Session 225: Getting Better Sleep

Session 225: Getting Better Sleep

Dr. Joy: Hey, y’all! Thanks so much for joining me for Session 225 of the Therapy for Black Girls podcast. We’ll get right into the episode after a word from our sponsors.

[SPONSORS’ MESSAGES]

Dr. Joy: One factor that is critical to our mental health is proper sleep but getting a good night's rest sometimes seems easier said than done. To help us hopefully sleep a little better, today we're joined by Ibinye Osibodu-Onyali. Ibinye is a licensed Marriage and Family Therapist in Temecula, California. Her practice focuses on incorporating scripture into treatment, helping women struggling with anxiety, self-esteem issues, and difficulties with assertiveness.

She also assists women in finally falling and staying asleep, utilizing cognitive behavioral therapy for insomnia. She and I chatted about some of the primary causes of insomnia, lifestyle choices that might make it difficult to sleep, how our sleep has changed during the pandemic, and she shares tips for how to improve sleep hygiene. If something resonates with you while enjoying our conversation, please be sure to share it with us on social media using the hashtag #TBGinSession. Here's our conversation.

Dr. Joy: Thank you so much for joining us today, Ibinye.

Ibinye: Thank you, Dr. Joy. It's so good to be here.

Dr. Joy: I'm very excited to chat with you. Sleep, I think, is one of those things that is often not paid enough attention to as it relates to mental health, but we know that there are so many ways that our mental health is actually impacted by sleep. I wonder if you could just get us started by talking about some of the most common sleep disorders that clients will come into the sessions with you for.

Ibinye: Oftentimes, it is insomnia. That's a huge one. They just cannot sleep. Very rarely, it would be hypersomnia (sleeping way too much) and sometimes clients are coming in with nightmares which are usually related to some type of underlying trauma going on. But usually, it's insomnia, that's a big one.

Dr. Joy: And so can you define insomnia for us?

Ibinye: Okay. How you know that you have insomnia–because people ask me this all the time–if you cannot fall asleep within I'd say about an hour, or stay asleep, and it's been going on for more than two to three weeks, then you do have insomnia. Because some people are like, well, you know, I have a job interview tomorrow and I can't sleep. That's more nerves than insomnia. It has to be going on for a while before you can categorize it as insomnia.

Dr. Joy: That's helpful, the duration as well as like the time, that really is helpful. You've already mentioned like sometimes stuff like anxiety, like we're worked up or stressed about an interview or a big day, something happening. Can you say a little bit more about some of the underlying causes of insomnia?

Ibinye: The first is physical. It could be hormones are out of balance or some type of a vitamin deficiency or health issues. Chronic pain, for example, that would obviously keep you awake for a lot of people. But when it comes to our mental health, it could be trauma, trauma related, or it could be anxiety related, it could be depression related. And sometimes there might be also psychosis that's keeping you up at night. But the first thing that I tell everybody is go to the doctor first and let's rule out all the physical stuff. And if they determine that it's not physical, then we can start to focus on the emotional.

Dr. Joy: I just want to back up a second. You mentioned hormones, can you say more about that? I feel like we’ve got to zero in on that one.

Ibinye: We see this a lot in women who are pre-menopausal. Or even some women who are not pre-menopausal, sometimes their estrogen is out of whack and I think this is when a lot of women freak out and they say, “Am I in menopause?” And I'm like, relax, relax, relax, go to the doctor first. And we also see this in women who have PCOS. Sometimes their hormones are out of balance but once they're able to get those hormones in check, then we start doing some of those CBT techniques, good sleep hygiene, to get them sleeping well again.

Dr. Joy: Do you also see some of this around menstrual cycles? Are there changes in our sleep that happen there?

Ibinye: Yes. A lot of women do have PMS symptoms and they just cannot sleep. Sometimes it's because of pain or sometimes it's, again, those hormones are out of whack during the menstrual cycles. And those women usually I’d send them to a functional medicine doctor for example, who will put them on supplements to just keep those hormones more balanced so that they can sleep better. But yes, that does happen. And it sucks because every month for a week, they are struggling with insomnia.

