How Stress Can Get You Stuck in an Insomnia Spiral, and How to Break Free
The occasional sleepless night is a near-universal human experience. Often, sleep disruption begins with a significant stressor, which leads to heightened physiological arousal and can affect your body’s circadian rhythms. In high-stress times, you may have slipped between the sheets and found yourself suddenly wide awake. Perhaps your mind then traveled to worrying, to-do listing, planning for a major upcoming event at work or school, or replaying an embarrassing moment from your past. Sound relatable?
Generally, the body naturally adjusts to acute sleep disturbance, with healthy sleeping patterns resuming as your body’s appetite for sleep builds. However, if you’ve been experiencing at least 3 months of significant sleep disruption, occurring at least 3 nights per week, you may meet criteria for Insomnia.
What Maintains Insomnia
Factors that interfere with the body’s natural recovery from sleep disruption and perpetuate insomnia include:
Behavior changes meant to cope with acute insomnia. When not sleeping well, it is intuitive to want to “grab” sleep wherever possible, including by spending more time in bed, napping during the day, and varying your bedtime and wake time. Unfortunately, these seemingly logical strategies can train your body to associate going to bed with wakefulness instead of sleepiness and can lead to less restorative sleep over time.
Thinking patterns. Insomnia can pull for emotionally loaded thoughts. For instance, you might worry that you’ll be stuck with insomnia forever, or that your insomnia will seriously impair your functioning at work/school or in other important parts of life. Buying into provocative thoughts like these also increases your body’s physiological arousal and can interfere with sleep.
Sleep urgency. When suffering with insomnia, it is natural to want to find relief NOW – of course you do! However, the pressure to sleep well on any given night can raise anxiety, which makes it harder to fall asleep and stay asleep.
How to Break Out of the Insomnia Cycle: Cognitive Behavioral Therapy for Insomnia (CBTi)
Cognitive Behavioral Therapy for Insomnia (CBTi) is a brief (~ 6 session) intervention and has been recommended by the American College of Physicians as the first-line treatment for Insomnia. CBTi is a structured and evidence-based therapeutic approach designed to address the behavioral, cognitive, and other factors that maintain insomnia. CBTi empowers individuals to take control of their sleep by identifying and modifying habits that are no longer working for them.
Initial Sleep Assessment:
Clients will first complete a comprehensive assessment to rule out potential comorbid disorders and confirm their diagnosis of insomnia.
Logging Sleep:
Clients will learn how to complete a brief daily sleep log, which is used to customize their treatment plan.
Sleep Restriction and/or Stimulus Control:
Two core behavioral strategies are the heart of CBTi: sleep restriction and stimulus control. Clients may use one or both. Sleep restriction focuses on initially limiting time spent in bed to the amount of sleep an individual can produce, which helps consolidate fragmented sleep. Over time, the allotted time in bed gradually increases as the individual’s sleep becomes more efficient. Stimulus control works to re-establish the connection between the bedroom and restful sleep. This involves creating a conducive sleep environment by eliminating stimulating activities from the bedroom and associating the bed primarily with sleep.
Changing Negative Thought Patterns:
Another core aspect of CBTi is addressing negative thought patterns that contribute to insomnia. Through CBTi, therapists work with clients to challenge and reframe these negative thoughts, promoting a more positive and relaxed mindset around bedtime.
Additional Interventions:
The CBTi provider will draw from additional optional techniques to meet each unique client’s needs. For instance, to counteract the physical and mental tension that often accompanies insomnia, various relaxation techniques may be used. These may include deep breathing exercises, progressive muscle relaxation, or guided imagery, all aimed at promoting a state of calm conducive to sleep.
CBTi offers a tailored and sustainable approach to re-establishing healthy sleep patterns.
CBTi can empower you with effective coping strategies to address the factors that maintain insomnia, and help you get back to a more energized life.