As most doctors will tell you, there are two things that disturb sleep: physical pain and worry.
It's therefore understandable that many people with anxiety report frequent sleep disturbance as a major problem.
Not being able to sleep can actually be quite traumatic for many people.
The first thing you need to understand about sleep is this: it's not the amount of sleep you get that's important, but rather the quality of the sleep.
Quality over quantity.
I am going to give you some quick tips to help tackle any problems you are having with sleep. Firstly, to break the insomnia cycle, begin by not presuming you will sleep! That seems like the wrong attitude, but if you approach each night as just a possible opportunity to sleep, this helps remove the pressure you are placing yourself under.
In a way, some people have performance anxiety when they think about sleeping:
"Will I be able to make myself sleep tonight?"
The answer is maybe yes, maybe no. If you're going through a period of sleeplessness, a good night's sleep isn't guaranteed, for whatever reason, so you have to accept that for the moment. If you get one or two hours' sleep, that's well and good, and if you get nothing, then accept it and move on. Each night, as you retire, say to yourself:
"I'm preparing for bed, but I won't try to force sleep. If it comes, it comes. If not, I won't beat myself up over it. This is a period I'm going through, but I'll soon return to normal sleep patterns."
Every person goes through periods of sleeplessness from time to time. It's very natural. You may not be aware of why you experience sleeplessness, but at the very least, you can accept it.
Let me emphasize the importance of surrendering to your inability to sleep. Surrender to whatever may or may not happen during the course of a night, and you'll put your mind under less pressure. After a certain point, it's really the anger and frustration that keep you awake most of the night.
Naturally the best way to get a good night's sleep is a good physical workout each evening in the outdoors. This is very effective because the mind may try to keep you awake, but the sheer physical exhaustion brings on sleep quicker. Couple that with a willingness to accept sleeplessness, and you'll find yourself sleeping much easier.
Remember that alcohol, caffeine, and nicotine should be avoided several hours before sleep. You may be the type who finds it initially hard to get to sleep as your mind races with anxious thoughts. Should you find your mind racing and you simply can't achieve sleep, keep a journal beside your bed. Sit upright and start to write down how you feel:
"I'm feeling quite restless. I keep turning over and over, trying to sleep, but I have worries on my mind." Now write down all of your worries, for example:
"Tomorrow I have to do X, and I'm afraid I won't be well rested, etc."
Continue to write down your worries until the exercise actually becomes quite boring. Then your body and mind will slowly want to return to sleep. Writing like this is a simple tool for preparing your mind in a linear way to wind down and return to sleep (an advanced form of counting sheep).
Don't be afraid of writing pages and pages of nothing in particular. What you're doing is helping the conscious mind release whatever is keeping it awake so it can stop obsessing and return to sleep.
You see, one of the reasons we can't fall asleep is that our mind feels these worries (whatever they are) are important to analyze over and over; they need urgent attention and therefore should be thought about all night long.
The more worked up you get by the worries, the more your body gets stimulated and the harder sleep is to achieve. Writing down all your worries on paper has the effect of saying to your mind:
"Okay, mind, you think these are important. I've written them all down in detail. They won't be forgotten, I promise. I can come back to them tomorrow and deal with them then-but RIGHT NOW, let's sleep."
The mind can be like a small child who just needs reassurance that things will be dealt with and looked after. That's all it needs to let go of these mental worries. You then discover, in the morning, that almost all of the worries or concerns aren't big issues. Many of our worries are the workings or an overactive imagination.
Dr. Dennis Gersten of San Diego suggests an approach that is effective for particularly restless nights. You may want to experiment with it the next time you are very restless in bed.
Try the following:
-As you lie there in bed, start by remembering a time in your life when you absolutely had to stay awake! Maybe it was an important exam you were studying for and you had to keep cramming through the night.
Maybe it was staying up all night nursing your baby to sleep. Maybe it was when you were traveling through the night on a bus and needed to stay awake in case you missed your stop.
I am sure there have been many different occasions in your life where you had to force yourself to stay awake.
-Remember the weariness and the effort just to keep your eyes open. Remember how your eyelids felt like lead weights and you wished you could close them, even just for a minute. At that time, you could not give in to your urge to fall asleep; you had to fight hard to stay awake. Relive those memories and really try and remember exactly what that felt like.
-Now think about right now, and how good it feels to actually be in bed with no pressing need to stay awake. Think how much you would have given to be where you are now, lying in your bed with your head resting on the pillow and the complete freedom you have to fall asleep. It feels really good to actually have full permission to fall asleep right now.
There are no demands on you to stay awake. With your eyes closed spend a few more minutes remembering that time.
-End of exercise.
Night Panic Attacks
People with anxiety disorders can sometimes be awakened at night by panic attacks. We know that most nighttime panic attacks aren't caused by dreams. Records of sleep polysomnographia show that most panic attacks take place during the early sleep phase (phase II), not during the REM phase associated with dreams. This is different from nightmares. Nightmares happen during the second half of the night, so we're often able to remember the content of these dreams.
It's important not to go to bed fearing you might have a panic attack. Go to bed confident that if one should arise, you'll successfully deal with it. That way, you don't put yourself under pressure to NOT have a panic attack. Many panic attacks are experienced at the very moment of falling asleep.
If you wake with a panic attack, implement the One Move Technique as outlined in my course Panic Away. (See end of email)
Here's a description a woman recently gave of her experience:
"Getting to sleep is a real problem. Just as I'm about to drop off to sleep, my body seems to jolt awake, like an electric shock, which then frightens me and keeps me awake for hours."
This jolt is called a hypnic jerk, or hypnagogic massive jerk. A hypnic jerk usually occurs just as the person enters sleep. People often describe it as a falling sensation or an electric shock, and it's a completely normal experience. It's most common when we're sleeping uncomfortably or overtired.
There's been little research on the subject, but there are some theories as to why hypnic jerks occur. When we drift off into sleep, the body undergoes changes in temperature, breathing, and muscle relaxation. The hypnic jerk may be a result of the muscles relaxing. The brain misinterprets this as a sign of falling, and it signals our limbs to wake up, hence the jerking legs or arms.
People turn hypnic jerks into panic attacks because they already feel nervous about their condition and the jolt scares them into thinking something bad is happening. Again, it's a fearful reaction to a sensation.
Usually when these people wake up, they gasp for air, and this can also turn into a fear of a breathing problem while sleeping. If you jolt awake with panic, then simply understanding the nature of a hypnic jerk can strip away the anxiety from the experience.
Reassure yourself that you're safe and that the jerk isn't something to worry about. It doesn't disrupt your bodily functions, and it doesn't put you in any danger.
That concludes the Anxiety Mini Series.
I hope you have been able to take something from it. I want to leave you with a few last comments. All too often people with anxiety are pressurized to end their anxiety. People pass remarks like:
"I wish you could just snap out of your anxiety".
Although people mean well, these type of comments are not helpful. People don't just think one thought and snap out of anxiety. There is a step by step process of removing the illusion that anxiety creates and for some this can take time where the anxiety has been present for many years.
As this is the last of the mini email series I really want to impress upon you that anxiety is curable. What you must never stop doing is searching for the right approach for you. By the way I hope I have not come across too strong in pushing my course Panic Away. I am excited by the results it gets and that is why I talked about it frequently.
After many years working in this area I am now more convinced than ever that every single person, regardless of how severe, can end their anxiety problem. If you have a thought that is telling you different then you need to lose that thought.