Before I get started, let me preface this by saying that I am not an expert in sleep assessment or treatment. I’ve had some decent training in principles and strategies for helping people overcome sleep problems, though. I’m also a pretty good sleeper!
Let’s say you’re struggling with sleep-related problems, and you have gotten some help and ruled out medical or biological causes such as sleep apnea, etc. What can you do to try to address these problems? Ideally, if you have access to treatment involving CBT for insomnia, you might find that, within a couple of months, you are able to tackle these problems.
In the meantime, here are a few tips to keep in mind. First, try to make it so that your bed (and ideally your whole bedroom) becomes a trigger for sleep. You want to lie down in bed and have your brain think, “Oh, I’m in bed, it’s time to go to sleep.” You don’t want your brain to think, “Oh, I’m in bed, it’s time to get really awake and active.” If you’re a person who hangs out in their bed during the daytime or brings their electronic device into their bed, you’re probably going to have to cut that out. Find another comfy place to hang out during the day, and make your bed and bedroom an electronics and work-free zone. If you catch yourself having significant discussions with your partner or other loved ones in your bed or bedroom, maybe find another place to have those discussions. My wife and I have those discussions on walks or on the couch in the living room. Try to help your brain learn that the bed and bedroom are places to sleep rather than places to be alert and active.
Second, try to figure out when you sleep best. If you are a night owl and keep trying to get yourself to get up and go to bed really early, you’re probably fighting a losing battle. You might be able to shift your brain’s natural circadian rhythm just a bit, but you might always be dissatisfied with your sleep if you force yourself to get up at 5 AM and go to bed at 9 PM. The reverse is also true if you are actually 5 AM to 9 PM person: Trying to get yourself to wake up much later or go to bed much later probably won’t work out. Therefore, find your ideal sleep window, and see if you can plan around it.
Third, once you have found your ideal sleep window, it’s more important to get up around the same time every morning than it is to go to bed around the same time every evening. Your wake up time basically sets your sleep time. Sleep drive works somewhat like other drives (thirst, hunger, etc.): The longer you go without sleep, the more your sleep drive tends to build. If your ideal wake up time is 7 AM, then you can probably expect that you will start to feel sleepy as 11 PM approaches. When you feel sleepy, that’s your signal to go to bed. Don’t go to bed just because you think you should go to bed. If you go to bed when you’re not sleepy, it’s probably going to take longer to get to sleep, and you are at risk of engaging in sleep effort – trying to get yourself to go to sleep. This is something to avoid.
Instead, wait until you notice signs that you are getting sleepy. Some of these signs might be that your eyes are closing while you’re watching TV, you have an urge to lie down and go to sleep, and so forth. Try to be mindful attuned to your own signs of sleepiness. That way, you will notice them and ideally make the wise decision to start getting ready for bed.
One thing that can get in the way of mindfully attending to signs of sleepiness is engaging in busy, stimulating activities in the hour or so before you ideally would go to sleep. If you’re trying to get a lot of work done, engaging in stimulating social activity, or spending time on your electronic devices, you might not notice the signs that you’re getting sleepy. Then, you might stay up past your ideal sleep window. So, try to build in a calming routine at the end of the evening that is conducive to noticing your signs of sleepiness.
Sleep is pretty important to emotion regulation. When we teach people in DBT how to reduce their vulnerability to problems regulating emotions, we often suggest that they try to balance their sleep, eating, and exercise. We also suggest that they be sure to address any physical illness that might make them vulnerable, and to avoid problematic use of mood-altering substances. Because sleep is so important for the health of our brains and bodies, addressing sleep problems is a great way to help yourself become more resilient and less likely to have problems managing your emotions. The nice thing about sleep is that you can follow some pretty easy, basic principles to improve your sleep: Remember that (a) sleep is a biological drive, (b) you probably have an ideal sleep window, and (c) it’s important to ensure that your bed/bedroom becomes a signal for sleep and only sleep. ~Alexander L. Chapman, Ph.D., R.Psych.