sleep…if I fall asleep now , I can still get four and a half hours of sleep…. If you become an expert mathematician during the night, constantly calculating how much sleep opportunity you have left, you will be too anxious to ease back into sleep. A team of sleep researchers at the University of California at Berkeley showed that watching the clock makes people think that their sleep is worse than it actually is (Tang, Schmidt, and Harvey 2007). Avoid the temptation to engage in mental arithmetic at night. Turn your clock around so that you cannot see it.
Avoid Thoughts That Create Performance Anxiety
Performance anxiety occurs in situations in which there is something that you have to do and you worry that you may not be able to do it, or at least do it well. People with insomnia often believe that they must exert effort to sleep. When you are not able to sleep readily, you may become anxious.
Do you believe that when faced with poor sleep you should try harder? Can you sleep only when you don’t want to, or when you should not sleep? For example, do you lie awake for most of the night but fall soundly asleep an hour before your alarm is set to go off? (Perhaps you can then sleep after the alarm goes off, knowing that you should really get up to get ready for work.) Or, perhaps you lay your head down after work to rest and find that you sleep for much longer than you intended. Or you doze in the evenings while watching television.
Although some people with sleep problems, no matter how tired, cannot sleep readily under any circumstances, you may find it difficult to resist sleeping under circumstances in which you should not sleep. Then, when you should sleep—that is, at night—you are unable to sleep. Why is it that you can fall asleep when you do not “want” to fall asleep but cannot sleep during conventional hours, when you “want” to sleep?
The answer is this: when there is a demand for sleep, sleep is more difficult to produce. When the pressure to sleep is alleviated, sleep is easier to produce. Nurses often use the following strategy when someone comes to the emergency room in the middle of the night because of an inability to fall asleep. They tell the patient, “The doctor is going to be a while, but please wait up so that you are awake when the doctor comes.” This is often successful in facilitating sleep for the patient, as there is now a pressure to stay awake. Similarly, one effective treatment for insomnia, called paradoxical intention, is to ask the person to stay awake all night. In response to this request, the person will often say, “But I do that every night”; however, the attempt to stay awake on purpose is often unsuccessful. The message behind this treatment is that it is easier to sleep when you are not supposed to sleep. An effective strategy for this problem is to determine a sleep window as described in chapter 2, and then develop a plan, such as enlisting someone to help make sure that you are awake at all times except during that window. In addition, you can change your thinking about sleep; that is, you can stop trying to sleep. If you find yourself awake during the night and it is obvious that you are not going to be able to return to sleep readily, give up the idea that you will try to sleep; instead, get out of bed and don’t return until you become sleepy again.
Stop and Question Whether the Thought Is Actually True
You may have noticed a general theme here: that having a thought or belief does not necessarily make it true. Challenging and changing the way you think about your sleep can be as important as challenging or changing your sleep habits. We ask you to stop and question the veracity of your thoughts, because thoughts about sleep can arise automatically. When thoughts are seemingly automatic, you may question whether you can change them at all. You may also believe that because they occur automatically they must somehow be true. Neither of these beliefs is
Avoid Thoughts That Create Performance Anxiety
Performance anxiety occurs in situations in which there is something that you have to do and you worry that you may not be able to do it, or at least do it well. People with insomnia often believe that they must exert effort to sleep. When you are not able to sleep readily, you may become anxious.
Do you believe that when faced with poor sleep you should try harder? Can you sleep only when you don’t want to, or when you should not sleep? For example, do you lie awake for most of the night but fall soundly asleep an hour before your alarm is set to go off? (Perhaps you can then sleep after the alarm goes off, knowing that you should really get up to get ready for work.) Or, perhaps you lay your head down after work to rest and find that you sleep for much longer than you intended. Or you doze in the evenings while watching television.
Although some people with sleep problems, no matter how tired, cannot sleep readily under any circumstances, you may find it difficult to resist sleeping under circumstances in which you should not sleep. Then, when you should sleep—that is, at night—you are unable to sleep. Why is it that you can fall asleep when you do not “want” to fall asleep but cannot sleep during conventional hours, when you “want” to sleep?
The answer is this: when there is a demand for sleep, sleep is more difficult to produce. When the pressure to sleep is alleviated, sleep is easier to produce. Nurses often use the following strategy when someone comes to the emergency room in the middle of the night because of an inability to fall asleep. They tell the patient, “The doctor is going to be a while, but please wait up so that you are awake when the doctor comes.” This is often successful in facilitating sleep for the patient, as there is now a pressure to stay awake. Similarly, one effective treatment for insomnia, called paradoxical intention, is to ask the person to stay awake all night. In response to this request, the person will often say, “But I do that every night”; however, the attempt to stay awake on purpose is often unsuccessful. The message behind this treatment is that it is easier to sleep when you are not supposed to sleep. An effective strategy for this problem is to determine a sleep window as described in chapter 2, and then develop a plan, such as enlisting someone to help make sure that you are awake at all times except during that window. In addition, you can change your thinking about sleep; that is, you can stop trying to sleep. If you find yourself awake during the night and it is obvious that you are not going to be able to return to sleep readily, give up the idea that you will try to sleep; instead, get out of bed and don’t return until you become sleepy again.
Stop and Question Whether the Thought Is Actually True
You may have noticed a general theme here: that having a thought or belief does not necessarily make it true. Challenging and changing the way you think about your sleep can be as important as challenging or changing your sleep habits. We ask you to stop and question the veracity of your thoughts, because thoughts about sleep can arise automatically. When thoughts are seemingly automatic, you may question whether you can change them at all. You may also believe that because they occur automatically they must somehow be true. Neither of these beliefs is
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