Could 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.
I can’t say this exercise has worked well for me. (Other therapies—such as sleep restriction—have 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.