Flip upside down for better sleep? Austin sleep specialist explains more

Some people find they sleep better if they flip around and out their head at the foot of the bed. Why does this work? An Austin sleep specialist explains more.

Mental health advice abounds on platforms like TikTok. Because sleep issues are so common, it’s no surprise social media platforms are packed with bite-sized and clickable hacks for better sleep.

I was interviewed as a sleep specialist in Austin for an article in Bustle about the TikTok sleep hack of flipping upside down; specifically putting your head where your feet normally go and vice verse. Go here to read the full article: https://www.bustle.com/wellness/tiktok-backwards-sleep-position.

I weighed in on if, how, and why this could work.

Now, this would never be my first line advice to someone who can’t sleep. Insomnia is a habit that’s been conditioned over time and doing one thing once is not going to change the habit. I also would caution against using this trick regularly if you prefer to ultimately sleep “right side up.” It might get you relief short-term but if you want to sleep with your head at the headboard, you need to train your brain to fall asleep in that position.

You might ask, what are some common reasons why someone might lie in bed for hours unable to fall asleep? How do you get to the point of contemplating whether being upside down would help?

One is a phenomenon called conditioned arousal which is common in insomnia. This is an experience where someone actually feels sleepy until they get into bed, at which point they are suddenly wide awake. Our brains like to pair things so we can develop a habit of being awake/anxious/agitated/etc in bed and then it starts to happen automatically, just like stopping at a red light. The other problem is something called sleep effort where the person starts working really hard to fall asleep. To fall asleep, you must disengage, and paying attention and exerting effort are the opposite of disengagement.

To be honest, I haven't heard this hack being used frequently. But it doesn't surprise me. People with sleep struggles will try anything. They're suffering and they're desperate. They've usually exhausted every option they can think of by the time they get to me.

The harder you strive to sleep, the less likely it is that sleep will come to you. Counterintuitively, it helps to drop the rope rather than pull harder. An Austin sleep specialist can help you do exactly that.

If there is any credibility here, how and why does it help?

If this hack is effective, my theory is that it either breaks the conditioned arousal pattern and/or removes the sleep effort. People with insomnia often find they sleep better in places other than their bed where there is less association with the stress of not sleeping. Switching positions puts you in a fresh spot that your brain has not associated with poor sleep. This hack could also be effective if it removes the sleep effort. Sleep does not reward effort and the harder you try, the more elusive it is. If flipping over is a way to stop trying to sleep, it could be effective. But if you're just adding in more sleep effort, it's likely to backfire.

So, if you're unable to fall asleep in your usual position, at what point should you switch positions and lie the opposite way?

I tell people after about 15 minutes or as soon as you realize you are agitated, stop trying to sleep. The typical advice is to get out of bed and do something fun and don't go back to bed until you feel sleepy. Being out of bed is what builds sleep drive. However, if someone has mobility issues, the advice is to sit up in bed and do something else until you feel sleepy.

What’s a reasonable expectation for time to fall asleep?

10-30 minutes is what I consider normal. If you are falling asleep too quickly, that could indicate a sleep disorder just as taking a long time to fall asleep does. Sliding into sleep is a gradual process, not an on-off switch.

If you are having trouble falling and/or staying asleep, and nothing has helped, you could likely benefit from CBT for Insomnia. Go here to find out how to schedule a free consultation with a sleep specialist in Austin. I can also treat nightmares and circadian rhythm disorders.