Updated: Oct 23, 2021
When clients come to me with insomnia-related sleep problems, they have often already made considerable efforts to improve the problem. They realise that their mental health and their sleep difficulties are correlated and are concerned to fix the problem. Commonly received wisdom says that to fix insomnia we should improve "sleep hygiene", including establishing a consistent bedtime and waking up time. Avoiding caffeine, alcohol and blue light near bedtime, having a wind-down routine and establishing a consistent time for getting up in the morning are all great advice. However, it is sometimes a mistake to go to bed at a set time if your body isn't telling you that you are ready for sleep yet. Going to bed because the clock tells us to can mean we end up tossing and turning because the body isn't quite ready for sleep. The mind can then start generating anxious and frustrated thoughts about what our inability to fall to sleep - "I won't be firing on all cylinders tomorrow" "I won't cope" "What's wrong with me, why can't I do a simple thing like falling asleep?" "What if my sleep problems never improve?"
When this pattern happens regularly, the brain, unfortunately, starts associating bed with anxiety and restlessness rather than with relaxation and sleep. We can then get locked into a vicious cycle of anxiety and sleeplessness. So, rather than giving priority to the clock as our signal to go to bed, we can help ourselves by being alert to the signs of drowsiness in the evening. Not just yawning, but also an achey feeling in the muscles (not dissimilar to flu-like aching), itchy eyes, drooping eyelids, head nodding...these signs are all telling us that it is time to get to bed. Even if this means you stay up later than usual, using your body's signs of drowsiness as a cue to go to bed can increase the likelihood you fall asleep quickly and strengthens the association in your brain between bed and sleep. This strategy is part of an evidence-based treatment for insomnia called "Sleep Restriction Therapy".
If you have problems with insomnia, check out my Resources page for helpful pointers to useful information.