The Sleep Fix: Keys to the reboot that can change your life.

At one time or another, we all have stretches where a good night’s sleep just doesn’t come easy. As just about everyone knows, the harder you try to force sleep, the further away that elusive sucker slips. Before you know it, the sun’s up, coffee’s brewing, and the world is shifting gears in order to get moving. All the while, you are stuck in neutral. Repeat that cycle of events on a daily basis and it can ruin your health, relationships, and your sanity. Needless to say, sleep is pretty important.

Diane Macedo’s new book, The Sleep Fix: Practical, Proven, and Surprising Solutions for Insomnia, Snoring, Shift Work, and More, is a practical, user-friendly guide to getting better sleep. The book flips the switch on common advice, illuminating her relentless search for a good night’s sleep and the surprising, scientific, and practical solutions she finds along the way.

Diane Macedo. (CREDIT: Danny Weiss, ABC)

Because of the way The Sleep Fix is formatted, your sleep struggles are broken up thematically by chapters. How long did you actually struggle with sleep problems?

I struggled for about 7 years. It started when I started working early morning news hours. I’m a night owl, which I didn’t know at the time is a biological trait, so waking up at 3am and 1:30am was awful for me.

 I was so incredibly tired for most of my working day, but when I tried to go to bed in the early evening I couldn’t fall asleep! I would just stare at the ceiling cursing myself for being awake, sometimes for hours. The next day, rinse and repeat. 

First I just dismissed the problem as “I’m a bad sleeper, that’s just the way I am” but once I moved to the overnight shift at ABC News it got so bad I couldn’t ignore it anymore. I tried sleep tip after sleep tip but nothing helped. I also kept reading that in order to sleep well again, I would have to give up all these things that I loved — including my job. I refused. So I went to my doctor and she prescribed Ambien. That worked like magic at first, but eventually even the Ambien stopped working.

So that’s when I turned into a sleep nerd. I got screened for sleep apnea and once we ruled that out I swapped all the popular sleep books and articles I was reading for sleep textbooks, clinical research, and books written by sleep clinicians and that’s where I finally found my answers. After about three weeks of applying what I learned, with a few practical tweaks, I managed the seemingly impossible: I started getting a full night’s sleep in the middle of the day.

It’s easy to dismiss insomnia or other forms of sleep issues because, at some time or other, everyone has trouble sleeping. Of course, an occasional sleepless night and insomnia aren’t the same thing and insomnia is very serious. What are some of the ways sleep problems can affect a person’s life?

Yes everyone has a bad night every now and then but when you start sleeping badly on a regular basis it can become all consuming. I immediately developed acid reflux when I started sleeping badly, and over the years I had dry eyes and issues focusing. I felt fatigued all the time, but also strangely hyper like my heart was racing. 

But I also spend so much time thinking about sleep, worrying about whether or not I would have another bad night, worrying about the long term repercussions this would all have. The ingredient I missed for so many years was how much all that thinking and worrying perpetuated the problem. 

Many other people have what I called “secret sleep disorders.”  Take sleep apnea for example. Sleep apnea is a condition that causes you to stop breathing up to 100 times an hour while you sleep. You then wake up in order to breathe again. These wake ups often happen so quickly the person doesn’t even realize it’s happening. 

There are a lot of people who think they sleep fine, when really they’re walking around extremely sleep deprived. That’s not only dangerous if they get behind the wheel of a car but apnea also puts you at higher risk of stroke, heart attack, high blood pressure, and several other conditions. My dad had a nearly fatal stroke two years ago and I have no way to prove it but I feel confident that the decades he went with untreated sleep apnea was a huge contributing factor. It can literally kill you, which is part of the reason I started the book with a focus on identifying the problem. 

My hope is that people, just based on chapter 1, will have a light bulb moment, recognize some red flags for these conditions, and get themselves tested and treated before it’s too late.

How long did it take you to find a solution? Did technology help at all?

It’s hard to say how long my reading and research took but when I finally saw a sleep specialist to screen me for sleep apnea, he sent me home with an at home sleep apnea test and another at home test to analyze my sleep structure. The apnea test was negative, but I was getting such little sleep that that test was basically invalid. 

