Lots of people who suffer from anxiety, agoraphobia or panic disorder have trouble sleeping. Likewise some people who suffer from depression also have trouble nodding off, despite a constant feeling of lethargy. As is so often the case with anxiety and depression symptoms, insomnia can be a vicious circle. It can move from being just a symptom to being a causative factor. What follows is a simple CBT approach to Insomnia.
First, the cognitive (thought related) part.
Examine the thoughts:
“I need to get some sleep, I must get some sleep, I should be asleep, I will feel terrible tomorrow, people say I look ill, I will get the sack because I can’t concentrate”.
You will probably find that these thoughts are an example of either “all or nothing thinking” or “catastrophizing”, which are common dysfunctional thought patterns in people with a tendency for anxiety, panic and depression. Not only are they largely false or gross exaggerations, but they are deeply damaging as they perpetuate the insomnia.
Ideally, when we are trying to sleep it’s best not to think about sleep! But anyone who has had insomnia knows that that’s almost impossible. So the next best thing to do is to counter the negative and dysfunctional thoughts similar to those above. The best thoughts to keep in mind are:
“It doesn’t matter if I sleep or not, my body will sleep when it’s ready, I can function on very little sleep, just relaxing now will help me feel better tomorrow, even if I get no sleep.”
Taking the pressure off yourself will help you to relax and increase your chances of sleep. This is similar to a paradoxical intention. Trying to will yourself to sleep doesn’t work. Giving yourself permission to sleep whenever you’re ready is much better. But you have to be gentle with yourself. You can’t say “It doesn’t matter if I don’t sleep but it does really”. Give yourself permission to allow whatever is happening at that moment to just be that way.
Read this mind relaxing sleeping technique on how to relax your mind to greatly improve your chances of dropping off. For more help on stopping the negative, dysfunctional thoughts, visit the CBT page.
So, we have dealt with moderating your thoughts, but you can also change your behaviour. The absolute worst thing to do when you are suffering from sleep disturbance is to lie in bed thinking about how you can’t sleep. So here is a list of behaviours that are more appropriate:
If you have been in bed and haven’t slept for half an hour, then do something!
The best thing to do is to get up, even if you don’t feel like it or feel to exhausted. Get out of your bedroom, move into another room in the house and start doing something else. Relaxing activities are best, reading or surfing the Internet are fine as long as you’re not exciting yourself! Drink a herbal tea (obviously no caffeine), play solitaire, use your active mind.
Don’t go back to bed until you feel significantly more tired, and try again for half an hour.
Make sure, though, that you get up at a decent time every day, and make sure it’s more or less the same time. Get into the routine of getting up at that time regardless of how you slept the night before.
Use your bedroom, and especially your bed, for sleeping only. Try to use other rooms in the house during the day and only go to bed when you are tired.