Your sleep cycle is erratic. You wake up in the evenings and fall asleep at noon.

You don’t get a full 6-8 hours of sleep regularly. On the days you actually do, it happened because your body is too tired from the stresses topical steroid withdrawal is giving you. You find yourself waking up every hour or so due to the itch or pain. Sometimes, the pain actually dulls the itch so much that it makes you stop scratching, and lulls you to sleep.

You are afraid to sleep because you fear you might tear your skin out while sleeping, and that makes you miserable.

You are extremely frustrated with the lack of quality sleep, and it makes everything in the world worse.

Having gone through all that and having recovered from the worst of my topical steroid withdrawal symptoms, the key lesson learned was to NEVER, EVER take good sleep for granted.

If you want to sleep well, you have to work hard for it.

Here are some lifestyle-centric tips tailored for TSW sufferers to improve your sleep.

(Note: These are lifestyle-centric tips to improve your sleep. I do not encourage the excessive taking of drugs or pills to improve your sleep. While they may be very helpful in the short term, there are unknown long term side effects that could be detrimental to your body and health)

The trick to develop a natural sleep routine at night is to wake up at a fixed time in the morning. Set your alarm clock and have the discipline to wake up on time. (You snooze, you lose!)

Short naps, proven by research, are incredibly helpful in recharging and repairing your body. Take them if you feel tired midday. And keep them short.

Do not let short naps become long naps, as they can screw up your natural sleeping cycle.

It is very easy to let your mind wallow in self-pity when your skin looks and feels horrible. Don’t let that happen.

Engage your mind in productive tasks – writing, solving problems, thinking on creative tasks. Work your mind actively so that you tire out naturally by the night. You will feel a sense of accomplishment doing and thinking about something by the end of the day and this gives you an additional feel good factor.

Work your body physically so that you create the “demand” for rest.

It may be difficult during withdrawal as your skin condition may limit your mobility. But do what you can. Simple tasks like taking a long walk, doing chores, lifting stuffs, swinging your arms and rebounding (the act of bouncing up and down) etc can definitely be done.

Start small and start progressively. When your skin allows you to work out to a sweat, do it! You will be amazed at how fast your recovery will be as your lymphatics and blood circulation improves.

The type (different wavelength) of light you are exposed to affects your natural circadian rhythm.

One easy trick to reset your circadian rhythm is to expose your eyes to sunlight upon waking and during the daytime. Just imagine you are a caveman and you are not living naturally in the wild, without walls, computers, handphones and tablets. Try living like one and you will reset your circadian circle naturally. Your mood will improve too!

Be mindful of artificial light that can affect your sleep cycle – light from incandescent bulbs, monitors, tablets, handphones, ipads etc. If you work with these items regularly, stay clear of them 2-3 hours before bedtime.

Tip: install f.lux if you work regularly on the computer and monitor like me. It will dim the monitor lights naturally after a certain time i.e. 6pm so that it does not over-trigger your senses.

Develop a routine to trick your mind into “knowing” it is bed time.

Taking a shower, then easing into your bed, reading, talking about stuff with your partner, doing some light static/dynamic stretches and etc. Do light activities that do not excite your mind or body 1-2 hours prior to bedtime. You have worked hard in the day, you deserve a chill out period in the night before you sleep.

Leave your worries to tomorrow by writing them down on a piece of paper and shoving them aside. Tell yourself that these will be fixed tomorrow, after you get a good nights sleep.

Sex and orgasms help you to sleep better. The natural hormones produced during and after sex helps to induce relaxation and hence draws you to sleep.

The problem is that this is often difficult for TSW sufferers, as our skin is usually bad and irritated. Sex could often by the last thing on our minds (at least for myself for a long period of time). Check out this good guide on how to have sex and intimacy with topical steroid withdrawal written by a fellow TSW blogger, Esther.

There are a number of benefits to sleeping naked.

Besides the benefit of having a better temperature regulation to help your sleep, there are other benefits specific to TSW:

Improving air circulation around your skin, so that your skin does not get infected by an induced and limited micro-environment provided by having a layer of shirt or cloth.

Improving cortisol regulation (due to temperature) and growth hormones production that is essential to your skin and immune system repair.

Find yourself rolling around in bed while your mind is still very active?

Get up and do something else. Grab a drink, sit up and read a book or the newspapers. Do something to chill yourself out.

If you have been doing things right in the day (following the above tips), your body will naturally tire out and soon you will fall asleep again.

Lastly, understand and see that having a good night’s sleep is highly beneficial to your health and make it a priority.

Do not be frustrated with your quality of sleep. You will definitely be affected by virtue of your horrible skin condition.

Instead of being frustrated, try to see it as a game of self-improvement. Incorporate little tips here and there to TRY to improve your sleep. Do things that you can control. Do things that improve your life, even if they appear slow and insignificant. Take one step at a time. Improve things one at a time.

Use this difficult period to hone your zen mentality. I can guarantee you that post TSW, you will have developed a positive mental attribute towards all challenges in your life.

Well, these are the tips that I’ve practiced. I’m not a saint in having the discipline to adhere to all the tips all the time, now that I’ve recovered. But I know more than ever, if I do not work hard to tire myself out during the day, my sleep quality will suffer in the night. Which is why I have this rule: If you want good sleep, you have to work hard for it. Never ever take simple things for granted. Good things in life don’t come freely and easily. You have to work hard to get them.

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