Sleeping problems and how I deal with them
I've had sleeping problems since I was twelve and more particularly since I developed ME/CFIDS thirteen years ago. I've amassed a lot of knowledge by now, some of it fairly well-known, some of it very little-known. If you have any sleep problems, read on.

Get a diagnosis

Work out what's wrong with your sleep, and if necessary, see a doctor or even a sleep clinic. Some sleep problems such as sleep apnoea are actually quite dangerous and warrant early investigation. Note that in the UK at least, sleep clinic waiting lists are long, and if you're paying for your healthcare then a sleep study is expensive. Keeping a sleep diary for a while (a week, a month) can be very useful. You will want to note down when you sleep, when you doze, when you get up, when you take any meds or treatments that can affect sleep or alertness, and optionally when you eat and get exercise. If you have sleeping partners, ask what they've noticed (e.g. stopping breathing during sleep, waking up with amnesia). I'm generally going to be talking about circadian rhythm disorders, such as Delayed Sleep Phase Syndrome (when you're an extreme night owl, e.g. you can't get to sleep earlier than 4 am no matter how hard you try) and Non-24 Sleep Wake Disorder (when your body clock is running on a 25 hour or 26 hour schedule, so that you will fall asleep an hour or so later every day, which is like living with permanent jet lag), as well as general insomnia and poor sleep quality. If you have ME, chances are that your sleep will be crappy no matter what you do, but it may be possible to improve it to some extent.

Sleep hygiene

Google this and read a few articles on it. This one by Dr Sarah Myhill (an ME specialist) is particularly useful, though I'm not convinced that we should all be going to bed at half-past nine. Note the areas you're not doing well in and think about how you might be able to improve them, even if it's just partially. Reserving the bed for sleep and sex only is hard for ME sufferers who are stuck in bed a lot, but sometimes you can set things up so that you switch to the sofa for a large part of the day, or even a spare bed in another room if that's possible. The main thing I had to stop doing was staying on the internet too late, it's a big sleep-killer. It's important to keep yourself in a steady routine as far as possible, including regular mealtimes, if you have any problems with circadian rhythms.

Eat right

Don't eat supper so late that you're kept awake by digestion, and on the other hand, don't go to bed hungry. The Myhill article discusses hypoglycaemia, which Myhill reckons is the cause of various symptoms such as waking up in the middle of the night sweating, overheated, struggling to breathe and/or with racing heartbeat. If you're getting this, try to improve your blood sugar levels in general (stay off sugar, switch to wholegrains) and have a small snack last thing at night, such as a handful of almonds.

Finding your best sleep pattern and napping

It's useful to know that a sleep cycle is 90 minutes long, and it's best to be sleeping in multiples of 90 minutes, as this means that you will be waking up at the right point in your sleep cycle rather than feeling horribly groggy and going straight back to sleep. Some people do best on a siesta pattern, which is commonly practised in hotter countries. I fall into this pattern occasionally myself, but I find it too difficult to keep up. I've already told people not to call me in the mornings as I may not be awake, and I can't forego afternoons as well. In addition, I want to be going to bed and getting up at the same time as my partner, and I find it easier to control my sleep if I'm having my night's sleep all in one go. Sleeping in the day is more likely to cause my sleep cycle to go wonky on me, for instance getting stuck at falling asleep at 4 am. It may work for you, though. Try 1.5 or 3 hours for a siesta.

The 90 minute cycle also affects when you will feel sleepy in the evening. The Myhill article above talks about "sleep gates" (yep, that's the official term), which usually occur at intervals of 3 hours, and while she advocates an incredibly early bedtime, it's still useful information no matter what time you go to bed. I often get sleepy around 9 pm or 6pm, and it's useful to know that I should make a special effort to keep awake and it will pass. It's also made me aware that missing my usual bedtime is really not a good idea, as I then may end up lying awake for hours.

