relaxation is paramount if we want to fall asleep.

How can we relax, melt away the tension in our muscles so we can sleep? You can command your body to relax. Close your eyes and relax your eye muscles, the muscles of the forehead, your face, the back of the head, neck, and down the whole body. The road to sleep must go through muscle relaxation. These are voluntary muscles. They can be persuaded by the mind. Let your mind mellow the tension away so you feel like your head and the rest of your body gradually sink to gravity.

What if you can’t seem to command your muscles to relax? In this case, mindful breathing can be very helpful. Simply breathe in and out through your nose. Focusing on the movement of air through the nostrils – in and out. I find that this helps to empty your mind of other thoughts. Some experts suggest practicing this for about 30-60 minutes every day. When it’s time to sleep, do the same deep breath in and out. At the same time, relax and untense your muscles from the eyes to the face to the rest of your body, feeling as though your body is sinking to the gravity of the bed. Sometimes, having a mental picture of a person sleeping (see photo below) can also help. If you feel yourself becoming tense and your mind wanders again, tell your mind “this too shall pass” and just gently direct yourself back to the breathing and relaxing exercise.

Other things to do that help with muscle relaxation is practicing mindfulness during the day, including activities such as toothbrushing, work out, walking, driving, yoga, etc.

Learning this process of sleep is like anything we do in life — to get better we need to practice and practice and practice. The more you practice, the more natural it becomes. The better you’re able to relax, the faster you’ll fall asleep. It may take a little longer at the beginning, but the process should get shorter as you keep doing it. For some people it takes a couple of tries and for other people, it may take longer. But you will get there if you keep trying.

Remember, relax your muscles and you will fall asleep! Sweet dreams.