The very best tips for insomnia
This is the handout which I give my clients who come to me for help with sleeping. Outside of treatment for actual medical syndromes, these tips constitute just about all the practical advice known to the human race about getting a good night’s sleep. Although there is an enormous amount of research into sleep, very little has come out of it beyond these tips, plus the fact that therapy can be extremely helpful. You can spend a lot of money on books about sleep, and look at all sorts of medical websites, but they will tell you no more advice than this.
If your sleeplessness is only caused by poor "sleep hyigene", then these tips are all you need. While many are only commonsense, they work well. Very often however, insomnia results from a self-feeding pattern of worry about sleep, or an ingrained unconscious mental habit. Further, it is often a symptom of stress, depression or anxiety. In all these cases, hypnotherapy is the ideal method for banishing insomnia and restoring sweet restful sleep.
In my sessions I work on a far deeper level than these tips. The medical profession recommends CBT (cognitive behavioural therapy) for sleep. Like other hypnotherapists, I believe that hypnotherapy for sleep covers everything useful that CBT covers, plus much more. CBT only deals with the rational, logical everyday mind, and it just is not the case that that is where problems originate from. It is the routine experience of hypnotherapists that when we talk to people in a normal conversational mode, as CBT therapists do, then the problem appears to be one thing. But when we invite people into hypnosis, it is revealed to be something quite different. I get a lot of clients with insomnia, and in my experience, hypnotherapy is highly effective.
How to get a good night’s sleep
Always check any physical symptom, including insomnia, with your GP. You can make a responsible and informed choice about whether to accept any drugs which are offered: but always go and check.
You don't need to do all of these tips! Different ones apply to different people. Pick the two or three which seem relevant.
- Remember, you can't make yourself sleep. Sleep comes naturally. So don't get into bed cudgelling yourself to sleep. Lie there and enjoy relaxing. If you do the "counting sheep" or "Betty Erickson" exercises below then do them in a spirit of enjoyment, not effortful striving.
- It's useful to keep diary for a week or so, recording how much you sleep and noting your daily routine, to pinpoint relevant factors.
- Go to bed when you are feeling sleepy, not before.
- Cut out caffeine completely in tea, coffee, and cola. For a couple of weeks, have none of these drinks at all. Even a cup of tea at breakfast can affect sleep. Once sleep is better, cautiously start to drink these early in the day. Chocolate may well be OK – but start by cutting that out too. Anyway, I reckon you can't beat Horlicks at bedtime!
- Do not smoke before bedtime. No matter what it feels like, nicotine is a stimulant. It disturbs sleep and can cause nightmares.
- Eat a carbohydrate snack (not sugary) around 45 minutes before bedtime. A banana and milk is ideal. Make sure your last big meal is at least two hours before bedtime, preferably also carbohydrate based.
- Don’t eat too late. Try moving your evening meal back earlier in the day. Especially if you are over 45 - 50, indigestion can be a significant source of insomnia. As we age we have fewer digestive enzymes and heavy food such as steak or even fish can sit in the intestines and not digest. It is well worth making a trial of eating very early, or only light food such as fruit, in the evening for a couple of weeks.
- Do not have naps during the day. (Exception - if driving or otherwise important for safety.) Don’t get into the habit of a siesta during the day.
- Consider food intolerances. This is a big area, and I am not an expert, but I have known people who got much better sleep when certain foods were excluded from their diet.
- Consider a late-night drink of valerian tea. Valerian is soporific. (Note many other herb teas are diuretic and may increase needing to get up in the night to pee.) You can also try chamomile and passion flower.
- A good many people who think they have "insomnia" actually have their body clock (circadian rhythm) running early or late. Teenagers and young adults can notoriously be semi-nocturnal, and don’t feel sleepy until 1:00 am. This also affects shiftworkers, and others. Research proves that it helps a lot it they are exposed to bright light, either bright sunlight or from a light box or bank of bright lights, from 6 – 7 am each day. Likewise elderly people may feel sleepy as early as 6 pm. They can be helped by bright light in the early afternoon. The light re-sets the circadian rhythm.
