4 ways to overcome the sleep anxiety of insomnia : NPR

Clinical psychologist Steve Orma was in his early 40s when he developed insomnia – difficulty falling or staying asleep.

He couldn’t stop focusing on it. “I started to get into the mindset that most people get caught up in. I was worrying, ‘What’s going on? Is there something wrong with me?” he said.

This fear of not being able to sleep is a phenomenon called “sleep anxiety,” says Orma, who has become a specialist in treating insomnia. If left untreated, this anxiety can prevent people from falling asleep.

“The more you focus on it, the less likely you are to sleep, which then makes you more anxious. It’s the cycle that goes around,” he says.

One of the most powerful ways to overcome sleep anxiety is cognitive behavioral therapy for insomnia (CBT-I). It is well studied, does not rely on sleeping pills, and has been shown to be effective for clinical insomnia. Orma used this treatment to treat her sleep, and it is now the main focus of her therapeutic practice.

Typically, a CBT-I program lasts about six to eight weeks, and each week you and a provider work on a strategy to reset sleep behaviors and restructure your thinking around rest.

But it is not necessary to be enrolled in an official program to benefit from CBT-I. Whether you’re dealing with some sleep-related stress or just occasional nights of rest, these CBT-I practices can help.

Wake up at the same time every day

Having a consistent wake-up time helps your body know when it’s time to go to sleep, says Aric Prather, sleep scientist and author of The sleep prescription: 7 days to get your best rest. Sleepy signals are managed by your circadian rhythm, or your body’s internal clock. A set wake-up time keeps your internal clock on time.

Prather uses the analogy of a “sleep ball.” When you wake up, your sleep ball is empty. Your balloon fills with sleepiness throughout the day. Once full, you feel ready to sleep. Waking up at the same time every day, even on weekends, keeps your sleep signals consistent.

Focus on relaxing time, not bedtime

Instead of trying to force yourself to go to bed at a specific time, even if you’re not sleepy, focus on go to bed earlier, says Dr. Ravi Aysola, director of the Sleep Disorders Center at the University of California, Los Angeles.

Choose a time to transition from daytime activities to nighttime activities. This might include unplugging screens, putting on comfortable clothes, and dimming the lights in your home.

He says that having a wind-down hour instead of a strict bedtime can help alleviate the feeling that you need to fall asleep immediately — and can reduce the anxiety that can arise when you don’t.

Plan your “worry time”

If all your stress floods in at bedtime, schedule dedicated “worry time” on your calendar during the day, says Prather. “Use your brain space when you are more rested to worry.”

That way, if your brain starts drifting toward tax season, childcare issues, or that big mess in the garage while you’re in bed, “you have a way of saying, ‘I’ve done this to myself before by worrying,'” he says.

Try taking just 10 or 15 minutes at the same time each day to write down what’s bothering you. This can help your brain relax when your head hits the pillow, says Prather.

Be Mindful When Tracking Sleep

Managing sleep anxiety also means being aware of how much information you absorb about your sleep.

The prevalence of sleep tracking devices and wearable devices has led to the advent of orthosomnia, a type of insomnia developed by anxiety related to the desire to obtain perfect sleep data, Aysola explains.

Sleep trackers can give you useful information about how you slept, but it’s important to have a good level of skepticism when it comes to the data and a plan for what you’ll do with it, he adds.

If you use these devices to track your sleep, ask yourself: “Is this information helping you change your behavior or lifestyle, or is it stressing you out and making insomnia worse?”

If you notice that you wake up feeling more refreshed, for example, that might be a sign that your new wind-down time and earlier morning wake-up call is starting to work for you.

If you tend to focus on your sleep tracking data, try tracking your sleep with pen and paper instead. It can help you focus on the quality of your sleep feeling to you instead of numbers.

Reshaping your sleep habits is only half the battle, says Orma. The rest of the work is about changing your mindset. Sleep varies from night to night and everyone has a bad night’s sleep from time to time, so adjust your expectations accordingly.

“When you have this mindset, your sleep starts to improve,” he says.

The digital story was edited by Malaka Gharib, with art direction by Beck Harlan. We would love to hear from you. Leave us a voicemail at 202-216-9823 or email us at LifeKit@npr.org.

Listen to Life Kit on Apple Podcasts And Spotifyand sign up for our newsletter. Follow us on Instagram: @nprlifekit.