One of the best studied and fastest treatments for depression is not a medication, it is waking up earlier and get bright light exposure…
We will write at a another time about the evidence for this, and maybe even why it works. But for now let’s talk about the practical question. How do I change when I get up?
First I should explain that I am naturally what used to be called an “owl” – when I was a teenager I had extraordinarily happy memories of staying up until the dawn. And I typically found the hours after midnight to be the best and happiest and most productive parts of the day.
However, when i had kids I discovered that this pattern did not work… for one thing putting my kids to bed was really hard work, and by the time they were asleep I was too tired to stay up much longer. For another, I found that the best part of the day was no longer the night, but rather the early morning before anyone was awake.
But there was still the question of how to make this change. I wrestled with this a lot… and started with the obvious thought that I should begin by going to sleep earlier. I was kind of surprised to see that this strategy was not terribly successful. What worked was actually the opposite – setting the alarm clock (s) (initially it required more than one) and religiously getting up early. And making sure that when I got up I got bright light exposure.
it is many years later, and I can tell you that I have found that this is the universal answer to the question of how to change your sleep pattern – to get up earlier and got to sleep earlier you have to focus on getting up earlier. The going to sleep earlier part will follow the change in waking up times.
Here is why –
If I am an owl and I decide to go to sleep earlier, I will find that when, at the end of the day, I finally feel that good feeling of calm and focus that is associated with the end of the day, all of the things that I am interested in make it impossible to go to sleep… and then the next morning I will tell myself that I am way to tired to get up early.
On the other hand, if I figure out how to get up earlier (enlist a partner, set several alarms, whatever) and if I actually do the work the night before. The odds are that I will get out of bed. And then I will stagger outdoors with my mind clearly focused on the notion that I will go back to sleep as soon as I can… However I will then get bright light exposure that begins to directly change my natural biorhythms… And I may not go back to sleep… after all I am up already… So by nighttime I will be really tired and even though the same fascinating things are out there to intrigue me I will be too tired to really do that internet research or read that book or watch that movie… and then I will go to sleep earlier.
To summarize, if you want to change your sleep cycle you need to –
- Figure out in detail a plan for getting up earlier. Imagine as you are going to sleep what it is that you are going to do when the alarm goes off (“without thinking about it I will get out of bed and go take a shower, or I will go outside and get the newspaper, or I will go out in my PJ’s to Starbucks…”). The key parts of the plan are – to have a goal that is pretty easy to reach, to tell yourself you are not going to think about it, and to do some of the work the night before (set out your clothes… set multiple alarm clocks… tell your partner to pull off the covers).
- When you get up get some bright light exposure before you tell yourself that you can go back to bed (30 minutes at least of therapy light or sunlight exposure).
- Ideally add to that either some physical activity (walk) or a conversation with someone.
- Continue to do this for at least a week.
At the end of this, even if you have gone back to sleep for naps, you should find that you are going to sleep earlier, waking up earlier, your mood is better, you are more alert in the daytime and you sleep more deeply at night.
Here are a couple of options for lights.
For advanced users –
For those of you who want to maximize the circadian rhythm stabilizing effects you may want to add melatonin. The optimal dose is not entirely clear but we suggest taking 5 mg of good quality melatonin about 1 hour (1/2 hour if you are very sensitive) before you want to go to sleep. There is no clear evidence that sustained release is any more useful than immediate release and may cause more of a “hangover” effect the next day. CVS and Target have melatonin supplements that have been tested by the only independent site that does supplement testing. The Puritan’s Pride form that we offer you a link to below is actually not only excellent quality (based on the same ratings) but among the least expensive forms you can buy..