Therapy Tips: Managing Insomnia
Between 10 to 15 per cent of the population suffer from insomnia. Fortunately there are short-term, non-medication treatments that can improve the sleep of most people with insomnia. Cognitive behaviour therapy for insomnia (CBT-i) offers us some techniques.
When our sleep is disturbed night after night, we often attempt remedies that we think will help us. However, our efforts often actually prolong our insomnia.
We might try going to bed earlier to try to get more sleep. But, probably that will only give us more time to lie in bed awake. What we end up with is seeing bed as a place to be tired and anxious – maybe even distress.
We might try sleeping in after a bad night’s sleep. Maybe helpful in the moment but this is likely to interfere with sleep the next night.
We might try just staying in bed even we are not falling asleep. But, this can very easily end up with us training ourself to be awake and be stressed sleep in bed while not getting more sleep.
We might try taking a nap during the day. But, mostly this makes it harder to fall asleep at night. This is especially the case if we nap later in the day for a long time.
We might try drinking alcohol. Alcohol tends to make us sleepy but, our sleep will be lighter and more broken. If we train ourselves to depend on alcohol to fall asleep, we are creating another problem.
All these strategies just maintain our insomnia.
This is where CBT-i comes in to change our sleep behaviours. CBT-I recommends the following:
Choose and maintain a standard bedtime and wake-up time. These times are based on careful records of your sleep using a sleep diary your CBT-I therapist can give you. The aim is to match the time you spend in bed overall to the average amount of sleep you are actually getting. Going to bed and getting up at about the same time each day, our bodies and brains learn to expect sleep at the right time and for the right length of time.
Maintain your set sleep schedule regardless of how you sleep each night. This step is critical to interrupt our counterproductive efforts to sleep. If you have a broken night’s sleep and still get up on time, you actually increase the chance of sleeping well the next night.
Avoid naps during the day. Not napping makes it more likely that you will be tired enough to sleep at night.
Get out of bed if you are not falling asleep in a short time-span. As soon as sleep is not happening or you begin worrying about things or about not falling asleep, get out of bed. Go read a book I dim light and return to be only when you feel sleepy.
Avoid sleep medications or aids where possible. Many have the possibility of distressing side-effects that can harm us in the long run. External agents like alcohol or drugs make us unconscious without providing high quality sleep. CBT-I relies on our natural ability to have sound, refreshing sleep, without having to use chemicals.
This is just a sample of CBT-i strategies. There is more to CBT-I you might want to explore.
*Gregg holds a Practice Certificate in Sleep Psychology from the Australian Psychological Society.
This article is for general advice only and does not replace seeing your GP or Sleep Physician. You might wish to ask your GP to write a Mental Health Care Plan to refer you to a psychologist.
To refer to Chapman Marques Psychology & Relationship Counselling, contact Reception at Belconnen Specialist Centre on 6251 1880; fax: 6251 6887