“The more important the next day is to me, the harder it is for me to sleep,” Jessica says. “So I worry about not sleeping and then it turns into a self-fulfilling prophecy.”
“I finally had about 4 good nights after starting sleep restriction (about 11 days ago) but had a horrible night of anxiety last night,” Stacy says. “I was anxious about not being able to continue my good nights of sleeping. I find it hard to practice relaxation exercises when I’m that anxious.”
Achieving a relaxed state conducive to sleep can seem impossible with a mind that’s racing from one fraught thought to another. Likewise, the physiological changes that accompany worry and anxiety—the release of stress hormones, a faster heart rate, bodily warming, tensing muscles—are a better preparation for fight and flight than for relaxation and disengagement.
How to stop obsessing about sleep and sleeplessness is the main concern of many insomniacs, yet finding a solution can be tricky. It may require experimentation before you home in on a strategy that works.
Different Schools of Thought
Research backs a handful of approaches to managing the problem, but even among sleep experts there is no consensus as to which works best. It may depend on the nature of your insomnia and which approach you find more appealing.
Some experts promote a type of talk therapy–called “cognitive restructuring–as effective in reducing worry and anxiety related to sleep. The idea behind it is that sleep-related anxieties develop in part due to the misconceptions people have about sleep and catastrophic thinking about insomnia. Replacing these ways of thinking with attitudes that are more realistic and sleep-supportive should help.
Cognitive restructuring is normally presented as part of cognitive-behavioral therapy for insomnia (CBT-I). It usually involves work with a therapist, who helps you learn to talk yourself out of worries and anxieties about sleep and sleeplessness.
Mind/Body Approaches to Curbing Arousal
Other experts suggest that psychological treatments for sleep-related anxieties may not be as effective as treatments that simply help insomniacs learn to relax. Physiological hyperarousal is the main cause of poor sleep, they say, with sleep-related anxiety and worry developing as a result. Treatment should focus on tamping down arousal that gives rise to these sleep-related worries, enabling a stronger and more dependable relaxation response.
- Relaxation training is recommended as helpful to sleep by the American Academy of Sleep Medicine. It may involve progressive muscle relaxation and/or autogenic training (guided visualization).
- Mindfulness-based therapies enable people to become more accepting of unpleasant feelings and sensations and, in so doing, alleviate them. Mindfulness meditation has been shown in a handful of studies to help insomnia sufferers by cutting down on pre-sleep arousal, reducing wake time at night, and enhancing sleep quality.
- Yoga has now been shown in several studies to help insomnia sufferers learn to manage stress and get more sleep. Not only does yoga practice effectively deactivate the stress system. Yoga postures, breathing, and meditation exercises also help people develop more resilience to stress.
Exercise, Anxiety, and Sleep
Still other experts advocate exercise as the best way to relieve the anxious arousal that sabotages sleep. There’s now solid evidence that regular exercise promotes sounder sleep and preliminary evidence that exercise is effective in reducing anxiety. A meta-analysis published in April shows that even a single bout of exercise has a small but significant anxiety-alleviating effect.
Strenuous exercise is the way I calm myself down in times of stress, especially when my old fear of sleeplessness threatens to stage a comeback. The minute I feel that happening, I push myself to work out longer and harder and, most of the time, it helps.
But which kinds of exercise will give you the most bang for the buck? University of Pennsylvania researchers, analyzing data from a huge survey of behaviors affecting health, have found that while walking is associated with better sleep compared with getting no exercise at all, aerobics, calisthenics, biking, gardening, golf, running, weight-lifting, yoga and Pilates are associated with even better sleep.
Consider these strategies if worry and anxiety are feeding your insomnia. Continuing to obsess about sleep and sleeplessness is surely worse than making a good-faith effort to try some of these practices out.