Dr. Joy: You mentioned CBT as a way after we have ruled out anything physical, so I think that that's really important. It sounds like the first step is making sure you check with your primary care physician or whoever takes care of your health, to rule out anything physical. And then is CBT typically like your first go-to to work through things like insomnia?

Ibinye: Yes, CBT is my absolute go-to. And because most people that struggle with insomnia also have underlying anxiety, I'll also do some DBT as well to help them with distress tolerance. Because it is extremely stressful to be laying in the bed, night after night, everyone is asleep and there you are just staring at the ceiling. It's so anxiety provoking. So I'll do some CBT around the thoughts. A lot of times there are a lot of negative thoughts about “I will never sleep. I'm going to die because I cannot sleep. Something bad is going to happen to me. I'm going to lose my job.” Like you just think about the worst possible thoughts which then worsens the stress, and when your body is under stress, it's really hard for it to shut down at night. So yes, CBT is my go-to for insomnia work.

Dr. Joy: And I want to back up a little bit because we have alluded to the mental health impact that not getting enough sleep has. But I would love for you to talk more in depth about like how exactly does it look when we are not getting enough sleep?

Ibinye: Oh, my goodness. Physically, a lot of people are getting chronic headaches or they just feel like they have butterflies in their tummy all the time, this nervous feeling. But mentally, I would describe it as angst, like I cannot sleep and all I want is to sleep, and there's this obsession with sleep which also comes with a fear about sleep. So all you can think about is getting sleep but you also fear nighttime because, in your mind, you know you're not going to sleep and then it's this self-fulfilling prophecy. “See, I said it. My body will never shut down.”

And that's when sometimes the anxiety and the depression around sleep starts to form and then some people will actually develop sleep phobia around this. Because they're terrified of evening time, they're terrified of nighttime, and it's just really, really horrible. And then of course, your concentration is just completely gone, your mood is shot, very quick tempered, because you haven't slept. You’re exhausted all day long.

Dr. Joy: You know, when I talk to my clients sometimes about we know what happens to toddlers when they miss their naps, right? And so if you think about an adult version of like a tantrum or a meltdown, it sounds like that's what you're describing.

Ibinye: Absolutely. It's almost sad because friends and loved ones don't understand. They say, “Why are you so cranky? Why are you in such a bad mood all because you didn't get enough sleep?” But it's the agony of just laying in the bed for hours and they often feel like they're the only ones going through this and loved ones often minimize it, unfortunately.

Dr. Joy: Ibinye, do we typically see sleep issues like insomnia kind of pop out, out of kind of nowhere? Or is there typically something that will trigger it?

Ibinye: It's usually something that triggers it. But when people come to me, they often say, “I've never been able to sleep.” Well, that's not true because at some point you were sleeping, so then we go all the way back and it's typically something that happened. It could be a loved one or it could be a death of a loved one or it could be a big move or a very stressful job. Or maybe hormonal changes or physical changes or some type of imbalance that's going on.

So then my job is to dig deep to figure out what triggered this and then we can move forward from there. But typically, something happened to cause this. Because most people were sleeping well when they were five years old so I always remind them that. I say your body was able to sleep at some point so it will be able to sleep again. We just have to figure out why it's not sleeping.

Dr. Joy: Can you walk me through maybe some of the things that you do with clients to help them? You've already talked about using CBT kinds of techniques. What kinds of things and what kinds of questions are you asking them? What kinds of strategies are you working with them on, to help them get better sleep?

Ibinye: A lot of it is understanding the science of sleep and understanding that our bodies are engineered to sleep. Because the first thing clients will say is I'm just not one of those people who is able to sleep. And so then when we rewind and say, how were you sleeping when you were 10? Oh, I slept no problem. So your body did know how to sleep at some point, right? Reassuring them first that your body will be able to sleep eventually.

And a lot of it is really just tackling the negative thinking around sleep and the fears of the bedroom. Because a lot of my clients don't even go into the bedroom anymore. They'll just go get changed and then they go and sleep in the living room or in the car or somewhere else because they're just terrified of the bedroom. So then we have to do a little bit of exposure therapy to get them comfortable in the bedroom again. And in addition to that, it's a lot of sleep hygiene and lifestyle habits.

