While evidence continues to pile up that sleep is the very backbone of mental health, few of the many Americans who are having trouble getting proper shut-eye choose to try sleep therapy. We're sadly encouraged to boast about how busy we are or how little sleep we're getting in a "do-more" culture. Combine busy schedules with caffeine, blue LEDs, ambient city noise, and a host of other maladaptive environmental factors and it's no surprise that one in three adults is apparently failing to get even seven hours of sleep.((CDC:
1 in 3 adults don’t get enough sleep)) Economically, one study estimates that inadequate sleep costs the U.S. $411 billion annually.((Rand:
Sleep Report)) More importantly, under sleeping puts our health in jeopardy. Your immune system, memory, microbiome, emotional calibration, and rational-decision making all rely on good night's sleep for proper functioning. In one shocking study, surgeons made 20% more errors when they'd under-slept when compared to their well-rested counterparts.((The Lancet:
Sleep Deprived Versus Rested Surgeons)) Many people turn to sleeping pills to find some respite for their sleep ailments, but the problem with pills is that they simply sedate the cortex without providing natural biological rest. In other words, medications don't necessarily improve the quality of sleep, just the amount of time you spend unconscious. Just as alcohol can make you drowsy while actually destroying your valuable REM periods of sleep, pills should not be your go-to either when it comes to finding more snooze time.
Why Is Sleep so Important?
"The decimation of sleep throughout industrialized nations is having a catastrophic impact on our health, our life expectancy, our safety, our productivity, and the education of our children." - Matthew Walker, Why We Sleep
The importance of sleep is often overlooked in our busy modern lives. Yet the very fact that evolution couldn't design an organism without it (even bacteria follow a circadian rhythm of activity) should tell us how important sleep is for our wellbeing. Sleep has been shown to make us more creative, happier, more attractive, slimmer, less anxious, and more resistant to disease. Furthermore, it lowers the risk of heart attacks, enhances memory, and allows us to live longer. (For a full analysis of the scientifically-proven health benefits, I recommend reading
Why We Sleep, written recently by a top neuroscientist sleep researcher.) Given our increasing understanding of the importance of sleep, it's no surprise that sports teams, like Manchester United, have started hiring "sleep coaches" specifically to ensure that their players get the best night's sleep possible. These coaches travel around with the team and ensure that air quality, lighting, mattress firmness, and a variety of other factors are optimized to ensure the best night's sleep possible. Sleep can not only give professional athletes a big edge over their competitors, but it can also give you a whole lot more mental clarity throughout the day. So if you're waking up feeling groggy, generally lethargic throughout the day, or just not receiving those crucial eight hours of shut-eye, here are a few therapeutic solutions you might consider.
The Antidote
Luckily, there are effective sleep therapy techniques that can help even the most restless sleepers get more shuteye.
1. Cognitive Behavior Therapy for Insomnia (CBTI)
The most widely-used method of sleep therapy is CBT, which has been shown effective in many patients after 5 to 8 weeks of treatment. CBT addresses negative thought and behavioral patterns. If you're tossing and turning in the sheets, it's often a mental pattern, such as excessive stress or anxiety that's contributing to the sleep problem. In short, the CBT method involves identifying negative thoughts and beliefs, challenging them, and establishing a more helpful way of thinking. For example, many people who have traditionally had problems getting to sleep begin worrying and catastrophizing about their inability to get to sleep, which compounds the problem in a snowball effect. CBT allows patients to break out of this harmful routine and create a better relationship with their own mind. This method is often more specifically applied to insomnia in what's called Cognitive Behavior Therapy for Insomnia (CBTI). You can read more about this method,
here.
2. Sleep Restriction Therapy (SRT)
The goal of this therapy is to limit the overall amount of time that the patient spent in bed not sleeping, creating a stronger association between bedtime and actual sleep. Developed by legendary psychologist Arthur Spielman, SRT follows a strict schedule for gradually increasing the amount of time you're allowed in bed. You begin with the amount of time actually spent sleeping each night on average. Let's say you go to bed at 10pm and wake up at 7am but only sleep for five hours. You'd start with 6 hours of allowed rest, going to bed at 11pm and waking up at 5am, for example. You then gradually add sleep in 15 minute or half hour increments each week until you're sleeping a healthy amount. There are several variations on this procedure and you might consult a sleep doctor or therapist for more detail. SRT has been shown to be the most effective sleep hygiene technique.((Kaiser Permanente:
Sleep Restriction Therapy)) The downside, of course, is that it's not a quick fix. It does take weeks of diligence to recondition your sleep schedule and see results.
