Steve Baxter's Blog
Sleep Easy – Dealing with Insomnia
About wakeful nights and sleepy days. Some ideas for helping people with sleeping issues including sleep walking, talking and Bruxism
In the training world the post lunch session is often referred to as the graveyard shift. Where even normally energetic and engaged students can descend into lethargy as their bodies struggle to digest lunch and absorb knowledge at the same time.
Yesterday morning I think I taught the ultimate graveyard shift – the first session on a Sunday morning, on the last day of a 10 month hypnotherapy diploma course and following an end of course and School summer party the night before. However what really earnt the session the ultimate graveyard shift badge was the topic – insomnia - teaching a room of sleepyhead students how to help people…with difficulties sleeping. An in depth talk-through of specific hypnosis processes was clearly out; lest I lead the room to slumberville.
Yet, more seriously, insomnia is a very common and debilitating issue. It can be a problem in its own right or a symptom of some other underlying issue such as stress, anxiety or depression. Then this insomnia and the subsequent daytime fatigue in turn can challenge or inhibit the sufferer’s ability to cope or deal effectively with that underlying issue – or any other challenges that life throws their way. Sleep deprivation affects our moods, our thinking ability and our perceptions. During sleep the brain is less active but still busy doing offline housekeeping essential to our mental health, recharging, organising memories.
I’m not going to repeat the whole 2 hour lecture here – but I’d like to share some key ideas, a short guide.
Insomnia
Insomnia comes in a number of flavours. Some people struggle to get to sleep, others struggle to remain asleep. Some fail to completely wake and sleep talk or sleep walk. There are more serious sleep conditions such as sleep apnoea (suspension of breathing) but we are only dealing with common, general insomnia here.
Babies and infants need a significant amount of sleep – around 18 hours is common, as they grow older this decreases to the adult norm of around 8 hours which further decreases to 6 hours in old age. So we should expect to need less sleep as we get older. We can cope with 2 hours less reasonably easily, yet some authorities on sleep suggest our waking hours have a cost; a sleep overdraft that needs to be eventually corrected
We have all had that experience of watching the beside clock tick by the hours as sleep eludes us. Perhaps triggered by a one off event, that ill advised Espresso after dinner; worries about that 9am meeting. When this becomes a pattern, a habit, what can we do about it?
Let us divide the potential causes of insomnia, which in turn suggest potential solutions, into three groups – biological, environmental and psychological.
Biology
The biology I am referring to is more about what we consume – we all know that tea, coffee is a stimulant. Ironically poor sleepers rely on their coffee to get them through the day possibly arriving at bed time with high levels of stimulants in their system. Alcohol also has a double edged effect, it can help to relax and promote falling asleep only to wake you in the small hours.
All these need to be identified and eliminated as a first step, even if they are not the root cause is it good to rule them out as part of finding that cause.
Some drugs can affect sleeping patterns - if you suspect your medication then this is something to discuss with your doctor.
Environment
It is possible to sleep in most environments. I impressed a good friend of mine over the weekend by snoozing in the passenger seat of a very loud, rigidly sprung Lotus sports car as it roared down the M3 motorway. Yet of course some environments make it easier to get regular good quality sleep. So what are the key elements of the perfect environment for sleep?
Firstly the room needs to be dark, our sleep/wake cycle is tied into our 24 hour day and light is a key part of our circadian (‘around the day’) rhythm.
Quiet is good – we can cope and quickly tune out or even be soothed by regular, rhythmical noises but unexpected, new sounds can jar us awake.
Temperature should be on the cool side. If we overheat this stresses the body and we wake to deal with it.
Comfort – is your bed correctly supportive yet yielding? Or do you wake with back aches?
Psychological
When dealing with general insomnia, the philosophy here is to re-establish the natural sleep/wake cycle. The key aspects of this are:
- Imposing routine by retiring/waking in a constant way. Having a bedtime ritual, sticking to a schedule training the body and mind to expect and recognise the time to sleep.
- Bed is only for sleeping, barring other adult bedtime activities (I think that is a polite enough way of putting it) so no reading or watching tv in bed. One approach priorities this point above the previous one by saying that you should not go to bed or remain in bed if you do not feel sleepy, so get up!.
- Avoid stimulating the brain in the hour/s before retiring. Going to sleep is often not a switch but a winding down – your bedtime routine should support this.
- Reflect on your attitude and self-talk. If you have an high level of expectation of sleeplessness and support this with unhelpful internal dialog (that voice in your head that says ‘I’m going to be SOO TIRED tomorrow I MUST get to sleep’ when you wake in the night) then this is likely to raise your level of anxiety!
- You cannot command or direct yourself into sleep, you can only create the circumstances that will allow it to happen. The more you focus on sleep and the need to sleep, the less likely it is to occur. So deliberately move your focus, play games with your mind. Counting sheep is boring (I think) I prefer to imagine some journey, or designing something in your head. Something that requires a little attention but not much effort, something you can become absorbed in.
- Learn self-hypnosis. Hypnosis can be used to achieve calm and relaxation and ease the drift into sleep – and again moves your focus and attention away from the need to sleep itself. Replace the normal end of the process and return to wakeful awareness with a decision and intention to allow yourself drift off into sleep.
Of course if you suspect or know there is an underlying issue – depression, stress, anxiety then you should deal with these directly. However, you should also recognise and acknowledge that the resulting insomnia is in turn probably contributing to the underlying condition, simply because your mental and emotional resourcefulness is depreciated by lack of sleep. Under the guidance of a therapy professional the correct approach may well be to deal with both in parallel. Indeed many therapeutic approaches lend themselves well to doing precisely this.
With sleep issues or where sleep issues are a symptom, I often teach my clients mindfulness meditation. This is a useful skill for allowing the mind to express itself and let go of internal chit chat and thoughts usually pushed aside during our busy waking hours. Mindfulness also improves our ability to be self-aware and appropriately self-critical of our thoughts.
Further reading and resources
For an excellent self help guide that uses the latest empirically supported psychological approaches I recommend ‘Overcoming Insomnia and Sleep Problems’ by Colin Espie, Professor of Sleep Medicine at Nuffield Department of Neuroscience University of Oxford. A well-grounded book focussed on giving both good, easily to consume information and offering practical techniques.
For learning self hypnosis I recommend ‘The Science of Self Hypnosis’ by Adam Eason (disclaimer – Adam is a close friend with whom I trained with and now train for – so am probably biased – but I still rate it highly, check out its high ratings on Amazon).
Adam has also produced a number downloadable hypnosis tracks for sleep issues available from HypnosisForDownload.com
If you have a smart phone such as an iPhone I also rate an application called Pzizz. I have used it personally for many years for power napping. Pzizz is your personal sleep hypnotherapist disguised as a MP3 audio track. The program generates a unique sleep program with beneficial suggestions each time you run it so you brain does not get used to or bored with it. The app includes sleep and nap modes.