Insomnia has been a struggle for me all of my life; ever since I was young, I've struggled with shifting sleep schedules and white nights. I'm far from alone. Studies show that as many as eighty percent of blind people struggle with chronic insomnia and conditions like Non-24 hour sleep disorder. Far too often, the problem is "treated" by Zolpidem or other powerful prescription sleeping pills. Unfortunately, these pills can be addictive, require ever increasing dosages, and have side effects. After years of trying countless solutions, I've finally got a collection of strategies that keep me sleeping on schedule about three quarters of the time without prescriptions.

Before we dive in, let's start with some disclaimers. To misquote Star Trek's Dr. McCoy: Damn it Jim, I'm an accessibility professional, not a doctor! I'm also not a sleep expert, or in any other way qualified to give you advice. I'm just some guy on the Internet, you know? Consult your actual doctor, and believe them over "random internet dude". These are just the techniques and tools that work for me, personally, posted in the hopes they might be helpful for those of you fighting the good fight against the insomnia monster.

The boring stuff

Yeah, I know these are all the things your Aunt Marjorie has told you in a condescendingly helpful voice over thanksgiving dinner. "Goodness, Marge, going to bed early and trying harder never occurred to me! I'm sure I'm fixed, now!" But as with anything in life, there are no quick shortcuts to overcome insomnia. The first step is doing the hard, annoying, and unrewarding work of building a good foundation. I know you've heard it, and tried it, so I won't dwell. But it does have to be said:

• no coffee after about noon
• no alcohol after dinner
• lie down at the same time every night
• have a sleep routine: brush your teeth, shower, whatever, as long as it's the same every night
• no books or phones or anything else in bed; bed is for sleeping
• bed should be quiet, cool, and comfortable
• get up at the same time every morning
• a maximum of one nap a day, one hour in length

If you don't have these basic building blocks in place, nothing else I can say here will offer you any improvement at all. Yeah, I know it's difficult to give up coffee and after-dinner booze, and go to bed at a normal time, when you know you're just gonna roll around, wide awake, for hours. But you've gotta try. In all likelihood, at least if your insomnia is related to blindness, your efforts will go completely unrewarded. But without those efforts you've got nothing to build on. So keep it up; you can plan your next blog article or something while you lie there.

Get The Data

How long did you sleep last night? It turns out, at least in my experience, people are remarkably bad at judging sleep length and quality. On top of that we tend to have no idea if, or why, we woke up in the middle of the night. Also, getting some data could uncover undiagnosed issues you had no idea about. I only discovered I have sleep apnea thanks to my Apple Watch. Treating that made a remarkable improvement to the quality of slumber I manage to get when I finally do fall off to sleep, though it didn't make getting to the gates of dreamland any easier. Lastly, if you don't have some source of measurable truth, you'll have no real idea if anything you're doing is helping. After a sleepless night, it feels like you've been tired for weeks! The only real way to tell if you're making progress is to have some numbers over time to examine.

While countless trackers and apps are available, I find the Apple Watch to be the most accessible option. Reviews show it may not be the most accurate, but increased accuracy does me no good if I can't access the data. If you can't spring for an Apple Watch, try to find a cheaper solution that links with Apple Health. That way you at least can access the various graphs and charts of your sleep with VoiceOver.

Getting Up is Fine

I said lie down at the same time every night, not stay down. If you're not asleep within 90 minutes or so, get out of bed for an hour or two. This is when you listen to your audiobook, or music, or whatever. The trick is not to just grab your phone and listen to an audiobook in bed. Bed is for sleeping. If sleeping isn't happening for you, get up, throw on a housecoat, and do something else relaxing for a bit. Just don't do that relaxing thing in bed. I keep a warm robe on a hook right next to where I sleep, and I have a comfortable chair to sit and relax in directly outside my bedroom. That means I can slither out from the blankets, and stay warm and comfortable, while not actually being in bed. When I finally feel Morpheus' soothing call, I can slip off the robe, and bed is just a couple steps away.

Medications

I currently don't take any prescription sleep medications. I've tried all the major ones, and none of them worked for me. If your doctor is telling you to take medicine, though, please don't take this article as a license to stop against medical advice.

I do, however, take Melatonin every night. While the studies about it's efficacy are inconclusive, I find it does help me; if you have no light perception, you don't produce Melatonin naturally, and too much of the published literature only includes sighted people.

