What does Wang Jie think - Covering with a thick blanket, listening to music, counting sheep, taking melatonin, which one can really save insomnia

Recently, many people have asked me how to improve "insomnia". Because my own sleep quality is okay, I rarely paid attention to this issue before. I simply asked people around me and found that insomnia is really a very common phenomenon. Many people think they have insomnia problems. So, I took some time to do some homework and briefly talk about this issue with you.

Before talking about the specific research progress, I must first state some of my basic views, otherwise, you may have some misunderstandings.

Three attitudes towards pan-medical information Nutrition and health care, a pan-medical field, is one of the most difficult research topics to obtain accurate conclusions in scientific research. When you hear an expert or an article express their views on this field, I suggest you treat them in the following three categories:

Don't take it seriously. Any information that only has conclusions but no source, such as what to eat, what to do, what to do, and what to avoid, as long as there is only a conclusion but no source, you should not take it seriously. There is a particularly prominent feature of information in this field, that is, there are often a lot of reasons, but no specific experimental data. To be honest, it is very easy to make up reasons in this field, whether it is from the classic quotations of traditional Chinese medicine or the terminology library of modern medicine, or by giving examples, it is not difficult to make up some reasonable-sounding reasons. My suggestion is: don't listen to their reasons, just ask them for evidence. According to my experience of paying attention to this field in the past few years, most of the statements widely circulated among the people are often unreliable or unconfirmed. Let the bullets fly. Some conclusions have evidence, but the level of evidence is not very high. For example, some conclusions are not from written materials of authoritative institutions, nor are they from research papers in well-known journals, but only from some formal institutions or less well-known scientific journals. In that case, don't rush to believe them, and wait for time to prove it. Because such conclusions are likely to be revised or overturned by higher-quality research. If a conclusion is published within 3 years, just wait and see, and don't believe it right away. Just believe it for now. The latest written materials released by authoritative institutions and the latest research papers published in top international academic journals. Note that my definition of "latest" is "within 2 years." Such research conclusions can only be "believed for now." In other words, if conditions permit, you can try the approach recommended by this conclusion, but don't have too much hope, as the possibility of being revised or overturned in a few years is not low. Some people may wonder why the best case scenario for you is to "believe it for now"? Are there no truly reliable conclusions in the field of nutrition and health?

Yes, of course. For example, conclusions such as "smoking is harmful to health" and "obesity is harmful to health" are very reliable, with sufficient evidence and have withstood the test of time. But the problem is that these reliable conclusions have been deeply rooted in people's minds and are difficult to be regarded as news. On the contrary, you should not take those sensational news that question these conclusions seriously.

3 safe ways to help you sleep

Regarding how to improve insomnia, the two latest research information I provide you below belong to the third category and are new knowledge that can be "tentatively believed".
New knowledge 1: Covering a 12 to 16 catties thick quilt can improve insomnia

According to a paper published in the American Journal of Clinical Sleep Medicine in September 2020, researchers in Stockholm, Sweden used a randomized controlled method to study the relationship between the weight of the quilt and sleep quality. 120 patients diagnosed with clinical insomnia and various mental illnesses participated in the trial, of which 68% were women and 32% were men, with an average age of 40 years old. The volunteers were randomly divided into two groups, one group covered with a quilt weighing about 3 kilograms, and the other group covered with a quilt weighing 12 or 16 kilograms. The sleep quality of the subjects was then tested using various instruments, and these indicators were objective. The researchers finally concluded that thickened quilts can significantly reduce the severity of insomnia and improve the daytime symptoms of various mental illnesses.
To be honest, I didn’t buy any of my household items, so I really had no idea how much my quilts weighed. After reading this paper, I searched for winter quilts on a shopping website and found that the weight of winter quilts sold in my country is generally around 6 jin, and 8 jin is generally double-thick.
If you are troubled by insomnia, you might want to try this method. However, if you want the quilt to be heavier than 12 kilograms, you either have to use 2 quilts or find a way to add weight to the quilt, such as finding something heavy but not too hard to press on it. But if it is too hot, you will obviously not be able to sleep. You also have to find a way to lower the indoor temperature. In short, the key is to make the quilt heavy enough and the temperature in the bed suitable for you. This requires thinking of ways to meet the conditions at the same time according to local conditions. To be honest, this new knowledge is easy to deal with in winter, but I think it is meaningless in summer.

