Sleep (Re)Training for Insomnia

What does falling asleep feel like? Good sleepers may never bother with the question. One minute they’re conscious and the next minute they’re out. But if you have chronic insomnia, falling asleep (or back to sleep) can feel like a tiresome slog.

Insomnia sufferers may actually lose touch with the feeling of falling asleep. So Sleep Technologist Michael Schwartz created a smartphone app to put people back in touch and increase their confidence and ease in falling asleep.

Insomnia sufferers relearn the feeling of falling asleepWhat does falling asleep feel like? Good sleepers may never bother with the question. One minute they’re conscious and the next minute they’re out. But if you have chronic insomnia, falling asleep (or back to sleep) can feel like a tiresome slog.

Insomnia sufferers may actually lose touch with the feeling of falling asleep, some have claimed. So Sleep Technologist Michael Schwartz created a smartphone app to put people back in touch and increase their confidence and ease in falling asleep.

Racing Thoughts and Brain Activity at Night

An independent study has found the smartphone app, called Sleep On Cue, to be accurate at detecting the start, or onset, of sleep. But let’s step back, for a moment, and imagine a typical insomniac night.

It’s after midnight and you’re obsessing about your deadlines tomorrow. Or you’re thinking about how to fight your way out from under all your student loans. The next thing you know the clock on your bedside table says it’s 2 a.m. In desperation, you stare at the clock face, willing time to stop. By 3 a.m. you’re still awake and hopping mad about it!

Maybe you have spent the last 4 hours with your entire brain spinning along in problem-solving mode. Chances are, though, that if on such a night you were undergoing a sleep study, your brain waves would tell a somewhat different story. Beta waves, fast wave activity commonly observed in people who are are thinking and solving problems, might be mixed in with alpha waves (slower waves linked to more relaxed states) and even slower theta waves, heralding the start of Stage 1 sleep.

Detecting the Lighter Stages of Sleep

But would it feel like you were actually sleeping? Research has shown that people woken up in Stage 1 sleep are often unaware that they’ve been asleep. In this liminal state, people can drift back and forth between sleep and wakefulness for quite some time before descending further into more sustained sleep, which is called Stage 2.

Stage 2 sleep is characterized by a predominance of theta waves and by features called sleep spindles and K complexes. Awoken in Stage 2 sleep, people are somewhat more likely to be able to sense that they were asleep.

But people with insomnia may not be as apt to report they were sleeping. Investigators have speculated that with all the nighttime baggage accompanying chronic insomnia—anxiety about sleep loss, lack of confidence in sleep ability, negative beliefs about sleep, increased beta wave activity during sleep—some insomniacs may simply lose touch with the feeling of falling asleep.

A Sleep Training Smartphone App

When a call went out for an inexpensive way to detect the start of sleep at home, Schwartz developed Sleep On Cue. A recent study comparing it to polysomnography (the test used in overnight sleep studies) found that Sleep On Cue was accurate at predicting the onset of Stage 2 sleep.

Why is this important? For one thing, the app (which costs $4.99) may prove to be useful in helping to administer intensive sleep retraining—an insomnia treatment developed in Australia—inexpensively in people’s homes.

But for readers of this blog, the immediate value of this app may lie in its potential to train or retrain insomnia sufferers to recognize what falling asleep feels like. This could alleviate some of the worry and anxiety about sleep and insomnia and thus make it easier to fall asleep and fall back to sleep.

Here’s How the App Works

Sleep On Cue works best, Schwartz says, if you conduct your training sessions when the pressure to sleep is high: late in the afternoon or early in the evening after a poor night’s sleep.

  1. Lie down and relax in bed, holding your smartphone in one hand. The phone will periodically emit a soft tone. Every time you hear the tone, give the phone a slight shake.
  2. When the app no longer detects movement, it assumes you’re asleep. Then, the phone vibrates to wake you up.
  3. The screen then displays this message: “Do you think you fell asleep?” Press “yes” or “no.”
  4. Next, you’re instructed to leave the bed for a few minutes. The phone will then vibrate to let you know when to return to bed for the next sleep trial. In this way, you begin to relearn what falling asleep feels like and gain confidence in your ability to do it.
  5. You decide when to end each training session. The screen then displays a graph with feedback about your sleep ability and your awareness of your sleep.

Here’s a link to the Sleep On Cue website. At $4.99, it’s not much of an investment and the payoff could be great.

If you’ve tried Sleep On Cue, did it improve your sleep and, if so, how?

Four Ways to Fall Asleep

I used to be a “disordered” sleeper. That, at least, is the term I’ve heard applied to someone with a sleep schedule as erratic as mine was. One night I’d start nodding off after dinner, and the next night I’d be up till 3:30 in the morning. There was no rhyme or reason to it that I could see.

I used to be a “disordered” sleeper. That, at least, is the term I’ve heard applied to someone with a sleep schedule as erratic as mine was. One night I’d start nodding off after dinner, and the next night I’d be up till 3:30 in the morning. There was no rhyme or reason to it that I could see.

falling

Falling asleep in those days was so much more exciting. Especially when, just as I was drifting off, I experienced a hypnic jerk—a muscle spasm accompanied by a feeling of falling. Red alert! Suddenly I was plunging down an elevator shaft, my arms and legs flailing madly in the air. My heart was hammering in my chest, my breathing ragged. And even when the breathing finally slowed, a racing sensation in my torso and limbs could keep me tense long into the night.

A voice then came out nowhere: “Thought you were falling asleep, my pretty? Not . . . so . . . fast.”

Another scenario was this: after a perfectly fine day—work gone smoothly, family happy, a special delivery even come in the mail—I was just about to part with consciousness when, tzasssssssss! A plane exploded in a fireball overhead! Or a trestle gave way and a train plunged into a valley below! A sociopath was clapping a hood over my head and tying a noose around my neck! I was face to face with a man with a gun!

Horrific images came hurtling out of my unconscious just at the moment I was drifting off. They all wreaked a familiar havoc: pounding heart, labored breathing, and stress hormones racing around my body causing mayhem for a couple hours.

A Gentler Send-Off

There were other nights when sleep announced its coming in tantalizing snippets carved from dreams. A strange child lept on a man in a Teflon overcoat and slid down him with glee. Or I picked up the phone and ordered an “Isthmé” T-shirt, an act that made perfect sense on the threshold of sleep. A sweet burbling sensation in my brain accompanied these images. It was a signal that I was in fact on the verge of sleep, one of the purest pleasures I knew.

All that changed when I gave up my disorderly habits for the more regular sleep schedule I observe today. In bed by 11:30 or 12, and up at 5:30. No jerks or spasms as I’m falling asleep, no crashes of planes and trains. No cute dreamlets, either. Just a clean and pedestrian break with consciousness, what I always imagined falling asleep should be.

Sound boring? I could certainly never write about it in a blog. But I’m not tempted to return to my wayward habits. Some things are better off unexceptional, and sleep is one.