Don’t let poor sleep ruin your life

How negative thinking can disrupt your sleep

How negative thinking can disrupt your sleep

When does worrying about sleep become a problem?

It’s quite easy to worry about things like your health, financial affairs and your loved ones. Often, this worry is useful and allows us to plan and prepare for the unexpected.

However, it can become rather unhealthy and lead to a counter-productive state of anxiety where we’re constantly picturing the worst thing that could happen.

reaper coming for your sleep

Once we’re doing that, we often look as hard as we can for signs that the worst thing that can happen is happening.

This pattern of worrying about something happening, looking for the ‘something’ happening, seeing signs of it happening and then getting even more panicked as a result is everywhere in our lives 1.

Let’s look at an example. A waitress who’s very good at not dropping dishes 2:

  • This waitress might receive praise from her manager because she’s never dropped dishes.
  • She then becomes conscious about the way she walks between the kitchen and the tables she’s waiting on - she wants to maintain her good reputation.
  • Over time, she’ll worry more and more about every step and minor loss of balance. Before she was praised this never crossed her mind.
  • Because she’s not concentrating on the dishes due to her worry, she makes more missteps and one day drops a pile of dishes!
Broken Plates

How does this apply to sleep and insomnia?

This is a good question. After all, if you’re reading this you’re probably not looking for lessons in balancing dishes. You want to get better sleep.

Simply, it’s very common for those living with sleep difficulties and insomnia to have performance anxieties linked to how well they’re going to sleep3.

This anxiety is totally understandable but causes more problems than it solves.

One way it causes difficulty sleeping is through the generation of psychological arousal at bedtime. Psychological arousal plays a huge part in keeping us awake.

For instance, someone with difficulty sleeping might:

  • Retire to bed, convinced that they’re going to have an awful night’s sleep.
  • Lie in bed, getting annoyed that they can’t fall asleep.
  • Start to get even more annoyed (i.e. psychologically aroused) about the fact they’re still awake.

The increased agitation makes it even more difficult to fall asleep and it all stemmed from the initial belief that a bad night’s sleep was inevitable.

In this way the original belief has become true: a self-fulfilling prophecy.

Thinking about sleeping

Now, with the problem identified, let’s have a look at one way to address a self-fulfilling prophecy called Paradoxical Intention.

Why (not) bother? The practical uses of Paradoxical Intention

Paradoxical intention is a practice that has been investigated as a way to deal with unhelpful, self-fulfilling prophecies about a number of things4, including sleep.

Applied to sleep, the theory behind it suggests that actively trying to get to sleep can be counterproductive when a person is stressed about their sleep.

These stressors are as unique as the individual, but might be caused by:

  • Fear that taking a long time to drift off means that they won’t ever fall asleep.
  • Annoyance at waking up during the night.
  • Fear that a lack of sleep will affect them the following day e.g. through poor concentration 5.
  • Fear that poor sleep will mean they will die early or develop serious medical conditions6.

What’s more, in studies where participants were instructed to fall asleep as quickly as possible under less conventional stressors like listening to lively music 7 or trying to win a prize for falling asleep 8, they either took longer to do so 7 or experienced more fragmented sleep 8.

Knowing this, we can turn the issue on its head and break self-fulfilling, fearful thoughts about sleep.

Using paradoxical intention to fall asleep faster

How do we use this information? The short answer is to try not to fall asleep! If worrying too much about going to sleep costs you sleep time, then the opposite should apply: thinking about, and trying to, stay awake should aid in falling asleep.

So, how do we “stop worrying” in a practical sense?

You need to challenge yourself to stay awake. A series of steps to do this are to:

  • Simply lie in bed in the dark (ideally after having followed your wind-down routine), either with your eyes open 9 or closed 10.
  • Avoid anything active when attempting to stay awake before or during this time. Steer clear of drinking a huge coffee before bed, making aggressive movements or doing things like reading once in bed.
  • Lie still and stay awake for as long as possible, gently resisting sleep.
  • Congratulate yourself for staying awake, even if you’re starting to feel sleepy.
  • Reassure yourself that it’s fine to stay awake this long. Remember that it’s OK - it’s the purpose of the practice. You’re doing well 11.

By observing this practice over a number of nights, you may feel that you fall asleep faster and that your sleep is less fragmented. Moreover, you may also find that the worries you have about your sleep don’t seem quite as bad as they once were 12.

Limitations

While this technique can work for people who have difficulty getting to sleep because of a set of beliefs they have, it won’t work for everyone with a sleep problem. Sometimes, it is more effective to incorporate other techniques to help you sleep. These can include stimulus control 9, thought blocking or sleep restriction as part of an integrated, tailored treatment plan.

If you’re finding that following the above isn’t really helping, it might be that what you’re doing needs an adjustment. At Sleepstation we offer tailored, fully supported digital sleep programmes that can help you make those adjustments. In doing this, we have helped even those with severe sleep problems find the sleep they want. Sign up or feel free to ask us any questions.

In short:

  • Being too worried about your sleep can cause you to lose sleep: a self-fulfilling prophecy.
  • An effective coping strategy is to try to stay awake once in bed.
  • Using alternative, clinically recognised methods of coping with bedtime stress may be helpful.

References


  • Wegner DM. Ironic Processes of Mental Control. Psychological Review. 1994;101(1):34–52.

  • Ascher LM. Paradoxical Intention and Related Techniques. In: Freeman A, Felgoise SH, Nezu CM, Nezu AM, Reinecke MA, editors. Encyclopedia of Cognitive Behavior Therapy. New York: Springer-Verlag; 2005. p. 264–268.

  • Lundh LG, Lundqvist K, Broman JE, Hetta J. Vicious Cycles of Sleeplessness, Sleep Phobia, and Sleep-Incompatible Behaviours in Patients with Persistent Insomnia. Scandinavian Journal of Behaviour Therapy. 1991 Jan;20(3-4):101–114.

  • Wegner DM. How to Think, Say, or Do Precisely the Worst Thing for Any Occasion. Science. 2009 Jul;325(5936):48–50.

  • Ascher LM, Efran JS. Use of Paradoxical Intention in a Behavioral Program for Sleep Onset Insomnia. Journal of Consulting and Clinical Psychology. 1978;46(3):547–550.

  • Medic, G., Wille, M. and Hemels, M.E., 2017. Short-and long-term health consequences of sleep disruption. Nature and science of sleep, 9, p.151.

  • Ansfield ME, Wegner DM, Bowser R. Ironic Effects of Sleep Urgency. Behaviour Research and Therapy. 1996 Jul;34(7):523–531.

  • Rasskazova E, Zavalko I, Tkhostov A, Dorohov V. High Intention to Fall Asleep Causes Sleep Fragmentation. Journal of Sleep Research. 2014 Jun;23(3):297–303.

  • Baillargeon L, Demers M, Ladouceur R. Stimulus-control: nonpharmacologic treatment for insomnia. Canadian Family Physician. 1998 Jan;44:73.

  • Relinger H, Bornstein PH. Treatment of Sleep Onset Insomnia by Paradoxical Instruction: A Multiple Baseline Design. Behavior Modification. 1979 Apr;3(2):203–222.

  • Sateia MJ, Buysse D. Insomnia: Diagnosis and Treatment. CRC Press; 2016.

  • Broomfield NM, Espie CA. Initial Insomnia And Paradoxical Intention: An Experimental Investigation Of Putative Mechanisms Using Subjective And Actigraphic Measurement Of Sleep. Behavioural and Cognitive Psychotherapy. 2003 Jul;31(3):313–324.

Further information