The light needs to be bright, say 10,000 lux for 30 mins early in the morning. This is the brightness of morning sunlight. Normal indoor lighting may be as low as 70 lux.
The procedure is simple - you sit near a portable bank of fluorescent lights. You can read, watch TV, eat or work on the computeras long as the light bank is big enough that you can move around a little. See here for links to research, instructions, and suppliers.
- If you can't sleep, do not toss and turn. DO NOT TOSS AND TURN! When you can't sleep for long enough that it begins to disturb you (say 15 minutes), get out of bed, ideally go to another room, and do something restful (such as self-hypnosis or listening to music or reading) until you clearly feel sleepy. Then return to bed. Don’t do productive work – this sets a habit in the mind, “it’s useful not to sleep, I get some work done.” There is some research from the Sleep Research Laboratory at Loughborough University that jigsaw puzzles or craftwork are the perfect things to do, but reading is also excellent.
- For many people, sleep consolidation can be very useful.
1. Get up at the same time every day, including weekends and don't lie in bed more than 15 minutes after you wake up.
2. Don't nap unless mission-critical, eg while driving
3. Go to bed later than usual, so that you are tired. If you have been sleeping for example around six hours on previous nights, then you go to bed six hours before your getting-up time. However, you should schedule a minimum of five hours between going to bed and getting up. The idea is that you get the same amount of sleep as on a normal sleepless night, but in a block. Over a couple of weeks, the sleep mechanism gets reset. Once you start to sleep more soundly, you can go to bed 15 minutes earlier each night. [People's estimate of how long they are awake for in the night is extremely unreliable, so in practice this really means "go to bed a couple of hours later."]
- The extreme version of sleep consolidation is "if you can't sleep, don't sleep." This is the method favoured by the Sleep Research Laboratory at Loughborough University. It starts of with the earlier advice, don't toss and turn. However, the Loughborough team applies this very rigourously - if you go back to bed and still don't sleep, once again, get up and read or do jigsaws , even if you are still doing them an hour before the alarm goes off. In tests, people who did this were sleepy the next day - PERHAPS TOO SLEEPY TO DRIVE SAFELY - but the following night, they slept very well. For safety reasons, such as driving, I advise caution with this method. You may wish to check with your doctor first.
In general, "less sleep promotes more sleep", and this is an excellent and proven method. However, it will not help where there is an underlying cause such a trauma, depression, stress or anxiety. In my experience, many people with difficulty sleeping are just too afraid of not being able to function the next day to even attempt "heroic" treatments such as this. And the good news is that hypnotherapy, combined with the less dramatic advice on this page, in my experience provides a gentler alternative which is just as effective.
- Do not exercise in the hours immediately before sleep, but do get vigorous aerobic exercise during the day, at least three hours before bedtime. Ideally, get half an hour per day in the later afternoon / early evening. (Exercise heats up the body, but a decrease in body temperature is one of the signals that brings sleep.) It’s simple – the more exhausted you are, the better you sleep.
- Have a bath. In one study, a hot bath was more effective for some people than sleeping pills.
- Consider filling your bedroom with lavender fragrance. Research has shown that this too can also work better than sleeping pills for some people. An electric aromatherapy vaporiser is safer and simpler than a candle-based aroma lamp, and lavender essential oil may be cheaper over the internet. Place a half-dozen drops of oil on a little water in the vaporiser a few minutes before you go to sleep, and again if you wake up. You should know within a week or so whether this helps you.
- Don’t work or do active things right up to bedtime. Wind down before going to bed. Have a relaxing everyday ritual – a bath, reading or listening to music. Do this every night after switching off the TV.
- Stress and emotional factors have huge impact on sleep. Most often, insomnia is a symptom of something mental or emotional, not an isolated thing on its own. There is evidence that following advice such as in this handout, and changing how you think about your situation, is better than at least one specific sleeping pill which was studied (Ambien / Zolpidem). So deal with stress.
