Cognitive Therapy

Techniques for re-establishing a good sleep cycle

Dr. David W. Sparks

There's an old saying that one should "think before speaking." That's because if you said whatever came to mind, whenever you think it…you would undoubtedly say a lot of things you don't really mean, and hurt the feelings of people around you.

That's why it's always better to send a letter…or e-mail to someone you're upset with…a day after the event or conversation takes place that gets you upset. You always feel better in the morning…and the thoughts and emotions in that letter or e-mail might turn out to be a little harsh.

It's the old "sleep on it" maxim. Now, what does this have to do with cognitive therapy? Cognitive Therapy is a way of approaching a problem in a scientific manner. In this case, taking a look at your particular sleep situation in an objective, analytical way. By studying your unique situation, as a researcher would, it's a way to getting into the nitty-gritty of what's truly going on in your life that may be keeping you from fully relaxing and getting to sleep.

A big problem for a lot of people is dealing with frustration or racing thoughts—and so they cannot relax.If that sounds like you, here's a cognitive approach:

• When you go to bed, do not try too hard to fallasleep• State to yourself that “sleep will come when it is ready,” andthat “relaxing is just as important as sleep.”
•  Try to keep your eyesopen in the darkened room and as they naturally start to close, tellyourself to “resist that just for another few seconds.” This is reallythe reverse psychology of sleep. It worked for Mary Poppins. (Rememberwhen she sung to her young charges, telling them not to sleep! Theycould not keep their eyes open!).
• Try to visualize a pleasing scene (atechnique known as image replacement therapy) or run through somerelaxation exercises in your head, ignoring irrelevant ideas andthoughts. But take your mind off of sleeping.

Now, it seems counterproductive to talk about restricting sleep when you suffer from sleep deprivation! However, this cognitive approach is about limiting the amount of time in bed to the actual time you spend sleeping. Sometimes, lying awake in bed fretting about not getting to sleep only exacerbates the problem, increasing anxiety and prohibiting sleep. Therefore, in sleep restriction therapy, a person is encouraged to get out of bed if sleep is not possible.

There are many ways to go about this. For example, if you estimate that out of eight hours in bed each night, the total hours you sleep are five, then set your alarm to go off five hours after bedtime. Find out if it is true. If you are not asleep in 20-minutes at the start of this exercise, then get out of bed until you feel sleepy and then return to start the process again, setting the alarm for five hours later. If you're awake at the end of five hours, then get out of bed and start your day.

Once you convince yourself to sleep about 90% of the time spent in bed for five consecutive days (at five hours, for example), then increase the amount of time spent in bed by small amounts. Behavior modification stimulus control of this nature is intended to establish a connection between the bed, bedtime and rapid sleep onset.

Another method is to truly restrict sleep until it comes naturally for a full night. Start by allowing yourself only a few hours of sleep a night. Mild sleep deprivation makes it easier to fall asleep. Each night, add a few minutes to the sleep schedule until the treatment goal is reached. The idea behind this treatment strategy is to turn time in bed into sleeping time. Our bodies are amazing computers, you just need to know the right kind of programming!

Remember, everyone needs to unwind. How you do it depends on what works for you. It is simply not healthy to go full bore through the day and then expect to fall into a state of bliss when your head meets the pillow. It won’t happen, period. You can fight it and face the predictable consequences of burn out and daytime fatigue, or you can set a schedule to follow each evening, and with the help of your family and friends, learn to respect the message your body is desperately sending out.

Here are some important reminders of how to do it:Determine to wind down during the second half of the evening. As we've learned, your body requires rest as well as sleep. If you have children, use the time after they have gone to bed to relax.

Set a work/activity deadline for 90-minutes before your bedtime. That means finish up paying bills, doing your taxes, helping with homework and doing chores around the house. The last 90-minutes of the day should be for relaxing, either alone or with the one you love.

Practice a relaxation technique before getting into bed. Concentrate on your breathing. Tense and relax the muscle groups, concentrating on the arms, neck, and shoulders. Don’t get into bed unless you're sleepy. Go back to reading or any other relaxing activity until you're ready to sleep.

The art of relaxation is a multi-million dollar industry that also includes techniques such as hypnosis, biofeedback (using a machine to help relax muscles), yoga, meditation classes and psychotherapy.Whatever method you choose to relax, the important point is that you do relax. Use a Sleep Journal to write some thoughts about what would work best for you in this category. You might want to list some experiences or frustrations in trying the breathing and focusing exercises in this chapter. Remember to give it time. There's no magic pill, although Americans spend $1.1 billion dollars a year trying to find one. You're always better off not using drugs, if possible.

Experts say that most visits to doctors are related to stress and stress-based problems. That's a pretty strong statement, isn't it? NBC, in a recent survey, found that three out of four people in America experience heightened stress every week; some health insurance records found that one out of three working women has taken a day off from work for stress-related reasons.

Some of the more common results of stress are hair loss, memory loss, high blood pressure, asthma, headaches, diabetes, depression, obesity, heart disease, and lots of insomnia.

And, there's not just good, but great news about stress. Stress can be kept at low, manageable levels depending upon the way that individuals deal with it.

To repeat the advice given by so many health professionals, the first way to deal with stress is to relax. Remove yourself from the immediacy of your own life and figure out which elements in your life cause stress. Take an analytical approach and resolve your emotions with reason. Some people find that keeping a diary helps them document the problem areas and in so doing, releases tension. You can find more information about this approach on our web site.

Talk is always good, as long as it's with the right person…meaning someone who honestly cares. Experts say that a supportive friend or spouse can make all the difference in coping with stress. When you talk about stress you're releasing tension verbally rather than physically. Other people also have the benefit of perspective-they're outside of your situation and can help you see beyond the stress in a more objective way.

There's guided imagery, relaxation therapy, professional therapy, dietary adjustments, inclusion of an exercise regimen. The one thing that you MUST do is address the problem if you have it.

In a few weeks we will be opening up a premium section in our web site entitled Actions Steps for Better Sleep and A Healthier Life. These steps incorporate some simple behavioral modification techniques to help solve your problems with insomnia along with some positive steps that you can take toward improving your wellness. We have some wonderful suggestions for diet and exercise. Think of this program as an "easy boot camp where you learn to go to war against insomnia". By the way, you can get this program for free with your purchase of one of my audiobooks entitled "Better Sleep in 7 Days".

Make sure you sign up in the Action Steps section and I will send you a sample of both the first day of Actions Steps for Better Sleep and A Healthier Life and Day 1 of The Better Sleep in 7 Days audiobook. We value your privacy and will not pass along your email address to anyone.

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