A lot of people are doing things that are triggering insomnia but they don't know it. The drinking of the coffee at 7pm or just living in a dark cave. I always say, are you living in a dark cave? Not wanting to expose our eyes to sunlight. There's a reason why because our body cycles just go with sunlight so when you expose your eyes to sunlight in the morning, your body temperature rises, that triggers some hormones to be produced which keeps you awake. And then as the sun sets and it gets darker, your body temperature falls which then triggers melatonin to be produced. So it's a lot of sciency things. And then they're like, “Oh, that makes sense. Okay, I can do that.” It's just little tiny habits that we can change to encourage our bodies to start to produce melatonin at the right time, which is at nighttime.

Dr. Joy: I wonder if there are other sneaky kinds of things. Like I think most of us are aware of coffee and caffeine but I think there are other things like the lifestyle issues that you're talking about, that may be contributing to us not getting enough sleep. What are some of those other things?

Ibinye: Exercise. A lot of people that have insomnia just don't move anymore because they say “I have no energy.” But exercising at the right time could actually help your body trigger all the right chemicals so that you can sleep at night. Not laying in the bed constantly–which, as usual, they look at me like, I'm only getting two hours of sleep a night and you're telling me to get out of the bed? Yes, get out of the bed. Reason being, when you are laying in the bed in agony, feeling anxious or depressed constantly, your body begins to think that your bedroom is a place of agony.

If you are laying in the bed and say you haven't been able to sleep in 30 minutes or one hour, get out of the bedroom. Go out of the bedroom, go somewhere else, do something else. Don't go out there thinking about sleep and worrying; just go out there, do something else. Read a book, you can even watch some TV, I'm fine with that. Come back in. And you do the 30 minutes on, 30 minutes off. First of all, that wears you out. Second of all, that is really boring and eventually your body will just shut down because it's just sick of the back and forth. I haven't had one client successfully do that twice. By the time they leave and come back, they're just like, “I was so exhausted, I fell asleep.” It's little things like that.

Or, you know, as soon as you get up in the morning, open up your blinds or your curtains so that your eyes can hit sunlight. And don't linger in the bed. A lot of people with insomnia are sleeping in too much. Get out of the bed as soon as possible within 30 minutes of waking up. Because when you’re just laying in the bed awake, that tells your body that your bedroom is a place of work or wakefulness, as opposed to a place of sleep. Good sleepers often don't spend a ton of time in the bedroom but people with insomnia, I find, are... Like how long do you spend in the bedroom? They're spending like 10-12 hours in the bedroom. So then, your body doesn't know that it's a place of sleep, it thinks it's a place where you just wake up and lounge.

Dr. Joy: You mentioned like the right time for exercise. When is the right time for us to exercise to make sure we're not messing up our sleep?

Ibinye: Morning time is usually best. Morning time is usually best because then your body temperature rises, which then triggers wakefulness in the body. But if you're not a morning person, as long as you're not working out, I'd say within four hours of bedtime. So early morning or mid-morning or maybe early afternoon. But if you struggle with insomnia, just ditch the evening workouts until your sleep has leveled off–then you can go back to working out in the evening. Because for some people, working out actually energizes them.

Dr. Joy: Mm hmm, yeah, we hear about these endorphins so you do want to be careful not to get that boost in endorphins when you're actually supposed to be laying down.

Ibinye: Exactly.

Dr. Joy: Got it. You mentioned sleep hygiene, which we use that term to talk about all the things you need to do to have a nice bedtime routine. Can you talk about what kinds of other things should go into our sleep hygiene?

Ibinye: Okay. If you struggle with insomnia, it means that your body has a hard time relaxing or shutting down. Some people's minds are just so busy from the workday that they can’t just lay in the bed and shut it off, so have an actual bedtime. A lot of adults are surprised that I say this–have an actual bedtime. We have bedtimes for our kids because it creates good structure. And when you go to bed around the same time every single day, your body produces melatonin around the same time every single day, so it's predictability within your body.

An hour before bed, shut everything down. No more electronics because those electronics produce blue light, which for some people will prevent melatonin production. Not everyone. Some people can stare at the phone and five minutes later they're fast asleep. I'm one of those people, like I could be in the bed on the phone, and then I’m like fast asleep. But not everybody can do that so shut down the phone.

