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 an 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
  • Gel­lis, L. A., Ari­go, D., & Elliott, J. C. (2013). Cog­ni­tive refo­cus­ing treat­ment for insom­nia: A ran­dom­ized con­trolled tri­al in uni­ver­si­ty stu­dents. Behav­ior Ther­a­py, 44(1), 100–110. http://doi.org/10.1016/j.beth.2012.07.004
  • Har­ris, R. (2007). The hap­pi­ness trap. Auck­land, New Zealand: Exisle Publishing.
  • Har­vey, A. G. (2001). I can’t sleep, my mind is rac­ing! An inves­ti­ga­tion of strate­gies of thought con­trol in insom­nia, Behav­iour­al and Cog­ni­tive Psy­chother­a­py 29(1), 3–11.
  • How­ell, A. J., Dig­don, N. L., & Buro, K. (2010). Mind­ful­ness pre­dicts sleep-relat­ed self-reg­u­la­tion and well-being. Per­son­al­i­ty and Indi­vid­ual Dif­fer­ences, 48(4), 419–424. http://doi.org/10.1016/j.paid.2009.11.009
  • How­ell, A. J., Dig­don, N. L., Buro, K., & Shep­ty­c­ki, A. R. (2008). Rela­tions among mind­ful­ness, well-being, and sleep. Per­son­al­i­ty and Indi­vid­ual Dif­fer­ences, 45(8), 773–777. http://doi.org/10.1016/j.paid.2008.08.005
  • Lich­stein, K. L., & Rosen­thal, T. L. (1980). Insom­ni­acs’ per­cep­tions of cog­ni­tive ver­sus somat­ic deter­mi­nants of sleep dis­tur­bance. Jour­nal of Abnor­mal Psychology.
  • Means, M. K., Lich­stein, K. L., & Epper­son, M. T. (2000). Relax­ation ther­a­py for insom­nia: night­time and day time effects. Behav­iour Research and Ther­a­py 38, 665–678.
  • Morin, C. M., & Azrin, N. H. (1987). Stim­u­lus con­trol and imagery train­ing in treat­ing sleep-main­te­nance insom­nia. Jour­nal of Con­sult­ing and Clin­i­cal Psy­chol­o­gy, 55(2), 260–262.

2 Comments

  1. Dr. Michael Trayford on May 30, 2016 at 7:32

    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!



    • Alvaro Fernandez on June 30, 2016 at 5:01

      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



About SharpBrains

SHARPBRAINS is an independent think-tank and consulting firm providing services at the frontier of applied neuroscience, health, leadership and innovation.
SHARPBRAINS es un think-tank y consultoría independiente proporcionando servicios para la neurociencia aplicada, salud, liderazgo e innovación.

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