by Chayim Newman, M.A.
“Time, motion and wine cause sleep.” -Ovid
In keeping with my last blog entry on self-care, I thought we’d direct our focus this month on sleep-related issues. According to data from the National Sleep Foundation, since 1999, over 50% of adults in the USA report one or more symptoms of insomnia several nights each week. Rates of sleep apnea have risen significantly, often linked to the increase in obesity. Other sleep disorders such as restless leg syndrome or narcolepsy affect smaller but significant portions of the population. As a society, we sleep quite poorly, and our emotional and psychological lives, our relationships and our performance throughout the days suffer because of it. Monster energy drinks and double espressos are a poor form of problem-focused coping.
Elaborating a little more on insomnia – the difficulty initiating or maintaining sleep – this most prevalent sleep disorder tends to be subdivided into three forms. Early insomnia is characterized by difficulty getting to sleep. Those who suffer from early insomnia often lay in bed or toss-and-turn for hours before finally falling asleep. Middle insomnia consists of awakening in the middle of the night and not being able to fall back asleep for a lengthy period of time. Late insomnia manifests as waking up an hour or more prior to the anticipated time and being unable to fall back asleep. Those who suffer from chronic insomnia often experience intense and debilitating fatigue during the day, walking around almost in a haze.
So what can individuals do, cognitively and behaviorally, to alleviate some of their sleep issues? Well, for starters, as we always espouse in REBT, work can be done to cultivate an attitude of acceptance rather than demanding that the sleep issues resolve immediately or awfulizing and self-downing about one’s struggles. Thus, at least the problem isn’t further exacerbated by worry or frustration.
Behaviorally, my recommendation is to start with a sleep diary, charting sleep and waking times, nap times, exercise and daily consumption of large meals, alcohol, tobacco, and caffeine. Sleep restriction – eliminating naps during the day – helps the body to sleep better at night. This can be very difficult at first for already-sleep-deprived individuals, but ultimately leads to a healthier night’s sleep.
Stimulus control interventions include following a consistent regimen of a nightly bedtime, setting up the conditions of the sleeping environment to be most conducive to sleep (adequate darkness and quiet, optimal temperature), and beginning to use the bedroom only for sleep, if possible, rather than for TV watching, reading, or doing work, thus creating a mental association between the bedroom and sleep. If struggling with insomnia, leave the bedroom and engage in an activity until more tired and ready to return to sleep. Daily rigorous exercise is linked to better sleep at night, though care should be taken not to exercise within a few hours of bedtime. And, of course, large meals, alcohol, tobacco, and caffeine should not be consumed close to bedtime.
Lastly, additional cognitive therapy (using REBT of course!!) can address underlying worries and anxious thoughts that may be contributing to poor sleep patterns. Following Ovid’s advice, if we learn to discipline our relationship with time, to remain active and productive during the days, and to moderate our wine intake, along with some good rational-emotive work, a better night’s sleep may be just around the corner. Now if you’ll excuse me, it’s my bedtime…