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In recent times, a lot of us have been experiencing difficulty sleeping – waking up a lot, waking up early or having poor quality sleep.
It’s no surprise our sleep has been disrupted – the way we operate on a day to day basis has completely shifted. We’re going through massive changes in the way we work, the way we have down time, and everything in between. Moreover ‘danger is in the air’ – in some ways quite literally – and this puts our whole system ‘on alert’.
It goes without saying that it is a different situation for those whose loved ones or themselves have been directly affected by the virus. My thoughts and best wishes are with those of you particularly struggling at this time.
For the rest of us, while changes in social interactions, work schedules, activity levels, and routines contribute to the sleep-wake cycle, four main factors can be seen to be affecting our sleep the most right now.
Excessive thinking, emotional stress, constant stimulation and a sense of unsafety are key in our understanding of sleep as they directly correlate to scientifically proven causes of sleep disruption: cognitive arousal, emotional arousal and stimulus control.
Essentially we have a lot more to think about right now. We try to comprehend the global scale of the pandemic, we think through changes in our working lives, careers and holidays, we consider how family dynamics are changing, perhaps plan about how to help children learn from home, figure out a new routine that works, and think about how to use our free time.
And in any spare minute we have after all that, it’s easy to circle back round to trying to comprehend the national and global scale of the crisis.
Thinking can seem necessary at this time – and it certainly is helpful to problem-solve challenges that arise from the current changes – but it can easily turn excessive and unhelpful.
In many ways so many of us are already addicted to excessive thinking. We are, as Wittgenstein said, bewitched by language, it seduces us… making us believe that just one more cycle of worry will make us safer. Of course, excessive negative cognitive activity goes hand in hand with physiological hyperarousal, making it difficult to fall asleep.
Emotional arousal and alcohol use
Thinking so easily tips over into worrying, and for many this is a very stressful and emotional time – with anxiety, stress, tension and low mood becoming part of their new daily norm.
There is a lot to worry about. Plenty of material for our “worry minds”. When upset and anxious, it’s easy to turn to alcohol to ease some of the intensity…but alcohol impacts sleep cycles pretty significantly, by speeding up onset and depth of sleep early on, but leading to lighter, fragmented sleep in the second half of the night.
Two or three glasses of wine and we are so much more relaxed in the evening, we fall deeply asleep so easily… but 4am and wow! We are suddenly wide awake and feel miserably fatigued. The alcohol has worn off during the middle of our sleep and our system rebounds from the suppressant effect of alcohol into hyperarousal.
So our half bottle of wine leads us to feel not very well rested at all, and feeling perhaps less able to cope with stress, worry, low mood – and so the cycle starts again!
A major part of these thinking and emotional patterns is our constant access to information. We can now, if we choose to, constantly consume live updates and articles (some more trustworthy than others!) day and night, whenever our phone is in hand.
If not to look at endless virus updates, screen-time allows us to contact loved ones, connect with larger social media audiences, and while away the hours of the day with the infinite – and sometimes questionable – entertainment options available with an internet connection.
Many people now look at their phones before they go to sleep, first thing in the morning and also whenever they wake in the night. It’s no surprise that a lot of us have become accustomed to never ‘switching off’ – as we are reliant on the instant update, contact, or distraction available with a click.
There is no way around it. Risks are higher right now. Financial risk, relationship risks – but most particularly our sense of physical safety. Our assuredness of how safe we are has been deeply undermined. At a very basic, biological and unconscious level our bodies feel less safe. So we do not fall asleep so easily and we wake up easily – partly because our system is on alert for danger.
What you can do about it
Like most CBT approaches, in the approach to therapy we teach, the client assumes an active role in treatment. The therapist’s main goal is to ensure the client is self-sufficient enough to solve their own problems.
People like to take cheap shots at “self help” – but fundamentally much of the cognitive behavioural approach to psychotherapy is about “self help”. Learning about the factors involved (psycho-education) and learning what to do (coping skills training).
This is particularly important when thinking about sleep issues as each individual has a different combination of “maintaining factors” – that is the ways of thinking, habitual behaviours and environmental factors that maintain the sleeping problem. It is vital to develop your own insight and awareness of the things contributing to, as well as maintaining, the problem.
Hopefully, with this guidance, you can become your own ‘personal scientist’ to discover what the main reasons behind your sleeping problems are, and how to change things – and develop coping skills to maintain that change.