And start to create a routine that works for you. For some people, it is stretching. For other people it is prayer or meditation. For other people, it is taking a nice warm shower. Some people like a cold shower. If that works for you, great. Drinking a nice cup of tea, something relaxing, you don't want coffee at night. Doing something that just feels relaxing and then just gently go into the bedroom. You can do some light reading.

Now a word about reading. I had a client tell me she listens to murder podcasts before bed and I'm like, and you're wondering why you're having these dreams? And then she was like, oh. I'm like, no, no, ladies. And I know we love our murder podcasts but probably not at nighttime. you don't want to listen to or watch or discuss anything that is anxiety provoking or scary. So those horror movies that we love to watch at night, Dateline and all those scary things, not at night. You want to think relaxation.

Even about your bedroom. When you walk into your bedroom, what feelings come up for you? Do you look at your bedroom and go, oh, I hate this place? And you don't have to spend a ton of money or anything like that. Let go of the clutter if you can. Let some light in in the morning. Spruce up the place a little bit. Invest in some soft sheets. Again, these things do not have to cost a lot of money. I'm not someone who's like, “Go and splurge and buy the most expensive thread count.” Nothing like that, just sheets that don't feel itchy. Even what do you wear to sleep? Is it comfortable? I'm a fan of cotton because it's breathable.

You can do some candles that have nice smells like lavender, for example. Cedar wood. Those really help with relaxation and calm. Putting on music or sounds of nature. You want to think about creating a spa environment in your bedroom so think about sights, sounds, smells, and touch. And maybe even taste if you're someone who likes to drink tea. Think about all of those things. When you walk into the bedroom, you want it to signal “This is a place of rest.” And also dim the lights at night so that your brain begins to understand that it's time to begin to wind down.

Dr. Joy: More from my conversation with Ibinye after the break.

[BREAK]

Dr. Joy: You talked about the devices and I think it's become even harder because a lot of us use our devices as like an alarm clock and that kind of thing. But I’d love to hear your thoughts about how the devices have impacted us. You’ve already mentioned the blue light, but also your thoughts about like televisions in the bedroom.

Ibinye: I am not a fan of TVs in the bedroom. I am not a fan of televisions in the bedroom especially if you have a streaming service because they'll just automatically go to the next episode and then the next thing, it's been five hours of your crime show and you're like, oh my gosh, why am I still awake? So I'm not a fan of TV in the bedroom. Except you have the most self-control possible, then sure, and you know you're going to just shut it down by your bedtime.

But that being said though, for some people, when they cannot sleep at night, I do advise them to just watch like the most boring TV show ever because that is not stimulating to them at all and that will help their mind shut down. Or for some people, they say that they can't fall asleep without the flickering light of the TV. So if you're one of those people, sure, do that but just make sure that you have the TV on low so that you're not hearing that blurring sound all night long. But I am not a fan of TVs in the bedroom. The bedroom is for sleep, rest and sex. That's it. Nothing else.

Dr. Joy: Besides the blue light, are there other ways that our phones and our computers are maybe impacting our sleep?

Ibinye: Yes. A lot of us have a dependency on our devices. It's now like a third limb or a fifth limb at this point. We just wake up in the morning and the first thing we do is we reach for our phones or we reach for our tablets. What I often advise my clients is not to put your phone on the nightstand. I know that for most of us our phones are our alarms–I'd say put it across the room. What that does is that forces you to actually get out of the bed and then go out there to reach it. So that's what I always say about the phones.

But the phones just create this dependency and so what I would say with that is to go into your phone settings and create some type of parameters so that you're not staring at the phone. And another thing that's also helpful is to go in there and to check your screen time because when you see how many hours... And I speak for myself, when I see how many hours, I'm like, what? What am I doing? So that creates checks and balances. And for some clients, I would say to even do a social media fast. Because if you're finding that you're just on there constantly, I say delete social media for a week and see how you feel and see how it impacts your sleep.

