Good night, sleep tight… but I just can’t!
By: Lee Sook Huey
Having a peaceful and easy sleep can be deeply satisfying. Unfortunately, one tenth of us suffer from insomnia, a condition characterized by difficulty falling or staying asleep. While most of us have experience days of poor sleep due to anticipation of exciting events or occasional stressful periods, we will usually be able to adapt to these situations within 2 weeks.
When the sleep problem lasts up to 2 weeks for at least 3 nights per week and affects our mood and functioning, we are likely to be suffering from acute insomnia. However, people usually seek help when they already have trouble falling or staying asleep for more than 3 months, when it has become chronic insomnia.
Recently, I came across a hopeful study done in Northumbria University finding that a one-hour session of Cognitive Behavioural Therapy (CBT) on insomnia prevents 73% of people with acute insomnia from worsening into chronic insomnia. Thus, I would like to share some tips based on the CBT approach, optimistic that you will learn to deal with insomnia and experience more relaxing and comfortable sleep. There are two main reasons for acute insomnia to worsen into chronic insomnia:
- People associate going to bed with sleeplessness and frustration for months.
- People become overly worried about sleep loss and try too hard to sleep.
Going to bed needs to be the cue for sleep
Many people with insomnia can relate to the problem of being able to sleep soundly on the sofa but not on their bed. I wonder whether you have noticed the power of association and applied this to sleep. We experience strong disgust when we see the food that once led us to have food poisoning. Similarly, associating our bed with frustration and sleeplessness will worsen insomnia. Thus, we have to ensure that our bed is strongly associated with sleep instead of negative emotions. These are the simple steps to improve our sleep efficiency through association:
- Cut down the time spent being awake in bed. Go to bed only after you feel drowsy. Do not go to bed early and toss and turn in bed.
- Fifteen-minute-rule. After spending more than 15 minutes trying to fall asleep in bed, get out of bed and do other things in another room. Do not “relax” on the bed by reading or watching TV.
- Set a consistent “out of bed” time. Wake up at the same time everyday regardless of sleep quality. Trying to catch up on sleep is counterproductive.
With these practices, your brain will start to associate your bed to sleep, and this is likely to help the situation significantly.
Let your mind drift off to sleep
Many people with insomnia force themselves too hard to sleep and get upset if they can’t get 7 hours of sleep. However, there are actually large individual differences in terms of our sleep needs, with the range stretching from 4 to 10 hours. We also need less sleep as we grow. Forcing ourselves to sleep longer than we need may result in unnecessarily stress and worry. In addition, the fact is that we can actually function quite well despite lack of sleep, parents of newborns being a good example.
Will you be able to tell the difference between when you are nearly falling asleep and actually asleep? How deeply asleep do we need to be to know that we are asleep? The answer is we wouldn’t know that we have fallen asleep! Sleeping is not something that we will to happen, but something that occurs gradually and naturally. This is partly why paradoxical intervention of “trying to stay awake as long as you can” may work for insomnia: By telling yourself that I am NOT drowsy, NOT going to sleep, NOT falling asleep, we just naturally drift off to sleep. The harder we try to sleep and worry about not sleeping, the more it interferes with the natural pattern of sleep.
Although a comfortable environment can contribute to a good night’s sleep, what is more important is our inner sense of comfort, and this is often within our control. When you are feeling a little drowsy and go to bed, find a comfortable position in bed, bring your mind to a calming place and let your mind wander as it naturally drifts off to sleep. Some people may imagine relaxing on the beach with the gentle sound of waves, while others imagine a beautiful night sky or being in a peaceful forest. Relaxing imagery helps your body to feel comfortable, your mind to slow down, and allows you to gradually lose awareness as you are falling asleep, just like the natural sleep process.
Guidance from mental health professionals
If you are suffering from insomnia, cognitive behavioural therapy for insomnia (CBT-i) has been found to be effective in treating this problem by addressing a person’s behavior and thoughts about sleep through sleep education and better sleep habits. Clinical trials show that patients who receive CBT-i fall asleep on average 20 minutes faster than those who did not receive treatment. Usually, treatment for insomnia takes 4 to 12 sessions each lasting about 30 minutes with a qualified mental health professional. Having a therapist guiding you may make the journey towards good sleep a smoother one.
May we all experience calmness and tranquillity from deep within with a good night’s sleep!
About the author
Sook Huey is a clinical psychologist who has worked with clients facing sleep difficulties. Read more about her here.