To rephrase John F Kennedy: “Ask not what I can do for you but what you can learn to do for yourself”!
So, there are five main ways you can understand and change your sleep:
- ‘Sleep hygiene’ changes
- Stimulus control
- Relaxation training
- Cognitive change
This is essentially improving daily habits which directly affect sleep quality.
While improving sleep hygiene needs support from the other strategies in order to be truly effective, it can be very useful in working out which day-to-day behaviours are affecting your sleep most.
It’s super helpful to keep a sleep diary and track these things, and then track your sleep quality if they change.
The main ‘hygiene’ elements are as follows:
- Caffeine intake
- Stimulants and cigarettes
- Screen time
- Regularity of daily routine
- The bedroom environment – making sure it is cool, comfortable and dark
- Performing exercise early
- Avoiding daytime napping
- Ensuring your bed is for sleep and sex only
Ensuring your bed is just for sleep and sex is the most important part of this. The key principle: lying in bed awake is one the main things that keeps sleeplessness going.
If we spend 30% of our time in bed being restless and frustrated – then our bed gets a “mixed association” in our mind.
So, based on classical Pavlovian conditioning principles, we need to re-associate the bed with sleep. Therefore choosing to not look at your phone, laptop or TV – or any other non-screen activities – when in bed will strengthen the connection between bed and sleep.
More importantly – do NOT lay in bed frustrated at not sleeping!!
Three important points:
- Go to bed only when you think you can fall asleep. If you haven't dozed off within 15 minutes, get out of bed and do something else until you feel drowsy. Limiting the amount of time you spend in bed when you're not actually sleeping increases your desire to sleep.
- Don’t lie in bed trying to fall asleep. You cannot try to fall asleep. If you don’t fall asleep quickly (in 10 minutes) get up and do something until sleepy.
- Don’t lie in bed in the mornings trying to sleep more. This can create associations of lying in bed awake.
The “just checking my messages and news” addiction
It would also be helpful for you to be mindful of ‘screen stimulation’ in a day-to-day sense.
Do you feel a compulsion to check your phone for the latest updates first thing in the morning, or whenever you have a spare minute – so maybe 20, 50 or even more times a day?
Ask yourself: how many times a day have I been checking global coronavirus figures on the John Hopkins website or Worldometers? Has it actually made me feel better?
It can feel tempting to think that we can alleviate coronavirus-related anxiety by knowing as much information as we possibly can about it.
However, this is faulty on two counts: you can’t ever ‘think yourself out of’ an emotional problem, and the amount of information on the internet is endlessly being added to. There are not enough hours in the day to read all the ‘relevant’ information – let alone to sift through all the false, pseudo-scientific stuff!
If you find yourself reaching for your phone to distract you from anxiety or stress, and continuing to refresh the news feed again, and again, or swapping from app to app and then back to the fist again – chances are when you put your phone down the anxiety has not decreased.
And this is just news-wise! We all use our phones to stay connected in some way or another. An activity made all the more appealing by our limited face-to-face interactions right now.
But if you find yourself taken along with a compulsion to (rather than choosing to) Whatsapp your friends, scroll through Facebook, as well as Google ‘coronavirus today’: it is probably worth assessing and changing your screen habits.
Perhaps try allocating specific ‘news’ or ‘social media’ times in the day. Or stopping all Internet browsing after 7pm.
(Actually, in my experience reading a novel (not about an epidemic!) for an hour or two before bedtime has been a tremendous aid to sleep.
I think that perhaps getting into “someone else’s story” for that much time switches my brain off from “my story and worries” – and so during sleep I’m not churning about my own stuff so much.)
So, try not to watch the news at least 2 hours before bedtime. Give yourself a different input. Watch a movie or boxset (not about an epidemic!) or listen to music.
Our ability to communicate globally and access information on so many Internet platforms is a great and powerful thing. But when engaging in it becomes obligatory, or a compulsion, we need to re-think the place of the screen in our lives and minds.
This is a key part of stimulus control – chances are your mind will feel quieter and more ready to sleep when you do turn in after a day of engaged but mindful Internet use.
As well as changing general patterns of arousal during both daytime and nighttime – of which screen use is super important right now – actively working on our general feelings of relaxation in bed boosts the ‘bed = sleep’ connection even more.