Because it's the idea of, did they like my picture? Did they like my picture? Did they comment on the picture? What are they doing? What are they doing? What are they doing? And you're just thinking about that constantly and that almost creates some anxiety for some people, just waiting and watching and watching to see how many people like me, how many people followed me, and all of that stuff. It's just that dependency. That instead of resting, you're wondering. That fear of missing out continues to happen. Like what's going on in social media? I can't shut down now because I’ve just got to know who liked the picture. That's a big thing that I see.

Dr. Joy: I think a lot of times when people struggle with sleep at night, you will hear them talking about like taking naps during the day. Is it possible for you to catch up on the sleep that you've missed at night by taking naps during the day? And if we are a napper, what kind of parameters should we have around naps?

Ibinye: Okay. Unfortunately, once you've missed out on sleep, you've missed out on sleep. There’s no catch catching up. There is no catching up, unfortunately. However though, when you've missed out on sleep, after a while, after a few days, your body will then create this really hard drive for sleep. So let's say you went three solid nights with only two hours of sleep. By about the fourth or fifth night, you’ll find that suddenly you slept eight hours straight because your body has this drive to self-protect and actually fall asleep. So that's what I tell people: don't worry, by about the fourth night, you will fall asleep.

Now, naps are fine as long as you're not napping for more than 45 minutes to an hour at a time and not too close to bedtime. If your bedtime is 10pm for example, don't take that nap at seven because you'll be too awake and alert by 10pm. Now, with naps, I say don't make that a routine for yourself. Because for some people, when they take too many naps during the week, by nighttime they're just not tired enough. You want to wear yourself out enough so that by your bedtime, you are visibly exhausted. You're yawning, you're blinking, you can't pay attention to conversation. But naps are fine as long as they're not for longer than 45 minutes to an hour and not too close to bedtime. Naps are great.

Dr. Joy: Okay, perfect. So naptime, we can keep that in our schedules.

Ibinye: Yes, yes, yes. Set an alarm.

Dr. Joy: Okay, an alarm, right. Because I would just like try to take a nap and wake up and it's two hours later, so the alarm part, it sounds like it's helpful.

Ibinye: Yes.

Dr. Joy: Ibinye, you've talked about how our difficulty sleeping sometimes comes from a place of anxiety or maybe we're depressed. And I know setting up the routines is an important part of getting good sleep, but sometimes anxiety and depression make it so that you don't have like the motivation to do these routines. And so we don't want people to feel like they're failing, like they get an F in their sleep hygiene. So what kinds of things might be helpful if people are struggling with those concerns?

Ibinye: First thing that I tell clients is that this is going to be a process, and when you're creating new routines it is going to be difficult for you. There's no pass, there's no fail, you're not being graded, you're not being judged. I actually create the routine with them, like I would actually run through the day with them and then we just pick the tiniest little change that they can make. And I don't ask them to change it every single day because I know, if you don't have motivation, how are you going to do this every single day?

And we just pick one day a week. Let's pick one day a week where you can just get out of the bed for five minutes and then you can just make your way back in. So that way, they get to see that they can do it. It is definitely something that I prepare them for. And it is important, though, one thing that I didn't mention is, when you're doing the CBT for insomnia, if there is that anxiety and the depression, it is important that that is being treated as well. So working on the two things at the same time because you can't really treat one without the other. Helping them to just realize that if you can just do this one time this week, that is success. And with the praise, I'm always big with the praise. And with time, they begin to see that they actually are mastering these habits.

Dr. Joy: I want to go back to some of your comments around like social media and thinking about people who work in digital spaces. Thinking about journalists and other content creators who really are required to be online most of the day, I wonder if you have thoughts about how they protect sleep when they maybe are required to be online maybe more than most of us.

Ibinye: If that is part of your work, then it is what it is and that is why having that strict bedtime and making sure that when you're not supposed to be working, you're off social media. Have that strict bedtime and have that wind-down time, 30 minutes to an hour before bedtime, so that your mind can kind of calm down from the activity and the hustle and bustle of the day. And during your wind-down time, do not touch the phone.

Dr. Joy: Thank you, that's helpful. Something else I've been thinking about, Ibinye, and I wonder if this has come up in your practice, just this idea of like grind and hustle culture and how that has really impacted (I think) a lot of people's relationship with sleep. I wonder if you have thoughts or if this is something that you've had to address with clients in your practice.

