Managing Insomnia

What is sleep? NOT an absence of wakefulness - it’s an important time when a lot goes on in both your mind and your body Sleep stages - we have different types of sleep throughout the night Light sleep Deep sleep Dream sleep (REM) We cycle through these stages several times during the night We may have up to six spells of dreams throughout the night - dreams are a normal part of sleep, whether we remember them or not

Why do we need to sleep? Physical rest - Mental rest – muscles need to rest helps the body to grow - the body works to rebuild itself for the next day Mental rest – sorting out things that have happened in the day and storing them in our memory Sleep is a natural need

What is insomnia? Difficulty initiating sleep (getting to sleep) or maintaining sleep (staying asleep) It is persistent and causes you difficulty during the day It occurs at least 3 out of 7 nights per week and has been going on for at least 3 months

What causes insomnia? Stress and strain Depression and anxiety Life changes Shift work Diet Bedroom Sleeping pills Pain, discomfort ….........................and lots of other things!!

How can insomnia be treated? Using Cognitive Behaviour Therapy, which includes – Sleep Hygiene Relaxation Imagery Putting the day to rest Thought blocking Giving up trying The 15 minute rule

Progressive Muscle Relaxation  Wind down during the second half of the night Slow down/ stop activity 90 minutes before bed Practice the relaxation routine while in bed Concentrate on breathing Tense and relax muscles and breathe Take exercises slowly - do not over tense muscles Practice, practice, practice

Imagery Imagery involves creating a mental image in your mind The imagery story should be – Vivid and clear in your mind’s eye Pleasant and enjoyable to follow through Relaxing (of course!) - the main thing is to avoid strong emotion Planned ahead - don’t just wait until the time comes Practised - regularly until you are good at it What is your imagery story going to be?

Putting the day to rest Set aside 20 minutes in the early evening (say around 7 pm) Sit down with a pen and paper Think of what has happened during the day, how it has gone and how you feel about it - put it to rest! Write down anything you still need to do on a ‘to do’ list with steps that you can take to complete any ‘loose ends’  

Putting the day to rest Try to use your 20 minutes to leave you feeling more in control When it comes to bedtime remind yourself that you have already dealt with things If new thoughts come up in bed note them down on a piece of paper at your bedside to be dealt with the next day  

Thought blocking To use thought-blocking follow three simple steps:   To use thought-blocking follow three simple steps: Repeat the word “the” every 2 seconds in your head with your eyes closed Don’t say it out loud, but it sometimes helps to ‘mouth’ it Keep up the repetitions for about 5 minutes (if you can!) Thought blocking works by stopping other thoughts getting in 

Giving up trying Sometimes people are unable to sleep because they are simply trying too hard! Trying to fall asleep actually keeps you awake and may lead to irritability when you don’t succeed Here are the steps you can take – Lie comfortably in your bed with the lights off but keep your eyes open Give up any effort to fall asleep Give up any concern about still being awake When your eyelids feel like they want to close, say to yourself gently “Just stay awake for another couple of minutes, I’ll fall asleep naturally when I’m ready” Don’t purposefully make yourself stay awake; but if you can shift the focus off working to fall asleep, you will find that sleep comes naturally

Making the link between bed and sleep Only use your bed for sleep and intimacy Watching TV, Reading, Eating, Telephones, Computers……..should be avoided   Also, avoid napping during the day, even for very short periods

The 15 minute rule If you are not asleep within 15 minutes of trying, get out of bed and go into another room In preparation for this – Leave the heating on Leave a light on Prepare a flask of a warm milky drink or a decaffeinated drink  

The 15 minute rule Only go back to bed when you feel sleepy again If you still cannot sleep, get out of bed again and repeat! You should follow these same rules if you waken up in the middle of the night for 15 minutes and cannot fall asleep You could read or listen to music, or do something else that is relaxing

Good luck and sleep well!