Struggling to sleep and brief bouts of insomnia are normal. We all struggle with sleep at times. Perhaps because we are stressed, experiencing hormone fluctuations, pain, an uncomfortable mattress and so on.
So, what is insomnia and when does it become a problem?
What is insomnia?
Insomnia is a difficulty falling asleep or staying asleep. It becomes chronic when the symptoms have persisted for more than three months. This is when treatment can become an option.
The other thing about insomnia that is often overlooked, is that it is a daytime, as well as, a night time issue. Focus tends to be drawn to what is happening overnight, but to manage insomnia we have to look at the whole person and what their day time looks like too.
How can CBT-I help?
CBT-I stands for cognitive behavioural therapy for insomnia. It is an evidence-based treatment for insomnia that involves looking at cognitions (thoughts from beliefs and/or experiences) and behaviours connected to sleep. CBT-I is a highly effective treatment for insomnia, offering lots of psycho-education around the neuroscience and psychology of sleep, as well as, standard treatment for they type of sleep disruption an individual is experiencing.
How can you help yourself?
If you are struggling to get a refreshing or undisturbed night’s sleep, one important thing to look at is how you are spending your daytime. Are you getting outside (yes, even on a rainy day)? Are you exercising in some way? Seeing people? Trying new things? Getting up and moving around? Do you have a wind down time in the evening? Eat regularly? Have a good look at whether your day is full of enough physical, mental and social stimulation. A good balance is what’s needed.
Also, very importantly, learn the difference between being fatigued / tired and sleepy. Sleepy is a signal for bed and sleep. Fatigue is the signal for rest and recovery, or a need for a change of activity / movement. Think about track cyclists after a race – they are fatigued and tired to the point of weak muscles, lactic acid pain, breathlessness and sometimes struggling to think straight and speak……. But 15 minutes later after rest and recovery time, they feel better. This is how the body signals and manages tiredness and fatigue – it is not the signal to tuck up in bed and will usually not be the point that a person can sleep. Eyes drooping / rolling / shutting, nodding off briefly and your head drooping are signal for sleep.
What is your bed for?
Our brains are very mouldable (the technical term is neuroplastic). The reason for this is linked to survival. However, as a result, behavioural cues can create habits and patterns that our brain thinks are OK to engage with. This readiness to link behaviours with activities can create a problem for sleep because the brain begins to associate the bed as somewhere we do XYZ and NOT where we sleep. Luckily neuroplasticity means we can remould the brain back to making helpful links – CBT-I can help with this.
The bed is for sleep and not for:
Thinking, ruminating and planning
Watching TV
Scrolling on social media or news
Using phones or devices in any way
Doing emails and working
Tossing and turning
There is only one exception to sleep and that is sex. Everything else needs to happen outside the bed.
Need help?
Reflect on what you think is making refreshing sleep hard to attain for you.
You can:
Try some strategies yourself that mean you only focus on sleeping in your bed.
Get some talking therapy for concerns and worries that are getting in the way of a good night’s sleep.
Find a CBT-I therapist who can assess the specific reasons for your sleep issues and apply appropriate, evidence-based treatment.
Further information:
Quiet your mind and get to sleep: solutions to insomnia for those with depression, anxiety or chronic pain. By C.E Carney and R. Manber
The seven-day sleep prescription. By Dr Aric Prather
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