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For a good night’s rest, combine general sleep hygiene with mindful and cognitive techniques

sleep——-

Most SharpBrains readers understand the benefits of stress regulation, and also the benefits of sleep. Recommendations for sleep hygiene are well publicized. They include avoiding alcohol and stimulants like caffeine; sticking to regular bed and wake times (even if you don’t get enough sleep); exposing yourself to light in the morning and afternoon; exercising in the earlier part of the day; using your bed only for sleep and sex; and limited or no napping.

But what should you do when in bed, eyes closed, wishing to fall asleep? Many who have trouble falling asleep ruminate, worry, and reappraise in bed. They might actively try to suppress these thoughts. Unfortunately, this strategy tends to backfire. Many old-school techniques, like counting sheep, don’t work either. And worrying you won’t sleep only makes matters worse.

While there is no silver bullet for getting to sleep, psychologists have developed and tested a number of helpful techniques. Let’s review them.

Some people find meditating in bed to be helpful. However, meditation is meant to promote alertness. If you practice mindfulness meditation during the day, then at night you’re likely to be less perturbed by the thoughts and worries that come to your mind. When thoughts come up while you’re wishing to sleep, thank your brain for the unhelpful content, and return to your cognitive plan. You’ll be better prepared to accept the possibility that you will not get much sleep, and hence be less productive the next day. The goal isn’t to fall asleep, but, paradoxically, genuine acceptance can promote sleep onset.

Falling asleep normally comes automatically. Given that striving to control normally automatic processes, such as speaking, urinating or gaining an erection can interfere with them, Dr. Colin Espie and his colleagues proposed that striving to fall asleep delays sleep.

So, they found that paradoxical intention (the deliberate practice of a neurotic habit or thought, undertaken to identify and remove it; as proposed by Viktor Frankl) can sometimes facilitate sleep. Comfortably lie in bed, in the dark but with your eyes open. Try to keep them open just a bit longer, and congratulate yourself for doing so. Remind yourself that you are not trying to fall asleep. If you worry that you’re not asleep yet, congratulate yourself for being successful. But also, do not resist sleep if it comes.

This technique doesn’t work for everyone. If you have a lot on your mind, you might not be able to focus on this boring, counterintuitive task. Fortunately, this technique can be combined with mindfulness training. In The Happiness Trap, Dr. Russ Harris popularized a well researched variant of this: acceptance and commitment training (“ACT”). With ACT, you learn that your brain produces all kinds of unwanted feelings and thoughts. You also learn to monitor and truly accept unpleasant feelings. You’re not asked to like your feelings, but to be aware of them, recognize they are normal, and not fight them. Similarly, your brain generates a lot of unhelpful thoughts, judgments and images that can be stressful. With practice, however, you can learn to recognize and “defuse” them by treating them as meaningless background noise. This doesn’t make them go away; it makes them less arousing.

There are also three promising techniques to replace stressful thoughts.

1. Dr. Les Gellis found cognitive refocusing to be helpful. During the day, choose an interesting, non-stressful activity to think about. It could be redecorating a room, planning a football game, or something else you like fantasizing about. Then, when you go to bed, you think about the playful activity. If you get distracted, then mindfully acknowledge the distraction and gently refocus on your topic.

2. Another helpful cognitive technique is imagery distraction. During the day, review color pictures of neutral concrete objects to imagine, such as a candle, a light bulb, an hour glass, a kite, a stairway, and a palm tree on a beach. Practice visualizing them a couple of minutes each. Then, when you wish to go to sleep or return to sleep, imagine one of the objects for several minutes at a time.

3. Some people find these techniques too boring to distract them from their pressing concerns. Serial diverse imagining is a new, more engaging form of imagery distraction. It is meant to put your brain in a drowsy, dream-like state similar to sleep onset where one’s mind drifts from one topic or image to another. In bed, imagine an object, place or scene for 5 to 10 seconds, and then switch to a different one. Deliberate mind wandering without an algorithm is tricky, so a fellow researcher and I created a “do it yourself” app, mySleepButton, that reads you diverse things to imagine.

In sum, combining general sleep hygiene with meditation and cognitive strategies is probably the most reasonable approach to good sleep. Bedtime is not a good time to be processing concerns, and directly suppressing thoughts or striving to sleep isn’t helpful. Mindfulness training (especially when also practiced during the day) can help you accept your problems, emotions, thoughts and wakefulness. And cognitive/ imagery techniques like those described above can help you replace stressful thoughts.

Luc_Beaudoin— Dr. Luc Beaudoin is an Adjunct Professor of Cognitive Science  and Education at Simon Fraser University. A self-described productivity geek, with a PhD in Cognitive Science from the University of Birmigham in England, he recently released the app mySleepButton.

Related articles:

Bibliography

  • Beaudoin, L. P. (2013). The possibility of super-somnolent mentation: A new information-processing approach to sleep-onset acceleration and insomnia exemplified by serial diverse imagining.  Retrieved from http://summit.sfu.ca/item/12143
  • Beaudoin, L. P., Digdon, N., O’Neill, K. & Racour, G. (Abstract accepted for 2016 publication). Serial diverse imagining task: A new remedy for bedtime complaints of worrying and other sleep-disruptive mental activity. Poster to be presented at SLEEP 2016 (A joint meeting of the American Academy of Sleep Medicine and the Sleep Research Society). Denver, CO.
  • Espie, C. A., Broomfield, N. M., MacMahon, K. M. A., Macphee, L. M., & Taylor, L. M. (2006). The attention–intention–effort pathway in the development of psychophysiologic insomnia: A theoretical review. Sleep Medicine Reviews, 10(4), 215–245. http://doi.org/10.1016/j.smrv.2006.03.002
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2 Responses

  1. Excellent article covering one of the top issues of our time. I particularly like the discussion on cognitive/imagery exercises as these are often overlooked for fear of them engaging the mind and being counter-productive, as you mentioned. Imagery distraction is something I look forward to sharing with our folks. Do you have any thoughts or observations on what types of exercises are better in concert with certain types of meds folks are taking regularly for sleep (i.e. benzos, barbs, etc.). Ideally, folks should be able to sleep without assistance of these classes of drugs, although the unfortunate reality is that so many are using them chronically – and resources like this can be quite helpful. Thanks and keep up the great work!

    • Michael, thank you for the thoughtful comment and question. I am not aware of clear research findings combining these types of techniques with sleep medications–what we do see is the growing adoption of cognitive techniques by individuals, insurers and even public health systems (like the NHS in the UK) to reduce insomnia and the need for sleeping aids. Regards

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