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Can’t Sleep? Here’s Why It Happens And What To Do About It.

Most humans spend approximately 30% of their lives asleep yet 43% of Americans between the ages of 13 and 64 report they rarely or never get a good night's rest. Proper rest is a big deal when it comes to physical and mental health. Sleep deficient folks are more likely to suffer from chronic diseases like diabetes, hypertension and obesity as well as depression.

What's Messing Up Your Sleep

Stress at Night: engaging in stressful activities like watching the news, paying bills or having conflicts with others increases cortisol and adrenaline levels and interferes with sleep. Instead, deliberately engage in calming activities at night and save the stress for other times.

Racing Thoughts: it's unfortunate that the very things that help promote sleep - quiet and stillness - also makes it easy for our thoughts to go on a rampage. Rumination often accompanies anxiety and depression which are exacerbated when our sleep is disturbed, forming a loop that can easily spin out of control. When racing thoughts occur, one of the worst ways to deal with it is to try and force sleep. It seldom works and often can make matters worse.

Unhealthy Food Choices: eating spicy or acidic food before bedtime can increase risk for heartburn or acid reflux. Food high in fats can interfere with the production of orexin, a neurotransmitter that helps regulate the sleep/wake cycle. High protein foods require extra energy to digest which, when eaten close to bedtime, can interfere with sleep. In addition, it is well documented that sleep deprived individuals tend to snack more often and crave extra carbs and fatty foods, so on top of being tired you're probably going to be struggling with weight.

External Factors: these may seem obvious but factors like room temperature, outside light, street traffic or a snoring partner can be significant disruptions to getting a good night sleep. The more you wake up during the night, the harder it is for you to transition to the deeper stages of sleep.

How To Sleep Better

  • Keep to a Schedule: our brains and bodies like consistency. Try to stick to established bed and wake times.
  • Eliminate Napping: short naps can be refreshing but if you are having difficulty sleeping at night, push on through to bedtime.
  • Avoid Electronics: blue lights from LED screens can mimic sunlight and inhibit melatonin production which regulated our sleep-wake cycle. Give your eyes a break from electronic devices before bedtime to help your hormones.
  • Dim the Lights: similar to above. Help your body recognize nighttime by letting it get dark.
  • Avoid Clocks: clock watching only serves to increase anxiety about being awake when you should be asleep. If the alarm hasn't gone off it doesn't matter what time it is. Cover the clock if you can't help sneaking a glance.
  • Reduce Alcohol: alcohol can help you fall asleep faster and stay asleep longer but it gets in the way of REM sleep which makes you feel less rested.
  • Reduce Caffeine: stimulants = bad for sleep.
  • Avoid Nicotine: see above.
  • Exercise: studies show that sleep is significantly improved when people get 150 minutes of exercise each week.
  • Read Before Bed: reading before bed can help reduce cortisol levels and help separate your sleep time from your daily stresses.
  • Use Guided Imagery: there are plenty of apps out there. Experiment to find one that works for you.
  • Breathing Exercise: exhale through your mouth; close your mouth and inhale through your nose to a count of 4; hold the breath to a count of 7; exhale to a count of 8; repeat x3.

Sleep is a tricky matter because what helps can vary significantly from person to person. What works for me is taking a hike in my mind. If I'm having a difficult time falling asleep I'll pick a favorite trail to follow. If my thoughts start to wander, I'll get back on the trail. I seldom reach the end before falling asleep. Your strategy may be different.

The relationship between sleep and mental health can easily become circular and can spill over into virtually every area of life. Let's work together to get your life back in order.

If you are struggling with sleep-related issues, let's talk!

How To Pay For Counseling


A lot of folks think they can’t afford counseling. I frequently have inquiries asking about free or heavily discounted services and although I am empathetic towards financial struggles I also have to make sure I can pay the bills and support my family. I reserve 10% of my active caseload for reduced fee clients and usually have a waiting list for those spots. I do not see clients free of charge.

If you are concerned about the cost of counseling consider your options. Many employers offer Employee Assistance Programs that may include behavioral health services. Many health insurance plans offer behavioral health benefits. I always recommend calling your insurance provider prior to making an appointment to verify coverage and benefits including copay amount, deductible and limits of coverage. Using an Out-Of-Network provider may also be an option as many health insurance plans will reimburse you for a portion of the out-of-pocket costs.

A Few Money-related Things To Consider When Choosing A Counselor

  • Ask if the counselor can offer a reduced fee if you can meet during “off peak hours.”
  • Seek out a Counselor Intern. Interns are typically recent graduates working under the supervision of an experienced licensed clinician.
  • Review your budget and have a good idea of what you can realistically afford to spend on counseling in a given month. Depending on circumstances, it may be appropriate to meet with your counselor less frequently than the typical once a week.
  • You can also explore organizations that help members with the cost of counseling. In Austin there are services for musicians, attorneys, members of the LBGTQ community as well as others. This is where Google can be your friend.

If you still have concerns, please reach out. If I can’t help I will do my best to steer you in the right direction.


Choosing a Counselor

michael hilgers choosing a therapst

Choosing a counselor can be an intimidating task. Research suggests that selecting a counselor who is a good fit has a more significant impact on successful outcome than the counselor’s degree, licensure or theoretical orientation. What constitutes a good fit is a difficult thing to measure and often comes down to trusting your instincts.

If you can, ask friends, family or coworkers for referral options to help narrow the options down. Most counselors have an online presence. Check out their websites, reviews and written material before reaching out.

If you plan to use insurance benefits do your homework first. I always recommend calling an actual representative to verify coverage for mental/behavioral health benefits, copay amount, deductible amount and any restrictions. Don’t necessarily rely on the information you find online about your policy. I’ve seen several people be unpleasantly surprised when their claims are rejected.

Reach out to a few counselors either by phone or email. Most counselors I know have limited availability by phone so anticipate having to leave a message and provide them with some good times to call you back.

Here’s a few things to consider:

Location: it is not ideal to arrive for counseling completely stressed out after hustling across town through traffic. If possible, try to make going to counseling as convenient as possible.

Insurance: if you find a counselor but they are not in-network, explore what options you have for using an out-of-network provider. Many plans will reimburse a percentage of the cost making it much more affordable.

Questions: write down what questions you have before making the initial contact with a prospective counselor. That first call can be intimidating and it is easy to forget things that might be important.

Questions that you might want to ask include:

How long have you been in practice?

Do you have a specialty?

Do you have experience with _________?

What are your thoughts on psychotropic medications?

Do you take my insurance?

How much do you charge?

How is contact handled between appointments?

What is your cancellation policy?

At the end of the day trust your gut. It may take an appointment or two to truly get a good feel but a lot can be determined even in that initial contact.