From eu.floridatoday.com
As I gradually regained consciousness in my bed, a sense of certainty told me it was nearly 6:30 a.m., the time my alarm usually sounds.
After tossing and turning a few times, I cautiously opened my eyes expecting to see the sun peeking through my bedroom window. To my surprise, the world outside remained pitch black.
Glancing at my phone, the truth struck me — it was only 2:30 a.m. Immediately, a negative thought crossed my mind: “I hope this isn’t going to be one of those nights.”
As I laid my head back on my pillow, I began to think about some of the goals awaiting me the following morning.
Thoughts of upcoming meetings quickly shifted to some challenging situations at work.
Then, my mind wandered to a new workout routine I’m considering.
Politics, golf, my children, and even the timing of my car’s oil change flowed through my thoughts.
An hour and a half later, I was still awake in bed, thoughts racing, questioning whether sleep would return.
My hunch is, I’m not the only one who has experienced one of these nights.
Unsurprisingly, research validates this common experience.
Roughly 30% to 50% of adults report struggling with insomnia at some point, and around 10% of the adult population suffers from chronic insomnia lasting over three months.
Each week, my team at Livewell Behavioral Health gathers to discuss relevant matters concerning the clients that we serve every day.
When psychiatrists, clinical psychologists, mental health counsellors and marriage and family therapists pool their expertise for discussions on clinical interventions, the wealth of mutual learning is remarkable.
One of the issues we talk about often is the profound impact of sleep deprivation on mental health.
It’s pretty remarkable how often we end up talking about sleep troubles when we’re discussing clients from all walks of life and different age groups.
Without a doubt, sleep issues are linked to numerous mental health diagnoses.
For instance, individuals dealing with depression often struggle to find peaceful sleep.
Those with anxiety disorders commonly find themselves trapped in cycles of worry during the wee hours of the morning. People grappling with bipolar disorder might endure up to 48 or 72 hours without sleep.
Clearly, sleep challenges affect a substantial portion of the population and are highly connected to mental health.
So, what steps can we take when we find ourselves in a situation like the one I experienced a few nights ago, with thoughts racing in the dead of night?
1. Understand sleep hygiene
Although sleep can be difficult for many throughout life, there are simple strategies we can adopt that will allow us to take control of our sleep hygiene and pave the way for optimal rest.
- Ensure your bedroom is both cool and dark, as sleeping in a hot environment is not conducive to a good night’s sleep.
- Reserve your bed solely for sex and sleep. While using it to wind down with reading or TV might seem relaxing, it associates your bed with stimulating activities, which can hinder relaxation.
- Avoid caffeine after noon. Given its stimulating nature, caffeine contradicts the calmness your brain needs for quality sleep.
- Disconnect from all screens for at least one hour before bedtime, including televisions, computers, tablets and phones. This helps create the mental and physical calm you need for good sleep, countering the overstimulation that disrupts rest. Research even suggests that glancing at your phone before bed can delay sleep by an average of 10 minutes. Also, drifting off in front of the TV isn’t any better; the light can penetrate your eyelids, exposing your brain to the overstimulating “blue light” that interferes with sleep. Consequently, falling asleep in front of a television often leads to fragmented sleep and more awakenings throughout the night.
2. Plan for sleep interruptions
As we’ve established, I’m not alone in the 2:30 a.m. wake-up call triggered by my own thoughts. Countless individuals grapple with how to react to restless sleep, spending endless hours tossing and turning in bed, consumed by worries about their inability to fall asleep.
The first strategy to combat waking up in the middle of the night is cognitive in nature. The way you talk to yourself in the early hours is incredibly important.
Let’s revisit my own experience: my initial thought focused on anxiety about being awake at that hour.
“Well, I hope this isn’t going to be one of those nights.”
People dwelling on anxious thoughts like this initiate a process of neurological activation, ensuring their brains remain alert.
What happens next is important because anxious thoughts often lead to a chain reaction of negative thinking, intensifying neurological activity.
“Oh my goodness, this is awful. I’m going to be so tired in the morning. I’ve got to get back to bed quickly.”
Once the cycle of anxiety-driven thoughts begin, a positive feedback loop starts, where escalating thoughts cause more anxiety, which in turn causes more negative thoughts.
With all this anxiety and brain stimulation going on, getting back to sleep quickly becomes pretty unlikely, and you might end up staying awake for quite a while.
The key lies in having a plan for managing your thought life when you find yourself up in the middle of the night. The thoughts to rehearse when you first wake up should sound like this: “Yes, it’s a bummer I’m awake, but I need to get out of bed until I feel sleepy again. Changing my environment will help me fall asleep faster.”
The tough part comes when you need to actually get out of bed. I cannot emphasize this enough: DO NOT STAY IN BED! Remaining in bed leads to more restlessness, checking the clock, and growing frustrated about not falling back asleep. This reinforces negative connections between the bed and sleep, associating it with anxiety and stress.
In short, trying to “rest” in bed is counterproductive. You need to stand up, move to another room and engage in something enjoyable that doesn’t involve a screen.
3. Address mental health problems directly
As we have already established, insomnia is a common aspect of life, but there are times when you must intervene quickly.
he clearest sign for identifying problematic sleep disturbance revolves around time and duration.
When insomnia lasts at least three days per week for three months or longer, it is termed chronic or long-term, potentially tied to an underlying mental health issue. This goes back to our clinical discussions at LiveWell.
In one of those meetings, our psychiatrist made a profound statement that has made a significant impact diagnosing insomnia within the clinical context.
Essentially, she stressed that a comprehensive understanding of any mental health concerns can’t be attained until the patient consistently achieves sufficient sleep.
Accordingly, our policy at LiveWell is to focus first on helping people develop coping skills for insomnia before heavily leaning towards long-term diagnoses.
Our clinicians frequently opt for a cautious approach when applying labels like bipolar or even generalized anxiety disorder, until they have been able to get the individual’s sleep disturbance under control.
In simple terms: if you have been struggling with insomnia three nights a week for more than three months, seeking guidance from a competent clinician is crucial.
They can help you unravel pertinent issues and address underlying mental health concerns head-on.
An accurate diagnosis is pivotal, as it lays the groundwork for learning the coping strategies for the symptoms of anxiety disorders or major depressive disorder, one of the only paths that will allow you to find healthy functioning in your sleep life.
Once diagnosed, your clinician can develop a treatment plan that might include cognitive behavioural therapy, TMS, and symptom-targeted medication.
Regardless of the chosen treatment path, forging a connection with behavioural health professionals who truly listen to your experience with insomnia and sensitively aid in crafting a personalized treatment plan is paramount.
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