In my last post, I talked about the resurgence of insomnia for many during this Covid19 Pandemic, and some simple steps to get your sleep back on track. I discussed the role of your sleep drive, your circadian rhythm, and touched on a really important element in sleep called “hyperarousal.” Arousal can be physical, emotional, and cognitive. Basically, arousal (all happening in your brain) is what can keep you up at night.
Three Types of Hyperarousal
Physiological Arousal
Heart racing or pounding, sweating, breathing quickly. Imagine if you just ran up 10 flights of stairs then jumped right into bed. Your heart would be pounding. You would be sweating and out of breath. How likely is sleep to occur in this state? Not likely. Physiological arousal can also be mild – almost not noticeable. But it’s this “alert” state that your body is in. Your body can actually become conditioned (or trained) to becoming “alert” in the bed. Cognitive Behavioral Therapy for Insomnia can help with this.
Emotional Arousal
Imagine just as you climbed into bed, you received news that your significant other was being unfaithful to you. Or, you just found out that your best friend was diagnosed with cancer. You would be emotionally upset and distressed (angry, scared, sad ,etc). How likely would you be to lie down and fall asleep? Not likely.
Cognitive Arousal
This is when your bran is thinking thinking thinking. A great example of cognitive arousal would be worry. Cognitive arousal can be related to stuff in your life like thinking about the big presentation or test that you have the next day. Cognitive arousal can also be about sleep. If you’ve struggled to sleep, then it makes sense that your brain is going to start worrying about sleep. What if I don’t sleep? I have to get some sleep or else tomorrow will be awful! I’m going to feel so tired. I’ll be in a terrible mood. I’m going to make mistakes at work. Oh my gosh what time is it? How long have I been lying here? I HAVE to get to sleep!
Why do we care?
Well, in most cases, what we think (or interpret) about what is happening, has a direct role in our emotions, and what we do. What we say to ourselves, impacts how we feel. If we just allow our brain to run wild without either a) checking those thoughts for accuracy or b) acknolweding them as just thoughts and nothing more – then we get hooked into the downward spiral of anxiety, frustration or whatever emotion arises from the chaos your brain has cooked up for you.
Here’s a quick example:
Situation: Lying in bed and can’t sleep –> Thought: What time is it? Why is this happening to me? I hate this. I have so much to do tomorrow. How much time do I have left to sleep? If only I could fall asleep.. Emotion: Anxious. Frustrated. –> Behavior: Try harder to sleep / Check clock / Take sleeping medication
Situation: Thinking about sister’s job and possibility of being laid off –> Thought: What will she do if she gets laid off? How will she pay her bills? What if I have to help support her? What if she can’t find a job? What if the entire economy tanks and she is jobless and has to live in a homeless shelter? Emotion: Anxious. Worried. Sad. –> Behavior: Continue worrying / thinking about the what ifs
STRATEGIES THAT DO NOT WORK:
Suppressing Thoughts.
Seriously. If thought suppression worked, none of us would be in this mess would we? We could just, stop thinking about what we want to stop thinking about. Yet, for some reason, we keep trying this tactic over and over again. Let’s try it together. Ready? Okay. Don’t think about a white bear. Now close your eyes for 30 seconds and don’t allow yourself to think about the white bear.
Did you not think about the… white bear? And, how do you know you aren’t thinking about the white bear? You have to say to yourself “oh good, I’m not thinking about the… ah dang it. White bear.” In fact, research shows that the harder we try not to think about something, the MORE difficult it becomes to not think about it!
So, any thoughts you have had recently that you have been trying to not think about? #coronavirus
Trying Harder – Increasing Sleep Effort
Surprise Surprise. Trying harder to fall asleep, doesn’t work either. And like the above, we just keep trying it don’t we? Funny, how we tend to rely on the same old worn out useless strategies. Our brains like to do what they’ve always done, and it takes effort to try new stuff.
What does help?
First, there is no magic way to shut down your brain, but with practice, we can essentially learn to “rewire” some of our brain’s automatic responses or re-direct them when they go into autopilot.
Problems / Solutions List
Believe it or not, the middle of the night is actually not the best time to try to solve life’s problems. You’re just not your emotional best at 2am. If you have a brain that likes to try to figure out your problems at night, do yourself a favor and do this prior to getting in bed.