Ibinye: Ah, yes, I’m not a fan of hustle culture. I am not a fan of hustle culture at all. Our bodies need to rest, our bodies need to sleep. And we do work a lot around that guilt that comes with sleeping and the guilt that comes with rest, especially for people who are entrepreneurial, running their own businesses, like I need to be going and going and going and going. And teaching them the value of rest and working around where they got the idea of what hustle is and where they got the idea of rest being bad and kind of like doing some CBT around that as well.

But hustle culture really definitely does contribute to insomnia because I hear this idea of like, I only sleep three hours a day, yay. And I'm like, that's not a good thing. Your body’s not happy. So we work around those pieces and teaching them really to listen to their bodies. If you're tired, you should probably sleep because your mood will be better in the morning and you'll be much more creative too.

Dr. Joy: Yeah, and it seems like an extension of that is really kind of viewing sleep as a reward. Like if I do this last two things on my to-do list, then I can go to bed. Are there some CBT kinds of things that can help with like breaking that kind of idea as well?

Ibinye: Yes. We talk about what sleep is for. In reality, what is sleep for? Sleep is really just to rejuvenate your body. Sleep is like air, sleep is like food. Your body needs food, like you cannot go without food and survive. You cannot go without sleep and survive. And we just do some affirmations around that. My body needs sleep. I'm a valued person and my body needs sleep. And sleep is not... I don't love the idea of sleep as a reward. Sleep is just the thing we should be doing because our bodies need it. Because I love myself, I sleep. So we do a lot of affirmations around that as well and with time, eventually, hopefully, they do learn to just value sleep for what it is.

Dr. Joy: More from my conversation with Ibinye after the break.

[BREAK]

Dr. Joy: I’d love to talk a little bit, Ibinye, about how our sleep has changed throughout the pandemic. Lots of people have been kind of studying our sleep, The American Academy of Sleep Medicine found that 20% of Americans said they had trouble sleeping because of the pandemic. And then they repeated the survey 10 months later in March, and sleep problems had only gotten worse–roughly 60% of people said they struggle with pandemic related insomnia. I wonder if that has come up in your practice? And maybe just things that you have observed about our sleep during the pandemic.

Ibinye: Oh, yeah. A lot of people transitioned from working outside of the home to working from their bedrooms and the one rule that I have for my clients is get out of your bedroom. And so then became the struggle of, but now my bedroom is my workspace, what do I do? If you find that your bedroom is your workspace, create an actual workspace that's off of the bed. You can't change that the bedroom is the workspace but just carve out a little, you know, nook if you can (if you do have the space) and let that be your actual workspace. And also, really stick with those guidelines of no napping all day long.

And when you're off of work, leave your bedroom if you can and just go to the kitchen or go to the living room or go wherever. If you live in a studio apartment, again, it is what it is but just walk away from that work niche. That way your brain can separate the difference between work and home, basically. But what I've noticed is that because of the high anxiety of the pandemic... People are worried about their health and people are worried about income and there are so many things going on and families are on top of each other, so a lot of it was the anxiety about the pandemic and that big transition from we were able to just move around freely to being a little bit more restricted in our movement.

So a lot of the anxiety brought on really, really hard insomnia and a lot of people who were really good about sleep hygiene, all of that just fell by the wayside. Even something as simple as transitioning from work clothes to sleep clothes because we were in our pajamas. We were in our pajamas so there was no mental transition. Because in the non-pandemic world, we would work outside of the home, a lot of us, and then in the evening or whenever it is we're off our shifts, we’d drive back home or walk back home, and then we’d transition our minds into the bedroom. But when there are blurred lines, everything just becomes very scattered. But if you can just continue to maintain that bedtime and continue to maintain the good sleep hygiene and continue to create a restful sleep environment, then your sleep will not be impacted too much by the pandemic.

Dr. Joy: Got it, okay. Something else that I have noticed, there's been more commentary around... I had not heard this term before the pandemic and so I want to know if you have, this term “revenge bedtime procrastination,” have you heard of it? Had you heard of that before the pandemic?

Ibinye: Yes, yes, yes.

