Modern life isn’t easy, with concerns about money, housing, work, relationships and living a “successful” life being frequently reported as sources of worry for many people.
Sometimes our worries can have a real impact. We can’t sleep, overthinking about these things.
Frequently, people living with stress, anxiety, depression and insomnia will say that racing, intrusive (unwanted) thoughts make it harder for them to get to sleep than any sort of physical discomfort or pain 12.
Therefore, when trying to get to sleep, those with insomnia will commonly try to shut out thoughts that are stopping them from sleeping. This might sound sensible at first, but it can cause more problems than it solves34.
By implementing better ways to deal with intrusive thoughts, the time between getting into bed and falling asleep needn’t be so difficult. You may also find it easier to fall back to sleep if your sleep isn’t interrupted by racing, intrusive thoughts.
There are a number of thought blocking strategies that have been studied for dealing with these intrusive thoughts in the context of insomnia. Many will be covered in a course of CBT for insomnia (CBT-i) 56.
The core of these strategies is that they enable a person to substitute thoughts that might keep them awake (arousing thoughts) with non-arousing thoughts. This should:
We’ll go over a few of these strategies here, in the hope that they’re useful to you or someone you know.
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One of the early, but effective solutions to racing and intrusive thoughts in bed is called “articulatory suppression,” in which you would mouth a word at a rate that makes formulating any other thought difficult-usually 3 to 4 times a second.
The underlying psychology is complex, but the theory is that mouthing a word requires a lot more mental power than just thinking it and the use of that mental power causes a blocking of the original intrusive thought. Choices of word for this method include:
The only requirement is that it has no emotional significance to you (i.e. is non-arousing). You can also extend the technique by:
Since everyone is different, it might take a few goes to find a process which works for you.
“Imagery distraction” is a technique in which you imagine yourself in an engaging and interesting scenario like:
Although there is less evidence to suggest imagining a scenario reduces sleep onset time compared to articulatory suppression, using mental imagery has been reported to increase sleep quality once a person is asleep 89.
Once chosen, the aim is to experience the scenario as deeply as possible by imagining all the sights, sounds, smells and ultimately relaxation that comes with it, so that it becomes impossible to think of anything else.
It is important to choose something that isn’t too arousing, like a sporting event or sexual encounter, because these scenarios are unlikely to be relaxing and therefore are less conducive to helping you get to, and stay asleep.
Since negative thoughts are often cognitively arousing, fixating on them can make insomnia worse. It’s interesting to note that:
Going over the good things in life may be more difficult for some people than others, such as those with depression 12 or anxiety. Specialised treatment should be sought for these conditions.
As strange as it sounds, not doing anything about your intrusive thoughts can be a surprisingly effective strategy to deal with them.
Here, the key is simply to accept that you aren’t able to sleep without worrying about the implications, or trying to fight your own thoughts 2. By doing this, the impact of your own intrusive thoughts is dulled, meaning that they are less liable to be arousing and to keep you awake.
These strategies, while effective on their own, are even more effective as part of a structured CBT-i programme 5. There are a variety of approaches that can can be used, depending on what appeals to you, with the ones covered here being:
If you’ve tried multiple techniques and nothing has worked you may need support from an expert sleep team. Sleepstation is a drug-free and clinically-validated sleep improvement programme that can help you optimise your sleep for better health. Get started today.
Harvey AG. I Can’t Sleep, My Mind Is Racing! An Investigation of Strategies of Thought Control in Insomnia. Behav Cogn Psychother. 2001 Jan;29(1):3–11.↑
Espie CA. Overcoming Insomnia: A Self-Help Guide Using Cognitive Behavioural Therapy [Internet]. London, UK: Robinson; 2006. Available from: eprints.gla.ac.uk/33995/↑
Schmidt RE, Harvey AG, Van der Linden M. Cognitive and Affective Control in Insomnia. Front Psychology [Internet]. 2011. Available from: journal.frontiersin.org/article/10.3389/fpsyg.2011.00349/abstract↑
Gellis LA, Park A. Nighttime Thought Control Strategies and Insomnia Severity. Cogn Ther Res. 2013 Apr;37(2):383–9.↑
Harvey L, Inglis SJ, Espie CA. Insomniacs’ reported use of CBT components and relationship to long-term clinical outcome. Behaviour Research and Therapy. 2002 Jan;40(1):75–83.↑
Trockel M, Manber R, Chang V, Thurston A, Taylor CB. An e-mail delivered CBT for sleep-health program for college students: effects on sleep quality and depression symptoms. J Clin Sleep Med. 2011 Jun 15;7(3):276–81.↑
Levey AB, Aldaz JA, Watts FN, Coyle K. Articulatory suppression and the treatment of insomnia. Behaviour Research and Therapy. 1991;29(1):85–9.↑
Harvey AG, Payne S. The management of unwanted pre-sleep thoughts in insomnia: distraction with imagery versus general distraction. Behaviour Research and Therapy. 2002 Mar;40(3):267–77.↑
Digdon N, Koble A. Effects of Constructive Worry, Imagery Distraction, and Gratitude Interventions on Sleep Quality: A Pilot Trial: Effects of Interventions on Sleep Quality. Applied Psychology: Health and Well-Being. 2011 Jul;3(2):193–206.↑
Schmidt RE, Van der Linden M. Feeling Too Regretful to Fall Asleep: Experimental Activation of Regret Delays Sleep Onset. Cogn Ther Res. 2013 Aug;37(4):872–80.↑
Wood AM, Joseph S, Lloyd J, Atkins S. Gratitude influences sleep through the mechanism of pre-sleep cognitions. Journal of Psychosomatic Research. 2009 Jan;66(1):43–8.↑
Malmberg M, Larsen JK. Depressive Symptoms: The Interaction between Rumination and Self-Reported Insomnia. Depression Research and Treatment. 2015;2015:1–4.↑
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