Twenty-five years ago, a lengthy bout of insomnia – combined with an excessive amount of anxiety about the “lack of sleep” – gradually rendered me unable to perform on my job as an ICU RN. I had difficulty remembering simple things. Decision making was next to impossible. Even everyday words were difficult to remember. I became worried that I would become unfit for work. The more tired I became, the less I slept. Eventually I had to quit a job I loved at the hospital.
I began to take a hard look at my lifestyle. I learned that what I was doing to promote sleep was making the insomnia worse, turning it into a chronic condition. Insomnia usually starts innocently with a few nights of having trouble falling asleep (sleep onset insomnia) or waking up in the early morning and not being able to fall back to sleep (sleep maintenance insomnia).
This type of sleep disruption happens to all of us at different times in our lives and it is usually due to excessive anxiety and stress. Most of the time sleep returns to normal once the stressful event is resolved. In highly sensitive people, like myself, one night of poor sleep can lead to a multitude of desperate behaviours that are counterproductive and propel the insomnia into a chronic condition.
The first thing many people do when they have a poor night’s sleep is go to bed early the next evening to “catch up” on sleep. Trying to sleep results in tossing and turning in bed or looking at the alarm clock and both these behaviours create tension which is incompatible with sleep.
Another common thing we do is to make an appointment with our doctor to get sleeping pills. This understandable act is a slippery slope for insomniacs. Sleeping pills are extremely addictive, both physically and psychologically. Most sleeping pills decrease sleep quality and work only in the short term. When people try to stop using the sleeping pills they get hit with rebound anxiety and the insomnia worsens.
Many who struggle with insomnia worry excessively about their lack of sleep. These negative thoughts about sleep create a cycle of anxiety which in turn fuels the insomnia. There is a lingering sense of loss of control over life. It is difficult to plan anything the next day because of the insomnia, so we tend to isolate ourselves and relationships begins to suffer or fall apart. We may have the thought that, “If I could get a good night’s sleep, everything in my life would fall into place.”
But sleep only gets harder to achieve with this type of thinking. There is a sense of feeling alone, frustrated, hopeless and depressed about the struggle with sleep. There can be a loss of confidence in oneself and in one’s body. I would get so down on myself thinking, “I can’t even sleep right. What a failure I am.”
Often people become conditioned to fear the sight of their bedroom. During my struggle with insomnia the mere sight of my bed would cause me so much stress that it was impossible for me to relax enough to allow sleep to come naturally. Sometimes I would be able to fall asleep on the couch, but my bed was a disaster.
So how did I finally improve my sleep? I learned to never try to sleep. Instead, I recommend:
- If you are not asleep within 30 minutes, get out of bed and do something relaxing. Read a book, colour, fold laundry – distract yourself until you became drowsy. Stay away from screens, put away iPhones, iPads and computers because the light emitted from these devices stimulate the arousal system in the brain. Return to bed only when drowsy and your eyelids begin to close. Repeat this as many times as needed until the drive to sleep is so intense it is impossible to stay awake. Another tip is to go to bed much later than normal to create a sleep deficit resulting in a better chance that you will fall asleep within 30 minutes of going to bed.
- Set your alarm for the same time every morning regardless of how much sleep you get. Keep a strict sleep window even on the weekend by going to bed later than usual and getting up early. Limit coffee to one or two cups, consumed before noon. Or give up caffeine entirely.
- Make certain your bedroom is cool, quiet and dark. Body temperature must drop to stimulate sleep, so put on the AC or open a window if it is cool outside. Go outside every day for a walk in the sunlight. This helps to establish a proper circadian rhythm and exercise is an outlet for tension.
- Become aware of the thoughts running through your mind, especially negative thoughts about sleep. Counteract negative thoughts with more balanced reassuring thoughts. The thought, “If I don’t sleep tonight, I will be a basket case tomorrow” can be refuted by, “I always manage to get through the day even if I don’t sleep well, so it will be OK.”
- Don’t cancel your plans due to insomnia. It is important to continue living life as best you can despite feeling tired. Learn to be compassionate with yourself, acknowledging that it is extremely difficult to grapple with insomnia. Offer yourself kindness and reassurance versus criticism. Remember that insomnia is a very common sleep problem and in time it will pass.
- Deal with stress in a timely manner with daily reflection and problem solving. Develop a wind-down routine before going to bed for the night and learn relaxation techniques such as deep breathing, body scan, or progressive relaxation. Put the day to rest by thinking about three things that went well and three that did not go so well. Plan activities for the next day.
- Finally, develop a formal daily meditation practice and coach yourself when negative sleep thoughts arise.
Keep in mind that when sleep evades you there are thousands of people in the same boat. Accept that you have a sleep problem but by following a few simple steps you can quickly and easily get your sleep back on track.