When the insomnia gets particularly powerful, I also supplement with Dimenhydrinate, as I find it has an extremely soporific effect on me, without the side effects I get from over the counter sleeping pills. If that isn't the case for you, you might also try Diphenhydramine as it has similar effects on some people. The problem with both medications is that the more often you take them, the less effective for sleep they become. I try to restrict Dimenhydrinate to no more than twice a month. But during the change to and from daylight savings time, I find I need it every night for a couple of days before and after the change to have any hope of keeping my sleep schedule on track.

Binaural Beats & Isochronic Tones

And that, ladies and gentlemen, is where the real science in this article ends. Now we're going to earn the "Pseudoscientific" in the title, as we adventure into unhinged nonsense that nevertheless works for me. If you've never heard of Binaural Beats, they're sounds that claim to be able to synchronize your brain to produce brainwaves of various frequencies, thus changing your mental state. Isochronic tones make similar claims, but are able to operate without headphones, unlike Binaural Beats. Unfortunately, when you dive into the science, you find studies claiming no effect, studies done by people selling Binaural Beat generators that claim a small but noticeable effect, and studies done by absolute lunatics claiming Binaural Beats can help you shift dimensions, become superman, or summon your spirit guide.

I'm not yet superman, I've never visited another dimension, and if I have a spirit guide she's not talking to me after the noodle incident. But I do find that Binaural Beats are extremely effective for getting to sleep. Unfortunately, I've never found a pair of sleep headphones that are comfortable enough for me to wear all night. But Binaural Beats are really useful for those hour long power naps. They help me get napping quickly, and an audio timer is useful to help regulate the length of the nap. I've tried Isochronic Tones through a speaker, but I've never found a way to generate them that I loved, and my results were inconclusive.

Currently, the best source of Binaural Beats is Amid Audio. It's available on IOS, Android, and Sonos, with an accessible interface on all platforms. It's also free for the moment, without even having any ads! I'm sure that will change at some point. You can find pink noise mixed with Binaural Beats under the "simple sounds" category. I also use it on Sonos as a source of brown noise, to block any distracting sounds in my bedroom.

Apollo Neuro

The Apollo Neuro is a wearable device that claims to use touch therapy to improve vagus nerve activity. The website sure does use a lot of science words, with many numbers and graphs! That must mean it's real science, right? Well, maybe. I'm not a researcher or doctor, so not qualified to read any of the studies they list to judge them. But I do notice that they seem to have paid for at least some of them. That said, I've found Neuro to be extremely effective in helping me get to sleep, stay asleep, nap well, and reduce anxiety. The placebo effect is strong, though, and I have no idea if my results are because of vagus nerve stimulation (whatever that is) or because a thing vibrating my arm convinces my brain that this is powerful science magic. Either way, it works well enough that I find the price of the hardware and subscription worth it. If I'm paying for a placebo, it's at least a placebo that helps me.

Things that didn't work for me

The following things didn't help me at all:

• CBT: my insomnia causes stress, but isn't stress related itself. Cognitive behavioral therapy did nothing for my sleep (though it helps a lot with anxiety)
• over the counter sleeping pills: generally give me one good night of sleep, followed by groggyness all the next day, with no effect the second night
• THC: absolutely no measurable effect
• Kava: makes me feel light-headed and drugged, but not actually sleep
• prescription sleeping pills: either don't work at all, or work far too well
• brain.fm: the music was distracting, the app was inaccessible, and it made my sleep worse
• Endle: started off excellent, and was my preferred solution before Amid Audio. However, it got less effective with every update.
• sleep stories and ASMR: if someone is speaking English, I don't sleep; I need to stay awake and listen to the words. Also, whispering makes me anxious. The only time people whisper in my life is when we don't want to get caught! I do find soft spoken ASMR in other languages can feel calming, but it doesn't actually put me to sleep.

Conclusion

Again, using all of the techniques above, I'm usually able to get a good nights sleep and maintain a regular sleep schedule about 75 percent of the time. That's a massive improvement from where I used to be! But nothing will be perfect. Sadly, if you're completely blind, occasional sleepless nights and tired days are probably just something you're going to have to live with. You can, however, improve things to the point where work, school, and social events don't have to be a constant and unending battle against exhaustion.