Dr. Joy: Really? I hadn’t heard that before. Well, yeah, I was like, oh, my gosh, there's a name for this thing that I have been doing and I definitely noticed it more in myself since the pandemic. Can you say a little bit about what revenge bedtime procrastination is?

Ibinye: It's that idea of, it's almost like when a child throws a tantrum, “No, I will not go to bed! I'm gonna stay up but I want to watch my show because I'm an adult.” We know we should be going to bed because we have a busy day tomorrow but we choose to just do all of the fun things, because maybe our days were just packed and we feel like we haven't had enough fun in the day. Although it feels great to do that, but then remind yourself about how you will feel in the morning when you're not getting enough sleep. Now, I know a lot of these parameters just sound super strict because people are like I'm an adult, I should be able to go to bed whenever I want. Yes, you should. So you can give yourself one or two cheat days.

Give yourself one or two cheat days where you're like, you know what, on Tuesday and on Thursday, I'm going to go to bed whenever I want but in all the other days, I will follow my strict bedtime routine. Because I often say that our bodies are like machines and they like predictability and they like structure and they just like the same old same old boring lifestyle. It's boring to have a bedtime and it's not cute. Nobody wants to say I have a bedtime. Give yourself one or two cheat days to stay up till whenever you want but the other five days of the week, you’ve got to be really good about your sleep so that your body isn't confused. Because the body often will get confused.

Dr. Joy: You know, I can't believe I didn't ask you this question but how much sleep should we be getting? Like how much on average should an adult be getting?

Ibinye: The golden number is actually seven hours. However, however... I know, I'm always like I'm a woman of science and then sometimes I’m like “meh.” I would say seven to nine hours because most people do not feel refreshed after seven hours of sleep so I think this should be on a case by case individual basis. If you tend to get seven hours of sleep and you wake up and you feel just great, then great, continue with your seven hours. But if you feel like seven hours aren't enough, then go up to eight. If eight isn't enough, then go up to nine. Some people even need closer to 10, whatever works for your body.

Dr. Joy: I know, Ibinye, that you are not a physician, you do not prescribe any medication, but I would just love to hear your thoughts because I'm sure you have clients who come in maybe using things like melatonin or over the counter sleep aids. Can you talk a little bit about like when maybe people should consider those or why maybe they should stay away from that? And when maybe they would want to talk with a psychiatrist or their primary care physician about like a sleep aid that is prescribed.

Ibinye: Okay. Personally, I am not a fan of sleep aids because I believe that our bodies are wired to sleep and if we do all of the right things, our bodies will naturally just heal and be able to sleep. However though, if your doctor has ruled out all the physical things and if we've tried all of the holistic things and the CBTs and the DBTs and the relaxations and all the sleep hygiene, and it's still not working, then I would say go to your physician and definitely get a prescription. However though, a word about those sleeping pills is that they don't actually cure insomnia. Because in my mind, a cure means you're not going to need the sleep aid anymore, your body would be doing what it's supposed to be doing and then it would just go away.

For a lot of people, it creates dependency and there's a lot of side effects, and the headaches, and feeling like a zombie, and grogginess and poor concentration, forgetfulness. A lot of people just have really bad side effects. Even from melatonin, which really surprises me because melatonin is over the counter but a lot of people just have bad side effects from it. But if you've tried all of the things and nothing is working, then I'd much rather you (of course) take a prescription and get the sleep that you deserve than just suffer through.

Dr. Joy: That's an important note. You've already talked about a couple of things, having sheets that are not scratchy and those kinds of things. Maybe smells that are comforting to you and induce sleep. Are there other things that you have suggested to clients or that clients have said, “oh, this really helped me” that we might want to consider adding to our sleep hygiene?

Ibinye: A lot of clients really focus on their thoughts around sleep and their fears around sleep because, for a lot of clients, they feel like their bodies have betrayed them. So a lot of my work is helping them understand that your body is your friend. And I think that has been the biggest lightbulb for most of my clients. “My body's actually trying to help me?” I say, yes, your body wants to sleep, your body craves sleep. And letting them know that you are your own sleep expert and that is the most important thing. Is realizing, listen to your body, if your doctor put you on a pill and it's not working for you, let your doctor know it's not working. If somebody is telling you you should only be sleeping eight hours but you feel like nine hours is more like it, then sleep for nine hours.

