So much of how we live our lives depends on getting good sleep. If you have a poor night’s sleep, you feel tired all the following day, you may be more irritable, and things just don’t seem to go right. At least a third of us have trouble sleeping from time to time. When that trouble becomes chronic, our plight increases and can include anything from falling asleep at the wheel of your car to getting physically ill to hallucinations. Both my parents had sleep issues, and that problem was handed down to me.
It seems strange to me that something so essential can go so wrong. It can be very frustrating when you follow all the sleep hygiene recommendations, even have a sleep study, and still have trouble. At times I would just ask my brain and mind in frustration, “Hey, you know life goes better when you get good sleep. What is the problem?”
The new book, End the Insomnia Struggle: A Step -by-Step Guide to Help You Get to Sleep and Stay Asleep, can help you find the problems and the solutions.
The authors, Colleen Ehrnstrom, PhD, ABPP and Alisha L. Brosse, PhD, are both clinical psychologists who have extensive experience working with people who have sleep issues. Their approach is based on cognitive behavioral therapy for insomnia (CBT-I) and acceptance and commitment therapy. This combination approach creates a nice balance for finding a way that works for you at this time in your life. They begin with an overview of how sleep works, sleep issues, and how the insomnia spiral comes to be. The emphasis is on sleep as a relationship, and relationships change with time and circumstances. We do have the ability to change the relationship.
An initial step is an extensive sleep diary that covers a few weeks so that you can start to see patterns and begin to look at interventions to change the relationship. The authors use the “3P” model of insomnia – predisposition to sleep issues, precipitating events that can trigger sleep problems, and perpetuating attitudes and practices that keep us in a problematic sleep relationship.
What I really like about this book is the authors’ flexibility. There is no “you must do this,” so you can find through experimentation what works best for you. That flexibility also comes in handy as you adapt to changes in your life that affect your sleep patterns. The authors found that those who had not benefited from CBT had either not worked the program (even though they thought they had — the sleep diaries and documentation showed they hadn’t) or they worked the program too well. The latter tried so hard and were so vested in it, that stress levels went up and sleep didn’t improve.
There is that paradox that at times the harder you try to accomplish something, the more difficult it becomes to achieve it. When you begin to relax and let it happen, things flow. That is where the acceptance and commitment therapy comes in. You develop the willingness to make the changes, including the willingness to not sleep as part of the plan to change your sleep relationship.
The authors use behavioral strategies, like stimulus control and sleep restriction, and cognitive strategies, like cognitive restructuring, changing self talk, and designating worry time. They give you many strategies and possibilities to individualize the program so you can find what works best for you. There are worksheets in the book and on the book website. There are also guided audio files on the book website to help with learning techniques such as willingness.
The authors help you to find what they call the “sweet spot” in sleep. You wake up rested and you are “sleeping to live rather than living to sleep.” I know that when sleep becomes problematic, it can become a focus, and you fixate on how to get good sleep. As the authors point out, however, the harder you try to control sleep, the more it will control you. I found this book extremely helpful, particularly with the explanations of how sleep works, and how to change the relationship into one that is healthy rather than almost antagonistic as sometimes happens when relationships don’t go the way we want. The CBT and ACT methods that Ehrnstrom and Brosse outline are useful for work on any relationship. As the authors point out, our brain knows how to sleep, we just need to get out of its way. This is a very comprehensive guide to getting and maintaining a healthy relationship with sleep.
End the Insomnia Struggle: A Step -by-Step Guide to Help You Get to Sleep and Stay Asleep
New Harbinger Publications, October 2016
Paperback, 232 pages