3. Meditation/Yoga Nidra
Meditation can also be used as a form of sleep therapy. Mindfulness, a state of mind achieved through meditation, has been defined by Jon Kabat-Zinn, a molecular biologist who created Mindfulness-Based Stress Reduction (MBSR), as,((Front Behav Neurosci.:
Into the Moment))
"the awareness that arises through paying attention on purpose in the present moment non-judgmentally."
By learning to experience one's thoughts, emotions, and sensations closely without judging them, meditators can calm down and prepare their minds for sleep. Mindfulness meditation allows individuals to shine a light into their inner mental programs in what's called introspective metacognitive awareness. In doing so, you're able to form a better relationship with your thoughts, ease anxiety and alleviate a host of other mental turmoil that may be preventing sleep. There's a specific method of Vedic meditation called Yoga Nidra that is an excellent way to slip into sleep.((Yoga International:
5 Benefits of Yoga Nidra)) The practice involves breathing deeply, setting an intention, rotating one's awareness around the body (which tires out the somatomotor regions of the brain, which process sensory information, and then often counting backward. The practice may also include visualizations, depending on the particular set of instructions. Yoga Nidra has been practiced for thousands of years and is effective at shutting off the "narrating mind," the voice in your head that won't keep quiet when you're trying to get to sleep. Especially in the early stages of doing Yoga Nidra, it's helpful to listen to a teacher or guided audio recording. Here's an example of Yoga Nidra: https://www.youtube.com/watch?v=v9chHovre6Q
4. Hypnosis
Hypnotic techniques put patients into a relaxed and suggestible state wherein their thoughts and beliefs can readily become "reprogrammed." For those unable to change their harmful negative thought loops using CBT, they may find hypnosis a suitable alternative. The hypnotherapist employs subtle suggestions to "relax," "let go," and other trigger words. While your brain's rational CEO in the neocortex is largely responsible for rumination and other thought patterns that might be keeping you awake, hypnosis allows the hypnotherapist to permeate your subconscious mind and plant code there that will help you fall asleep quicker.
5. Breathing Exercises
Breathing directly affects your autonomic nervous system, which in turn influences your mental activity. Sometimes, trouble getting to sleep is associated with an over-active "fight or flight" sympathy nervous system, and breathing is a quick way to put the breaks on this mechanism. There are several aspects of the breath that influence your mind-body system. Here are 3 important aspects of a calming breath that can immediately influence how your mental state:
- Breathe smoothly: The opposite of this would be a jerky, staccato breath. Rather, you'd like there to be a constant flow of air entering and leaving your lungs between pauses.
- Breathe rhythmically: What's important here is that your breath has a consistent ratio of inhale to exhale. To further calm yourself, you might try exhaling for longer than the inhale in a fixed ratio of say 4:6. Four seconds of inhalation, followed by 6 seconds of exhalation. When practicing, it can help to use a metronome to find a rhythm at first (free phone apps are available).
- Breathe into your belly: So-called "belly breathing" uses your full diaphragm and ensures that you're using your lungs as they are designed. If you'd like to see proper diaphragmatic breathing just watch how a baby breathes naturally.
All three aspects of breath work to activate the "rest and digest" parasympathetic nervous system, calming down your body and mind.
Bonus Sleep Tips
You also might consider these sleep hygiene strategies to improve your sleep, which include:
- Going to bed and wake up at the same time every day
- Making your room as dark as possible and relatively cool in temperature
- Avoiding your bed unless you're sleeping
- Not eating or exercising right before bed
- Taking a hot shower before bed
- Getting sun exposure in the morning
- Journaling your thoughts before bed or reading fiction
- Avoiding naps after 3pm
- Avoiding alcohol, tobacco, caffeine, and other drugs
- Dimming house lights and shutting off electronic screens two hours before bedtime, or at the least use a blue light filter like f.lux
- Bonus: using a white noise machine if you live in a noisy neighborhood
If problems persist after implementing these changes, it might be worth contacting a professional sleep physician or specialist to improve your sleep.
The Bottom Line
Sleep is not just a "hack," it's a necessity. While people spend billions on supplements, exercise machines, and diet books, there's a free area of great improvement that would benefit many. In my opinion, if there's one aspect of our lives we don't pay enough attention to, it's the whole third of our lives (if you're getting enough of it!) spent slumbering on the pillow. After reading this article, you have all the tools you need to optimize your sleep and, in doing so, potentially transform the quality of your waking hours.
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