Hopefully this is all starting to make sense – it’s important to keep viewing the module 1 videos and really take the information in. It’s fine to be sceptical, especially when we have held certain beliefs for so long. Even when presented with the facts, it can be very difficult to swallow. At this point it’s important to do your own research so that you are comfortable with the changes in your ideas and beliefs. The more you truly understand and resonate with the science, the more likely you are to follow the strategies and get sleep back on track quicker. This will not be easy and you will not see results in seven days! It’s easy to feel quite euphoric and excited in anticipation of finally getting the sleep help you need, and this can often lead to a momentary break in insomnia with a few good night’s sleep without really trying. This is great, but it would be wrong to say that one session of this course has magically fixed you forever. Your usual habits will return if not dealt with correctly. So be prepared for the good times and the not so good in order to get that long-term, consistent sleep you have been waiting for.
Now that we have all the basics out the way, we need to talk about the practical strategies. Let’s start slow and easy and only add a few rules to your routine this session.
We need to weaken the association between the bedroom, waking activity and the frustrations of insomnia. After all, you have had many nights of little/poor sleep and, possibly, anxiety now; your brain is so smart it has registered this and is encouraging it, because it thinks that’s what you want! It’s creating a regular pattern. These rules will gradually replace these with positive associations between the bedroom and sleep.
- Use your bedroom for sleep only (sex and getting dressed/undressed is allowed!). This strengthens your brains association between the bedroom and sleep. Try not to watch TV, do emails, pay bills, make phone calls, text, exercise, iron, listen to music/radio, etc. in the bedroom. If possible, remove everything unrelated to sleep, such as the TV and computer, from the bedroom. Do not read in bed. It’s absolutely fine to read before you go to sleep, but do it outside the bedroom. If it helps, stick a note on your bedroom door which says, “Are you sleepy? No? Go away, then! This room is for sleepy people only!”
- The get out of bed if your not sleep rule. If you aren’t asleep after around 15 minutes, stop fighting it! After all, it doesn’t work, does it? Get up, go into another room, and engage in a fun activity until you feel sleepy. Have some ‘me’ time. Also, it doesn’t have to be 15 minutes – it could be when you know you’re not going back to sleep anytime soon. Do not clock watch. It’s important to do something you want to do – don’t try to bore yourself to sleep or wear yourself out. This doesn’t work! (have a look at the activities you might try document) Everyone is different and you need to evaluate what activities make you feel relaxed, and which ones actually wind you up even if other people swear by them. When you are sleepy (and only when you are sleepy), return to bed. If you are still awake after another 15 minutes or so (don’t clock watch! Just an approximate guess), repeat the above. If you wake up in the middle of the night and can’t get back to sleep, follow the same rules. This is not designed for you to suddenly feel amazingly sleepy – this rule is designed to break down the association between being awake and being in the bedroom.
This may seem wrong, and it can be difficult to follow for the first couple of nights. But the point is to reduce the time you spend awake in bed, fretting about sleep. In the long run, this will help strengthen the association between the bed and sleep. You should see this extra awake time as an opportunity to engage in fun times for you – what have you always wanted to do, but never get time to do? As long as it’s something you want to do and not something you need to do, you are on the right track. We are always saying there are never enough hours in the day – so make this time positive! Remember, if you spend this extra awake time sitting comfortably doing a fun activity, your body will be just as rested as if you are lying awake in bed – but you won’t be so anxious and annoyed at yourself and more likely to be distracted rather than thinking 100 thoughts an hour. Doing this tonight won’t make you sleep better tonight; it’s about sleeping better consistently in the long term. Let your body get used to it and don’t worry if you can’t stick to it all the time. It is a hard rule, but know that this is the other option to what you have been doing, an alternative evidence-based option. Also, when your sleep improves, there will be no need for this rule!
- You must wake up at the same time every day. Select the earliest time that you have to get up on most days, then set your alarm for that time and stick to it, seven days a week, no matter how well or badly you have slept. If you wake up earlier, that’s OK, you can get up – but no sleeping in! This isn’t forever and can be tweaked, but bear with me for now. The time you wake up in the morning dictates so many important processes that happen during the day – when you get hungry, when you feel happy, when you feel most alert, when you need to go to bed, etc. – that’s why, when we use the clock on the wall to dictate when we do things, we aren’t always syncing with what our bodies want. Our bodies are going by our wake time that morning as its guideline. This desynchrony encourages weight gain, sleep problems, mood problems – the list goes on. Also, as a happy byproduct of having a consistent wake time, once you get into a habit, you will actually feel refreshed on waking. You won’t want to lie in – you want to get up and not waste the day away! Wouldn’t that be fantastic?
- Do not nap. I know, you probably don’t feel like napping right now (chance would be a fine thing)! But the point of this course, in the first instance, is to get your sleep drive back – or, to put it another way, make you feel very sleepy at the right times to encourage healthy sleep. In order to do that, we must let it build up – the other rules will help with this. The problem is, people with sleep problems often fear this sleepiness. This is because we are taught that we shouldn’t feel sleepy and we need to get rid of it. So we go to bed early, nap and lie in. Then it’s gone, and you’re back to square one, and still with a sleep problem. This can be why you notice after a while you can have a good night’s sleep, but then it goes right back out of sorts again. You need to start looking at this differently. Once you start feeling this sleepiness – you need to remember that this is a very good thing. It means that the course is starting to work, that you have a healthy innate sleep drive just bursting to get out! Sleepiness is a positive thing, not a negative thing, and right now you need to use it to reset your sleep/wake cycle. You won’t feel like this forever, but for now you need to store it up like fuel, because you’re going to need this to get through the night.
Some techniques you can use to avoid napping:
- Use caffeine. If you know there is a particular period where you are likely to be sleepy, take your caffeine 30-60 minutes beforehand. Try to avoid caffeine after 3pm. Want to avoid caffeine? Try eating an apple instead – they can help us feel more awake!
- If you know there is a period where you are at high risk of falling asleep, schedule physical activities or interactive activities rather than passive activities. For example, go for a walk instead of watching TV.
- Ask your family to support you. If they see you falling asleep, ask them to wake you, talk to you etc.
- Bright light fresh air and physical exertion can be very effective at promoting wakefulness.
- Use chewing gum, which is proven to help to resist sleepiness.