There's a new gadget called the Sleeptracker which is meant to follow the stages of sleep you are in and wake you up at the best point. I've not tried it, I'm doing OK with light therapy, but it looks interesting for people who need to get up in the morning and struggle with this. I have no idea how well it works, and online reviews are mixed. Interesting idea, though.

I do nap occasionally when I really need it. The sleep specialist advised me not to nap for more than one hour, as after that you get into deep sleep and it will disrupt your night's sleep. This advice was excellent. I don't fall asleep immediately, so I set a timer for one hour and ten minutes. I also make sure that I nap with the curtains open and the light coming into the room. No one suggested this, but I reckon it will help my circadian clock realise that this is not nighttime, and I do find napping easier now that I'm following these two rules. If for some reason my sleep has been totally buggered and I need to catch up on several hours, I may draw the curtains, but thankfully this is rare.

Sleep in total darkness and quiet

Make your sleeping environment as dark and quiet as you possibly can. If you have tinnitus or are troubled by background noise, look into getting a white noise generator. I was given this one by my hearing therapist, and it was very useful when I was living in a noisy place and with a landlord who liked to play loud music at interesting hours, not to mention helpful when I was going through a spell of bad tinnitus. It makes a variety of sounds as well as white noise, I personally liked the rain one. It can also be plugged into a special pillow if you have a partner.

I used to sleep with an eye mask on, but while my one was also good for dry eyes it was not a particularly friendly thing if you have a partner (he used to call me Bug Lady and would yelp if the bulbous shape of the eye mask hit him during sleepy cuddles), plus I decided that I wanted to try dawn simulation again. There is some research suggesting that light is taken in by the skin as well as by the eyes, so some people think an eye mask won't do if the room isn't dark enough. There are several views on the subject, though, so personally I wouldn't worry about it. If an eye mask suits you and doesn't fall off during the night, go for it, it's a nice easy solution.

Once I stopped using the eye mask, I had to go to quite a lot of effort and a certain amount of expense to get the room as dark as possible. There's a borrowed light above the bedroom door, and I taped a piece of blackout fabric onto that shortly after moving in years ago. The curtains are beige and glow nicely when the light comes through, even when I have the blackout blind (which is a cheap and nasty thing from Ikea that is a few inches too short) down, so I bought blackout curtain linings, managed to extend them (the joys of 10' ceilings), and they improved matters quite a lot. Lots of light still came in around the sides and top, so I bought self-adhesive velcro and stuck one side to the window surround and stapled the other side to the blackout linings, thus blocking off the light at the sides. I must be ridiculously sensitive to light as I was still getting woken up by the dawn light coming over the top of the curtains, so I rolled up an old duvet into a sausage shape and painstakingly attached it to the window surround above the curtains, having to adjust it a while later as it kept trying to fall down in the middle. I've borrowed my neighbours' stepladder so often in the past few months that they must think I'm nutty. There's still a tiny bit of light once the sun is up but I think this is the best I can do now, and hey, having a slight seasonal variation in the amount of true darkness I can get is probably good for me, there's research somewhere that humans' biological clocks do follow the seasons to some extent and that we're evolved to have more darkness in winter etc.

Short-term medication

Doctors are reluctant to hand out sleeping tablets for good reason. They're most often highly addictive and can cause rebound insomnia. They can be used sensibly, however. If you're going through a particularly stressful time such as a bereavement, sleeping tablets may be used for a few weeks. If your bedtime has crept to far too late, sleeping tablets may be used for a short time (no more than a week; I can only do three days, then I get rebound insomnia), preferably in conjunction with bright light therapy, to move it back to where it should be. Sleeping tablets can be scary things, so research side effects carefully and the first time you take a new med, make sure you can sleep in the next morning if need be. I've tried Zolpidol and Zolpidem (Ambien), and while Ambien seemed to work OK at first, I tried it again and got hallucinations that night and was groggy for the next week. I now use temazepam 20mg for no more than three nights in a row, and probably do this a few times a year.

