Rewire Your Brain: Think Your Way to a Better Life

core sleep
. It is during core sleep that you engage in 
deep sleep and half of your REM sleep. 
Over - the - counter sleep aids tend to suppress the important stages 
of sleep. They can also lead to tolerance buildup (that is, more of the 
drug will be needed to achieve the same effect) and withdrawal. 
Millions of people treat their insomnia with either over - the - counter 
sleep drugs or physician - prescribed sleeping pills. The over - the -
counter aids, such as Sominex and Excedrin PM, contain the allergy 
medicine diphenhydramine (Benadryl), and therefore produce some 
sedation. Upon wakening the next morning, you may experience 
grogginess and have more diffi culty concentrating. 
Two major surveys of hundreds of studies on the effectiveness of 
treatment for insomnia have shown that sleep medications are rela-
tively ineffective. Prescription sleep medications (benzodiazepines) 
are half as effective as behavioral approaches. Benzodiazepines are 
simply not effective as a long - term treatment for insomnia. There 
is tolerance and withdrawal. If you take them on a regular basis, 
you ’ ll experience daytime grogginess, shallow sleep, and withdrawal 
(making it even harder to sleep). 
If you ’ re taking a sleep medication, you should not stop abruptly 
but should gradually taper off. Withdrawal from benzodiazepines 
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should be supervised by a physician. The following guidelines are 
important: 
1.
In the fi rst week, reduce the dose by one night. It is advisable 
to choose an easy night, such as a weekend night.
2.
In the second week, reduce the dose by two nights, but not 
two consecutive nights; space the nights apart.
3.
Continue this pattern until you are down to the lowest pos-
sible dose for all nights.
4.
Follow the same procedure until you achieve sleep with no 
medication at night.
Make sure that your bed is for two purposes only: sleep and sex. 
If you toss and turn for more than an hour, you should get up and go 
to another room. Getting out of bed allows your body temperature to 
drop and shifts the neurodynamics of lying there and thinking about 
the fact that you ’ re still awake. 
Don ’ t try too hard to go to sleep. Your brain activity increases 
when you worry about not getting enough sleep. Research has 
shown that
trying
to fall asleep promotes increased muscle tension, 
heart rate, blood pressure, and stress - hormone production. One 
study offered a cash prize to the participant who could get to sleep 
fi rst. The participants took twice as long as they usually did to fall 
asleep, because they were trying so hard. 
Sleep scheduling is another way to reestablish a normal sleep 
pattern. By adjusting the time you go to bed — for example, by 
staying up considerably later than usual — you ’ ll build up pressure 
to go to sleep and stay asleep through the night. This is because a 
sleep - deprived person will fall asleep earlier the next night to catch 
up on lost sleep. If insomnia has become a habit and you assign 
considerable importance to the problem, it ’ s usually a good practice 
to establish a schedule that is commensurate with reconditioning 
your sleep cycle. Sleeping late in the morning, which might seem 
sensible, is only likely to make it more diffi cult for you to fall asleep 
the next night. Sleep scheduling, in contrast, requires that you get 
up in the morning at the usual time no matter how much sleep you 
had the previous night. 
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137
Calculate how many hours you actually sleep, on average, and 
then add an hour to the total. Use this formula to schedule how 
much sleep time you should allow yourself. For example, if you aver-
aged fi ve hours of sleep a night for the past month despite staying 
in bed for eight hours, you can allow yourself six hours of potential 
sleep time. If your normal wake - up time has been 6 a.m., you should 
be in bed at midnight. You should use this schedule for at least four 
weeks. Your goal will be to fi ll up most of your time in bed with 
sleep. Eventually your body temperature will adjust and the sleep 
pressure will build up so that you can add another hour. 
This approach is useful if you have chronic insomnia, not if you 
have experienced a night or two of poor sleep. If you ’ re a chronic 
insomniac, the task is to repair your sleep cycle. If your sleep cycle 
is out of sync, sleep scheduling helps you to move it back into sync 
and reestablish more normal neurodynamics. By practicing sleep 
scheduling, you ’ ll increase sleep effi ciency. 
Negative sleep thoughts (NSTs) push temporary insomnia into 
long - term insomnia. NSTs are essentially inaccurate ideas about 
sleep that create a self - fulfi lling prophecy. If you believe these 
NSTs, then you ’ ll have more diffi culty falling asleep again because 
of the buildup of stress. NSTs result in negative emotions such 
as anger and in all the biochemical changes that are associated with 
anger, all of which are activating rather than sedating. NSTs set off a 
chain of events that result in insomnia. 
Identify your false thoughts and replace them with accurate 
information about sleep. For example, if you wake up in the middle 
of the night, try to interpret your wakefulness in one of the follow-
ing ways: 
•
I might get back to sleep or I might not. Either way, it isn ’ t the 
end of the world.
•
This isn ’ t great, but at least I ’ ve got my core sleep.
•
If I don ’ t get a good night ’ s sleep tonight, I will tomorrow night.
Adopting these thoughts will, paradoxically, help you to get 
back to sleep. By adopting reasonable thoughts about sleep, you ’ ll 
take the pressure off yourself and relax enough to get to sleep. 
