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Insomnia – Part 2:
Manage Insomnia and Improve Your Sleep

So you can’t sleep and you’re feeling fatigued and run down. Well, here’s some good news: you can improve your sleep by addressing the factors that contribute to your insomnia. Let’s look at three very effective measures for reducing stress-related insomnia:

  • reduce our physical arousal level
  • improve our sleep hygiene
  • reduce our mental and emotional arousal level

Woman  sleeping well after treatment for insomnia

Sleep Aids

Sleep aids such as Zolpidem (Ambien) are often prescribed to treat insomnia. Medication can help in the short term to get you over a rough patch. But in the long term it causes problems. First, drugs can create dependency, where you require medication in order to sleep. Second, the kind of sleep you get with a sleep aid is not a natural sleep. As a result, sleep aids can cause forgetfulness, bizarre behavior such as sleep-walking, and sluggishness because you are basically sedated persistently throughout the day. Not such a great solution!

To get lasting relief from your insomnia, you need to address both the physical and mental or emotional factors contributing to your insomnia.

Physical Causes of Insomnia

To get lasting relief from insomnia, you need to address both the physical and emotional factors contributing to your insomnia.

First, consider whether you have physical factors creating insomnia, such as sleep apnea, restless leg, or a neurologic conditions such as Parkinson’s.

  • Sleep apnea can be addressed by weight loss, use of oxygen at night, and through consultation with a sleep specialist.
  • Restless leg can be addressed with medication, but it also improves with stress management and exercise.
  • Physical illnesses such as Parkinson’s need to be treated by a specialist, such as a neurologist.

Improve Your Sleep Hygiene

We think of hygiene when it comes to our teeth, feet, or skin. But did you know that sleep also requires hygienic habits and practices if we want to sleep well on a regular basis? They say “Sleep hygiene is the key to sweet dreams.” Here are some suggestions to improve your sleep patterns:

Establish a routine for waking and sleeping.

Set your alarm to wake up the same time every day, even on weekends. Creating a routine for arising and retiring to bed trains your body to expect to sleep at a certain time every day.

Relax to prepare for bed.

Try to read, listen to soft music, take a warm bath, do relaxation exercises, practice deep breathing, or meditate to slow down and guide your body towards sleep.

Lay in bed only when you’re sleepy, especially if you wake up in the middle of the night.

Don’t lay there worrying. Get out of bed if you’re awake. Redirect your focus by reading a book. If you are ruminating over the same thoughts, write them down until you feel like you’ve got them “out of your head” and can put them aside for the night.

Turn off the screen.

Do not work on your laptop, surf the Internet, play games on your mobile phone, or watch TV before sleeping. The colored light and motion on the screen are stimulating and can keep you awake.

Avoid caffeine after noon.

Drink that double latté in the morning and switch to decaf by lunch. Caffeine can increase your state of arousal through the evening and keep you awake or disturb your sleep.

Avoid alcohol.

Lots of people drink alcohol with the belief that it relaxes them. But in fact, alcohol can increase stomach acid reflux, which in turn causes episodic awakening.

Emotional and Mental Causes of Insomnia

Most of us at some point in time have insomnia related to stress or anxiety. To manage our insomnia we need to modify our physical and emotional response to stress.

First let’s address the physical responses to stress we identified in Insomnia – Part 1: Why Can’t I Sleep?:

  • Increased arousal
  • Increased heart rate
  • Increased blood pressure

We can reduce all these physical effects through a few measures to quiet our daytime stress response:

  • Regular daily exercise. Physical exercise such as walking reduces blood pressure, heart rate, and stress-metabolic by-products. It’s best not to exercise immediately before bedtime, as it may increase your level of physical arousal just as you’re about to try to sleep.
  • Meditation. Deep breathing can be done throughout the day in brief (e.g. 2-5 minute) episodes to mitigate daily stress, reduce both heart rate and blood pressure, and create calmness and mental well-being.
  • Yoga. Very effective at reducing heart rate, breathing rate and silencing “the chattering monkey” of the mind, yoga is a great way to reduce the metabolic by-products of stress.

These suggested activities provide outlets to quiet the body physically.

Cognitive Behavioral Therapy (CBT) is a very effective way to reduce our mental and emotional arousal. CBT consists of using the mind to redirect worry, automatic negative thoughts, and rumination. Elements of CBT include:

  • being mindful of your emotional state
  • consciously interrupting “runaway” anxiety, rumination, worry, negative thoughts and replacing them with neutral or positive thoughts such as affirmations
  • incorporating physical relaxation with the conscious process of slowing down the mind

Recent evidence shows severe insomnia responds best to cognitive behavioral therapy.

You can read more about CBT with the resources listed below, or seek the help of a cognitive behavioral therapist in your area.

To summarize, we’ve seen that sustained management of insomnia requires:

  • addressing the physical causes of insomnia,
  • establishing good sleep hygiene,
  • reducing our level of physical arousal during the daytime, and
  • making use of cognitive behavioral techniques (CBT) to manage worry and rumination.

Thank you for reading, and sweet dreams!

If You Liked This Article: Check out Anxiety and Panic: Early Signs of Peri-Menopause?

Share your experience!

How do you deal with worrisome thoughts that cause insomnia?
What do you do to relax and wind down before sleeping?

Leave a Comment in the box below. Thanks for sharing!

Sources and Resources

Scientific Articles

Morin et al. Cognitive Behavioral Therapy, Singly and Combined with Medication, for Persistent Insomnia: A Randomized Controlled Trial JAMA May 20, 2009—Vol 301, No, 19, page 2005.

Basta, M et al. Chronic Insomnia and Stress System Sleep, Med Clin. 2007 June 2(2): 279-291.

Cognitive Behavioral Therapy, Relaxation Techniques

Bourne, Edmund J. The Anxiety and Phobia Workbook, Fourth Edition New Harbinger Publications, Inc. Oakland, CA, 2005.

Spradlin, Scott E. Don’t Let Your Emotions Run Your Life New Harbinger Publications, Inc. Oakland, CA, 2003.

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