Long-term medication

Most people shouldn't be taking this. If you have a sleep disorder that can only be helped by medication, it may be possible, though it should always be discussed with your doctor. My sleep study showed that I don't get enough deep sleep, as is common with ME. I can improve my sleep hygiene until the cows come home, I'm never going to get enough deep sleep, so long-term meds make sense for me as long as I can tolerate them. Rarely people will take the stronger hypnotics for long-term use, but it's far from being a first port of call and I would not be able to do it myself. Antihistamines and low-dose tricyclic antidepressants are common for long-term use. I didn't get on well with either: the antihistamines made me a zombie in the day but not particularly sleepy at night, while the amitriptylene (low-dose tricyclic) did great things for my sleep but caused too many side-effects.

I've eventually settled on a herbal sleeping aid, Lifeplan Valerian Formula. If you've tried herbal sleeping tablets before and found them useless, check the dosage you were taking, as most of the ones on the market are so low-dose that I doubt there's more than a placebo effect going on. The Lifeplan one has a nice reasonable dose. Some studies suggest that valerian should be taken off and on to avoid building up a tolerance, so for half my cycle I take the valerian formula, and the other half (when I'm premenstrual and more likely to get anxiety) I take 600mg passiflora and 400mg skullcap at bedtime, both in capsule form by Biohealth herbs. The main herbs for sleep are relatively well-researched by now and often come up as effective as benxodiazepines, so again do your research, make sure it's a reputable manufacturer, and talk to your doctor about what you're doing.

I've tried melatonin tablets but they didn't do a thing for me. They're not used in the UK, which makes me fairly cautious of them to begin with, and it's uncertain how well melatonin works when given in oral tablet form. I prefer to use darkness therapy instead.

Light and darkness: an overview

Arguably the biggest factors in sleep pattern regulation are light and darkness. Humans evolved outdoors, getting plenty of strong daylight during the day and complete darkness at night, and averaging 12 hours of each. It's this light/dark signal that keeps the body on a 24 hour schedule: people who are completely blind almost all have sleep disorders, as the natural body clock runs on a 25 hour schedule for some bizarre reason and they don't have the light/dark signals to keep it that way. Now we sleep indoors, we mostly work indoors where the lighting is nowhere near as strong as sunlight, many of us barely get any sunlight (and those of us with ME may not get any), and instead of following the natural pattern of darkness, we are in darkness only for the time we sleep and that may not even be complete darkness, and we will be under artificial light right up until bedtime. This chart shows the relative light level from various outdoor and indoor conditions. Even a well-lit office is still only 10% as bright as an overcast sky, and nighttime road lighting is 50 times as bright as a night with a clear full moon. Our light/dark signals are all mixed up, and this is showing in the high prevalence today of not only sleep disorders, but medical conditions which are affected by light/dark.

The very basic version is that bright light stimulates serotonin, and a lack of it can cause low serotonin levels and thus depression. Cortisol is another hormone affected by light levels. Melatonin is the hormone which makes us feel sleepy, along with a host of other roles in the body, and melatonin is produced when we are in darkness, which should average out to 50% of our time over the year but is now nothing of the sort.

Good general links on light therapy and darkness therapy: This is a good site for both light therapy and darkness therapy. It's geared towards bipolar disorder and depression but it's very well-written. Other good sites: Lumie for light therapy (I'm not specifically endorsing their products, though, I prefer other ones myself) and Low Blue Lights for darkness therapy (ditto).

Bright light therapy

This is best known for treating Seasonal Affective Disorder, where it has been found to be as effective as anti-depressants, although the most effective treatment is to combine light therapy with anti-depressants. What is less well-known is that bright light therapy is almost as effective in non-seasonal depression and is extremely useful for circadian rhythm disorders. The main myth about bright light therapy is that it's about full-spectrum lighting. It isn't. The most effective wavelength for resetting the circadian clock is 470nm, blue light, so you need either blue light or white light which has plenty of blue in it. The other important thing is the intensity of the light. When a traditional fluorescent lightbox is used, 10,000 lux is preferred, though there are a few models around which use 5,000 or even 2,500 and require proportionately longer usage times. Merely installing a full-spectrum/natural daylight bulb into your domestic light fittings will not make a blind bit of difference, as the light isn't anywhere near strong enough.