I started trying all these at home solutions that I was learning from the sleep medicine literature I was reading and I think it was about three and a half weeks later that we did the test again and I was getting 6.5 hours of good quality sleep — which is great, especially on an overnight shift!

Technology helped a lot. I was able to not only do the sleep tests at home but the specialist also used telemedicine which wasn’t common at the time. Otherwise I don’t think I would have been able to do the apnea test because my sleep hours didn’t match your typical overnight sleep study. I also used a therapy light to help my body clock adjust to my work schedule and a few other gadgets. 

Two of the biggest game changers were sunglasses that I wore at the end of my shift, a notebook that I used for a practice called “constructive worry” which I describe in the book, and strategic sleep scheduling which I also describe in the book.  There is some great sleep tech out there, but you don’t have to spend a fortune on expensive tech in order to sleep well. 

In The Sleep Fix, you tell an amusing story about how your husband, being British, was used to sleeping with a blanket and duvet but without a top sheet. It affected your sleep enough that it would lead to the occasional meltdown. A lot of people sleep with partners and can relate. It makes fixing sleep a little more complicated since there is another person to factor in. Do you have any advice for people in similar situations?

In my defense it was just one meltdown over the lack of a top sheet but a rather humorous one in retrospect. He still doesn’t understand my need for a top sheet but he goes with it. 

It’s frustrating enough when your own body and mind are keeping you awake, so add a disruptive bed partner to the mix and it can lead to all sorts of grumpy interactions. It’s such a problem that the term “sleep divorce” is now becoming a familiar term to describe when couples decide to sleep in separate rooms. For example, I don’t have a spare room and I know I’m not alone there. So I lay out a whole chapter of alternatives in the book. 

What works best for you will depend on what your problem areas are but some of my favorites tips are:

  • use a motion activated underbed light. This allows you to navigate the room safely overnight but because the light is dim and pointing down it’s unlikely to wake your partner and will make it easier for you to fall back asleep. 
  • treat the bed like two sleep zones — we all have different needs from our bed so customize each side to your liking. You might put a mattress topper on just one side of the bed if you want more cushioning, or maybe you put plywood under just one side of the mattress if one of you wants more support. You might each have your own comforter or you might keep a throw blanket on the bed that only one of you uses overnight. If you’re shopping for a new mattress you can even use two twin mattresses on a king platform so you can each get a mattress exactly to your liking. 
  • if one of you likes to listen to a meditation, or book, or music in bed, headphone headbands can be a comfortable way to do that without disturbing your partner. 
  • try to find a sleep mask you love. They come in all shapes and sizes and a good fit can make all the difference. They can also be easier to tolerate if you pair them with a nasal strip. 
  • most importantly if you suspect you might have insomnia or sleep apnea or both get them treated asap. Treatment can make you much less sensitive to sleep disruptions and, especially in the case of apnea, can also make you much less disruptive to your partner. 

My husband rarely wakes me up any more because I’m a less sensitive sleeper than I was when I had insomnia. On the rare occasion it happens I’m relaxed about it because I know I’ll just fall back asleep. I get a good night’s sleep and he no longer has to deal with a grumpy, sleep deprived wife who’s cursing him for… you know… breathing too loudly.  Win win!

From your experience, are there any sleep hacks people should absolutely not do?

There’s so much out there on the internet and social media now I won’t even pretend to know them all. I’ll just say this, if you are taking any sleeping pill — prescription or over the counter — on a regular basis, you should be doing so under the guidance of a sleep specialist. Because even our primary doctors can be a little too quick sometimes to prescribe sleeping pills when other solutions are more appropriate. Those pills can often make the situation worse. If you are already taking sleeping pills regularly, a sleep specialist can help guide you on how to get off them safely. 

Finally, there is so much information in The Sleep Fix. It’s almost like a user-friendly guidebook on navigating sleep troubles. Any advice on how your readers should use your book?

I laid out Chapter 1 to help people identify their specific problem or problems and then go from there. I think most people will benefit from reading the whole book since sleep problems are often complex and intertwined but whatever you do definitely don’t skip Chapter 1. Different sleep problems require different solutions, so the key first step to finding the right sleep solutions for you is to identify what it is that’s keeping you awake. 

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