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Not being able to sleep can be one of the most frustrating things in the world. This article presents an overview of the Cognitive Behavioral Therapy for Insomnia program, focusing on how our thoughts can be a significant barrier to restful sleep.
Understanding the Two Types of Thoughts That Keep Us Awake
There are two primary categories of thoughts that disrupt our sleep. The first are thoughts related to our daily lives: dwelling on events that happened during the day, worrying about future challenges, or simply being unable to let go of whatever has been on our minds.
The second category is thoughts related to our sleep itself, or more specifically, anxious thoughts about the fact that we can't sleep. This article will focus on managing both types to improve sleep quality.
Managing Everyday Thoughts and Stress
If you lie in bed stressed with a racing mind, you need to find a way to leave these thoughts behind. The most effective strategy is to learn to manage stress, anxiety, and negative thoughts better during the day so they don't affect you at night.
However, thoughts will inevitably linger. If you tend to worry at night, I highly recommend scheduling a "worry period" in the early evening. Spend 20-30 minutes addressing negative thoughts, doing any necessary planning or problem-solving, and then consciously set those thoughts aside for the rest of the evening.
Remember, just because a thought appears doesn't mean you need to engage with it. Practice letting go of thoughts that are unrelated to your current activity. When trying to sleep, you don't need to be having any thoughts at all.
The Power of the Relaxation Response
When thoughts keep you awake at night, you need a tool to clear your mind. A highly effective method is a relaxation exercise called the **Relaxation Response**.
You can use this guided audio in two ways:
1. Go to another room, listen to it until you feel relaxed and sleepy, and then return to bed.
2. Play it in bed as you try to fall asleep.
Using the Relaxation Response during the day is equally important. practicing it at a scheduled time or whenever you feel stressed can prevent anxieties from accumulating, making you more relaxed by bedtime.
**Crucial Tip:** Before using the Relaxation Response to aid sleep, get comfortable using it during the day. If your first attempts are focused on trying to fall asleep, the pressure can make the experience frustrating rather than relaxing.
Confronting Negative Sleep Thoughts
The other major impediment to sleep is our **Negative Sleep Thoughts** about insomnia itself. These are thoughts like:
* "I'm never going to be able to fall asleep."
* "I have to be up in a few hours; I'll never function tomorrow."
* "I need my 8 hours of sleep."
* "My insomnia is ruining my health."
* "I haven't slept a wink."
We toss and turn, our minds racing with these thoughts, making it even harder to fall asleep. To sleep better, we must learn to modify these negative patterns.
Replacing Negative Thoughts with Sleep-Promoting Thoughts
The opposite of negative sleep thoughts are positive, or **Sleep-Promoting Thoughts**. These aren't just superficial positive thinking; they are balanced perspectives that have a positive effect on sleep. We use a CBT technique called **cognitive restructuring** to replace biased negative thoughts with more realistic ones.
To create effective sleep-promoting thoughts, they must be based in your own reality and beliefs. Replacing a negative thought with a positive one you don't believe is ineffective.
Dispelling Common Sleep Myths
Many negative thoughts are fueled by common myths. Let's dispel some of them:
* **Myth: I need eight hours of sleep a night.**
* **Fact:** Most people don't need eight hours. People who sleep seven hours a night live longer on average than those who sleep eight or more. Sleeping for 5.5 hours has about the same mortality risk as sleeping for eight.
* **Myth: I won't be able to function.**
* **Fact:** While lack of sleep can impact problem-solving and memory, these effects generally don't happen after just one or two poor nights. Studies show people with insomnia often don't perform worse in these areas than normal sleepers.
* **Myth: I'll be miserable.**
* **Fact:** Lack of sleep affects mood, but it's not a simple cause-and-effect. If we have a good reason for lost sleep (like caring for a newborn), we can frame it as an acceptable sacrifice, and it affects us less. Our *thoughts* about poor sleep can impact our mood more than the sleep loss itself.
How Much Sleep Do We Actually Need?
For most people, performance on alertness, memory, and problem-solving tasks can be maintained with only about **5.5 hours of core sleep**. Core sleep allows us to get 100% of the vital Stage 3 (deep sleep) we need and 50% of our REM sleep. If we miss core sleep one night, our brain prioritizes getting these crucial stages the next night.
Interestingly, people with insomnia average just under 6 hours of sleep yet often don't have worse daytime alertness. This is because they are still getting their core sleep. We also tend to *underestimate* how much we sleep, overestimating how long it takes to fall asleep by an average of 30 minutes.
Examples of Cognitive Restructuring for Sleep
Here is how you can modify negative thoughts into sleep-promoting thoughts you can believe:
* **Negative:** "I'll never fall asleep."
* **Sleep-Promoting:** "I'll fall asleep eventually as I get more tired and my body strives to get its core sleep."
* **Negative:** "It's only 3 AM, I'll never get back to sleep."
* **Sleep-Promoting:** "I'm alert because I've gotten some core sleep. If I don't fall back asleep, it'll be okay."
* **Negative:** "I need my eight hours."
* **Sleep-Promoting:** "Most people average seven hours. Five and a half gives me my core sleep, and my body will make it up tomorrow if needed."
* **Negative:** "What's wrong with me?"
* **Sleep-Promoting:** "20-30% of adults struggle with insomnia. I'm not alone, and there's nothing wrong with me."
* **Negative:** "I'm so tired; today will be unbearable."
* **Sleep-Promoting:** "I have insomnia and I still function. If I'm miserable, my thoughts play a role, and I have some control over them."
A Key Step to Better Sleep
Modifying our thoughts, especially our negative sleep thoughts, is one of the most effective things we can do to combat insomnia. By using techniques like cognitive restructuring and the Relaxation Response, you can quiet your mind and create a more positive environment for sleep.
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