Lightboxes are used for periods ranging from 15 min to 2 hours, depending on the type and the patient's needs. Unless you have Advanced Sleep Phase Disorder, where you fall asleep too early in the day, the usual time of treatment is first thing in the morning, just after you get up (which for some people isn't actually morning!), whether this is for sleep disorders or depression. If you have DSPS or Non-24 Sleep-Wake Cycle, using bright light therapy in the morning has a high chance of stabilising your circadian clock and can even move it backwards so that you are falling asleep and waking up earlier. I found that using a bright light box just after awakening immediately stabilised my sleep pattern at 24 hours instead of the 25 it had been on for years, and started this four and a half years ago. However, if my bedtime and waking time was too late, I needed to combine bright light therapy with a few days of sleeping tablets, taking the tablets an hour earlier each evening. After that, the morning light therapy would serve to keep my waking time where it should be. This has worked pretty well for me, although my sleep pattern may wander out of synch a few times a year and need to be chased back.

There are two main types of lightbox, compact fluorescent and LED. Fluorescent are the traditional ones and have been around for longer. They are larger, require a longer treatment time, produce white light, and may cause medical problems for people sensitive to fluorescent light, such as migraine, visual problems, dizziness and so on. The manufacturers try to dodge here and say that they have better ballast, but in my experience they're just as bad as strip lighting and can cause nasty migraines. LED lightboxes have been around for a few years and may produce either white or blue light. They are smaller and require a shorter treatment time. Not everyone gets on with coloured light, and as the LED panel is composed of lots of little LEDs that look like dots, some people report getting spotting in front of their eyes, although I suspect that they were using the lightbox incorrectly. You're not meant to stare into it, you're meant to position it at the side, or even better above your eyes, so that it hits your peripheral vision. I have a GoLite, previously made by Apollo and now made by Phillips, which is a blue LED lightbox and very highly thought-of. I also have a Lite-Pad, which is a cheap white LED lightbox I picked up on eBay for a tenner, which I use by my sewing table to save messing around with cables when I want to quilt for my morning lightbox stint, and also means that it doesn't affect my colour judgement. The Lite-Pad is rather harsh, so I cut a piece of transparent blue plastic and taped that on top, reasoning that I wouldn't be limiting the necessary wavelength. The light now appears a bit colder but it's much easier on the eyes, and I no longer get spotting in front of my eyes when I happen to glance at it. The GoLite does have a lot more bells and whistles, such as a clock and the ability to set both the light intensity and the length of time for up to three different preset programmes. The Zadro looks like the best of the cheap lightboxes if you're in the US, and indeed looks like a very good lightbox in its own right. You can also buy combination lightbox/dawn simulators, of which more below.

Since you can't tell which lightbox you will get on with in advance, or even if it will work for you, and since these things are very expensive, find a company who will offer either hire-purchase (e.g. the National Light Hire Company) or a free trial (e.g. Lumie). You may need to spend a while working out the right amount of time to use the lightbox for.

Of course, an entirely free alternative is simply to make sure you get outside for at least one hour every morning. It doesn't matter if it's cloudy. I've run into a woman online who managed to get the same effect by using a 150w fluorescent light (that's actually 150w, not the equivalent to 150w incandescent) such as this grow light in her overhead light during the whole day, not just for an hour. This is far, far brighter than normal domestic lighting, and while it won't save you energy and many people (especially with ME) will find it uncomfortable on the eyes and/or likely to provoke migraine, for some people it's a good solution.