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In addition, while you ’ re lying in bed, use the opportunity to relax. 
Relaxation methods, such as deep, diaphragmatic breathing, quiet 
the mind. Relaxation during the daytime will help you to sleep at 
night. Relaxation methods work best if practiced twice daily, once 
during the day and once before bed. They reduce the effects of 
stress. 
Thus, there are several techniques that can help you to achieve a 
healthy sleep pattern. Follow these guidelines: 
1.
Don ’ t do anything in bed other than sleep and have sex. Don ’ t 
watch television, balance the checkbook, discuss fi nances 
with your spouse, or argue. Reading in bed is fi ne and often 
relaxing. Associate your bed with sleep.
2.
If you can ’ t sleep, get up and go to another room.
3.
Don ’ t try too hard to go to sleep. It will increase your stress 
and lead to a paradoxical effect. Try telling yourself one of 
the three statements listed earlier. The change in expecta-
tion will free you up to be able to relax and get to sleep. The 
harder you try to go to sleep, the harder it will be to induce 
sleep.
4.
Avoid drinking large quantities of liquid at night, which low-
ers the sleep threshold and causes you to wake up in order 
to urinate.
5.
Avoid bright light at least a few hours before going to sleep. 
Don ’ t work on the computer late in the evening.
6.
Do all planning for the next day before you get into bed. If 
you think of something you need to remember, get up and 
write it down. This will help to postpone thinking or worry-
ing about anything until the next day.
7.
Avoid all daytime naps. Think of naps as stealing sleep from 
the nighttime.
8.
Try eating a light snack with complex carbohydrates before 
bed. Foods rich with L - tryptophan are advisable. Don ’ t eat 
anything with sugar or salt before bed.
9.
Avoid protein snacks at night, because protein blocks the 
synthesis of serotonin and promotes alertness.
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10.
Exercise three to six hours before going to bed.
11.
If noise bothers you, use earplugs or a source of white noise 
such as a fan.
12.
Avoid alcohol for fi ve hours before bedtime.
13.
If you ’ re troubled by chronic insomnia, try sleep scheduling.
14.
Use relaxation exercises. These will help you go to sleep or 
go back to sleep if you awaken during the night.
15.
Keep your body temperature cool. Don ’ t cover yourself too 
heavily. Crack your window open in cool weather, use air con-
ditioning in the summer, and make sure that your bedroom is 
not overheated in the winter.
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141
M
arc came to see me after his thyroid test results came out 
negative. He had asked his primary care physician for the test 
because he thought that he might have hypothyroidism, a condition 
that is characterized by a low level of the hormone thyroxine. Its 
symptoms include low energy and mild depression. 
His primary care physician thought that Marc might be de pressed. 
He knew for sure that Marc was terribly lonely. In fact, he told me that 
Marc frequently went online to research medical conditions so 
that he could justify an appointment for a medical checkup. The real 
reason for the appointments was to come in and chat about the con-
ditions. “ It ’ s like he views me as his best friend, ” the doctor said. 
When I sat down with Marc, he acknowledged that he had no 
friends besides his acquaintances at work and the people he played 
bridge with online. Even with the latter, he never actually developed 
much of a relationship. At work, he never went out to lunch with 
people or took walks with them, and he certainly did not see them 
outside work. I asked him if he was lonely. 
“ No, no, I ’ m fi ne by myself, ” he said unconvincingly. Then Marc 
told me that he was forty - two years old, had never been married, 
7
Social Medicine
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and had dated only a few times. “ Relationships are too complicated. 
I like to keep it simple and live alone, ” he insisted. 
I pointed out that he went to his physician on many of his days 
off and that those visits were his only social contacts. 
“ Well, he ’ s a good friend, ” he said, then realized that he had 
implied more than he intended. 
“ It sounds like you need a friend. ” I suggested. 
“ I ’ ve got all I need, ” he replied. 
“ You mean your doctor? ” I asked. 
“ Did he complain about me? ” Marc looked hurt. 
“ Not at all, ” I answered. “ He ’ s concerned about you and thinks 
that your loneliness is making you feel ill. ”
“ That ’ s nice of him to care, ” he said, looking comforted. “ But it ’ s 
not necessary. ” He tried to recompose himself. 
“ It feels good when people care about you, doesn ’ t it? ” I inquired. 
Marc shrugged his shoulders, looking as if he didn ’ t know how 
to answer. 
I told him about the fi ndings from a huge body of research 
that people who have close personal relationships experience fewer 
health problems, live longer, and are less depressed and anxious. 
“ That may be so for some people, but not for me, ” he claimed. 
“ Yet you ’ ve had some symptoms associated with having few social 
contacts, such as those you thought were connected to hypothyroid-
ism, ” I pointed out. 
His eyebrows shot up. Marc seemed more receptive to hear-
ing more now, since he had symptoms correlated with loneliness. 
I suggested that one way to rule out the connection between his 
symptoms and the possibility that he was lonely would be to see if 
increasing his social contacts would reduce his symptoms. 
His immediate answer was to say no. Then I told him about the