Getting a better night’s sleep often means understanding what is preventing sleep, and how to overcome it. If you or your clients struggle with insomnia, here are three common sleep difficulties, and recommended therapeutic techniques that may help.
(Much of this information comes from the self-help workbook, Quiet Your Mind & Get to Sleep, by Colleen E. Carney, PhD, and Rachel Manber, PhD.)
- Trying too hard to get to sleep.
As insomnia drags on, it’s natural to want to “fight” for a good night’s sleep by going to bed earlier, staying in bed longer, or thinking “Go to sleep!” while lying awake at night. Unfortunately, these efforts can become counter-productive.
Focusing energy on avoiding something often makes it more likely that you will encounter that very thing. Instead, use “acceptance” thinking toward things that cannot be avoided. For example, instead of thinking, “I’ll be so miserable in the morning,” reframe your thoughts as, “It’s going to be difficult, but I will get through the day.”
Another cognitive technique to use is called paradoxical intention, which requires a person to engage in a behavior they want to avoid. With insomnia, a person actually tries to stay awake. This reduces the “performance anxiety” of trying to sleep. This does not mean taking extra steps to stay awake, such as consuming caffeine or exercising late at night. Instead, try to stay awake while engaging in restful, relaxing behaviors, such as reading or listening to music.
- Struggling with an overactive mind.
Racing thoughts and an overactive mind are common with insomnia. Whether these thoughts involve neutral or negative emotions, many of the same techniques apply to both.
Build a mental wind-down period into the end of your day to process the day’s activities and create a sense of closure that can create a more restful mind. This might involve journaling, taking a walk, or meditating.
Get out of bed. This keeps your mind from associating your bed with active thinking. Go to another room to read, meditate, or listen to music. You might do something productive but less stimulating, such as washing dishes or doing laundry. You might have to repeat this activity for days or weeks to break the mental association.
Use cognitive distraction to replace racing thoughts. Imagine a story in your mind, such as what happens after the end of a movie or video game. (Avoid emotionally arousing stories, such as a horror movie.) This breaks up the cycle of racing thoughts with something more pleasant and relaxing.
- Fear of nightmares.
Bad dreams can cause anxiety that makes you afraid to fall asleep or wake too early. If nightmares are caused by post-traumatic stress disorder (PTSD), then trauma-based therapies may help.
An activity called dream rehearsal, or imagery rehearsal therapy (IRT), also may help with nightmares. This type of cognitive behavioral therapy involves focusing on the dream itself, rather than its potential cause. Part of IRT involves writing down the dream in as much detail as possible, and then reimagine the dream in a way that makes it no longer a nightmare.
Sleep disorders are common with mental illnesses, but they also worsen mental health symptoms. Understanding sleep difficulties and their solutions may help improve client outcomes.
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