Another possible solution is to buy an LED bulb in white or blue and sit with it at a level just above your eyes for a couple of hours a day. The blue bulb will be exactly the right wavelength, and while the white won't have as much blue, white LEDs peak at the right wavelength so it will have a lot of it. It won't be as strong as a therapeutic lightbox but if you use it for long enough and keep it close to the top of your eyes, you may be able to get a decent result out of it. If anyone tries this, do let me know how you get on. I've got one of the blue bulbs which I've used for messing around with moonlight simulation (this is popularly known as Lunaception and is meant to improve menstrual cycles, although for me it just wrecked my sleep), and I've noticed that I tend to feel wired after looking at it, and that using it for half the day was enough stimulation that I had trouble sleeping that night. So I reckon there's quite a bit of potential with those little blue bulbs, and they're better filtered than lightboxes so you don't get spotting after looking at them.

Dawn simulation

Dawn simulation works by gradually turning on a light, generally 40w or 60w, over a period of time, most typically 30 min, in order to simulate a sunrise. The light goes through your eyelids and moves your sleep stage to the point where it should wake you up naturally, meaning that you wake feeling as refreshed as you're going to get and that hormones such as cortisol do what they're meant to. I find that when it wakes me up, it feels like I blink and I'm awake, rather than being dragged kicking and screaming into consciousness. They all have backup alarms you can set just in case. Most people don't need them, but some do, and can still find that while the light isn't quite enough to wake them up on its own, they do feel much better when they wake up.

As well as making it easier to get up in the morning, some research has found dawn simulation to be as effective or nearly as effective as bright light therapy for treating SAD, and I think possibly non-seasonal depression as well. This is despite the fact that it doesn't use such bright light, it just uses an ordinary bedside lamp or equivalent. It's thought to be something to do with the gradual increase in light having the effect. The advantage over bright light therapy is that the treatment is over by the time you get up, you don't have to tether yourself to a light box in the morning, but the disadvantage is that it may not be as effective. Companies selling both tend to recommend it for mild SAD and bright light boxes for more severe SAD, I've noticed.

Dawn simulators also generally offer dusk simulation as well, where the light fades down gradually to help you get to sleep. I think there's some research around showing that it helps a bit with insomnia. I've not really used this setting much, though I find it relaxing when I do. I use dawn simulation because it helps stabilise my sleep pattern even further, and because it helps both myself and my partner to get up in the morning.

One common problem with dawn simulators is that they tend to buzz. The best solution is to get one of the new energy-saving halogen bulbs which are the same shape as standard incandescent bulbs and can be dimmed, as not only will they save you 30% on energy (42w is equivalent to 60w and so on) and last longer, but the light is good quality and they don't buzz. You can't use fluorescent bulbs in a dawn simulator (I never recommend them anyway as the light causes problems for so many people), you can't use the usual halogen bulbs, you can't use LED bulbs if you've managed to find one, you can just use them with standard incandescent or low-energy halogen. This is for where you put in the bulb yourself: there are a couple of types of dawn simulator around using fluorescent or LED lights already built in. If you get the type of dawn simulator which plugs into a lamp, again it has to be the sort of lamp which takes incandescent bulbs, and it can't be a lamp which already has any sort of dimmer fitted, such as a touch lamp. Just use an ordinary table, bedside or desk lamp.

There's a new type of dawn simulator which is combined with a lightbox, such as this one (do read reviews, there are some crappy ones out there by other manufacturers). They may be a good solution for people wanting to try both dawn simulation and bright light therapy, but bear a few things in mind. Firstly, it comes up to full lightbox brightness rather than the brightness of a 40w or 60w bulb, so that you will most likely be awake long before it's anywhere near fully bright. One solution could be to set a 90 minute sunrise and assume that you'll be awake after, say, 30 min. You need your dawn simulation to be by your bed but are unlikely to want to be using your bright light box by the bed, though if you read in bed in the morning or have your laptop close to your bed you could be OK. The other point that occurs to me is that since the light is much brighter than is needed for dawn simulation, you could place it further away from the bed (e.g. by your computer) and just point it in the right direction. If I was starting light therapy all over again, I'd probably have gone for one of these and hoped that I'd be able to work something out once I'd fiddled with it enough.

