Do you ever experience a night of “bad sleep,” find yourself tossing and turning, becoming more frustrated, agitated and restless as time continues to pass? You are actively trying to fall asleep, but your body seemingly won’t let that happen. Though difficulty falling asleep is common from time to time, when it becomes a chronic difficulty, insomnia and its effects can be extremely distressing.
Sleep health is influenced by a variety of factors, including: the consistency of your sleep schedule, your bedtime routine, your sleep environment, lifestyle choices that affect the body’s ability to relax, and mental health factors like stress, anxiety, and mood.
Part I of this series addressed behavioral interventions to improve sleep. Part II will identify common sleep-related thoughts that might be keeping you awake, and discuss some ways that cognitive-behavioral therapy can help you change your relationship with those thoughts to get better sleep.
Distressing thoughts typically match the tone and intensity of your emotions. If you are experiencing anxiety about difficulty falling asleep, your thoughts might reflect the intensity of the anxiety by being rigid and extreme in nature. For example, thinking “Because I am having trouble sleeping tonight, I am going to have trouble every night!” Thoughts like this are not necessarily true, and likely do not reflect reality. These kinds of thoughts are considered cognitive distortions. There are two ways to address these thoughts: by identifying and challenging the cognitive distortions, and through meditation techniques that ground you in the present moment.
Here are some common cognitive distortions that contribute to difficulty with falling asleep:
Jumping to Conclusions occurs when you use information about a current situation to predict what the future will hold. Oftentimes, “jumping to conclusions” entails making predictions that are rigid and extreme (i.e. distorted), and match the tone (i.e. negative) and intensity (i.e. acute) of your emotions at the time you are making the prediction. For example, “I’m having trouble sleeping tonight, so now I won’t be productive at all tomorrow!”
Should/Must Statements imply that there are rules or expectations about how our body is to function, which have not been met, and therefore elicit within us feelings of frustration and anxiety. Some “should/must statements” about sleep include: “I should be asleep by now,” “I must be asleep by a certain time to have a good day tomorrow,” and “I should be able to fall back asleep quickly after waking up.”
All or Nothing Thinking involves drawing extreme conclusions about a situation, without leaving space for ambiguity or alternative explanations. Thinking “I won’t get any sleep tonight,” after having difficulty falling asleep for longer than 20 minutes is an example.
Having difficulty falling asleep can be stressful, but actually, getting stuck in these cognitive distortions tends to make everything feel worse. In our work here at CTWPS, we can help you identify thoughts and beliefs that may be leading to sleepless nights. We will also teach you how to employ cognitive restructuring so that you can shift negative thoughts and beliefs to be more balanced and less emotionally activating. For example, if you are making the prediction that you cannot be productive at work the next day if you have not had a restful night’s sleep, we can work together to challenge that thought by paying attention to past instances of a poor night’s sleep. We would collect data about how you felt the following day, and your ability to cope. We might come to a conclusion, for example, that “Having a poor night of sleep does make me feel less alert and energized the next day, but based on past experience, I am still able to complete my tasks and make it through my day.” By restructuring this thought, we acknowledge the truth that you might feel more tired during the day, while also recognizing that you can still be productive. This prediction about the future is now grounded in evidence from past experience, and does not activate the same intensity of anxiety as the previous prediction.
In addition to cognitive restructuring, mindfulness meditation practices can also be helpful to focus thoughts on the present moment, limiting the opportunity for jumping to (distorted) conclusions. Getting into the practice of listening to a guided meditation focusing on the pace of your breathing, or creating an image of a safe and relaxing place, can allow your body’s nervous system to calm down, your emotional intensity to decrease, and your thoughts to match the feelings of relaxation that you are experiencing in your body. Even if you are still awake, your experience of being awake will feel less stressful and more relaxing, increasing the probability that it will be easier for you to fall asleep.
If you are experiencing difficulties with sleep, and are interested in improving your sleep health through behavioral and/or cognitive interventions, please reach out to us and we will be happy to help you feel better and well-rested!