Sleeping Mindfully with Cognitive Behavioural Therapy for Insomnia
When you’re unable to sleep, the natural response is to do whatever you can to immediately fix it.
We are conditioned to respond to problems like not sleeping, with action and “doing” something. Cutting down on caffeine and screen time, putting up blackout blinds, buying earplugs and consuming herbal teas before bed, all seem like proactive and sensible ways to improve your sleep when insomnia strikes. But paradoxically, in the case of sleep, this effortful struggle to control what is not in fact under your control, can end up being the very reason why sleep continues to be elusive.
Persistent efforts to sleep results in anxiety, frustration and worry, leading to emotional, cognitive and bodily tension, all of which results in a physical state that is not at all conducive to restful sleep and creates a vicious cycle which only perpetuates and worsens the insomnia.
These physical behaviours, worries and negative thoughts around sleep can be addressed through cognitive behavioural therapy for insomnia (CBT-i). This treatment involves changing the habits and behaviours which develop over time as a result of poor sleep, and which paradoxically, keep the insomnia going.
CBT-i also looks to identify patterns in thinking about sleep, in order to calm the active and racing mind, manage dysfunctional thoughts and beliefs about sleep, and help produce a relaxed and calm state to enable sleep to arrive. There’s increasing evidence for example, that incorporating mindfulness-based approaches into this treatment can help improve self-awareness, reduce unhelpful thoughts about sleep, reduce stress and provide the opportunity for healthy sleep to return. No wonder therefore that CBT-i is the best-evidenced treatment for insomnia which lasts for more than 4 weeks (called “chronic insomnia”).
Mindfulness meditation is an approach aiming to enable us to pay attention to the present moment, letting go of preconceptions and judgements and thereby, fostering curiosity, openness and acceptance. It is not about ‘switching off’ the mind, but instead, ‘letting go’ of those things that we can’t change, in order to to develop patience, and bring a fresh perspective to our experiences.
In a mindfulness approach to insomnia, thoughts about sleep are allowed to come and go without judgement or criticism. Rather, they’re accepted for what they are: just thoughts and feelings which aren’t right or wrong, but rather, should be welcomed and explored. The mind and body are seen as having the capacity to self-regulate and are trusted to balance the need for sleep if allowed to do so. Patience is cultivated through the understanding that this change in approach will not occur overnight, but will take time as new characteristics of the mind are learned. Each night is treated as a separate entity, with no preconceptions or assumptions based on what happened that day or the night before, and labels such as “insomniac” are avoided, since they give the insomnia an unjustified power.
Rather than using a ‘doing’ mode of mind, which often involves dissatisfaction as we experience a discrepancy between how we believe things should be and the reality of how things really are, resulting in attempts at problem-solving, over-thinking and negative ruminations; mindfulness approaches encourage and train us to enter a ‘being’ mode. In this mode, there’s no attempt to achieve a particular goal or state, but instead, the experience of the present moment is explored through sensations such as sight, touch, and hearing, with no attempt made to change the experience, or to relate it to past or indeed future events.
Mindfulness is a way of thinking and an approach which needs to be learned.
There are a variety of online programmes which provide the opportunity to explore mindfulness meditations, but the key is that this approach requires regular practice. It takes time to learn these new attitudes or ways of thinking, and daily practice for 20-30 minutes is required for at least 6 weeks to develop the skill.
Initially, practice should take place in the daytime, and then be used at night time once you feel confident. There’s good evidence that the more you practice, the more successful this approach is. So, rather than constantly struggling to sleep, maybe it’s time that you employed feelings of acceptance and openness to mindfully welcome healthy, restful sleep back into your life.