Tips for Relieving Stress and Improving Sleep

Do stressful situations throw your sleep off track? You’d probably score high in sleep reactivity, a stable trait associated with insomnia. If a rough day at work kept you tossing and turning last night, then similarly charged situations—arguing with your spouse, getting bad news, preparing to speak in public—may disrupt your sleep now and then.

But what if the stress is chronic? Then it’s time to deal with it head on. Here are four ways to reduce stress and improve sleep.

Stress-related Insomnia can be alleviated with social supportDo stressful situations throw your sleep off track? You’d probably score high in sleep reactivity, a stable trait associated with insomnia. If a rough day at work kept you tossing and turning last night, then similarly charged situations—arguing with your spouse, getting bad news, preparing to speak in public—may disrupt your sleep now and then.

But what if the stress is chronic? Then it’s time to deal with it head on. Here are four ways to reduce stress and improve sleep.

Have a Physical Outlet for Stress

Persistent activation of the stress-response system results in higher-than-normal levels of cortisol and other stress hormones, all harmful to long-term health. Not only does this increase your susceptibility to chronic insomnia, but it also suppresses your immune system and elevates your risk of hypertension, heart disease, and depression. It interferes with learning and memory as well.

Exercise—jogging, swimming, bicycling, playing tennis—protects against development of stress-related disease. Immediately following a workout there’s a decrease in muscle tension and a release of body heat, which can hasten sleep onset and enhance sleep quality. Exercise can also help to elevate mood. Long-term, regular exercise tends to lower the resting heart rate, making it easier to relax.

But to maximize stress relief, choose a form of exercise you enjoy (or at least find tolerable). Regularity in the timing of workouts, like regularity in the timing of meals, is also conducive to regular sleep. Continuing practice of yoga and meditation can yield similar results.

Reach Out to Friends

Feeling overextended and stressed out can be isolating. Your instinct may be to cut people and relationships out of your life as you move full speed ahead on whatever you need to accomplish.

But having an active social support system is another key way to reduce chronic stress. Research suggests that regardless of who’s doing the talking and who’s doing the listening, interactions with friends and supportive family members help cut down on chronic stress. Participating in group activities can also help with stress relief.

Increase Your Sense of Control When Possible

Some situations are beyond control—diseases that have no cure, job losses due to economic factors, deaths that cannot be prevented. Trying to take control of these situations will likely send your stress off the charts.

But there are situations where exerting more control affords stress relief. For instance, if you’ve got too much on your plate, separate tasks into “musts” and “shoulds” and prioritize them accordingly. To nonessential tasks just say no.

And say no when someone else tries to foist on you a responsibility you cannot fit in. You’ve watched the grandkids for the past three days—now it’s someone else’s turn.

Yes, browsing the internet for the latest political news can be invigorating. But if it tends to work you up too much, vow to tear yourself away from the iPad by 8 p.m.

Increase Predictability

No one likes monotony. Yet a degree of predictability in life tends to lower stress. Says neuroendocrinologist Robert Sapolsky, “When it comes to what makes for psychological stress, a lack of predictability and control are at the top of the list of things you want to avoid.”

If your boss is liable to throw projects your way at any time, including 3 p.m. on Friday, muster up some negotiating skills and request advance notice. If late night phone calls tend to stress you out, ask friends and family to refrain from calling after 9 p.m. If you’re having trouble making ends meet, work up a monthly budget.

The more predictable life is, the better able you will be to plan coping strategies, which will make for better stress resilience and better sleep.

What activity or strategy do you find is most helpful in lowering stress?

Why Are Insomniacs Prone to Hyperarousal?

My insomniac nights are rare these days—but I had one last week. Nearing bedtime, it felt like a train was running through my body with the horn at full blast.

The mechanisms underlying hyperarousal are still unknown. But according to a study recently published in the journal PNAS, it may be linked to fragmented REM sleep and unresolved emotional distress. Here’s more:

hyperarousal is a common daytime symptom of insomniaMy insomniac nights are rare these days—but I had one last week. Nearing bedtime, it felt like a train was running through my body with the horn at full blast.

