How do we influence our sleep?
Many people experiencing insomnia, before seeking help, try their own ways and ideas to improve the quality of their sleep. As we mentioned in our previous articles, sometimes people resort to the following methods: widening the sleep window – i.e. going to bed earlier, waiting for sleep to come, and staying in bed longer to catch up on sleep debt; drinking coffee or tea during the day (and alcohol in the evening) for better sleep; reading in bed or watching TV; having naps during the day; watching the clock at night to check how much time is left before it's time to get up; limiting activity after a sleepless night or taking over-the-counter medications.
What factors contribute to insomnia?
We also touched on three groups of underlying causes for insomnia. These are predisposing, precipitating and perpetuating factors. The first group includes genetic predisposition and personality traits. Those factors increase the propensity for agitation and anxiety in response to a wide range of situations, which affects sleep. Personality traits, in this case, include higher emotional reactivity, sensitivity, excessive worrying, dwelling on the past. Such people tend to be agitated and tense more often than others. If you have such predisposition and precipitating triggers occur, such as stressful life events, you may experience harder time in terms of sleep. This may be short-term insomnia, which is a very sound response to anxiety or nervousness. Once the trigger weakens or ceases, most of the time your sleep should return to normal. However, sometimes, short-term insomnia will transform into a chronic disorder. This is caused by perpetuating factors. Paradoxically, these are usually activities undertaken in good faith, aimed at improving sleep quality. They usually include watching TV in bed when we can’t sleep, drinking alcohol, spending more time in bed by going to sleep earlier and waiting for sleep to come, and catching up on sleep to eliminate sleep debt.
This strategy only makes your sleep problems worse: your sleep becomes shallower, you wake up in the middle of the night more often, and the bed-sleep link in your brain is weakened. The more you think about being unable to asleep and wait for the sleep to come, the more difficult it is to actually fall asleep. You start experiencing concerns and anxiety about the situation and its consequences, its adverse impacts on your performance and health, falling into a vicious cycle of negative thoughts, which makes you even more agitated, and this, in turn, aggravates your insomnia. The harder we try to influence it, the bigger the problem becomes.
Often our loved ones cannot understand what we are experiencing. They try to help saying “Just lie down and start thinking about sleep", "Try harder" or “Don't think about anything at all and you will fall asleep”, “Get tired before going to bed”, “Take it easy, just wait for the sleep to come”, etc. They mean well, they want to help, but all of this goes against the essence of insomnia: the more you focus on sleep and its related problems or activities that are supposed to make you fall asleep, the more counterproductive they become.
Healthy people fall sleep automatically. Unlike patients with insomnia who plan their sleep, they often think about it from the morning, afraid of what the upcoming night will bring. They cannot turn off the wakefulness that causes the body to be overstimulated, as we have already mentioned before. Attention and planning are processes associated with activity, wakefulness, but not with sleep. Proper sleep comes on its own, without any conscious effort. Insomnia is difficult for patients as when they try to improve their condition, they ultimately achieve the opposite effect. This can be – and indeed is – frustrating. Many people resort to drug-induced sleep because they feel increasingly helpless and desperate.
The most effective treatment for insomnia
Pharmacotherapy can be used to treat insomnia if the response to therapy is insufficient. This can also include two parallel processes. The recommended method of treating this disorder is cognitive-behavioral therapy. This is an effective, non-pharmacological method of treating mental disorders. Specialists also use it to treat depression, anxiety disorders and various types of phobias.
It is also successfully used for insomnia, as it focuses on removing the factors that cause the disease to linger on. This method has a clearly defined purpose, is structured and short-term in nature. It predominantly focuses on here and now, on the present, not the past. Using various therapeutic techniques, the psychotherapist can help overcome established habits, reactions, thoughts and behaviors in order to teach the patient new, desired reactions. Therapy effects are long-term. The effectiveness of cognitive-behavioral therapy has been confirmed in many studies, which have shown that patients who have undergone the treatment sleep much better, and experience less anxiety and fear.
