1. Managing Insomnia

2. 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

3. 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

4. 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

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

6. 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

7. 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

8. 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?

9. 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’

10. 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

11. 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 

12. 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

13. 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

14. 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  

15. 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

16. Good luck and sleep well!