Earlier that evening I’d returned to a place where I had a humiliating experience a few years ago. Being at that place made it feel like the incident was happening again. The emotions it recalled were so powerful that at midnight I was still too aroused to fall asleep. I had a bad night and woke up to what I call an “insomniac day”: the feeling of being depressed and anxious at the same time.

Insomnia is often described as a problem of “hyperarousal,” and when I look for signs of hyperarousal in myself, this sort of situation comes to mind. It starts with a powerful emotion (like humiliation or excitement) and with what I’ve come to feel is an impaired ability to calm down. I have coping strategies that work pretty well in the daytime. But if something triggers strong emotion in the evening, I’m sunk.

The mechanisms underlying hyperarousal are still unknown. But according to a study recently published in the journal PNAS, it may be linked to fragmented REM sleep and unresolved emotional distress. Here’s more:

Sleep Helps Regulate Emotion

Sound sleep helps stabilize emotional memories in long-term memory. It also reduces their emotional charge. Being robbed at gunpoint just 2 blocks from your house is a frightening experience. But if you sleep well that night, the next day, although you’ll recall the robbery clearly, the fear accompanying it will be less distressing than it was the day before.

Rapid eye movement (REM) sleep, associated with dreaming, plays an important part in this process. Intact REM sleep enables us to regulate negative emotion and wake up in a better frame of mind. But when REM sleep is fragmented, as often occurs in insomnia, less resolution of emotional memories can occur. In this study, scientists looked for relationships between fragmented REM sleep, slow-resolving emotional distress, hyperarousal, and insomnia.

Shame and Other Self-Conscious Emotions

In the past, scientists investigating REM sleep’s role in emotion regulation have looked at its effects on basic emotions like fear and anger. But the authors of this study claim that people more often need help with problems involving self-conscious emotions such as pride, guilt, embarrassment, humiliation, and shame.

In this study, they focus on shame because “it may interfere the most with healthy psychological functioning. . . . By obstructing effective coping mechanisms, shame often hinders therapeutic progress, to the point that it may even lead to a negative therapeutic outcome.”

A Two-Part Study

Thirty-two people participated in the first part of the study, 16 with insomnia disorder and 16 with normal sleep. They spent two nights in a sleep lab undergoing polysomnography, a test that records brain waves. They also filled out a questionnaire about the frequency and content of their dreams.

Participants whose brain waves indicated more frequent arousals and who experienced increased eye movement during REM sleep (i.e., the insomnia sufferers) experienced more thought-like (rather than dream-like) mental activity at night. Investigators concluded that a higher “nocturnal mentation” score could be used as a stand-in for the experience of restless REM sleep.

For Part 2, about 1,200 participants in the Netherlands Sleep Registry filled out a battery of questionnaires concerning nocturnal mentation, the duration of emotional distress after a shameful experience, insomnia severity, hyperarousal, and a host of related phenomena.

Hyperarousal Linked to Slow-Dissolving Distress

The researchers analyzed their data using sophisticated statistical techniques and here’s what they concluded:

  • The overnight resolution of distress from shame (and likely other negative emotions) is compromised in people with insomnia
  • This deficit may result from a build-up of unprocessed emotion and contribute to hyperarousal
  • This deficit seems in part to develop due to restless REM sleep (with frequent arousals and high-density eye movements) and thought-like nocturnal mentation.

If all this is true, then insomnia treatments need to target restless REM sleep. No treatment available now has been specifically shown to do that. Still, given that cognitive behavioral therapy for insomnia (CBT-I) has been shown to help people with insomnia and depression, another disorder characterized by irregularities in REM sleep, it might be the best treatment on offer now.

