“I’ll never make it through the day tomorrow if I don’t get to sleep.”
“I’ve got only three hours until I have to get up.”
“I’m sure I’ll get sick if I don’t get to sleep.”
Many people with primary insomnia — the kind not caused by an underlying medical problem — suffer from psychophysiologic insomnia, a conditioned sleep disorder in which the fretting focuses on sleep. Why can’t I fall asleep? Will I wake up in the middle of the night? How will I get through the day tomorrow? As the worry builds, it becomes increasingly difficult to doze off, which only perpetuates the insomnia.
Excessive worry about sleep is the main symptom of psychophysiological insomnia. This type of insomnia is more common in women and symptoms need to last at least a month in duration. People with psychophysiologic insomnia often have trouble relaxing in bed, and drift off more readily when they’re away from home or doing something monotonous.
Clearing your mind of intrusive thoughts isn’t easy, especially if you have bad habits supporting them, but the right mind-set can make a difference. Find a way to create a sleep-inducing environment, and work hard at feeling relaxed before bedtime. Sometimes that process begins by adjusting your attitude.
Okay, it’s true: Sleep is important for your health and well-being. It strengthens your immune system, puts you in a good mood and helps you do all that you do in a day. Studies show that without enough zzzzs, you may be at risk for health problems such as weight gain, high blood pressure and heart disease.
But in reality, short-term bouts of occasional insomnia aren’t likely to cause long-term health problems, says Nancy Foldvary, DO, director of the Sleep Disorders Center at the Cleveland Clinic and author of The Cleveland Clinic Guide to Sleep Disorders. “Infrequent bouts are probably not life-threatening, but they can affect daytime functioning” she says.
Overthinking the importance of sleep only perpetuates the anxiety that keeps you awake. “Attributing everything bad that happens to poor sleep increases the importance of sleep and similarly the anxiety and stress of sleeping poorly,” says Donna Arand, PhD, clinical director of the Kettering Sleep Disorders Center, in Kettering, Ohio. “This can be a vicious circle.”
If you have insomnia, it’s important to accept that you can get through a few days without enough sleep and do just fine — a message your brain must absorb. “You have to believe that the occasional insomnia is normal,” says Mark Mahowald, MD, a professor of neurology and director of the Minnesota Regional Sleep Disorders Center in Hennepin County Medical Center, in Minneapolis. “You have to acknowledge that it’s part of the human condition. Nothing bad is going to happen to you if you had a bad night’s sleep.”
Turn Hope Into Action
Many insomniacs start to dread bedtime in the late afternoon, saying, “Gee, I hope I sleep tonight,” or “I’m afraid I’ll be up again.” These thoughts don’t exactly set the stage for a night of sound slumber and may actually fuel your sleeplessness, Dr. Mahowald says.
Instead, he says, "You should say, "I'm going to do this new program. I'm not going to bed until I feel sleepy, and I won't spend more than 15 minutes in bed awake. That kind of thinking empowers you."
Calming the overactive mind involves relaxing the body. Research has shown that many people with insomnia have more sympathetic nervous system activity — the system that kicks into gear when you’re under stress. “They have slightly higher body temperatures, heart rates and metabolic rates compared to those without insomnia,” Dr. Arand says.
That’s where relaxation exercises can help. Techniques such as deep breathing, guided imagery, meditation or progressive muscle relaxation exercises train you to calm down. When you relax, you engage the parasympathetic nervous system, which slows your heart rate and respiration, and prepares your body for sleep. Other ways to relax include listening to music, taking a warm bath or shower or doing some gentle stretches.
Strike a Pose
Doing yoga may be one of the most effective ways to relax a restless mind. In fact, a study in the Journal of Alternative and Complementary Medicine suggested that yoga may be even more effective than reading. The researchers compared subjects who did yoga for an hour with other subjects who read for an hour. The researchers measured the subjects levels of gamma-aminobutyric (GABA), a brain chemical that signals the body to relax. In those who did yoga, they found a 27 percent increase in GABA levels, but no change in the group that read.
Avoid poses that are too invigorating, and stick with those that promote relaxation. Peggy Hall, a certified yoga instructor in Aliso Viejo, California, suggests doing a modified pigeon pose:
Sit in the middle of your bed, knees bent and feet flat on the mattress. Let both knees fall to the right so you're sitting on your right buttock/hip and your feet are to your left. Draw your left leg behind you a few inches so it's not resting on your right leg or foot. Place your hands on either side of your right bent knee and then lower yourself over your thigh. Bend your elbows and rest your forehead on the back of your hands, or use a pillow under your forehead instead. Take all of your body weight onto your right leg. Relax and let go. Empty your mind. Rest for a minute or two, then press yourself up slowly. Repeat on the other side.