Worrying about insomnia may be worse than lack of sleep
Evelyn Lewin | Fairfax Media | November 16 2017
Like millions of Australians, I have trouble sleeping.
While sleep disturbances come in many forms, I used to think those of us who slept badly had one thing in common: we suffer for it the next day.
Now a new review is casting doubt on that idea.
The review was published in the journal Behaviour Research and Therapy in October this year.
It found that, whether or not you sleep poorly, the way you function the next day has more to do with your attitude than the number of hours you snoozed.
Those with "insomnia identity" (people who believed they slept badly) have more daytime impairment than those who slept poorly, but didn't let it bother them.
"We thought that poor sleep and insomnia are linked, but now we know this is a soft link," said author Dr. Kenneth Lichstein, UA professor of psychology.
"There are clearly people with poor sleep who are relaxed about it, letting it roll off their back, and they are at low risk for impaired functioning.
"Insomnia identity drives the daytime dysfunction, not the sleep."
Sleep consultant Dr David Cunnington, co-founder of Sleep Hubcouldn't agree more.
When managing insomnia, he says a main focus is on reducing people's distress about sleep, rather than necessarily helping them snooze longer.
In fact, he says if you objectively measure sleep, a subset of people with insomnia sleep almost normally.
The problem is, they're also "highly distressed" about it.
To minimise that distress, it's important to understand how sleep works.
Sleep doesn't happen immediately, nor does it occur in one long, uninterrupted block.
We're biological beings, Dr Cunnington reminds, not "machines that can switch on or off at will". So it takes time to unwind before we ease into slumber.
Night awakenings are also normal.
In fact, he says for people age 50 it's normal to awaken at least three times per night.
We're also unlikely to sleep for the entire duration we set aside for that pursuit.
So, just because we will have eight hours before our alarm goes off, doesn't mean we will sleep that whole time.
As Dr Cunnington says, humans simply "don't sleep like that".
He says the key to better sleep is having more realistic expectations.
Don't expect to fall asleep instantly, nor sleep through.
But even if you adjust your expectations, it can still be stressful to lie there tossing and turning.
Unfortunately, all that worry will likely worsen the situation, says Health and Community psychologist Marny Lishman.
She says if you enter sleep while worrying, your brain is going to be on high alert while you're asleep.
"So in the lighter stages of your sleep cycle, you're more likely to wake up rather than just roll over and fall back asleep again."
Being in that "hyper-vigilant" state can then interfere with your sleep cycles, leaving you feeling even less refreshed the next day.
If you can't fall asleep, Lishman suggests getting up, leaving the bedroom and engaging in a quiet, calming pursuit (like reading) until your eyes are tired.
Dr Cunnington agrees, saying you should only return to bed when you feel "calm and sleepy" – not because you're worried about how late it is.
When you lie down again, he says the last thing you should do is "try" to sleep.
Instead, distract yourself, with a relaxation or meditation exercise, or by counting or listening to the radio.
Once you stop actively trying to sleep, he reassures your own biological sleep mechanisms will kick in.
Then, if you wake in the night, remind yourself such waking is normal, expected and not worth worrying about.
In fact, lack of sleep in general isn't something we should stress about.
As the review noted, such thoughts may make us feel worse the next day.
Besides, Dr Cunnington adds: "For most people – as long as they don't have significant physical or mental health problems – their body will take the sleep it needs."
Turns out our bodies are programmed to sleep – just not the way we necessarily expect.
When I next struggle to nod off, I'll keep that in mind.
Main photo by David Mao on