Learning to Sleep in Grief: Tips from a Widowed Pharmacist

Since Kailen’s death, I’ve averaged less than 5 hours of sleep a night. During the torrents of my early-grief, and continuing for more than a year after her passing, I often slept 2 hours or less, relying on copious amounts of caffeine and rage (more on that in future posts) to get me through the day.

It’s no small wonder I’ve aged 10 years in the last 3.

As many of you already know, sleep and grief have a complicated relationship. The deep emotional turmoil of bereavement makes it nearly impossible to obtain quality sleep, especially in adequate quantities, and in turn, mental and physical exhaustion amplify our agony.

Then the cycle repeats until the bags under your eyes look more like satchels.

First let me say – we as grievers haven’t cornered the market on sleep issues. Depending on which source you consult, as many as half of Americans report battling sleeplessness and consistently experiencing poor quality sleep.

For most of these folks, a scientifically-proven list of habits and principles, collectively known as “sleep hygiene,” can be immensely helpful. (Note: grief-related insomnia is much more complex and difficult to treat; I’ll address this later.)

I was first introduced to the concept of sleep hygiene while in pharmacy school. I admit I was initially quite skeptical, but after 3 years of pharmacy practice, I’ve heard enough patient testimonials to know that for many people, the principles of sleep hygiene can be sincerely life-changing.

In my estimation, both from personal and clinical experience, here are some of the most important takeaways:

1) To the best of your ability, stick to a consistent routine (i.e. try to sleep and wake at around the same time every day)

2) Avoid caffeine (and nicotine) after 4 PM.

3) Exercise for at least 30 minutes each day.

4) Limit alcohol consumption to 2 drinks or less (But, you’re pleading, alcohol helps me sleep! No, it helps you FALL asleep. It negatively impacts overall sleep quality.)

5) If you’re having trouble falling asleep, quit trying. Get up, read, do some light stretching, walk the dog – but only come back to bed when you’re feeling tired.

6) Keep your bedroom cool (less than 70 degrees) and dark.

7) Use a sound machine.

8) Once in bed, don’t watch TV or look at your phone. (Approximately 99.6% of you, including me, will struggle mightily with this one.)

9) If principles 1-8 aren’t getting the job done, consider taking over-the-counter melatonin. It’s cheap, safe, and though it varies from person to person, generally very effective. I recommend starting with one 5 mg capsule each night, 30 minutes before bedtime. (Pro tip: it will be more effective if you take it while already lying down in a dark room)

Implementing one or more (or all) of these principles may not cure your insomnia, but they’re sure to have some positive impact on your overall sleep health.

HOWEVER, here’s the tough part – as usual, grief changes everything.

Sleep hygiene is a powerful tool, but it’s often pathetically futile in the face of bereavement. Whereas the average person struggles with sleeplessness as a result of daily stressors, poor eating habits, lack of exercise, and altered circadian rhythms, the griever battles sleeplessness (or somnolence) because an actual and literal hole has been ripped into the fabric of their humanity.

The bereaved don’t toss and turn and wake up at 2:00 AM because they had too much coffee; they toss and turn and wake up at 2:03 AM, because that’s the precise moment their spouse, or child, or parent, or sibling, or friend left the world.

The bereaved don’t toss and turn and reach for their phone so they can scroll through Facebook or play Candy Crush; the bereaved toss and turn and reach into the vacuous space next to them, the now-empty side of the bed that was once occupied by love, the empty life that was once full.

The bereaved don’t wake up worried about deadlines and facing the perfunctory tasks of another workday; the bereaved wake up to face the abyssal darkness of their bedroom, the overwhelming loneliness of another sunrise.

So, you’re wondering, what’s the answer? 

To quote Megan Devine from her book, It’s OK That You’re Not OK, you simply must do the best you can.

It’s frustratingly simple and painfully complex all at the same time.

As a pharmacist, I would direct you to the 9 sleep hygiene principles discussed above. They are powerful behavioral tools proven to improve sleep quality.

As a 29-year-old-widower, I must confess to you that there will be times when absolutely nothing helps. Sleep hygiene will fail, melatonin will fail, and you will lie awake, neither dead nor alive, apathetically awaiting the approach of another soulless dawn. It hurts me to say these words, but I owe you the truth.

All I can do is offer you the encouragement that sleep hygiene might help, even if it’s just a little bit. Even if you just get 45 minutes of sleep instead of none, it’s still a valiant attempt at self-care, or in Devine’s words, “the best you can do.”

Daily exercise, keeping the bedroom cool, using a sound machine, and nightly melatonin are all things that eventually helped me start sleeping again.

They might help you, too.

Or they might not.

In this case, the simplest answer is the only answer: you must do your best.

Keep trying. Don’t quit. And always, above all else, know you are never alone.

Though I don’t generally recommend prescription sleep aids (such as Ambien or Lunesta), they certainly have their place. If you have questions about sleep hygiene, or about how medication can help you regain healthy sleep habits after your loss, please don’t hesitate to contact me using the form below. I’ll be glad to help.