When nearing bedtime, a relaxation-focused exercise can help your body and mind get into a “sleep ready” state.
You could try listening to this ‘One meditation’ recording – an excerpt from our latest webinar. It’s an exercise designed to help you focus and relax your mind before sleeping.
Committing to relaxing properly before bed allows you to recondition your bed/bedtime/bed environment – your bed will become increasingly associated with pleasant relaxation rather than stress.
The more you practise being mindful of your arousal (and decreasing where necessary) as well as practising relaxation exercises, your ability to relax properly will increase.
Assessing your thoughts and beliefs surrounding sleep problems can massively impact how we approach sleep itself.
You can use the following steps to identify the level of general virus-related anxiety you feel at the moment, and then to consider how those feelings affect your perceived ‘ability’ to sleep.
For example, the belief: ‘Coronavirus is so scary and worrying I cannot stop thinking about it. I won’t be able to sleep properly until this is all over’ – can be debunked in the following ways.
Step 1/ Identify dysfunctional thoughts and beliefs – realise and accept that this belief is ‘dysfunctional’ as it is preventing you from sleeping.
Step 2/ Question, challenge and sow doubt regarding those thoughts and beliefs – this could include:
“Does worrying about it actually help…at all?”
“Do I actually have to worry, or am I choosing to?”
“Why do I think that lying in bed awake at night worrying is the only option?”
Step 3/ Offer alternative, more helpful thoughts and beliefs
“I will change my thinking and behaviour and my sleep will improve”
“I am in control of how much worrying I do”
“Worrying does not help at all”
These cognitive changes can be reinforced using self-hypnosis… the next strategy!
Self-talk, hypnosis and self-hypnosis are super effective in reinforcing new beliefs, attitudes and behaviours.
In 2001, the British Psychological Society confirmed that hypnosis can be used in several ways to help with insomnia: “Likewise, hypnotic treatment may assist in insomnia in the same way as other relaxation methods.” (BPS, 2001)
What self-hypnosis can be used for:
- To suggest and support the improvements we are seeking
- To strengthen the “bed=sleep” connection of the sleep reflex.
- For relaxation and creating a sleep-ready state
- To reinforce your new beliefs about sleep and your capacity to overcome sleep problems
- And also to mitigate the effects of a poor night’s sleep, reduce negative expectancy about the day ahead and increase positive expectancy of mood, energy and performance.
- And to tell yourself – my bedroom is my safe space, I am safe here, my body can relax here because I am completely safe here, in my safe space, my bedroom
Try it for yourself! You can listen to this free self-hypnosis recording for deep relaxation here.
I would recommend that you take a single recording and listen to it everyday before bedtime for at least a week. Record your results in a diary – briefly making note of your experience.
In our approach hypnosis and relaxation and skills that we can learn and develop. So avoid “all or nothing” / “success or failure” thinking – and be more of a learner/problem solver. This will help you work out how to do hypnosis and relaxation better.
Remember, we do not consider hypnosis as something “done to the client”. Hypnosis is “an act that the client engages in” with cues and ideas presented by the hypnotist (in this case the recording).
I hope you have found this article helpful, and you feel you start to understand your own sleep behaviours and beliefs and how to begin to change these if necessary.
It is important to understand that you are not at the mercy of poor sleep. That you have a role in that and can exert some influence and control over the experience, depth and quality of your sleep. This is very important.
And I particularly want you to remember that your body does know how to fall asleep, how to sleep deeply and how to awaken from good deep sleep. This is nature’s gift to us. We merely have to help our body and mind get into a sleep ready state.
It is important to be mindful of our daily activities and how over-stimulating ourselves can feed into our beliefs and general state of mind during this time. And how to feel confident in our ability to overcome seemingly insurmountable emotions – and sleep problems.
I hope that, from an increasingly well-rested place, you are finding the resilience, adaptability, creativity, purpose and strength to carry you through these times, making the best of the time given to you each day – and supporting and uplifting those around you.
Find out more
You can read more about the upcoming Hypno-CBT for Insomnia workshop here. We are running the workshop in both webcast and online formats.
The British Psychological Society, 2001. The Nature Of Hypnosis. [online] Leicester: The British Psychological Society. Available at: https://ukhypnos-wpengine.netdna-ssl.com/wp-content/uploads/2015/01/The-Nature-of-Hypnosis_0.pdf