I started off years ago with an all-in-one Bodyclock by Lumie where the lamp is built in, but even though it was a 60w bulb I found that it wasn't bright enough for a reading lamp, plus Lumie often get slated for poor product build quality. I sold it on eBay and bought myself a Sunrise System which plugs into a lamp or lamps of your choice, and vastly prefer it. Mine went faulty and I recently sent it in for repair, where they reported that it had been damaged by a power surge (at which point I promptly bought a surge protector) and sent me a replacement which is slightly different from the older model. They can take a bit of getting used to, and I think the company needs to continue tweaking them (though at the very picky level), but generally they're excellent. They have lots of useful features, such as being able to set the time individually for each day of the week. We have it set to finish at 9 am Mon-Sat and 9.30 on Sunday, when D starts work later. Actually he starts quite a lot later, but I want to keep myself in a good routine. I might change it to 10, though, I like having the odd lie-in.

One of the great things about dawn simulators of this sort is that you can plug them into more than one lamp as long as you don't exceed the total wattage, which in the case of the Sunrise System is 200w in the US and 300w in Europe. That's enough to hook it up to lights all over the bedroom if you like, though most people like to hook it up to a light on each side of the bed. We've found that I get woken up better than D does by light, that he doesn't like waking up to full light and generally prefers it to be dimmer on his side, that he still needs his alarms as he's trained himself to respond to those, and that I take longer to get up once I'm awake, so that by the time he's had a shower and got ready for work it's about the time that I'll be getting up. So on my side of the bed, the dawn simulator is hooked up to my bedside light, which is a 40w equivalent low-energy halogen bulb in an anglepoise lamp that faces the wall, and on D's side there's a little 25w spotlight hidden behind a vase which points into the corner and is enough for ambient lighting. D's bedside light is independent of the dawn simulator. The dawn simulation starts at 8 am, which is when the first of D's three alarms go off. D gets up at 8.30 when the light is up to half brightness, and I get up at 9 when the light is at full brightness. As there are alarms going off from 8, I can be anywhere from awake to dozing to having fallen asleep again while the light is increasing, but it doesn't seem to prevent it from being effective. Occasionally I sleep in later than 9, but it's probably only once a week, which for me is fantastic. This helps keep my sleep stabilised even if I went to bed too late the night before, I'm getting up earlier than I used to (even when I was using the lightbox), and it's great being able to get up earlier in the morning and go to bed at the same time as D.

Darkness therapy

The idea behind this is that humans do best when they have melatonin being produced for half the time (averaged out over a year, it won't be 12 hours all the time unless you're living on the equator), and that it's useful both for aiding sleep and for other things such as fertility and cancer risk. There have been studies using 12 hours of complete darkness to treat bipolar disorder, but this is difficult to implement and is generally thought not to be necessary, though I've read a website (which I can't find just now) by one guy who feels that it is essential and discusses washing up in the dark!

Since it's blue light which affects circadian rhythms and tells the body that it should be awake and not producing melatonin, you can practise darkness therapy by simply omitting or filtering out blue light for several hours before you go to bed and while you are in bed. There are a few ways of doing this.

Coloured light bulbs. For general use while awake, I prefer yellow-coated incandescent bulbs. If you're in the UK, they're just sold as yellow bulbs. If you're in the US, they're more likely to be called bug lights. The bulb should be painted completely yellow and will produce an amber light which I find pleasant but which D can't stand. Unless you live alone or are only planning to use these lights while alone (e.g. while breastfeeding or if you need to get up in the night because you can't sleep), this is a potential snag. For use when I'm going to the toilet at night, or if I just want to find something in a bedside drawer, I bought a couple of red bike lights. One lives on a shelf in the toilet, the other lives in my bedside drawer. Since I'm an evening bather, I've even managed to learn to shower with one of these sitting on the shelf above the bathroom basin, although D thinks I'm crazy for doing this.

