Embracing the Wakeful Nights: A Different Approach to Overcoming Sleep Challenges

I want to talk to you about SLEEP.

 

We all know we need it, and I posted a little while back about the importance of sleep, and how scientists know more about what the different functions are of the different stages of sleep (if you want to know more, “Why We Sleep” by Matthew Walker is an incredible book).

I’ve noticed a lot of my clients have difficulties sleeping, and this in turn can increase anxiety. Anxiety in the evening, leading up to bedtime as they’re concerned that it’s going to be another night unable to sleep at a “sensible time”; anxiety in bed thinking about all the things they have to do or haven’t done, as well as the fact they’re not asleep yet; and then anxiety the next day due to tiredness and frustration. It’s a vicious cycle.

A different approach though is to take the emphasis away from being in bed to sleep, but rather being in bed to be in bed. Now bear with me as I walk you through this view, encompassing acceptance rather than defeat!

 

The Problem of Sleep Anxiety

If you struggle with sleep, you probably know from experience that, as mentioned in the introductory paragraph, anxiety about not sleeping can exacerbate sleep issues, which in turn can increase anxiety and worry – which then can lead to more sleeplessness. It’s a vicious cycle, and can impact children and teens as much as adults. This invokes a psychological and physiological response in us, which can be helpful to understand.

Anxiety triggers a state of heightened awareness and arousal. When you worry about not being able to sleep, this worry becomes a source of mental stress. Instead of relaxing and letting sleep come naturally, the brain enters a state of hyperarousal, constantly monitoring for signs of sleep or the lack thereof. This mental state is counterproductive to the relaxation needed for sleep.

Physically, anxiety activates the body’s stress response system, the sympathetic nervous system, releasing stress hormones like cortisol and adrenaline. These hormones increase heart rate, blood pressure, and alertness—all of which are beneficial in a fight-or-flight situation but detrimental when trying to sleep. You want to be in bed relaxing – not preparing to fight or run from perceived danger! The body, therefore, remains in a ‘ready’ state, unsuitable for the calmness required for sleep.

Does this cycle described below sound familiar?

The cycle often starts with a few nights of poor sleep. This could be due to various factors, such as stress, changes in sleep environment, or even an irregular sleep schedule. After experiencing difficulty sleeping, you may start to worry about your ability to sleep in the future. This worry is not just about the immediate effects of sleeplessness (e.g., feeling tired the next day) but also about the long-term health consequences of chronic sleep deprivation.

As bedtime approaches, the anxiety and stress about the potential of another sleepless night increase. This anticipatory anxiety makes it even harder to relax and fall asleep, as you become preoccupied with monitoring your state of wakefulness, and trying to force sleep. The increased stress and anxiety at bedtime often lead to difficulty falling asleep, frequent awakenings during the night, or unrefreshing sleep. Even if you fall asleep, the quality of sleep may be poor. After a night of poor sleep, your  concerns about your sleep problems are reinforced. You become even more worried about your ability to sleep well in the future, further entrenching the anxiety-sleeplessness cycle.

 

A New Perspective on Wakefulness

This might seem counterintuitive, but it seems one of the best ways to manage this anxiety is to accept being awake. So rather than focusing on trying to sleep – accepting that in the moment, you’re awake. This involves developing something called psychological flexibility; by not fighting wakefulness, you can reduce stress and arousal which makes sleep more attainable. This is a concept that underpins mindfulness, more of which I’ll talk about in a little while.

As we’ve discussed, the effort to sleep can become a source of tension. Accepting wakefulness and remaining relaxed in bed minimizes this tension, allowing sleep to occur naturally. This is based on the understanding that trying too hard to sleep can actually keep one awake. Even when awake, lying down in a relaxed state allows the body to conserve energy and provides a form of physical rest. This concept of restful wakefulness suggests that relaxation can be beneficial, even if it doesn’t equate to full sleep.

Practicing acceptance can involve focusing on breathing, performing a body scan, or engaging in mindfulness meditation. These practices keep the mind present and prevent it from engaging in anxious thoughts about sleep.

Mindfulness-based interventions for insomnia, and acceptance-based therapies, have been validated in studies for improving sleep outcomes. For instance, Ong et al. (2014) demonstrated that mindfulness meditation significantly improved sleep quality, reduced sleep onset latency, and increased sleep efficiency.  Additionally, Black et al. (2015) found that mindfulness meditation was effective in improving sleep quality among older adults with moderate sleep disturbances, further underscoring the benefits of mindfulness and acceptance in managing sleep issues.

So in a nutshell, the approach of accepting wakefulness and emphasizing relaxation over forced sleep attempts can, paradoxically, lead to easier sleep. This strategy, supported by research like that of Ong et al. (2014) and Black et al. (2015), offers a significant shift in managing sleep difficulties, moving away from anxiety and towards a more peaceful nighttime experience.

 

Pre-Sleep Routine: Taking Control

I know, I know, the thought of a sleep routine might sound boring or maybe you just think it’s pointless. But routines are really important for our brains and bodies to build habits. Habits aren’t bad either – they’re merely a repeated behaviour ingrained into our day to day lives, for better or worse. Our brains thrive on predictability and routine. Establishing a pre-sleep routine sends clear signals to the brain that it’s time to wind down and prepare for sleep. This predictability can significantly enhance the brain’s readiness for sleep, making the transition smoother and more natural. Therefore, a consistent pre-sleep routine helps reinforce our natural circadian rhythms, the internal processes that regulate our sleep-wake cycle. By performing the same activities in the same order every night, we can strengthen these rhythms, which in turn can lead to more consistent and restorative sleep.

