We all have the the occasional restless night, and sometimes this can carry on for more than just the odd single night. But if you find yourself tossing and turning on a regular basis you might be worrying whether you have a sleep disorder that requires expert advice.
A disturbed sleeping pattern can have a big knock-on effect on your life – whether that be as a result of reduced productivity at work, or causing you to be generally more irritable than normal. It can also cause us to behave in unhealthy ways, such as eating or drinking more than we normally would. This post is focused on people looking for advice on what psychological therapy is on offer for people with insomnia, and so discussion of drug treatments will be kept to the minimum. Similarly, it will not go into detail about some of the other causes of insomnia because there are many reasons that you might have a disrupted sleep pattern. Like any health problem, the best action to take if you are worried about something is to seek expert advice from a trained medical professional.
What are the symptoms of insomnia?
A diagnosis of insomnia means that that you have a disturbed sleep pattern, however, this is not sufficient. There is no single diagnostic tool for insomnia, but rather a range of questions about a person’s lifestyle and sleeping pattern. You might also have a scan, called a ‘polysomnograph’, which is used to assess your sleep quality, duration, and depth. Insomnia is not one single issue. It could be a difficulty getting to sleep, staying asleep, or not sleeping deeply enough. It might be chronic, that is a problem that goes on for a prolonged period of time, or acute. Insomnia might be a problem in and of itself, but it could also be indicative of a more serious health problem like a dietary deficiency. Fundamentally you may be diagnosed with insomnia if you have trouble falling asleep or staying asleep even when you are tired or it is bedtime. Beyond that there are many other criteria that are used to assess the severity of a period of insomnia and what treatments are required.
If you have been diagnosed as having insomnia by a medical professional then Cognitive Behavioural Therapy might be right for you. Clinicians increasingly prefer to use techniques that resolve the issues causing insomnia, rather than simply using drugs to treat the symptoms. Drugs may be suitable for acute insomnia, for example as a result of distress, but they are addictive and quickly lose their effectiveness at the recommended doses. CBT for Insomnia, known as CBT-I, has been shown to be a long-term solution to poor sleep.
How does CBT for Insomnia work?
All cognitive therapy aims to encourage patients to reconceptualise their problems by helping them think about issues in a different, more constructive way. One of the important aims of CBTI is to reduce your overall anxiety levels, so that you are not lying in bed worrying before you go to sleep. It also uses a technique called Stimulus Control. This involves conditioning yourself into only using your bed for sleep and sex, but to avoid using it as a de facto sofa. To be most effective you should avoid reading or watching TV in bed. Creating a strong mental link that reinforces the association between bed and sleep will improve sleep quality and overall restfulness.
Another important part of CBT-I is that you only go to bed when you feel tired. If you are unable to go to sleep after 20 minutes you get up to do something relaxing. This may sound counter-intuitive, but it links back to creating an association between being in bed and being tired, which can be disrupted if you are in bed but not asleep. If you find yourself lying in bed worrying it can be much more effective to just get up and do something else until you feel tired. It is also important that you try and get up as soon as you are awake, however tempting it might be to spend those extra minutes in bed! Getting up quickly will help you wake up, rather than feeling groggy all morning.
As the Royal College of Psychiatry explains, CBT-I uses Sleep Restriction to help you train yourself to sleep in a regular manner. Sleeping for too long can disrupt the internal sleeping patterns, so making sure that you do not over-sleep, or that you sleep the same number of hours each night, including weekends and weekdays. By restricting your sleep you can help to regularise it. This, in conjunction with muscle relaxation techniques and a good bedtime routine, has been shown to be an effective way to increase the quality and duration of sleep for many people who suffer from insomnia.
If you are suffering from insomnia it can be difficult to see a way out sometimes. Regularly feeling tired changes how we interact with those around us, and can have negative consequences for the rest of our lives. However, it can be reassuring to know that there are ways to change poor sleep behaviour.
Have you suffered from insomnia in the past? Are you currently concerned about your sleep pattern? We would love to hear from you! Feel free to post a comment below. If you want to know more about therapy for insomnia then fill in our contact form here to be put in touch with one of our trained clinicians.