Even with coloured light bulbs, it's best to keep the lighting in the evening fairly low. I have a 60w yellow bulb in a desk light by the bed for reading by, and a 25w bulb hidden behind a vase in the corner on D's side of the bed for ambient background lighting. Sometimes we go for tealights or twig lights (they're white rice lights, which are slightly yellowy; note that LED fairy/twig lights are a bright white which peaks in the blue spectrum) instead, which is better than nothing, and absolutely fine if I'm wearing my orange specs (below).

Monitor filters. Computers and television screens emit an awful lot of blue light, and using them in the evening can really mess up your sleep all on its own. Low Blue Lights and its friends sell expensive amber filters, but I simply got some samples of amber gels from a theatrical lighting company and cut them to size. They stick on fairly well by static, unless you have the computer screen tilted quite far forward, and are easy to take off for daytime use. I have a 17" widescreen laptop and there are several inches to spare, so these would probably do you for up to 19" or 20" widescreen. They're a bit of a nuisance, they won't work for larger monitors, and again D doesn't like looking at them (some people just don't get on with coloured light), but they're cheap.

If you're looking at a monitor through an amber filter or glasses, colours will be quite strongly affected. The general effect is golden yellow more than orange, oddly enough. Whites will be yellow, blues will be greens, everything will be a bit different. This may annoy you, and it may restrict your activities. I can't do any quilting that requires me to select colours, and it's not the time to go internet shopping for clothes. This isn't entirely a bad thing, as it forces me to wind down in the evenings and look at those hours during darkness therapy as relaxation time.

Tinted glasses. There are two ways of doing this. You can buy ready-made tinted glasses which will block all blue light, for instance from the range here, or you can get prescription glasses made up with a tint that will block blue light. If you want to try standard sunglasses in brown, orange, yellow or red, check with an optician to find out whether they block 100% of blue light. You also want these glasses to provide good coverage, as opposed to some of the tiny lenses you can get these days.

If you're going for anything expensive, try out darkness therapy with coloured bulbs and optionally monitor filters first to see whether you get on with it and whether it helps. Since I can't see without glasses, I decided to try some fitover glasses in amber which had the advantage of very good coverage. Unfortunately I found them horribly uncomfortable, and they looked terrifying on me, being huge and so dark that my eyes were utterly obscured. D and I didn't want our evenings together spoilt by this, so I gave up on the fitover school of thought and had some prescription glasses made up instead. If you're a friend of mine on Facebook, you can see them on me here. On my optometrist's advice, they were tinted with Wratten Tint 21, which is a nice orange. Optical Express (who do some rather nice cheap frames) could get that orange in 50% light transmission, which was more than enough to block 100% of blue light but still not so dark that my eyes were obscured. (Remember that brown is just orange with black added, so while they will look more conventional and may distort colours less, they will need to be darker.) The glasses are very cute, if I say so myself, and I've had no complaints that they make me odd to be around.

I still keep the ambient lighting low when possible, as there will be a bit of light creeping in around the edges, and when D is out I use the lamps with yellow bulbs. I generally put on the glasses at about 9.30 for a bedtime of midnight, and have been using them for nearly two months. I'm getting sleepy earlier in the evening, sometimes I even fall asleep at 11ish, and I think I'm sleeping more solidly. They're also very relaxing to wear. When D comes home late from poker, in the past I'd be so thoroughly woken up that I couldn't get back to sleep for hours. Now he's lucky to get a coherent "hello darling" out of me, and I go straight back to sleep. I haven't had an episode of not being able to sleep until unholy o'clock in the morning, or waking up at night and not being able to get back to sleep for well over an hour, since I started using the glasses. There have been a few nights where I've stayed up until 2, yawning all the time, but where in the past (using bright light therapy alone) I would have messed up my sleep cycle by doing that and would be unable to sleep before 2 (or worse) for the nights afterwards, now (using bright light therapy, dawn simulation and darkness therapy) my sleep pattern snaps right back into place.

I wouldn't say that my sleep is perfect now, I'm probably still not getting enough deep sleep, but apart from that it is hugely improved in several ways.

Cross-posted to my journal and cfids_me.