writing-bedCould simply changing your thoughts about insomnia lead to better sleep? Some sleep therapists claim it works this way. They promote a process called “cognitive restructuring,” typically offered as part of cognitive behavioral therapy for insomnia. It involves identifying negative thoughts about sleep and then challenging them. The goal is to wind up with thoughts that are more sleep friendly.

Sounds like a tall order, right? I agree. I’ll say up front that I had limited success with it myself. But the experts say this exercise is helpful for many who struggle with chronic insomnia. You may be one.

Take a Quiz

Do you find yourself thinking that

  • you must have 8 hours of sleep to function well during the day
  • you’ve lost control of your ability to sleep
  • one bad night wrecks your sleep for the rest of the week.

Thoughts like these create anxiety and make it harder to get to sleep and get back to sleep. These are the thoughts you examine during the process of cognitive restructuring.

Examine Your Negative Thoughts

Take a minute to download a Dysfunctional Thought Record right now (or do it after you finish reading the blog).

When you can’t sleep and you’re worrying about it, write your thoughts and feelings down in the Record. Then answer a series of questions, using the prompts at the bottom of the six columns. The goal of the exercise is to ease your worries about sleep.

Here’s an Example

Let’s say you can’t sleep one night and you start to grow anxious. Now would be a good time to get out the Dysfunctional Thought Record and set to work, asking yourself questions and writing down answers.

Situation. What led to the worry about sleep? “An early morning meeting where I have to make a presentation, the clock striking 12 and me not feeling the least bit sleepy.” What physical sensations do you have? “A racing sensation in my chest and feeling way too hot.”

Automatic Thoughts. What thoughts or images are going through your mind? “I won’t be at my best tomorrow. I’m going to bomb my presentation, and everybody’s going to ignore what I say.” How much do you believe that? “95 percent.”

Emotions. What emotions do you feel, and how intense are they? “Frustration that I can’t sleep! Fear that I’m going to do a poor job on the presentation. It’s pretty intense.”

Distortion. In what ways might your thinking be distorted? Are you catastrophizing? overgeneralizing? jumping to conclusions? “I’m probably catastrophizing.”

Alternative Thoughts. Here’s your chance to do a kind of reality check to see if your negative thinking is realistic or not:

  • Q: So, what are the chances you’re not going to sleep at all tonight?
  • A: Low. I usually get some sleep.
  • Q: How did you sleep last night?
  • A: Pretty well.
  • Q: So how realistic is it to think that a single short night’s sleep is going to incapacitate you tomorrow morning?
  • A: Probably less realistic than I thought.
  • Q: Have you prepared for this presentation, or is it something you’re doing on the fly?
  • A: I’ve been preparing for two weeks.
  • Q: How realistic is it to think that a short night’s sleep is going derail a presentation you’ve worked on for two weeks? . . . And so on.

Outcome. How much do you now believe your automatic thoughts (that you’re going to be wasted tomorrow and give a lousy presentation)? “Maybe it’s down to 40 percent.” What are your emotions now, and are they less intense? “I’m feeling less tense and maybe a little more confident . . .”

You get the idea. Feeling less tense and more confident can only make it easier to get to sleep.

After going through this process a few times, you may be able to dispense with the paper and pencil and simply talk yourself out of catastrophizing in your head. With luck you’ll eventually develop a more positive attitude toward sleep—at least, that’s what you’re aiming for.

Parting Thoughts

I can’t say this exercise has worked well for me. (Other therapies—such as sleep restrictionhave helped.) But the American Academy of Sleep Medicine says cognitive restructuring is beneficial for some insomnia sufferers—and I’d guess they know what they’re talking about.

If you haven’t yet tried cognitive restructuring and are open to experimentation, have a go at it. Then please write in and tell me how things turn out.

Posted by Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.

2 Comments

  1. Melinda Beaver May 6, 2014 at 5:46 pm

    I was wondering what type of cognitive behavioral program did you do? Did you see a therapist? Pull strategies from a book or the internet? Just curious…

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    Reply

  2. Hi Melinda,

    As part of the research I did for my book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep, I underwent several therapies for people with trouble sleeping. One was cognitive behavioral therapy for insomnia, a type of CBT designed specifically for people with insomnia. For the most part, the 7-week treatment I went through in the University of Michigan’s Behavioral Sleep Medicine Program was devoted to improving sleep using behavioral methods: Sleep Restriction and Stimulus Control Therapy. These therapies were most helpful to me.

    But in addition to the behavioral therapies, there was a cognitive component, which involved examining dysfunctional thinking about sleep. Often, people who have trouble sleeping develop fears and anxieties about sleep. The thoughts that accompany these fears and anxieties can be examined and possibly changed.

    The exercise I’ve written about in this blog is exactly the one used in the program I went through at the U of M. While I didn’t find it so useful myself, other people in my group (there were four other participants) did feel that it helped them change some thoughts that were interfering with their sleep. So I thought it would be a good topic for a blog.

    I say more about CBT for insomnia in my book. In fact, in chapter 8, I describe the main components of therapy and then launch into an account of how I and the four others in my group experienced our 7-week treatment, including outcomes.

    But you’re right, there are also CBT-I materials available on the Internet.

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    Reply

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