The following is a question-and-answer session that may prove helpful in your journey toward better sleep. I try to address some of the most baffling aspects of chronic insomnia that tend to make us all a little crazy. Let’s see where it leads…
What is the ultimate cure for insomnia?
The ultimate cure depends on the ultimate cause of insomnia, and this could be any number of things. However, insomnia has some strange configurations, such as:
- It may start from one cause (such as jet lag, pregnancy, stress or back pain) and then end up with an entirely new one (such as sleep anxiety).
- Some causes are simply unknown.
- Insomnia may have multiple causes some known, some unknown.
The bottom line is, because sleep anxiety is such a common second cause of insomnia, and because it has a tendency to worsen, magnify, obscure, interfere with and otherwise complicate all other causes, this site mainly focuses on this issue.
With that in mind, the ultimate cure for insomnia caused by sleep anxiety is to stop being anxious about not sleeping.
Now let the paradox begin!!!
Why is the cure for insomnia caused by sleep anxiety so difficult?
Well, it isn’t really. It is just our impatience with the process and our frustration over how long it takes that makes it seem so very hard.
The cure is simple enough—to convince ourselves over a period of time that once we stop worrying about sleep, we will sleep better—so there is no point in continuing to worry about sleep! Yes, it is a tricky little puzzle, a funny little brain teaser.
But there is an indisputable logic behind it that the brain DOES understand and WILL accept if you only give it the opportunity, the encouragement, the motivation, the support and the time to do so. This is what CBT is for.
Why doesn’t simply telling ourselves to stop worrying ever work?
The brain has built-in anxiety and fear mechanism for a very compelling reason—survival. If all we had to do to stop feeling afraid is to tell ourselves—“hey, it’s nothing, quit being such a sissy”—if it were really that easy to calm ourselves and erase all worrying thoughts—sure, we’d be nice and mellow all the time, but we might also be dead. So even though it is a huge pain sometimes, you might as well respect your fear factor, because the intention behind it is certainly positive.
Now obviously in our plush and civilized lifestyles, this anxiety response tends to overstate its case 99 percent of the time… but that still does not mean we can talk ourselves out of it with a snap of the finger and a few magic words. Doesn’t work that way and never will, so why keep beating ourselves up? Just move on to what might actually help us.
So how do we stop worrying about sleep?
We use logic and reassuring self-talk to take away the motivation to worry. Once our brains fully understand that it is self-destructive and pointless, they begin to let go of the compelling habit. But the understanding process is not quick. It takes a long time for this habit to change completely. However, gradual and incremental improvement can start sooner.
Why is worrying so addictive?
Well, that’s a tough one! I’m guessing it has something to do with what I said previously about worrying being tied to the fear response and therefore survival instinct.
But I think there is another reason. People who suffer from sleep anxiety sometimes have a problem identifying their worrying thoughts. Some don’t have very many conscious thoughts about sleep, but most are so convinced that their thoughts are reflecting absolute truth that they don’t consider them subjective or something that they can change. When you believe your worries reflect an accurate reality, they are harder to change.
How does the brain change its sleep anxiety habits or addictions?
The only way I know about is through CBT, which feeds it a consistent daily stream of rational, reasonable, reassuring, encouraging thoughts to “answer back” to the worrying thoughts in a type of inner dialogue I describe in this article.
This sounds like a tedious process, and it is. There is usually no flashes of insight, no sudden enlightenment, no light bulb going off.
It is, in fact, similar to many other forms of learning, where first a new concept is introduced. Then it is repeated enough times to become familiar and understandable. And then finally, it turns into something we know so well, so deeply, that we don’t have to work at it anymore. It becomes second nature.
Sometimes, as with all learning, the process can be enhanced and helped along through other techniques such as hypnosis and relaxation, techniques that help break down some resistance to new knowledge. But if this doesn’t work for you, CBT alone is fine.
How do you deal with the panic about not getting enough sleep, an essential human requirement?
First you need to understand a few points about sleep deprivation:
- Mild sleep deprivation is not harmful and many people safely go through months and even years getting less than optimal sleep and retain both health and sanity. Parents of young children, night-workers, medical interns and many others do OK with less than normal sleep.
- More severe sleep deprivation does have some health consequences, but they are not usually terrible ones. The human body is designed to weather long periods of little sleep without serious or permanent damage. One problem is the increased possibility of accidents caused by impaired alertness. This is something you really need to watch out for, especially if you have others in your care. Those in dangerous jobs need to be more proactive in seeking remedies for moderate-to-severe insomnia. But in general, the condition is not dangerous by itself.
- Prolonged severe sleep deprivation, meaning many nights in a row of very little to no sleep, should be considered a health problem and should be medically treated. Even so, people can recover very quickly once they start getting decent sleep through whatever means possible.
So in essence, there is no reason to panic about not getting enough sleep. Stay away from news reports about sleep deprivation, continue to practice CBT to address your panic, acknowledge the fact that the panic is an overreaction to the problem at hand, understand that the problem of poor sleep will be much easier to solve once you have treated your anxiety about it… and you will get through it. Perhaps not today or tomorrow, but soon enough.
Why is it important to have lots of options?
Knowing that we have lots of options to treat our insomnia is a calming, rational, true thought that can give us relief from the anxiety that is making everything worse. Options include: medication, visits to sleep clinics, CBT, diet changes, relaxation techniques, exercise programs, breathing exercises, hypnosis, self-hypnosis, psychological counseling, yoga, earplugs, home insulation, air purification, job change, life changes, treatments for underlying problems–such as sleep apnea, menopausal hot flashes, chronic pain, allergies, chronic anxiety, circadian rhythm disturbance, PTSD–and much more. Lots of options means you can approach the problem in a creative problem-solving state of mind.
What is the ultimate purpose of CBT exercises?
The ultimate purpose of CBT is to create a habit of calming, rational, reassuring inner dialogues that help you deal with anxiety. Since having anxious thoughts is already a habit, we simply add another habit—that of answering back to them—so we can maintain a more balanced, philosophical, open-minded and creative way of thinking. The goal of CBT is not necessarily to eliminate all anxious thoughts, as that would be, for many of us, impossible. But it can offer great improvement.
Why is it important to understand that CBT is not mandatory?
While CBT is helpful, it is not something to become obsessively concerned about. This would obviously cancel out its benefits. If you don’t feel like doing it for a while, just stop. If you think it is in any way causing you to feel worse, than stop. You can always start up again. The point is, you are the one in charge. This is the first step to successful self-therapy.
Why does it take so long to change the brain’s concepts about sleep anxiety?
This is the great mystery. No one knows why insomnia comes on so quickly but takes so long to go away. Why is it so easy to develop a habit based on fear, worry or anxiety… but so hard to break it using rational self talk? This may just be the way our brains are wired, and we need to accept it and work with it. If anyone has any better ideas, I would certainly like to hear them!