Friday, 19 April, 2024
HomeSleep MedicineBattling insomnia? Stop trying so hard, says sleep expert

Battling insomnia? Stop trying so hard, says sleep expert

There are millions of people worldwide who have “tried everything” to get more sleep, but as sleep coach Camilla Stoddart advises in The Guardian, effort is not rewarded: in fact it is actively punished. The more you try the less likely you are to succeed.

Many insomniacs have adjusted and readjusted their routines based on the advice they have found on the internet or read about. Many are doing all the right things – spending time winding down before bed, curbing screen time, meditating – but still they struggle.

The problem is that when it comes to sleep, effort is not rewarded, because sleep is a passive process, like breathing or digesting. It cannot be controlled and nothing we can do can force it to happen. If we can stop trying, sleep will naturally follow. But not trying to sleep is extremely hard, especially when you are exhausted and desperate.

What people need to do is shift their attention towards the main causes of sleeplessness: lack of sleep drive and hyperarousal. Tackling these two factors (which happily respond well to some effort) can then create the right conditions to allow sleep to happen all on its own.

The more scientifically sound advice addresses these factors too, but it also gives the false impression you can make yourself sleep by doing certain things and so creates a frustrating cycle that is difficult to break. Insomnia is like a Chinese finger trap which grips tighter the more you pull your finger away. The only way out of the trap is to go against your instincts and push. Sometimes you have to do things differently to get a different outcome. Here are seven ways to improve your sleep that might just work, as long as you don’t try too hard.

Give up trying to sleep tonight

As brutal as it sounds, there is nothing you can do between now and bedtime to guarantee you will sleep tonight. However, there’s plenty you can start doing to improve your chances of sleeping well next month. It takes time to optimise your sleep drive and reduce hyperarousal, and there are no quick fixes, so instead of worrying about the night ahead, make sleeping well a long-term goal and expect to see progress in weeks rather than tomorrow.

Breathe less

According to James Nestor, author of Breath: The New Science of a Lost Art, modern humans tend to over-breathe, which can raise blood pressure and keep us in a state of constant nervous arousal. Slowing your breathing down from our regular 12–20 breaths per minute to four or five breaths per minute engages the parasympathetic nervous system which counteracts this arousal.

To boost your chances of better sleep, consciously slow your breathing down for at least 10 minutes a day (breathe in for roughly five seconds and out for around seven seconds). Do this sitting comfortably, focusing on each breath, though it works just as well if you do it during regular activities like watching TV, hanging out the washing or working at your desk. Don’t do it just before bed, however, because relaxation techniques can be the opposite of relaxing when you desperately want them to send you to sleep.

In fact, tackling hyperarousal should be thought of as a 24-hour project rather than something you do only in the run-up to bedtime. Introducing a breathing exercise every morning, for example, will not only help you to feel calmer during the day, but reduce the amount of hyperarousal you deal with at night.

Have a late night

The only thing that generates sleep-drive is being awake, in the same way that the only thing that generates hunger is not eating. Adults need to be awake for at least 16 hours to generate enough sleep-drive to sleep for eight hours at night. However sensible it seems, having an early night can mean you won’t be sleepy enough to fall asleep easily, which can lead to frustration and anxiety about sleeping. If you have been having trouble falling asleep, get up at roughly the same time every day, including at weekends, and make your earliest bedtime roughly 16 hours later. But don’t obsess about the exact times or the hours of sleep you are getting – the details don’t matter. And don’t take naps in the day – they take the edge off your appetite for sleep, like having a snack before sitting down to a three-course meal.

Wind up your wind-down routine

If you have an elaborate wind-down routine that takes up your whole evening but doesn’t often lead to a good night’s sleep, try something different. Which elements of your routine do you enjoy and which do you endure purely because you think they will help you sleep? If you look forward to a bath at the end of the day, then have a lovely hot bath. However, if you don’t enjoy a bath but feel anxious that you won’t sleep if you don’t have one, then stop.

Instead, reclaim your evenings and spend the time doing relaxing things you actually like doing, such as watching TV in bed or scrolling through Instagram reels. It isn’t the blue light from the screen that keeps you awake, it’s anxiety about whether you will sleep. Doing something you enjoy is the best way to overrule this anxiety and will help you look forward to bedtime rather than dread it.

Embrace being awake

One of the things perpetuating insomnia is a fear of being awake. This triggers the body’s fight or flight response, with its accompanying cocktail of stress hormones. To retrain your brain to not react this way, make friends with being awake. Try to accept it as part of your night and instead of spending the time worrying, do something that genuinely gives you pleasure like listening to a comedy podcast or an audiobook, reading or doing Wordle. Stay in bed if you can remain relaxed there, but, if not, get up and find a cosy spot elsewhere until you feel sleepy enough to go back.

If this seems too gentle an approach, try facing the fear of being awake head on by keeping your eyes open for as long as possible. Doing the exact opposite of what you want to happen reduces the pressure to fall asleep and stops you trying so hard. This is called paradoxical intention and was developed by the Austrian neuroscientist and psychiatrist Viktor Frankl who said: “Sleep [is like] a dove which has landed near one’s hand and stays there as long as one does not pay any attention to it; if one attempts to grab it, it quickly flies away.” Trying to stay awake at night might just help you fall asleep.

Smile more

A quick way to counteract stress hormones is to smile. Smiling releases serotonin, dopamine and endorphins, all of which reduce hyperarousal and promote relaxation. As you turn the light out at night, try to think of something funny or imagine someone you love and smile to yourself in the dark. Likewise when you wake up in the middle of the night. It doesn’t have to be a genuine, heartfelt smile; even a fake smile is enough to send a message to the brain that reduces stress and lowers your heart rate. It may feel like the last thing you want to do when you’ve woken up yet again, but it can be a powerful way to change your mood and retrain the brain to be comfortable with being awake, reducing hyperarousal and allowing sleep to follow.

Stop reading articles about sleep

Colin Espie, professor of sleep medicine at Oxford University, defines insomnia as a “preoccupation with sleep”, and when you battle to sleep, it’s easy to become obsessed by it. But none of the researching, monitoring or analysing actually leads to better sleep. In fact, constantly looking for a solution makes things worse. So give sleep less of your attention. Make this the last article you read on the subject, then go and find something more interesting to think about.

 

The Guardian article – Want to get a good night’s sleep? First of all, stop trying (Open access)

 

See more from MedicalBrief archives:

 

Many commonly used insomnia drugs poorly tolerated and have adverse results – Oxford meta-analysis

 

New US clinical practice guidelines on treatment of chronic insomnia disorder

 

Sleep meds make no difference to insomnia over the long term

 

Weighted blankets can decrease insomnia severity – Karolinska Institutet

 

 

 

MedicalBrief — our free weekly e-newsletter

We'd appreciate as much information as possible, however only an email address is required.