New Knowledge 2: Playing the sounds of nature to help you sleep Although this may not seem like new knowledge, because all kinds of sleep-inducing sound effects albums have long been available on music platforms, and I have even bought a pillow that can play the sounds of nature, but I usually use it to listen to popular science programs to help me sleep. However, before there is formal scientific research, we can only regard this practice as an unconfirmed experience and not take it too seriously.
In March 2017, Nature Group's Scientific Reports published a research paper. For the first time, scientists used medical instruments such as brain scans and heart rate monitors to objectively evaluate the subjects' physiological indicators. The study confirmed that compared with various artificial noises, the sounds of nature can indeed improve sleep quality, enhance anesthesia experience, speed up postoperative recovery, and so on.
I think this method is simple and easy, and there is no risk at all, so it is worth a try. But from my own experience, it seems that I am more likely to fall asleep when listening to popular science programs, especially those about physics.

"Old" knowledge: relaxation response The above two are relatively new scientific researches. Now I will tell you about a more well-known method to help you sleep. Dr. Herbert Benson, a cardiologist and professor at Harvard Medical School, invented a method of self-suggestion 10 years ago. This method is now often recommended by some doctors, and after so many years, I have not found any articles that disprove this method. Therefore, in my opinion, this method is also a method that can be trusted and tried.
This method is called "relaxation response" and it is very simple to do: when you go to bed, silently recite a word or sentence that impressed you today, such as "involution" or "Versailles". Then you keep reciting this word in your mind. Under normal circumstances, it is difficult for a person to concentrate on reciting a word, and he will definitely be distracted. Once you find yourself distracted, say to yourself in your heart: "Ha, I was distracted", and then continue to return to this word and continue to recite it until the next time you are distracted. It is such a simple method that can quickly put you into a state of relaxation. This kind of relaxation can be objectively quantified using physiological indicators. Once a person relaxes, it is easy to fall asleep. This method is suitable for situations where you have been working very hard on a certain job during the day and your brain has been replaying a small movie.

Two common questions about insomnia

Having discussed these three safe and simple methods for improving insomnia, I will now answer a few questions that I am often asked.
Question 1: Does drinking alcohol before bed really help?
Many people think they can sleep soundly when they are drunk, but some people say that they feel tired and sleepy the next day after being drunk. It seems that this kind of sleep is not a real rest for the brain.
To this end, I read a paper published on the official website of the National Institute on Alcohol Abuse and Addiction, titled "Sleep, Sleepiness and Drinking". The conclusion of this paper is: For healthy people, acute high-dose alcohol not only fails to improve sleep, but also reduces sleep quality; but for insomniacs, low-dose alcohol may be beneficial. The low dose here refers to the amount of one to two small glasses of red wine. However, data from healthy people show that tolerance to the sedative effects of alcohol may develop quickly. In other words, if you drink a little occasionally, it can indeed improve insomnia, but if you do it all the time, it will soon be ineffective.
In my opinion, this method is not worth recommending. Not to mention that it will soon become ineffective, alcohol is a carcinogen and is harmful to the body. It is better to take medicine than to drink.

Question 2: Can I take medicine to improve insomnia? First of all, sleep aids are divided into prescription drugs and over-the-counter drugs. Drugs that you can buy at a pharmacy are all over-the-counter drugs. Generally speaking, there are two types of over-the-counter drugs.
The first category is melatonin or various health products containing melatonin. There are too many research articles on whether melatonin can treat insomnia, and the conclusions vary. It is difficult for me to give a definite answer. However, according to my own view on the level of information sources, the American Academy of Sleep Medicine Clinical Practice Guidelines may be the most reliable document I think. According to this guideline, there is still a lack of evidence on the relative effectiveness or long-term effectiveness of melatonin for insomnia. So, my suggestion is to give it a try.
The second category of over-the-counter drugs is antihistamines. The primary purpose of this type of drug is to fight allergic reactions, but people have found that these drugs can easily make people sleepy, so they are also used as the main ingredient in sleep aids. But the problem with this type of drug is that it is effective only when used occasionally, but it is basically ineffective with long-term use. The human body will quickly adapt to these drugs and develop tolerance. If you take them more often, you will no longer feel sleepy. So, my suggestion is to buy a bottle and put it by your bed. If you really can't sleep, you can take it once in a while, but don't take it all the time.

In addition to over-the-counter drugs, there are also a variety of prescription drugs, but everyone should remember that all prescription drugs must be taken under the doctor's orders. I am not a professional doctor, and talking more about this would go beyond the scope of a popular science program.