Insomnia and sleep hygiene

Dateline, Portland, Oregon—Amelia J. Wilcox, Ph.D.: If you struggle with insomnia, chances are good people have talked with you about sleep hygiene. While sleep hygiene principles are important, many people find it necessary to pursue sleep therapy, a treatment focused on clarifying thoughts and feelings related to troubled sleep patterns and insomnia, with accompanying exercises designed to put insomnia to rest.

If you have difficulty sleeping, you’ve probably been given the following advice by many people:

·         Go to bed and wake up at the same time every day

·         Don’t nap during the day

·         No caffeine-containing beverages or chocolate after 3:00 p.m.

·         No liquids at all after 7:00 p.m.

·         Remember that alcohol is a CNS depressant, and can cause middle of the night wakefulness when it wears off if you tend to drink more than you should

·         Have a bedtime ritual that signals your body it’s time to go to bed

·         If you can’t sleep, get out of bed and do something quiet in a dimly lit room

·         Bed is for sleep and sex only—no screens or books or work or studying

·         Make sure your bedroom is cool, dark and soothing—and that your mattress is comfortable

·         Exercise regularly—but not after work

These excellent suggestions come under the general heading of sleep hygiene. They are common sense and practical interventions anyone can use to manage periods of bad sleep. It makes sense, for example, to keep yourself from being awakened by your bladder if getting to sleep is difficult for you.

The suggestions are great, but they have a somewhat limited utility for people who have got themselves into a poor sleep pattern that has gone on for a while. Often times that sleep pattern comes along with thoughts, feelings and behaviors that worsen bedtime anxiety and decrease the likelihood of sleep, no matter how closely sleep hygiene principles are followed.

If this is the case for you, it can be helpful to work with a psychologist who is skilled in cognitive behavioral interventions for sleep. That person will work with you to sort out nature of your relationship to sleep—what you are thinking about it, the triggers for those thoughts and how you respond both behaviorally and emotionally as a result. You will be given exercises to use, including exercises designed to tease out the above chains of thought and feeling, and exercises designed to help you short circuit those patterns and relax into sleep again.