A well-established pre-sleep routine can decrease the amount of time it takes to fall asleep, known as sleep latency. By engaging in relaxing activities before bed, we can help reduce mental and physical arousal levels, making it easier to fall asleep quickly.

Some ideas for relaxing activities include:

Engaging in reading before bed, especially material that is not overly stimulating or distressing, can be a perfect way to relax the mind. Opt for physical books or e-readers without backlighting to minimize exposure to blue light, which can disrupt sleep patterns.

Activities that require minimal mental and physical effort can help prepare the body for sleep. This can include gentle stretching, listening to soothing music, or practicing relaxation techniques such as deep breathing exercises.

Reducing exposure to screens and electronic devices before bed is crucial, as the blue light emitted can interfere with melatonin production, making it harder to fall asleep. Establishing a “technology curfew” can be a beneficial part of a sleep routine.

 

Developing a pre-sleep routine requires a commitment to making and maintaining changes in behaviour. This involves recognizing the impact of current habits on sleep quality and being willing to adapt for the sake of better health. Part of personal responsibility includes creating an environment conducive to sleep. This can mean investing in comfortable bedding, ensuring the room is dark and at a comfortable temperature, and minimising noise pollution. The effectiveness of a pre-sleep routine hinges on consistency. It’s important to stick to the routine as closely as possible every night, including weekends, to reinforce the sleep-wake cycle and build lasting habits. Finally, being mindful of how different activities affect sleep quality and adjusting the routine accordingly is essential. Reflecting on the routine’s effectiveness and being open to adjustments can help find the optimal pre-sleep practices for individual needs. So rather than trying something, feeling like it doesn’t work and giving up, what could you change for it to be more effective next time?

 

Common Misconceptions

 

Many people who struggle with falling asleep believe that they are unique in their struggle, while assuming that others have no difficulty. However, this perception is far from the truth. Sleep studies and surveys show that a significant portion of the population experiences insomnia or difficulty falling asleep at some point in their lives. For instance, the American Academy of Sleep Medicine highlights that about 30% of adults have symptoms of insomnia.

 

The belief that “everyone else falls asleep easily” can exacerbate feelings of frustration and isolation for those with sleep difficulties. This comparison can increase anxiety, making sleep even more elusive. Recognizing that sleep challenges are widespread can help people feel less alone and more open to seeking solutions or sharing their experiences.

 

The truth is, the process of falling asleep, known as sleep onset, is often accompanied by a stream of random, flowing thoughts, known as hypnagogic thoughts. These thoughts can be visual, auditory, or sensory in nature and are a natural part of the transition from wakefulness to sleep. Understanding that experiencing random thoughts while trying to fall asleep is a normal part of the process can be reassuring for anyone troubled by their presence. Instead of fighting these thoughts or worrying about their implications for sleep quality, accepting them as a natural aspect of the sleep onset process can promote relaxation and ease the transition into sleep.

 

Conclusion: Embracing a New Sleep Mindset

In our journey through understanding sleep and its complexities, a central theme emerges: the significance of adopting a new mindset towards sleep, one that emphasises relaxation and acceptance over the pressure to fall asleep. This mindset shift is not just about changing how we approach our nightly routine but also about transforming our relationship with sleep itself. The essence of this pivots around the concept of easing the mental and emotional strain we often place on ourselves to achieve sleep. The conventional emphasis on the necessity of immediate sleep can inadvertently lead to increased anxiety and a counterproductive cycle that makes sleep more elusive. Instead, the goal is to be at peace with being in bed, to cherish the rest and comfort that the bed provides, irrespective of whether sleep comes quickly or not. This approach encourages the body’s natural sleep mechanisms to operate without the hindrance of psychological stress.

 

Central to this new sleep mindset is acceptance—acceptance of wakefulness when it occurs, acceptance of the body’s natural rhythms, and acceptance of the fact that sleep cannot be forced. By acknowledging and accepting these truths, we foster a more conducive environment for sleep, one that allows us to engage with our pre-sleep routine and our bedtime in a way that nurtures our sleep readiness rather than detracts from it. Encouraging a relaxed, accepting attitude towards sleep involves embracing practices that enhance relaxation and reduce pre-sleep anxiety. This includes mindfulness and meditation, establishing a comforting pre-sleep routine, and engaging in activities that signal to the brain that it’s time to wind down. It’s about creating a sanctuary for sleep that begins with our mindset and extends to our environment and behaviours.

 

Understanding the science behind sleep, the impact of anxiety on sleep patterns, and the benefits of relaxation techniques empowers us to make informed choices about our sleep practices. Education on these topics, combined with the practical application of relaxation and mindfulness, can dramatically improve our sleep quality and our relationship with sleep.

 

Now, I  encourage you  to experiment with this new sleep mindset, to explore the practices that foster relaxation and acceptance, and to observe the changes in your sleep patterns and overall well-being.

 

References:

– Ong, J. C., Manber, R., Segal, Z., Xia, Y., Shapiro, S., & Wyatt, J. K. (2014). A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia. *Sleep*, 37(9), 1553–1563. This study provides evidence on the effectiveness of mindfulness meditation in improving various sleep parameters in individuals with chronic insomnia.

 

– Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances: A Randomized Clinical Trial. *JAMA Internal Medicine*, 175(4), 494–501. This research highlights the benefits of mindfulness meditation on sleep quality among older adults, offering a non-pharmacological approach to enhancing sleep.

– American Academy of Sleep Medicine. (2021). “Insomnia – Symptoms & Causes.” This reference provides statistics on the prevalence of insomnia and underscores the commonality of sleep difficulties among adults.

– National Sleep Foundation. (2020). “Understanding the Sleep Cycle.” Offers insights into the brain’s activity patterns during sleep onset and the significance of hypnagogic thoughts.