Clinical psychologist Steve Orma He was in his early 40s when he developed insomnia — difficulty falling asleep or staying asleep.
He couldn’t stop focusing on it. “I started getting into the state of mind that most people get into,” he says. “I was worried, ‘What’s going on? Is there something wrong with me?'”
This fear of not being able to sleep is a phenomenon called “sleep anxiety,” says Orma, who has become a specialist in treating insomnia. If left untreated, this anxiety can actually prevent people from sleeping.
“The more you focus on it, the less likely you are to sleep, which makes you more anxious. That’s the cycle,” he says.
One of the most powerful ways to overcome sleep anxiety is cognitive behavioral therapy for insomnia (CBT-I). It is well-studied, does not rely on sleep medications, and has been shown to be effective in treating clinical insomnia. Orma used this therapy to treat his sleep, and it is now the main focus of his therapeutic practice.
Typically, a cognitive behavioral therapy (CBT-I) program lasts about six to eight weeks, and each week, you and your provider work on a strategy to reset sleep behaviors and restructure your thinking about rest.
But you don’t have to be in a formal program to benefit from CBT-I. Whether you deal with some stress at bedtime or just occasionally outside at night, cognitive behavioral therapy (CBT-I) practices can help.
Wake up at the same time every day
Having a consistent wake-up time helps your body know when it’s time to feel sleepy, says Aric Prather, sleep scientist and author. Sleep Recipe: 7 days for your best rest. Sleepiness signals are managed by your circadian rhythm, or your body’s internal clock. Setting a wake-up time keeps your internal clock ticking on time.
Prather uses the analogy of a “sleep balloon.” When you wake up, your sleep balloon is empty. Your balloon is filled with sleepiness all day long. Once it’s full, you feel ready for bed. Waking up at the same time every day, even on weekends, keeps your sleep signals consistent.
Focus on relaxation time, not sleep time
Instead of trying to force yourself to go to bed at a specific time, even though you don’t feel sleepy, focus on… “Getting ready for bed early,” he says. Dr. Ravi Aisoladirector of the Sleep Disorders Center at the University of California, Los Angeles.
Choose a time to transition from daytime activities to nighttime activities. This might look like unplugging from screens, wearing comfortable clothes, and dimming the lights in your home.
He says setting aside time to wind down instead of a strict bedtime can help reduce the feeling of having to sleep right away — and can reduce the anxiety that can occur when you don’t.
Schedule your “worry time.”
If all your stress comes at bedtime, put some “worry time” in your calendar during the daytime hours, says Prather. “Use your mind space when you are most comfortable to do some worrying.”
That way, if your mind starts to drift toward tax season, childcare woes, or that big mess in the garage while you’re in bed, “you have a way to say: ‘I’ve already done this worrying,'” he says.
Try to set aside just 10 or 15 minutes at the same time every day to write down what’s bothering you. Prather says it can help your brain relax when your head hits the pillow.
Be careful when tracking sleep
Managing sleep anxiety also means being aware of the amount of information you receive about your sleep.
The proliferation of sleep trackers and wearables has given rise to sleep disorder, a type of insomnia that arises from anxiety about wanting to achieve perfect sleep data, Aisola says.
He adds that sleep trackers can provide you with useful information about how you’re sleeping, but it’s important to have a healthy level of skepticism when it comes to the data and a plan for what you’ll do with it.
If you’re using these devices to track your sleep, he says to ask yourself: “Is this information helping you make changes in your behavior or lifestyle, or is it stressing you out and making your insomnia worse?”
For example, if you notice that you are waking up feeling more rested, this may tell you that your new break time and early morning alarm are starting to work for you.
If you tend to focus on your sleep tracking data, try tracking your sleep with pen and paper instead. It can help you focus on how you sleep sense you instead of numbers.
Reshaping your sleep habits is only half the battle, Orma says. The rest of the work comes down to changing the way you think. Sleep will vary from night to night, and everyone will have a bad night’s sleep from time to time, so adjust your expectations accordingly.
“When you have that frame of mind, your sleep starts to improve,” he says.
The digital story was edited by Queen Gharib, with art direction by Beck Harlan. We would love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org.
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