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Trouble Sleeping? A Simple Breathing Exercise Could Help Break Insomnia’s Grip

A health writer’s quest to find new ways to nod off and end the no-sleep cycle


spinner image Insomnia/Counting Sheep
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My history with sleep is like a roller coaster — making arduous, steady climbs to stretches of adequate rest, then careening with compounding speed into long stretches of little more than four hours a night.

Early in my career, I actually took great pride in my belief that I didn’t require as much sleep as my colleagues. I could get more done in a day! I was ridiculously productive and ridiculously exhausted.

As a health journalist, I inevitably learned the truth about sleep. It is crucial, not just for productivity and accuracy, but also for overall health, brain function, mood and longevity. But about the time I started to seriously seek the sandman — purchasing a sleep mask, earplugs and Tylenol PM; determinedly going to bed and waking up at the same times on weekdays and weekends; regularly soaking up eight hours, which felt like water for a very, very dry sponge — I had kids.

With my firstborn, I went from eight regular hours to four — on a good night. It was a free fall that I didn’t even try to recover from until my youngest set her sights on her tweens.

By then, something had shifted. My old tricks, even trading Tylenol PM for something more potent, gave me no traction. Night after night, I tossed and turned for hours and often found myself wide awake at 3 in the morning.

I can thank the onset of menopause for this new twist, says Rachel Salas, M.D., a sleep expert and professor of neurology at Johns Hopkins Medicine in Baltimore: “Hormone changes can disrupt sleep.”

She explained that, among other things, shifts of progesterone and estrogen can spur warmer body temperature: “The body actually needs to cool down even further when you transition into the deeper stages of sleep. If you’re too hot when you’re sleeping, it may negatively affect your sleep quality.”

Whatever the reason, the sleep logs on my Fitbit revealed clearly my sad state of un-slumber. On a Tuesday, I logged a full five hours, then I plummeted to 1 hour and 52 minutes on Wednesday. Banking a turn, I logged 4 hours, 52 minutes, on Thursday, then held tight at 4 hours, 56 minutes, on Friday. Next, I free fell to 1 hour, 8 minutes, on Saturday and 1 hour, 40 minutes, on Sunday.

This newest nadir left me feeling tired, incapable of completing a single thought. And irritable? — well, that doesn’t even come close to describing it. I wanted off this roller coaster once and for all.

A conversation with Salas yielded multiple suggestions that I’d heard, even tried, before, such as avoiding LED lights (or any blue or green light) in the evening and before bed, developing a regular sleep routine and keeping a consistent bedtime. She did mention something that caught my attention though: trying relaxation through breathing and meditation. I suppose it sounds a bit like a no-brainer to say you need to relax to fall sleep, but researchers are beginning to home in on the reasons breathing and relaxation exercises help to improve sleep.

Some research, for instance, indicates that breathing exercises may increase heart rate variability, a sign your body is pumping blood on an “as needed” basis and not responding to stress (as it would do with a steady, robotic rhythm.) Researchers in California determined mindfulness meditation improved sleep quality in people who’d reported difficulties with sleep.

Meanwhile, a study published in the Journal of Clinical Nursing put the two together, finding that breathing exercises were instrumental in improving sleep and heart rate variability.

Salas warned me that much more research needs to be done before scientists can establish a clear link, but in my desperately tired state, the approach felt more than worth giving a try.

I started with a technique that always worked well on my kids when they were little. It’s called progressive muscle relaxation. You basically start by tensing then relaxing various body parts, starting at your toes and working your way up to your head. This method, developed by physician Edmund Jacobson, who published a 1929 book about it, is based on the theory that calming the mind will calm the body. That was certainly true for my kids; I rarely made it to their shoulders before they were snoozing away.

spinner image Besty Stephens Headshot
Betsy Stephens found insomnia wreaking havoc on her life as she got older.
Courtesy Betsy Stephens

When I tried it, I also rarely made it to my shoulders — not because I was asleep, but because my mind had skittered to my to-do list.

Scratching that approach, I next came across a method used by the military, which was first written about in a book called Relax and Win: Championship Performance in Whatever You Do. When I read that, it could put me to sleep in as little as 120 seconds I decided to investigate, clunky title be damned. I didn’t hesitate when I learned that I’d need to practice the method every night for six weeks, but I did balk at having to imagine myself enclosed in a black velvet hammock in a dark room night after night. Can anyone say claustrophobia?

Finding relief at last

Finally, I came across a method that had the least research to back it up, but seemingly the most promise for me. It’s called 4-7-8 breath and it sounded relaxing, like something you might do in a yoga class. It was developed by physician-author Andrew Weil and its proponents claim it will put you to sleep in a jiffy – 60 seconds. 

I wanted to try it out immediately, so I quickly skimmed the instructions, which note you keep your tongue in one spot, just behind your upper front teeth, for both inhales and exhales. They also said your exhales should be audible, and last twice as long as your inhales. As for the breathing pattern itself: 

  1. Exhale completely through your mouth, making a “whoosh” sound.  
  2. Inhale “quietly” through your nose to the count of 4.  
  3. Hold your breath (gently) to the count of 7.  
  4. Exhale audibly through your mouth, making another “whoosh” sound, to the count of 8.

On my trial run, I was still awake after 60 seconds, but I did feel more relaxed. I think I nodded off after about 10 rounds. I didn’t stay down for long, though. Having apparently drifted off during Step 3, I woke up gasping for breath.

The next day, I took a closer look at the instructions. In fact, I watched a video of Weil explaining how to do the technique. That’s when I learned you’re supposed to do only four rounds of this breath at one time and practice it twice (at a minimum) daily for four weeks for best results.

The advice to practice the exercise more than once a day reminded me of something Johns Hopkins Medicine’s Salas told me when we were discussing the impact stress can have on sleep:“The more you can get people to recenter — practice a couple of minutes of mindfulness or meditation — throughout the day, the less stress they are going to have when they’re going to bed.”

In the same way some people might watch their caffeine consumption throughout the day in order to better their sleep at night, I began to monitor my stress level using the 4-7-8 breath. I did this midmorning, late afternoon and, of course, at bedtime.

Something shifted.

I began getting into bed earlier each night, perhaps because taking time out to think about sleep throughout the day primed me to prioritize sleep at night. Or maybe I was becoming relaxed enough that the thought of getting into bed was more appealing than it was anxiety provoking. Whatever the reason, something was putting the brakes on my insomnia and driving the numbers in my Fitbit sleep log up.

About two weeks in, on a Wednesday night, I logged 7 hours, 55 minutes. The very next night I logged 7 hours, 51 minutes. On Friday, I dipped slightly to 6 hours, 31 minutes, but I was back on track at 7 hours, 27 minutes, on Saturday, 7 hours, 53 minutes, on Sunday and a steady stream of seven-hour-plus nights followed.

My mind is sharper, I’m happier, less irritable, more productive. I’m off the roller coaster for now and, hopefully, for good.

Editor's Note: This story, first published Jan. 25, 2019, has been updated.

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