Mindfulness and Sleep: Advice from Experts

This article is Part Three in a series, click to read Part One and Part Two.

I am just a little bit obsessed with sleep. My own, my children’s and… well… even yours really. Of course I am not alone in that. There are many books, websites, organizations and careers built around getting better sleep!

When you are a new mother, the level of sleep deprivation you experience can be a shock, unlike any kind of tiredness you have ever felt before. It can undermine your health and well-being very quickly, and clearly has flow on effects on your enjoyment of motherhood and your child’s well-being.

I used to joke after a good night sleep that it was better than coffee. I was luckier than some because my sleep debt didn’t accumulate for too long before I was able to catch up and feel human again but it really sensitized me to how much I valued sleep and now I do everything I can to have consistently good sleep.

We are much more informed about sleep and it’s importance to our health, our mood and our effectiveness than we were a decade ago but actually getting enough of it can be easier said than done. The Institute of Medicine estimates that 50 to 70 million adult Americans have a chronic sleep disorder.

Lack of sleep has been linked to many issues including:

• Road accidents
• Moodiness, irritability and inability to focus
• Poor learning, academic and job performance
• Anxiety
• Depression
• Alzheimer’s disease
• Cancer
• Cardiovascular disease
• Obesity
• Pain sensitivity
• Suicide

I interviewed Jason Ong, Ph.D., a sleep psychologist at Rush University Medical Center who works with Mindfulness-Based Therapy for Insomnia, and he had this to say:

Kellie: How widespread is insomnia? How many people have difficulty getting a good night’s sleep?

Jason: Chronic insomnia affects about 10-15% of adults while about 50% of adults will report occasional difficulty falling or staying asleep (i.e., less than 3 times per week).  Women are at greater risk than men for having insomnia, and the risk of insomnia increases with age.

Kellie: What do we know already that helps with insomnia?

Jason: Pharmacological treatments have demonstrated efficacy for immediate relief (i.e., works within the first few days). In studies that examined comparisons between sleep medications and behavioral treatments over the course of 4-8 weeks, both medications and cognitive-behavior therapy  for insomnia (CBTI) are effective.  For long-term outcomes (more than 6 months after treatment), the effects of CBTI tend to be durable, while medications tend to lose their effectiveness.

Kellie: How does mindfulness fit into this picture and why do you think having a mindfulness practice helps people sleep better?

Jason: Many people with chronic insomnia perpetuate the problem by engaging in thoughts and behaviors that actually lead to increased sleep-related arousal.  For example, they might begin monitoring the clock more, spend more time in bed, and also avoid certain social engagements in an effort to try to sleep better.

We believe that having a mindfulness meditation practice can help to reduce emotional distress and physiological distress that is associated with chronic insomnia. It is a different way of working with the problem compared to CBTI or medications. Rather than trying harder to solve the problem, it is about being present, decreasing the effort to sleep, and reconnecting with the body’s cues for sleepiness. In this way, it allows the brain to regulate sleep, thus returning to a place where sleep just happens.

Rather than trying harder to solve the problem, it is about being present, decreasing the effort to sleep, and reconnecting with the body’s cues for sleepiness. In this way, it allows the brain to regulate sleep, thus returning to a place where sleep just happens.

One way to summarize this is to say that we are helping people get out of their own way so that they can re-connect with their brain’s natural way of regulating sleep and wakefulness.

Kellie: What would your top tips be for somebody reading this, who wants to get a better nights sleep?

Wake up at the same time every morning. This will help to strengthen your biological clock and your brain will begin to know when it should be awake. At night, pay attention to sensations of sleepiness (as opposed to fatigue or tiredness). Only when you are sleepy, should you go to bed. Doing a meditation practice (e.g., yoga in the morning, quiet meditation at night) can help you reinforce these behaviors.

Kellie: Are there any other resources you would recommend if people want to find out more?
Jason: The Society of Behavioral Sleep Medicine has excellent resources to help explain what behavioral treatments are appropriate for which sleep disorders.  See: What Is Behavioral Sleep Medicine? and The National Sleep Foundation also has resources on insomnia.

When I interviewed B Alan Wallace recently, he also shared how mindfulness helps him get a better night’s sleep. He gives the following advice to those who ask:

• Finish with the Day: Have clarity in your mind that there is nothing more you need to do today. To release your busy mind and not get caught in loops of your unfinished “things to do” list, have a plan for tomorrow before you get into bed and make a point of “finishing” with today. Have confidence that you can let it go now and not ruminate.
• Then you move into the restful part of your sleep routine. Alan has a practice of lying straight on his back and slowly taking his awareness down to his feet and the points of contact of his body with the bed and just tuning in to that. After a few minutes he completes that and rolls over for sleep.

Here are some other ways mindfulness helps my clients develop healthy sleep habits:

• See Each Night as a New Beginning: When we get caught up in stories about all the nights past when we have struggled to get to sleep, we are missing the opportunity to practice “beginners mind” that sees each moment as a fresh opportunity, a new beginning. This is mindfulness of sleep moments!
• Try Mindful Breathing or Loving Kindness: I have several bedtime mindfulness practices I do with my children that help them drift off to sleep, like here and here. I’ve discovered they work for me too. Try each one for a few nights or get an audio here
.
• Accept Lack of Sleep and Just Rest: As Jason said, most people who struggle to sleep get stuck in worrying about that, and trying to force sleep. If instead you can just gently tune in to your breath mindfully, and accept that you are not sleeping right now with the reassurance that even rest is still restorative, you are more likely to relax and drift off to sleep than if you try too hard. Let go of the longing for sleep.
• Tune in to your own body rhythm and trust your own findings of what works and what doesn’t — these are all suggestions based on what research shows work for many people but may not all work for you. Wind down. Do those sorts of things that you know are going to ease you off into sleep.

There are also a number of proactive things you can do to establish what is known as good “sleep hygiene” or habits that support good sleep:

1. Turn off all screens 30-60 minutes before bed.

2. Reduce your amount of light exposure at least 30 minutes before bed. Light increases levels of alertness and will delay sleep.

3. Wake up and go to sleep at the same time each night.

4. Have a wind down process that begins 90 minutes before sleep, including a warm shower and mindfulness practice like Alan Wallace’s.

5. Tune in to sleepy signs and don’t push through them.

6. Make your bedroom a sleep haven:
   1. No screens or devices – unplug completely.
   2. Cool but not cold temperature.
   3. Make it all about sleep – a relaxing and inviting space that is separate from the outside world and associated only with sleep.
   4. Quiet – use earplugs if they help.
   5. Dark – light prevents the production of melatonin, a hormone that helps you sleep. Consider wearing a sleep mask (they work).
   6. Lie down and do what helps you relax.
7. No caffeine in the afternoon – not from coffee, tea or food.
8. Don’t turn the bathroom light on during night time visits (natural or dim night light best).

If you would like support to sleep better, email me at kellie@flourishtime.com.

May you sleep well

from World of Psychology http://psychcentral.com/blog/archives/2016/12/04/mindfulness-and-sleep-advice-from-experts/