I know I talk about naps but if you're napping every single day and it's not impacting you at night, then keep napping every single day. If you're sleeping six hours and it seems to work for you, then it's fine. So listen to your body, that is the biggest thing. I say I'm only here to guide you, I don't know your body as well as you know your body. If you take melatonin every single night and it seems to work well, you don't get headaches, you're not groggy, it feels good, do what works for you.

Know your body, listen to your body and focus on those thoughts about sleep and that fear about sleep. A lot of it is really the mental, the “I cannot sleep, I'm not good at sleeping, my body's betraying me, my body will never sleep, my body will never shut down.” And trying to combat those thoughts with “my body does know how to sleep and it's going to sleep again.” Because those negative thoughts trigger stress and our bodies have a hard time shutting down when they're under stress.

Dr. Joy: You know, something that just came to mind is if you are sleeping with someone, like maybe a partner or other kids, if you are having sleep problems, then it is likely that their sleep is also being impacted. I wonder if there are things that you can suggest about how we might help a loved one who might be struggling with sleep issues? Are there things we can do to help?

Ibinye: Oh, yes. Oh, absolutely. If you're sharing a bed with someone, let them know that you're struggling and let them know that you're trying to create this new structure. Because for a lot of clients, they'll say “my partner is in the bed and they have YouTube on and it's loud.” Or “my partner is in the bed and they're just real sweaty and all that” or “it's just really hot in here and I'm uncomfortable.”

Starting to have those conversations around what you need for sleep. Like these sheets are not working for me anymore, can we try something else? Or you coming into the room in and out at 2am and 3am and odd hours isn't working for me anymore, can we meet in the middle? I need quiet time from this time to this time, is that something that you can do? Or can you put headphones on when you're listening to YouTube? Or can you make sure that the TV in the bedroom is off and you watch it on your phone or something?

Having those conversations around what you need and helping them understand the emotional impact of insomnia because if you have never struggled with insomnia, it's really hard to understand the emotional and physical toll that it takes. So just opening those lines of conversation so that they can cater to you and your needs.

Dr. Joy: Thank you for that. Are there other resources that you typically share with clients or things that are kind of go-tos for you to help people kind of learn some of this stuff?

Ibinye: Yes, yes, yes. YouTube is a big one. There are like a million relaxation videos on there, there are a million body scans. I'm a fan of deep breathing and body scans and relaxation. Some of my clients love ASMR so I say just go on YouTube and just type it–ASMR–and just pick the one that you like. Go on YouTube and go to guided meditation. Go on YouTube and look up yoga. So they are finding resources that work well for them. And usually, most of my clients will just pick the one and they do that every single night. I’m like, if it works for you, keep doing it. I think that is super important.

So YouTube. I also love the Calm app, that's a big one, and I love Headspace as well. But I'm a big fan of YouTube because it's free. You don't have to subscribe to anything, you don't have to pay anything, it's right there at your fingertips.

Dr. Joy: Perfect. We'll be sure to include those in the show notes. Tell us where we can find you, Ibinye. What is your website as well as any social media handles you'd like to share?

Ibinye: My website is TheZinniaPractice.com. I’m on Facebook and Instagram @TheZinnia Practice as well. And no, my name is not Zinnia, because people call me Zinnia all the time! So yeah, that’s how you can find me.

Dr. Joy: Perfect. Well, we really appreciate you sharing all this helpful information to help us get a little bit better at sleeping. I thank you.

Ibinye: It was really great to be here with you.

Dr. Joy: I’m so glad that Ibinye was able to share her expertise with us today. To learn more about her and her work, visit the show notes at TherapyForBlackGirls.com/session225. And don’t forget to text two of your girls and tell them to check out the episode as well.

If you’re looking for a therapist in your area, be sure to check out our therapist directory at TherapyForBlackGirls.com/directory.

And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the Sister Circle. It’s our cozy corner of the internet designed just for black women. You can join us at Community.TherapyForBlackGirls.com. Thank y’all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care.