Improving Sleep Series - Understand Insomnia
Insomnia involves difficulty falling asleep, waking in the night and/or waking not feeling restored.
Insomnia is a normal adaptive response in the short term to the ‘fight or flight mode’. Reduced sleep is designed to help you manage the risks and stress in your life. If your insomnia has only being occurring between 1-4 weeks, there is not need to do anything about it.
Around 9% of people have chronic insomnia. Chronic insomnia is defined as insomnia lasting 12+ weeks. At this stage the body is not in ‘fight or flight’ mode. Instead, it is thought certain behaviours may perpetuate sleep difficulties.
Factors that increase a person’s vulnerability to insomnia include being an older woman, having anxiety and having physical health issues. Being a caregiver, going through big life events (e.g. grief) or smaller events (e.g. everyday stress, wondering how you will cope) are also triggers.
Insomnia is often more subjective than objective. For example, one study found there is only a difference of 35 minutes between those who feel they slept well and those who felt they did not sleep well). It is a mixture of distorted perceptions and real sleep deprivation.
Model of Insomnia:
1. People worry that they will not or have not been able to sleep (‘I can’t sleep…there is only 4 hours and 20 minutes till I have to be up’) or worry about life concerns (‘I have to be up early for that meeting and if I don’t sleep I’ll be grumpy’)
2. Selective attention – the person is scanning for internal signs (bodily sensations) and external signs (bedroom clock; birds outside) in their environment to see if they are asleep yet.
2. This worry triggers physiological arousal (stress hormones) and distress that is incompatible with the initiation or maintenance of sleep. This can result in sleep non-restorative sleep or the inability to sleep.
3. The next day many behaviours are impacted. This person may reduce their workload, taking things easy, be preoccupied with sleep, cancel social outings or nap. All of these things result in the development of unhelpful beliefs about sleep and the impact of not getting sleep, which put more pressure on you the next night when you try to sleep.
There are many strategies for overcoming insomnia and that will be tailored to you as an individual and your specific situation. However, some general tips are below:
1) Do not let a lack of sleep impact your actions the following day. Do not change plans, as if this will put more pressure on you to get the ‘perfect night of sleep’.
2) Do not nap. This will make it much more difficult to sleep at night.
3) Get up at the same time each day. Our body clock loves routine.
4) Write down all the worries, to-do lists and concerns down before bed so you give yourself permission to focus on sleep. Even worries like ‘will I be able to sleep tonight?’.
Photo by Humphrey Muleba on Unsplash