- If necessary, learn relaxation or self-hypnosis. Or, listen to a relaxation CD. Some people like to stretch for ten minutes before getting into bed. You can do relaxation / self hypnosis either earlier on in the evening, or in bed. In that case, some people like to do it lying down as part of sleeping, others prefer to sit up and do the exercise until they feel sleepy.
- Listen to soft music of your choice for 45 minutes before sleep. Research in the Journal of Advanced Nursing Study reports that this can improve sleep by up to a third.
- If your mind is full before bedtime, write down a worry list each evening. List - actually write down - each and every thing which is on your mind, and then tell yourself there’s nothing you can do until the morning. It is OK to sleep!!! - you will sove the problems better if you sleep, and right now, there is nothing you can do about the,
- If you are a shift worker, then if all else fails, seriously consider finding a way to work days again. Shift work is bad for sleep.
- Make sure your bedroom is dark, cool, and quiet enough. These all promote sleep. Have thick curtains which keep the morning light out.
- Turn your alarm clock round so you can’t see the face if you wake up. Knowing the time makes you anxious about sleeping.
- In bed, only sleep and make love – do nothing else. If you really must read, read sitting up. You want the clearest possible association: lying down in bed equals sleep and nothing else.
- An optional exception to the “if you don’t sleep, don’t work” rule is that you can make a deal with yourself that if you are not asleep in a certain time, you will get up and do some job you totally hate, such as dusting or deep-cleaning the kitchen. But it has to be a job you hate, and you have to keep your commitment. This is not popular, but it works.
- Counting sheep works! Just don’t do it while tossing and turning. Either do it as soon as you put your head on the pillow, or, if you have once started to toss and turn, then sit up in bed to do it. Or count backwards from 5000. Imagine each number in detail and then let it fade away. Choose to remain focused on the exercise. Don’t lie down until you feel sleepy; if you don’t, get up and read until you do.
- Another variant on counting sheep is "Betty Erickson self-hypnosis." You imagine yourself in a calm, peaceful place you would like to be and you tell yourself five things you can see in that place, five things you can hear, five things you can feel or touch; then four things you can see, four things you can hear, four things you can feel or touch; then three of each; then tw0 .... zzzzz. (On a practical note, it's OK if you hear or see the same thing over and over, eg ... I can hear the sea ... and I can hear the sea ... and I can hear the sea. Just don't repeat it by rote, actually check each time what you imagine hearing and if you discover it is the same as last time, fine.)
Some people like the quiet peaceful place ot be their own bedroom, and the imagine what they would see and feel and hear if the lights were on.
- Some people find the following effective: instead of striving to sleep, vividly imagine that it is time to get up. Bring to mind that feeling of being dragged out of bed, the hateful noise of the alarm clock, calculating how often you can push the “snooze” button and still get out of the house on time, the groggy pre-coffee feeling, cold floors and bathrooms. Vividly imagine how those feel like, look like, sound like, smell like – how awful it is to have to get up. Some people find that they next thing they know – the alarm really is ringing.
- And finally - what about that joking quotation from the top of the page - "People who say they sleep like a baby generaaly don't have one?" Even here, there is hope. There is persuasive research that both parents and children sleep better when young children sleep in their parents' bed or bedroom - and the children grow up healthier and happier. See the insomnia links on the resources page for details.
If you would like to take the first step to heal your insomnia and have a good night's sleep with the aid of hypnotherapy, then just give me a ring. Call any time of the day or night - if it's 3:00am, call right now! - leave a message, and I'll call you back. Andrew White 0845-3510604 / 0117-968-7307. I'm happy to answer questions or arrange, in Bristol or Taunton, a free, no-obligation half-hour initial meeting. My approach is friendly, respectful, and very effective.
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People who say they sleep like a baby usually don't have one.
Anon
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