Sometimes just knowing the body knows how to sleep is the most reassuring thing.
Recovering from insomnia is never a quick, easy, and linear process. The disorder is unique for everyone, with each insomniac encountering their own personal version of the disorder defined by their lifestyle, their environment, and sometimes, their own internal enemies. The journey to recovery can be equally individual and arduous, but good outcomes are thankfully common.
For Barbara Graham, her story of insomnia was cemented in with an underlying belief, a series of thoughts that have made deep ruts in the confines of her mind, the wheels of rumination spinning and reinforcing it night after night:
“My body doesn’t know how to sleep. There’s obviously something very wrong with me. The only way I can fall asleep is to take a pill and sometimes the only way to stay asleep is to take another pill. I hate how groggy the pills make me, but I am helpless and powerless to stop taking them. If I try, I’ll never sleep…”
Three to four hours was a particularly bad night of sleep for her, while six was considered a good night. With the coming of each new day, the prospect of nightfall would already arise a sense of foreboding and anxiety about what that night’s sleep struggle would entail.
Her insomnia started after a bad experience with the beta blocker Inderal, after which sleeping pills entered her life at the advice of her doctors, but her use of them was always with the understanding that the long-term effects of these drugs, especially benzos, were not sustainable long-term.
Over time, she gravitated towards Eastern medicine. She discovered natural supplements and herbal sleep remedies. She meditated, exercised, tried tai chi, qigong, yoga, acupuncture, shrinks, energy healers, and Reiki masters.
She found temporary relief, sometimes unaided natural sleep, but life would happen again. Deadlines would encroach, trips and meetings would be upcoming, and the doctor’s orders of 1 pill of xanax nightly would loom over her before bedtime once again.
With a third of adults complaining of insomnia and an occurrence rate of upwards of 60% in people over 60, she knew she wasn’t alone. In fact, based on current statistics, insufficient sleep is more along the lines of a public health epidemic. On top of all that, women are twice as likely as men to have trouble falling or staying asleep.
“Insomniacs are solitary warriors, our brains pumping furiously as our bodies fight for repose”
Over time, she found great respite in CBT-I – Cognitive Behavioral Therapy for Insomnia. The program is built around the same core principles that CBT is: If you change your thoughts, you change your emotions and your behaviours. Insomnia is caused by learned thoughts and behaviours that can be unlearned or changed (excluding insomnia caused by organic brain disorders). “I will never sleep” can be reframed as “my brain knows how to drop down and wants to obtain restorative sleep.”
In her five-week CBT-I course, she learned sleep scheduling and stimulus control, cognitive restructuring, medication reduction techniques, daytime relaxation techniques, stress-reducing attitudes and beliefs, bedtime relaxation techniques and lifestyle practice for improving sleep.
Over time and with the help of a mindfulness practice inspired by MBTI (Mindfulness Based Therapy for Insomnia) that has been shown to greatly improve sleep quality in adults, she has been sleeping drug-free for months, sans a small herbal cocktail of tryptophan, melatonin and other supplements. But most importantly, her relationship with her insomnia has changed. For Barbara, it gradually became something to not resist or fear so strongly. Lousy nights no longer create panic episodes, as she put it:
“Letting go into sleep is no longer the dark herald of death, imprinted in me so many years ago.”
Sleep is like grasping at the water, the more you try to grab for it the quicker it flies out of your hand. It is a process that cannot be forced but should be allowed to unfold. Sometimes, sleep psychologists will even recommend trying to purposefully stay awake when insomnia is occurring, so that the anxiety behind trying to actively control sleep induction is eliminated.
Totally trusting in the process, and knowing that our brains evolved for billions of years to sleep restoratively can do heaps towards reversing negative thought patterns that instil the belief of how hopelessly sleepless we are. Know that if we sleep bad tonight, tomorrow we may have an even deeper sleep with more vivid dreams (known as REM rebound). Most importantly though, the journey towards great sleep is a long one that requires patience and acceptance, and titrating what works is a very individual process, but by no means is anyone ever alone in it!
