Sleep Cognitive Behavioural Therapy

I have always struggled to sleep. We rant and rave about the teenage generation who stay up until the early hours dancing round the streets or ogling memes in bed. Even the pre-teens are absconded for arguing over bedtimes, begging for another fifteen minutes of telly time before bed. I, however, would take myself up and off to bed before even the set 8 o’clock. My parents found this hugely amusing, the child putting herself to bed before the set bed time. I was always anxious of what would come about could I not sleep; a sort of anxiety about the world ending if I was tired. This would often (and still does) turn into a vicious cycle of clock-watching. You calculate the hours of sleep that you’ll get, should you fall asleep right now, and panic slightly, only to find yourself tossing and turning in an increasing state of restlessness at 3am – you’d only get four hours of sleep should you fall asleep now so is there even point to it?

The word insomnia has been thrown around in regards to my sleep patterns. I’m physically incapable of napping, for one, unless on the brink of exhaustion. I can lie awake for hours in periods of stress, not even thinking of whatever’s causing me stress but rather a myriad of thoughts all at once. Like remembering to buy hummus tomorrow. And googling that catchy song I heard on the radio earlier. I struggle to sleep in new places. I’m also heavily reliant on good sleep, and even then can find myself exhausted during the days.

My sleeping patterns this year have been worse. At one point I was going to bed at 4.30am and waking up at around midday. It’s hard to argue with your body clock, when you go through the daylight hours listless and yawning, and suddenly feel all ready to rise and grind come 11pm. This does however make life hugely inconvenient. Waking up pre 10am would lead to a sure fire day of hell, and I was still spending a good 2 hours lying in bed like a vegetable, waiting for sleep to embrace me.

Feeling particularly exhausted and poorly rested a month ago, I researched sleep clinics in my area. I will admit to paying £95 for each appointment, of which you are supposed to attend 6, when there is an app available (Sleepio) and books on the issue. I do however think the price made me more likely to commit to the treatment.

Sleep Cognitive Behavioural Therapy, or Sleep CBT is a non-medicated form of treating insomnia.
To begin with, you put Sleep Hygiene as a priority. You alter your lifestyle to encourage good sleep, by doing things such as limiting caffeine, turning off screens before bed, sleeping in a dark, quiet bedroom and putting your phone and alarm away at night.
Stimulus Control encourages your body to associate the bed only with sleep. So no lounging around in bed on your phone or reading books. You have a set bedtime and alarm time. The biggest and most daunting factor is giving yourself 20mins to fall asleep; if you haven’t done so, you take yourself up and out of bed and partake in a non-stimulating activity, like reading or drawing, until you feel tired and return to bed. This is repeated until you fall asleep within the 20mins.
Relaxation also comes into play, and you’re taught methods similar to meditation to help you sleep.

The most difficult section of the CBT is Sleep Restriction Therapy. As an insomniac, your body has probably set itself to strange sleeping patterns, and the purpose of the CBT is to change those to a more natural pattern. The first 14 days of engaging in this were actual hell. It takes commitment, acceptance that you’re going to feel like a zombie, and loving support of your family and friends to turn a blind eye to your quivering upper lip when you accidentally tip over a cup of coffee. Your body resists the initial cycle of giving yourself 20mins to fall asleep, and as I was to set my alarm for the earliest I had to wake up for work (8.30am), I was getting around 5hrs sleep per night. This continued for a few days, driving me into more exhaustion, until I began to fall asleep on the third time back into bed. Then the second, and finally the first time I went to bed. This was indeed amazing after months of at least a good 2hrs pre falling asleep, but at the cost of moping around the house craving my bed and crying over trivial frustrations.

That being said, I pursued with dragging myself out of bed (it takes a good deal of willpower to get out of a nice warm bed when you’re truly exhausted, and accustomed to lying in the dark patiently waiting to fall asleep). Three weeks later and for the past week I have gone to bed at around 11.30pm, fallen asleep within 20mins, and woken up at around 8.30am, either by alarm or of my own accord. I’ll have to keep you updated on progression, but I have begun to feel much more energetic during the days, and tired only an hour or so before bedtime. I still experience a little anxiety creeping into bed every night, that it’s all been a little too good to be true and that I’ll spend the next few wakeful hours growing more and more anxious over an inability to sleep, but so far so good. I’m also confident in my ability to fall back on the stimulus & restriction methods should I enter into another difficult sleeping pattern, to get myself back on track.

As with most things in life, consistency seems to be key, and I do really recommend trying out Sleep CBT if you suffer from insomnia, either the pricey but supportive route via therapist or the apps available.

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