Relaxation for insomnia
Relaxation has been practised for many years, with meditative forms of Hindu yoga dating back over 5000 years. Over time, the types of relaxation have changed and more recently methods used include guided imagery, passive body focusing and variations of mindfulness. Devices have also been used such as with biofeedback. Although the methods of relaxation have changed over time, the aim and effects of relaxation have changed little over time. Research suggests that in insomnia an active mind, is more important than physical arousal, so the mental calmness that accompanies well-practised relaxation can be a helpful tool in managing insomnia.
Does relaxation for insomnia work?
Whilst there are few studies suggesting that relaxation by itself works for insomnia, it can be an important part of an overall strategy for managing insomnia. Relaxation is one of the five core components of cognitive and behavioural therapy directed towards insomnia, with relaxation tending to be more effective for difficulties getting sleep rather than difficulties staying asleep. Nonetheless, even for people who have trouble staying asleep, practising and honing relaxation skills that can be used across the day to reduce stress and anxiety are an important skill.
As a stand-alone technique, studies have shown that relaxation produces improvement in sleep quality ratings, as well as shortening the time taken to get to sleep and the amount of time spent awake during sleep. However, studies that included relaxation as part of an overall management strategy such as cognitive behavioural therapy or a multicomponent treatment have produced better results compared to relaxation alone. Given this research, I’ll rarely use relaxation on its own as a treatment for insomnia, but do see it as an important part of an overall strategy.
What type of relaxation works best?
It doesn’t matter what type of relaxation method is used and there has been little research to differentiate the effectiveness of varying styles of relaxation. The most important aspect is regular practice and honing of the skill of relaxation. This often takes scheduling practice into the day rather than doing it when and if the time arises.
Although the type of relaxation is not particularly important, when relaxation is practiced is important. If people have been having trouble with sleep, often they aim to relax prior to retiring to bed. However, it may be very hard to relax on getting into bed, particularly if there is a lot of sleep-related anxiety. Given this, practising relaxation during the day is the best for developing the skills of relaxation. They should be done at a low-stress time, in a quiet environment and in a comfortable position.
Types of relaxation that have been used include:
Passive relaxation procedure: This has a number of components: a relaxed attitude, slow deep breathing, passive body focusing and autogenic phrases. The entire relaxation process takes around 10 minutes. An example of this form of relaxation is obtaining a relaxed attitude then taking five deep breaths, holding each for five seconds and softly saying “relaxed as” with each exhalation. Then focus on a body part such as starting with the arms then face then trunk then legs, dwelling on each part for around 45 seconds and seeking out relaxing feelings in each body part. At the end of relaxation you can then focus on sensations of heaviness and warmth in the arms and legs.
Progressive muscular relaxation: teaches you how to relax your muscles through a two step process. First you systematically tense particular muscle groups in your body, such as your neck and shoulders. Next, you release the tension and notice how your muscles feel when you relax them. An example of a progressive muscular relaxation technique can be found here.
Meditation techniques: are also forms of relaxation. This can take a number of forms, such as sitting or laying down, however active movement such as some forms of yoga can also be meditative. Mindfulness-based meditation has been used to help with insomnia. As well as helping with relaxation and reducing anxiety, mindfulness helps deal with some of the emotions that can accompany sleep disturbance. Click here to listen to an interview with Dr Giselle Withers (Psychologist) on how mindfulness can help sleep.
Visualisation: generally involves resting quietly in a peaceful environment, then visualising a peaceful scene in nature. Some examples of guided visualisation practices can be found in these audio files.
Biofeedback: is a specific form of relaxation treatment that differs from other treatments because it actually provides feedback either mechanically or with computers and amplifiers to help people learn now to control physiological parameters such as finger temperature or muscle tension to reduce cognitive arousal. Like other forms of relaxation, biofeedback works best when used as part of an overall strategy with a range of components. An example of a device that we have used in people with insomnia is the HeartMath emWave 2 device.
Give relaxation a try
If you’re having trouble sleeping, developing the skill of relaxation is an important tool to help reduce the worry an anxiety that can come with disturbed sleep. So give it a try. This collection of relaxation recordings from Western Sydney University are a great starting point
Related posts & links:
- Relaxation audio recordings – Western Sydney University
- Relaxation techniques – Mayo Clinic
- Cognitive behavioural therapy for insomnia
- Using mindfulness to help sleep – Video
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