Bedtime is approaching and Jeff is dreading it. He knows what tonight will bring: the torment of another night of insomnia. Each night has become agonizingly familiar. He feels exhausted, gets into bed, turns out the light only to lie wide awake. The harder he tries to fall asleep, the more he tosses and turns, and the more frustrated he gets.
A wave of anxiety and stress comes over him as he thinks, “If I don’t get some sleep I will never be able function tomorrow!” He worries about the problems in his life: an important meeting, Friday’s deadline, his mother’s failing health. Even when he falls asleep, after just a few hours, he awakes and tosses and turns then falls asleep to get another hour before the sun rises. When his alarm clock rings, Jeff drags himself out of bed, angry and depressed in the knowledge that another day feeling wiped out awaits him. Insomnia has been Jeff’s living nightmare.
All of us have experienced occasional bouts of insomnia as the result stressful life events such as a death, a divorce, family or work-related stresses, health problems or relationship changes. For some, these short-term bouts of insomnia for a few days can turn into chronic insomnia lasting a month or more.
Insomnia is the most frequent health complaint today affecting about one half of all adults. Yet 85 percent of insomniacs do not seek medical treatment. Unfortunately, sleeping pills and over the counter sleep aids do not cure insomnia because they do treat the cause of insomnia. Psychotherapy is not an effective treatment for insomnia because most insomniacs do not have psychiatric problems such as anxiety or depression.
Those of you who work shifts, who travel frequently and suffer jet lag or have babies or young children, need to be particularly diligent in learning about how to get better sleep.
Fortunately, if you understand some basics facts about sleep and insomnia it can be cured without using drugs in about six weeks according to Harvard Medical School Psychologist Gregg Jacobs.
Facts about Sleep and Insomniacs
- Short term insomnia becomes chronic as the result of worrying about sleep loss and then engaging in behavior that seems to help in the short run but actually sustains insomnia. (for example: going to bed earlier and sleeping later on weekends, trying to force sleep, taking naps, using alcohol, reducing physical exercise. )
- The average number of hours of sleep needed by adults is seven and a half and many adults need less. The way to determine how much is enough is by asking the following questions:
- Do you need an alarm clock to wake you?
- Do you sleep late habitually on weekends?
- Do you fall asleep during meetings at work?
- Sleeping pills do not cure insomnia and can keep you from gaining control on your life.
- Insomniacs worry about loss of sleep and have more active brainwaves in pre-sleep than good sleepers.
- Insomnia is a learned problem and can be unlearned by
- changing negative stressful thoughts about sleep,
- managing stress more effectively,
- eliciting the inborn relaxation response,
- strengthening the brain’s sleep rhythm,
- receiving enough exposure to sunlight,
- exercising at the proper times in the day,
- unlearning the “trying to sleep” habit,
- using naps to boost mood and performance,
- developing a sense of control over your sleep.
- Body temperature fluctuations throughout the day are called circadian rhythms. Body temperature is lowest before sunrise and increases gradually until mid afternoon, drops slightly until peaking at about 6 pm. It then drops until we fall asleep. When asleep it drops further until about 4 a.m.
Steps to Eliminate Insomnia
In his book Say Good Night to Insomnia, Dr. Gregg Jacobs outlines the six steps in six weeks to eliminate insomnia. After assessing your baseline sleep pattern you begin to assess what may be interfering with your sleep. Here are the steps he suggests to help you eliminate insomnia.
- Change your thoughts about sleep
In the story above, Jeff had many negative thoughts. Here are a few positive sleep thoughts he could substitute for them and said to himself instead:
My performance will not suffer if I get my core sleep (5hrs).
I am probably getting more sleep than I think.
My daytime functioning is not only effected by my sleep.
Since I have survived other nights of insomnia, I can handle this one. - Establish sleep-promoting habits
Trying to compensate for lost weekday sleep, by sleeping in on weekends plays havoc with this circadian rhythm. Going to bed earlier Sunday night before tired will also be also not help. Developing a regular sleep schedule of when you go to bed and get out of bed supports the body’s natural body temperature rhythm which gradually rises in the morning with getting out of bed, activity and sunlight. - Lifestyle and environmental factors that affect sleep
Regular physical exercise helps with the body temperature rhythm. Sunlight causes melatonin, a naturally occurring hormone found in the brain, to decrease which signals a rise in body temperature.
It is a good idea to reduce or eliminate the stimulant caffeine found in coffee, tea and cola as it stays in the body for six hours. Nicotine is also harmful to sleep and has the same effect as caffeine on sleep. While alcohol may make getting to sleep easier, it inhibits deep sleep. - The relaxation response
Our body’s inborn counter balancing mechanism to stress is called the relaxations response. Meditation, and other forms of relaxations can trigger this natural relaxation response which slows brain wave patterns, reduces the heart and breathing rates, increases blood flow and relaxes the muscles throughout the body. Create a soothing bedtime routine to trigger the relaxation response. - Learning to think away your stress
Negative self talk is what Jeff was doing in the story above. “If I don’t get some sleep I will never be able function tomorrow!” Cognitive restructuring and reframing these statements to more balanced and realistic thoughts can help reduce the stress response and increase the chances for sleep. - Developing stress-reducing, sleep enhancing attitudes and beliefs
Optimists live longer than pessimists. They also do not suffer from insomnia as much. Learning to adopt a positive set of beliefs and attitudes will help you reduce stress improve your relationships. Know more