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Dr. T’s Advice on How to Get a Great Night’s Sleep

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Sleeping woman In this multi-part series, I am reviewing the elements of the SHINE protocol for CFS and fibromyalgia: Sleep, Hormones, Infections, Nutritional Supplements and Exercise — I’m reviewing the basics and also discussing new developments in treatment for each of the five elements.

In part 1, I looked at natural remedies for sleep. In part 2, below, I continue talking about sleep, first looking at “sleep hygiene” (daily habits that can help or harm sleep), and then at how to effectively use multiple, low-dose medications to treat the sleep problems that are so common in CFS/FM.

Good Sleep Hygiene

A number of daily and nightly habits will enhance your ability to fall asleep:

  • Hot bath. Take a hot bath before bed.
  • Cool room. Keep your bedroom cool.
  • Caffeine-free. Don’t consume caffeine after 4:00 pm.
  • Alcohol early. Don’t consume alcohol near bedtime.
  • Snack to snooze. Have a light high-protein snack before bedtime. Hunger and hypoglycemia (low blood sugar) cause insomnia in all animals, and humans are no exception. Eat a 1-2 oz. high-protein snack at bedtime to see if this helps sleep (a hard-boiled egg, nuts, cheese, turkey or other meat).
  • Bedroom, not office. Don’t use your bedroom for problem solving or work.
  • Ignore the clock. Put the bedroom clock out of arm’s reach and facing away from you, so you can’t see it. Looking at the clock frequently aggravates sleep problems — and it’s frustrating!
  • Solve snoring. If your partner snores, sleep in a separate bedroom (after tucking in or being tucked in by your partner). Or get a good pair of earplugs and use them. The wax plugs that mold to the shape of the ear are often best.
  • Better bladder control. If you frequently wake up to urinate during the night, don’t drink a lot of fluids near bedtime. Unfortunately most pain patients wake up during the night because of the pain or because their sleep center isn’t working properly. Because they also have a full bladder, they think they’re waking up because they have to urinate. But this is not the case. They are waking up because of their pain syndrome. The following is a simple way to remedy this problem:

If and when you wake up during the night and notice your bladder is full, just talk to it (in your mind, so your spouse won’t think you’re nuts). Say, “Nighttime is for sleeping. We will go to the bathroom in the morning, when it is time to wake up.” Then roll over and go back to sleep. If you still have to urinate five minutes later, go to the bathroom. Most of you will find that your bladder will happily go back to sleep — and when you wake up in the morning you won’t even have to urinate as badly as you did when you woke up in the middle of the night.

Sleep Medications

I much prefer natural remedies to prescription medications. But the sleep disorder in CFS/FMS patients may be too severe to be dealt with by natural remedies alone. However, even if you are someone who needs prescription sleep aids, adding natural remedies can be very helpful and usually decreases the amount of medication that you will need, resulting in fewer side effects. In addition, once you come off the sleep medications (usually after 9 to 18 months, although they can be used indefinitely if needed) you may find that all you require are the natural remedies. But whatever treatments you use, it’s important that they not only increase the duration of sleep but also maintain or improve the deep stages (stages 3 and 4) of sleep. Unfortunately, most sleeping pills in common use (for example, Dalmane, Halcion and Valium) may actually worsen the quality of sleep by increasing the amount of light stage sleep (especially stage 2), and decreasing the stages of deep sleep. You want to be certain that the treatments and medications you use leave you feeling better the next day, not worse.

There are several approaches to sleep when treating pain patients. Some doctors prefer to use a single medication or treatment, and push it up to its maximum level. If that works, great. If not, they stop it and switch to another medication. Other doctors prefer to use low doses of many different treatments together until the patient is getting good, solid sleep regularly. I strongly prefer the latter approach. Most of a medication’s benefits occur at low doses and most of the side effects at high doses. In addition, if you combine low doses of a few different sleep aids, each of them will be cleared out of your body by morning — so you won’t be hung over. Meanwhile, the effective blood levels that you have during the middle of the night from each treatment are cumulative, and will keep you asleep for eight to nine hours of solid sleep each night without waking or hangover. To see which medications I recommend for sleep, scroll down to the sleep section (page 4) of our SHINE treatment protocol document (a 46-page pdf file).


Dr. Teitelbaum, also known as “Dr. T,” is an integrative physician and one of the country’s foremost experts on fatigue, sleep and pain management. The treatment program he developed for combating Chronic Fatigue Syndrome (CFS) and Fibromyalgia and related conditions has helped hundreds of thousands of sufferers reclaim their health and vitality.

Dr. Teitelbaum is the Medical Director of the National Fibromyalgia and Fatigue Centers and author of the best-selling books, From Fatigued to Fantastic!, Beat Sugar Addiction Now! and Pain Free 1-2-3. He has also authored several landmark scientific studies. Dr. Teitelbaum has firsthand experience with CFS and Fibromyalgia — he battled the condition when he was in medical school and had to drop out for a year to recover. Since then, he has dedicated his career to developing effective strategies to treat these conditions and educating the millions of people who need help.

Visit his web site to learn more.


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10 responses to “Dr. T’s Advice on How to Get a Great Night’s Sleep”

  1. […] Millions of people suffer from mild to moderate sleep problems, and often turn to pharmaceutical sleep aids to help them get the sleep they need to feel healthy and energetic. However, these drugs often do not promote the deep, rejuvenating sleep that your body requires for optimal immunity and vitality. One of the best ways to improve the quality of your sleep is to improve your sleep hygiene. To learn more about what this means, be sure to check out sleep expert Dr. Jacob Teitelbaum’s article on how to get a great night’s sleep. […]

  2. […] begin, you should review my recent articles on natural sleep support and prescription sleep support and sleep hygiene. After that, consider trying these two excellent natural sleep […]

  3. […] Experiments show that depriving an animal of sleep suppresses its immune system. Don’t experiment on yourself! Your immune system is sleep-sensitive, too. Aim for 8 hours nightly. I suspect poor sleep in CFS/FMS is an important contributor to immune dysfunction. Can’t get a good night’s sleep? Here’s how you can! […]

  4. […] begin, you should review my recent articles on natural sleep support and prescription sleep support and sleep hygiene. After that, consider trying these two excellent natural sleep […]

  5. […] a big reason why — although we can wean most FMS patients off most treatments — continuing to treat sleep problems (and providing nutritional support) is a must for their long-term […]

  6. […] general recommendation for sleep is eight hours, each and every night. However, there is a growing body of evidence that suggests […]

  7. […] is equally as important. Consider creating a sleep regimen. About 45 minutes before going to sleep, drink some chamomile tea, spray lavender mist onto your […]

  8. I live in a noisy block so wear earplugs all the time. My best pair were custom molded from a kit, they are much better than normal ear plugs and don’t seem to wear out. It’s far less expensive than having your ear plugs custom made by an audiologist; I would definitely suggest them to anyone who uses them often.