Is the way you think or behave around sleep making things worse?
How people think and behave around sleep change once they develop sleep problems. If you think about good sleepers you know, it’s likely they think about sleep very differently to someone who doesn’t sleep well. They probably also behave differently around sleep, not respecting any of the sleep ‘rules’ but still sleeping well. This change in thinking and behaviour around sleep can be one of the factors that perpetuates sleep problems.
How people think about sleep and pain has a major impact on how they sleep. In fact, changed thinking about sleep can perpetuate poor sleep even when pain and other medical conditions are well controlled. People can find that they develop an anxiety about sleep itself. Fortunately, this changed thinking about sleep responds well to cognitive and behavioural therapy. Some key points to thinking better about sleep are:
1. Stop trying too hard. When people are sleeping poorly, they begin to analyse everything we are doing to try to work out what we can change to improve sleep. This leads to constantly monitoring sleep throughout the night to see whether the changes that have been made are having an effect. People also put pressure on themselves throughout the night with thoughts like “I need to get to sleep in the next 30 minutes to ensure I get at least 6 hours sleep which is the minimum I need to function tomorrow”. Thoughts like these increase the pressure on sleep and make it more elusive. A better approach is to replace these thoughts with rational thoughts based on facts that are known about sleep like “I trust that my body will get the sleep it needs.”
2. Don’t put all your eggs in the sleep basket. What I mean by this, is don’t see better sleep as the only way to improve how you feel during the day. Too often I see people who say things like “if only I could sleep better, my pain would be tolerable and I’d be able to get on with life.” Whilst good sleep is important, there are lots of other factors that impact on pain. Seeing sleep as the key puts too much pressure on sleep and increases anxiety about sleep, as well as meaning people don’t focus enough on other important factors.
Do you spend too much time in bed?
Once people begin to sleep poorly, their behaviour around sleep changes. Often in an attempt to get more sleep they go to bed earlier or stay in bed later, sleeping in, allowing more time for sleep. Other things people do is begin to more and more carefully control their sleep environment, blacking out windows, sleeping with earplugs and at times becoming quite obsessive about getting everything ‘just right’ for sleep. But all of these behaviours actually exacerbate the problem as people end up spending longer and longer in their carefully controlled bedrooms getting more and more frustrated when sleep doesn’t come. Some simple strategies to implement to change behaviour around sleep are:
1. Match the amount of time in bed to how much sleep you are actually getting. This can be quite a drastic change to behaviour but is one of the most powerful strategies to get sleep working better. Keep a record for a week of how much sleep you get on average each night, and the next week make that amount of time plus 30 minutes the maximum amount of time you spend in bed each night. I usually make the minimum 6 hours, so if you are sleeping 5.5 hours or less, keep your time in bed at 6 hours.
2. Use the bed for sleeping, not rest. Particularly when people have pain, they feel the need to rest and lay down. But this shouldn’t be on the sleeping bed as resting on bed will build up an association between being awake and being in bed. Better to rest on a couch or on a bed in another room that is not the place where you usually sleep.
3. Don’t try to too carefully control the sleep environment. As long as our bedroom is reasonably dark and quiet, further measures to ensure absolute darkness and silence tend to increase the expectation around sleep and paradoxically make sleep worse.
Need more information about how you can sleep better?
At Sleephub we understand the struggle people endure with sleeping problems which is why we have created a comprehensive FAQs page with information for those seeking information about sleep disorders and potential solutions.