The Insomnia/Perfectionism Connection

Do you hold yourself to high (sometimes impossibly high) standards? Do you tend to be self-critical and cringe at making mistakes? Is it even difficult sometimes to take pleasure in your own hard-won achievements?

These are signs of perfectionism, and perfectionists are more susceptible to insomnia than people who can shrug off their mistakes.

Perfectionism may or may not be a predisposing factor to insomniaDo you hold yourself to high (sometimes impossibly high) standards? Do you tend to be self-critical and cringe at making mistakes? Is it even difficult sometimes to take pleasure in your own hard-won achievements?

These are signs of perfectionism, and perfectionists are more susceptible to insomnia than people who can shrug off their mistakes.

The theory that perfectionism and other personality traits (such as neuroticism and internalization of negative feelings) are the main drivers of insomnia has not withstood the test of time. But the evidence for an association between perfectionism and insomnia remains fairly strong. Even so, a team of Swiss researchers has found that when they take stress, poor coping strategies, and poor emotion regulation into account, perfectionism’s role in explaining insomnia all but disappears. There’s a message here for those of us who want to improve our sleep.

Where Perfectionism Comes From

Like many personality traits, perfectionism appears to have both environmental and genetic components. “It is likely that a perfectionistic orientation develops over time, and family history may contribute to the development of perfectionism,” wrote Cal State University researchers David R. Hubbard and Gail E. Walton, who in 2012 reported interviewing 36 students about perfectionism and the motivation to achieve. Two aspects of experience differentiated the perfectionists from their nonperfectionist peers:

  1. The perfectionists felt pressure from their families to succeed.
  2. Their parents were overly critical of their mistakes when they were growing up.

But inherited genetic material may also make people more inclined to perfectionism. When researchers at Michigan State administered a series of tests to 292 young female adults in the Michigan State University Twin Registry, they found that both anxiety and maladaptive perfectionism (concern about mistakes and doubts about actions) were moderately heritable—on par with the heritability of general intelligence. A second twin study found that identical twins were more alike than fraternal twins in how much they idolized skinny celebrities—another sign of perfectionism.

A Relationship Between Perfectionism and Sleep

Chronic insomnia is attributable to a mix of factors: physiological and psychological, environmental and behavioral, inherited and learned. The dysfunctional processes underlying perfectionism (manifesting as doubts about abilities, concern about mistakes, and so forth) might be similar to those that underlie trouble sleeping, the Swiss researchers reasoned. So they gave a battery of pencil-and-paper tests to 346 college students to see what relationships would emerge.

Statistical analyses showed that perfectionistic traits were associated with trouble sleeping and the same daytime complaints of people with persistent insomnia: tiredness, reduced concentration, and low mood. But when perceived stress, poor coping strategies, low emotion regulation, and low mental toughness were factored into the equation, perfectionism’s contribution to sleep disturbance was nil. In other words, the researchers conclude, “It is not perfectionism per se, but rather the underlying psychological mechanisms that best explain the association between perfectionism and poor sleep.”

Why Is This Important?

Let’s assume you have insomnia. A therapist you’re working with thinks the problem is personality-related and sets out to address it by helping you modify your perfectionistic tendencies.

Changing personality traits originating in childhood and/or predisposed at birth is a real challenge. It might not be impossible to free yourself from a harsh inner critic that developed under the watchful eyes of Mom and Dad, yet the effort it would take—several months (if not years) of psychotherapy—would be great and the results, uncertain. As for improving your sleep, well, good luck there. Psychotherapy has never been found to be an effective treatment for insomnia.

Targeting the psychological mechanisms underlying chronic insomnia directly would be a faster, more effective approach to improving sleep, the researchers conclude, particularly in insomnia sufferers with perfectionistic tendencies. Cognitive-behavioral therapy for insomnia (CBT-I) does this. Its cognitive restructuring component is aimed at dismantling the mental and emotional underpinnings of persistent insomnia. So CBT-I is a better treatment option than psychotherapy if your goal is better, sounder sleep.