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Beat insomnia – without drugs

Insomnia refers to difficulty falling or staying asleep, resulting in impaired functioning during the day. It could be a free-standing sleep disorder, not explained by any other medical, psychiatric or environmental cause, or it could also be secondary to other conditions such as depression or being in physical pain.

It is important not to go to bed before you feel sleepy
- Fleur Mifsud Bons

There is a popular belief that we need eight hours of sleep to feel rested and recharged. This is actually the average requirement rather than the general rule, so you might actually need more or less than this.

It would be important to have an idea of how many hours of sleep you need to aim for, because sleeping more than required will only make you feel sluggish and sleepier.

If you suffer from insomnia try keeping a sleep diary to help you find out more about your sleep habits and patterns. Record what time you went to bed, an estimate of how long it took you to fall asleep, what time you woke up and what time you actually got out of bed. This will highlight any bad habits.

Some problem habits which make insomnia worse include the following:

• If you find you cannot sleep, monitoring the time by constantly checking your alarm clock will actually increase your arousal levels, reducing further the chances that your body will relax sufficiently to be able to fall asleep

• Getting a worrying thought in bed, which you continue to think about, will also result in hyperarousal – increased blood pressure and heart rate, increasing the likelihood that a state of rest is not achieved sufficiently to be able to fall asleep

• Spending excessive time in bed, alert, tossing and turning, trying to sleep, will result in the brain linking the bed with being awake, instead of inducing the association of the bedroom as being a place of calm, rest and relaxation

• Adopting irregular sleeping patterns such as variable bedtime and waking routines disrupts the body’s circadian clock

• Napping during daytime may also be a problem, unless naps are scheduled carefully so as to have less impact on sleepiness later on at night

So if you want to reduce these bad habits and instead integrate good sleep hygiene into your lifestyle, try these tips:

• Train yourself to relax through a number of different techniques such as breathing deeply, tensing and relaxing different muscle groups (a technique called progressive muscle relaxation) or imagery (think of a time when you felt very relaxed and imagine the sights, smells and sounds as if you are there. Enjoy the relaxation the image creates in you and use it to induce this state anytime you need to).

• Do not use the bed to carry out activities which require attention and concentration such as checking work-related emails. Even reading or watching television could make insomnia worse simply because you will develop a dependency on carrying out these activities before being able to sleep.

• If you are in bed, unable to sleep, get up and engage in a dull and boring activity which you can stop as soon as you start feeling drowsy. Go to bed again but if you do not fall asleep after 20 to 30 minutes, get up again and repeat the activity.

• If you go to bed at 9pm but actually fall sleep at 2am, it is recommended to actually go to sleep at 2am and increase the time backwards in 30-minute increments. The key is not to go to bed before you feel sleepy. The brain will thus start to associate the bed with a state of sleepiness.

• Do not vary your waking-up time by more than 45 to 60 minutes. Sleeping-in is actually not re-commended for those suffering from insomnia.

• Have a bedtime routine or a series of tasks you do before going to bed which you repeat in the same way every day. These cues signal to the brain that the time for sleep is near.

Ms Mifsud Bons is a clinical psychologist and psychotherap-ist and co-director of the Maia Psychology Centre.

This article is based on RESTore, a computerised cognitive-behavioural therapy programme designed specifically for insomnia sufferers and recommended by the American Academy of Sleep Medicine. RESTore is offered exclusively in Malta by the Maia Psychology Centre. For more information contact [email protected].

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