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Common effects of sleep deprivation:
Your nights don’t have to be sleepless. Knowing that you can do something about your insomnia is the first step towards getting some much needed rest. Behavioral self-help techniques are the preferred treatment for people with chronic insomnia. Up to 80% of those with insomnia improve with these approaches, and, unlike many medications for insomnia, behavioral techniques do not carry significant risks and side effects.
There are several things you can do to increase your chances of sleep success, including:
Sleep hygiene refers to sleep habits and conditions which promote sleep as opposed to habits such as drinking alcohol or caffeine in the evening, which make it hard for you to unwind and get to sleep. Sleep hygiene should be your first line of attack against insomnia, and it is often used in conjunction with stimulus control and cognitive behavior restructuring (see below). Review your habits and make some changes in your routine to see if behavioral and environmental changes improve your sleep.
Progressive Muscle Relaxation (PMR) – PMR is a set of exercises you can use to reduce anxiety and stress at bedtime. PMR is a two-step process where you first tense certain muscle groups and then relax them. As you go through the process, you should be focused on actively tensing and then relaxing, helping to relax your mind as well as your body. The procedure takes some time to learn, but after learning it, you can practice a shorter version of the exercises. When practicing PMR to help with sleep, you should plan to fall asleep before finishing all of the exercises. See Progressive Muscle Relaxation for detailed information and instruction on the technique.
Diaphragmatic breathing – Learning to breathe slowly and deeply from your belly or diaphragm is a good way to slow down. To practice belly breathing, put a hand on your stomach and take slow breaths, letting your stomach expand as you breathe in. As you breathe out, relax your chest and shoulders. Concentrate on your breathing as you do it to encourage your mind away from stressful or anxious thoughts.
Visual imagery relaxation – Practicing visual imagery means choosing peaceful, soothing thoughts to focus on which calm you and allow you to stop thinking of your to do list. Everyone’s peaceful situation is different, and you can choose to think about things that personally soothe you – a walk in the mountains, canoeing on a lake, swimming, petting your dog, etc. As long as the image doesn’t excite your mind, it should work. You might also choose to focus on something that is very repetitious as a way of relaxing. For example, if you are a skier, you might imagine going to the slopes, zipping up your jacket, putting on your gloves and hat, tightening your boots, riding the chairlift and then the smooth and rhythmic motion of sinking your poles in and turning side to side as you ski down the mountain. Slowly going over every detail of a repetitious activity can be soothing and relaxing.
Stress management – If you learn to deal with stress more effectively through meditation or self-guided imagery, you should be able to fall asleep more easily.
Recommendations to reduce stress:
Anger management – Anger, anxiety and frustration can stand directly in the way of getting a good night’s sleep. You may feel angry or anxious when you go to bed or you may become angry and frustrated when you can’t go to sleep. Regardless of the source of the anger, recognize that it keeps your mind occupied and your body tense, two conditions which don’t encourage sleep.
A few things that might help you deal with your anger or anxiety
Suggestions for mental games:
About CBT: One presumed advantage of this treatment is that it includes treatment components which address the range of cognitive and behavioral factors that perpetuate insomnia. As a result, this treatment may be more universally effective across insomnia sufferers regardless of their presenting complaints (e.g., sleep onset complaints vs. sleep maintenance difficulty).
Cognitive behavioral therapy addresses a person’s beliefs about sleep and helps replace negative or unhelpful behaviors with positive ones. The significance of one’s thinking about sleep is often underestimated. Sleep problems which start as isolated incidents can become chronic because of mental hang-ups.
The more important it is to get a good night's sleep, the less you sleep. Believing that a poor night's sleep is a disaster only generates more anxiety and worry about your sleep. Challenge this thinking and consider alternative thoughts that reduce the importance of sleeping on the rest of your life (i.e. "It's no big deal", "I'll be a little tired and cranky tomorrow but nothing I can't handle.").
The more you try to control your sleep, the less you sleep. Sleep is a natural body response. Telling yourself that you must sleep and trying to force yourself to sleep only puts pressure on you and makes your sleep worse. Focusing on what you can control (sleep habits, schedule, when you are in or out of bed) and letting go of what you can not control will allow falling asleep and staying asleep to happen naturally.
Stimulus control – Stimulus control therapy derives from the idea that a person with chronic insomnia associates bedtime and the bedroom with not being able to sleep. The technique limits the amount of time spent in the bedroom for non-sleep activities to retrain the brain to associate bedtime and the bed/bedroom with successful sleep attempts rather than sleeplessness.
Paradoxical intention – Paradoxical intention is a psychological approach that is based on doing the opposite of what you want or fear and taking it to extreme. Some people who experience insomnia may continue to experience insomnia because they fear another sleepless night or they fear the thoughts and worries that accompany going to bed, and their fear keeps them awake. Paradoxical intention focuses on confronting, and hopefully, eliminating the fear so that it stops getting in the way of sleep. This approach is used for other fears as well. Rather than trying, unsuccessfully, to go to sleep night after night, try to stay awake and do something instead. Turning your attention to something else removes the fear of not being able to sleep and may allow you to relax and eventually go to bed. See Paradoxical Intention for more information on the technique.
Sleep restriction – Sleep restriction is based on the idea that people require different amounts of sleep, and that often, a person with insomnia stays in bed thinking that they will get more sleep, when staying in bed really just increases frustration and sleep difficulty. Sleep restriction therapy reduces the amount of non-sleeping time a person with insomnia spends in bed.
To practice sleep restriction, you determine your average total sleep time by keeping a log of your sleep habits for two weeks. If you usually sleep 6 hours per night, but spend 8 hours a night in bed (tossing and turning, watching TV, reading, staring at the ceiling for the other 2 hours), sleep restriction therapy will only allow to spend 6 or 6 1/2 hours in bed at first. In the beginning, you might not sleep all of the time, but gradually, the time spent sleeping should increase. If you continue to have trouble sleeping, the time allowed in bed is further restricted to encourage sleep when you are in bed. The overall time spent in bed is adjusted as it becomes clear how much sleep you need.
Its been reported that acupressure, a technique using principles similar to acupuncture, has shown to be effective in improving sleep as well, especially among elderly people.
Massage is thought to have similar effects on a person’s ability to relax, and thus, can also promote better quality sleep.
It is often used to treat patients coping with:
To reduce the chance of experiencing these minor side effects, it is recommended that you begin light therapy very slowly and consult your doctor before use. See bright light therapy for more information.
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