Beth thought she was losing it. She had a hard time concentrating at work, struggling with memory recall, frequently moody, short tempered, slow to make decisions, craving sugar and caffeine, and got into a couple of minor car accidents within the last few months. Her bizarre symptoms didn’t seem to add up to anything at first.
So she went to a medical doctor. After several tests, her doctor said there was nothing medically wrong with her and recommended her to a therapist. During the first session, the therapist inquired about the quality of her sleep. Beth confessed to having wrestled with insomnia for the past several years. Some nights, she had a hard time getting to sleep while other nights she woke up several times. Her physician gave her some sleeping medication years ago but it did not seem to be working anymore.
The therapist suggested an alternative approach to her insomnia. Cognitive behavioral therapy designed for insomnia has been proved to be more effective than taking medication alone. Beth was willing to try the approach. Here is what her therapist recommended.
- Minimize negative thoughts. Beth would tell herself at night, “I’m never going to get to sleep,” and “I won’t stay asleep for long.” Saying these sentences is like a self-fulfilling prophecy. The more it is repeated, the more likely it is to happen.
- Maximize positive thoughts. Replace the negative thoughts with positive ones like, “I’m going to get as much sleep and I need,” and “I can sleep through the night.” Beth wrote out a couple of statements that she would say every night as part of her new bedtime routine.
- Decide the amount of sleep. Not everyone needs the same amount of sleep. In Beth’s family, her relatives tended to only get about 6 hours per night. She reported feeling fine with this amount of sleep as long as the time was consistent.
- Set target sleep times. The therapist discovered that Beth went to bed at different times nearly every night. She also did not have a set time to wake up in the morning. Knowing that she needed 6 hours per night, she agreed to try going to bed around 11pm and waking up around 5am.
- No napping. In the past, Beth would take naps when she got home in the afternoon. Sometimes, she would sleep for several hours at a time. This made sleeping at nighttime even worse. Even though she enjoyed her naps, Beth agree to give them up.
- Arrange bedroom for sleep. Beth set up a small office area complete with computer and TV in her bedroom. Every time she went into her bedroom, she was conditioned to think about work instead of sleep. This made sleep more difficult. So she moved her office area to the living room instead.
- Minimize electronic devices. Part of Beth’s old nighttime routine was to watch TV and play a game on her ipad. She thought this was relaxing her but it really overstimulated her and made sleep more difficult. She agreed to stop using all electronic devices about 30 minutes before bed.
- Eliminate obsessions. One of the things that kept Beth up late at night was her thinking about all the things she needed to do the next day. Instead of making a to-do list just before bed, Beth made it 2 hours earlier. This allowed her to schedule time to obsess about her work without it interfering with her sleep.
- No exercise before bed. Beth often worked out at night, about an hour before she wanted to go to sleep. This only increased her adrenaline which made it difficult to fall asleep. She instead changed her work-out time to first thing in the morning.
- No eating before bed. Late night dinners were very popular in Beth’s family. After she worked out, Beth would eat her dinner. Instead, she was asked to not eat a main meal within 2 hours before bed. She could eat a light high-carb snack if she was hungry but not a meal.
- Limit alcohol. Beth used alcohol to encourage sleep. However, this is a poor solution as too much alcohol can impair the quality of sleep. Instead, Beth agreed to limit the alcohol consumption to one small serving.
- Bedtime routine. Most parents naturally do a bedtime routine for a child: take a bath, read a story, and listen to soft music. But adults seem to lose these good habits. Beth decided to adopt a similar routine of doing some mild yoga stretches, drinking chamomile tea, taking a bath, reading a light book (not on the ipad), and doing deep breathing exercises.
With her new rules in place, Beth found that she was sleeping more soundly within a few weeks without the use of medication. Her insomnia was gone, her memory improved, she was in a better mood, and her accidents subsided.