Get a piece of paper out and draw two columns. On the left hand side write “Problems” and on the right hand side write “Solutions.” Write down one of the problems that you currently have in life. Then, on the solutions side, write down the next logical step to fixing that problem. Because problems can be big and complex, just write down the most immediate and concrete next step that you can do. If you figure out how to resolve the problem completely, then go ahead and write that down. If you’re not sure what you need to do but you know that you need to ask someone for help, write THAT down! If you decide after thinking about it that there is no way to solve this problem right now no matter how much you think about it, write THAT down too! Remind yourself that it doesn’t mean it’s hopeless, it just means that dedicating more mental energy to the problem right now is not going to help resolve anything.
At night, when you’re lying in bed and your brain naturally wanders to that problem, remind yourself that in your best state of mind you have already come up with the next logical step and it’s on that piece of paper so you don’t have to continue thinking about it. Kindly redirect your brain to something else (your breath, the feeling of the pillow beneath your head, the story line from the book you were reading earlier, etc).
Know Thy Thoughts
Are you aware of what kinds of thoughts will likely swirl around in your head at night? If I asked you – what are the top 5 concerns your brain is going to bring up tonight, could you list them out? If so, then you should list them out, just not at night. Find a time during the day to write down your brain’s top 5 concerns likely to show up at night. Then, take some time to address these, from a logical and helpful perspective.
Example: Brain is likely to say “What if you only get a couple hours of sleep tonight? It’s going to be awful. You can’t handle this.
- Thanks Mind : The problem with thoughts is not that we’re having them, but that we’re taking them super seriously. Rather than buying into the thought and getting sucked into the story, you can simple say to yourself thanks mind for that thought and move on. When your brain returns to that thought, again, thanks mind for that thought. This stops the process of “why am I think this? Oh no! What if it is true?” Thanks mind……… It’s as if your mind is that unhelpful neighbor who just has to comment on everything. But you take their opinion with a grain of salt. You can do the same for your own mind. You don’t have to be bossed around by it.
- Challenge your beliefs. Sometimes it is helpful to engage with your thoughts and challenge their validity. Can you challenge the validity of It’s going to be awful. Really? Is this the only way to see the situation? Are there any other perspectives you could take on this? Can you think of evidence against your thought? How is this thought helping you? How is holding on to this thought serving you? What would happen if you could let it go? Same for the thought, You can’t handle this. Really? You can’t handle this? Have you handled it before? Did anything catastrophic happen? Are there other perspectives you could take on this? What’s a better and believable thought that could take its place? You might start saying to yourself “Sure, tomorrow I might not feel great but I’ve had nights like this before. I’m always okay. Nothing terrible happens. I’ve had awful days even when slept great. The quality of my day doesn’t always depend on my sleep I can’t control this anyway, and getting some rest is better than none. It will be okay.”
Get out of bed
If you have tried all these strategies but you’re still lying in bed wound up and anxious, the best next thing you can do is to get out of the bed. The longer you spend in bed upset, anxious, and frustrated, the more you are training your body to expect anxiety and wakefulness to occur in the bed. This is not an association that we want! We want your bed to be associated with sleep and relaxation. So, one of the quickest ways to stop the brain from worrying in bed is to get OUT of the bed and go do something else for awhile. I know it’s hard to pry your body from the warm comfort of your bed, but continuing to do what you’ve always done is not helping your cause. Find a nice warm place on the couch. Read a good book. Work on a puzzle. Listen to a podcast. Then, when sleepy and calm, return to bed and try again.
These strategies take practice and consistency. Changing your thoughts and automatic responses requires effort. With time, you will notice a difference. Remind yourself that under stressful times, it’s normal for the brain to be more “wired.” You’re not alone. If you need help working on these, feel free to reach out.
Kathryn Tipton has passion for sleep and wants to help you return to sleeping through the night. She uses Cognitive Behavioral Therapy for Insomnia (CBT-I), a non-pharmacological treatment to help clients gain control over their insomnia and improve the quality of their sleep. She is a Licensed Professional Counselor with a Masters degree in Clinical Psychology. Her private practice is located in central Houston, in the Montrose district. Additionally, she conducts sessions online/via ZOOM or Facetime with clients from the comfort of their own home or office.