Sleep disruption is associated with daytime fatigue, poor concentration, irritability, and inefficiency. Understanding the causes behind sleep-related issues and ways to manage sleep can help. This post discusses the factors that cause and maintain sleep problems and psychological approaches for managing sleep.
What Causes and Maintains Sleep Problems?
Some contributing factors that can cause sleep-related problems include changes and transitions in a persons life such as moving house, starting a new job, financial issues, or having a baby. The accumulation of such potentially stressful factors can alter the quality and quantity of sleep.
Some behaviours can also maintain sleep problems such as taking naps during the day, going to bed when not sleepy, using screens in bed (e.g. TV, phone) or working in bed. These actions keep the mind and body active, and reduce the possibility of a restful sleep.
Practical strategies to improve sleep:
Declutter your bedroom.
Put lavender spray on your pillow.
Avoid caffeine after lunchtime.
Try to go to bed at the same time every night, and wake up at the same time.
Don't drink alcohol before bed.
Have a night time routine one hour before going to bed that does not involve any screens or loud music.
Turn off all lights if this is comfortable for you. If not, use a nightlight that is not too bright.
Keep the bedroom quiet. Earplugs might also be helpful.
Keep the bedroom at a cool temperature.
Write a manageable to-do list for the next day so you are aware what you are doing when you wake up, but you don't feel overwhelmed by it.
Attending therapy sessions for sleep
If the above practical strategies do not work, and sleep problems continue, then it might be useful to attend therapy sessions to assist in improving your sleep. Below are some potential areas that can be covered in therapy sessions to help improve sleep.
According to the cognitive model of insomnia, sleep-problems are associated with worrying about poor sleep and its consequences. These concerns can result in emotional distress and arousal that can further interfere with sleep and daytime functioning. Cognitive restructuring attempts to manage this by focussing on intrusive assumptions about sleep. Cognitive restructuring involves three basic steps: identifying intrusive thoughts, challenging intrusive thoughts, and replacing intrusive thoughts with positive and realistic thoughts.
Intrusive thoughts can have a significant impact on sleep. They can serve as a self-fulfilling prophecy and maintain sleep issues. Sleep-related instrusive thoughts might include, “I won’t be able to sleep tonight”, “I can’t sleep until I take a sleeping pill”, “If I don’t get to sleep by 11pm I won't be able to function tomorrow”.
Challenging intrusive thoughts and replacing them with more realistic ones can be difficult but can potentially contribute to improved sleep. Practicing positive self-affirmations can help with this process, but it is not easy to replace well-established patterns of thinking. Therefore, this approach will take time, patience, and consistency.
According to the metacognitive model of insomnia, sleep can be improved throughout the development of mindfulness and acceptance skills. These approaches can help reduce arousal and improve natural sleep.
An approach, known as “paradoxical intention”, involves accepting that intrusive thoughts and reduced sleep are currently part of your night time routine. This intention can reduce the anxiety and frustration from trying to fall asleep, and thereby improving the chances of being able to rest.
Visualisation involves imagining a peaceful and relaxing place such as sitting by the ocean or in the mountains and noticing sensory details such as sounds, textures and colours. Practicing visualisation before sleeping might improve relaxation and sleep.
Another technique is guided visualisation in which a script is listened to and mental images are imagined.
For more information about attending therapy sessions for managing sleep, please contact Belfast Psychology Services at firstname.lastname@example.org.