Does a Busy Mind Keep You Awake at Night?

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Do you toss and turn at night? Do you churn things in your mind, robbing you of much-needed sleep? If so, you aren't alone. The American Academy of Sleep Medicine recommends that adults need seven or more hours of sleep per night to reduce the risk of adverse health outcomes. Many fall short of this guideline. And, short sleep duration and lack of sleep quality may negatively impact our cardiovascular, metabolic, mental, and immunological health (Watson et al., 2015).

Worry and rumination are significant contributors to:

  • Difficulty in falling asleep (McGowan et al., 2016)

  • Poor quality sleep (Cropley et al., 2015)

  • Shorter total sleep duration (Nota & Coles, 2015)

Worry is defined as the constant and repetitive churn of our concerns and fears to solve a problem or challenge. Rumination is defined as persistent negative thoughts about what we could have or should have done in some past situation. Both worry and rumination have been found to lead to high blood pressure, increased heart rate, and higher cortisol levels (Ottaviani et al., 2016).

Here are some specific ways to deal with the ongoing worry and rumination that’s preventing you from getting your much-needed sleep.

  • Try worrying earlier in the day. When your mind is racing with concerns while you're trying to fall asleep, that can make it nearly impossible to drift off. You might try blocking out 15 minutes during the day to process what's on your mind. Creating a to-do list or thinking about solutions can be a healthy way to deal with stress and prevent it from interfering with sleep later.

  • Focus on breathing. Something as simple as silently saying to yourself, "breathe in and breathe out," while focusing on the gentle rise and fall of your breath, may be enough to relax you and allow you to fall asleep. This works because when you keep your brain focused on one thing it helps you power down.

  • Leverage gratitude. A simple practice of mentally listing all the things/people you are grateful for may soothe your worries and help you put your worries and concerns in perspective.

  • Distract yourself. If you can't fall asleep, get up and try doing something to distract you from worrying about falling asleep. You might flip through magazines, do calming stretches, or engage in some type of relaxing hobby, like knitting or coloring. Avoid anything that's goal-directed or too physically or mentally activating, such as household chores, paying bills, or working on a computer.

  • Calm your mind. Many relaxation techniques can help you calm your mind throughout the day and improve sleep. Breathing exercises can help you achieve calm, but it can also be as simple as taking a walk when you have a short break at work. If you practice techniques for calming your mind during the day, then it will be easier to trigger your relaxation response at night

  • Develop a wind-down routine. Your wind-down routine can be as formal or as informal as you like. Try a few techniques to find out what works for you. Any practice that allows you to have a calming and consistent routine will help signal to your body that it is time for bed.

  • Get out of bed after 20 minutes. If you are having trouble falling asleep after 20 minutes from turning off the lights (or if you wake up and can't fall back to sleep in 20 minutes), get out of bed. Perhaps do something relaxing until you feel sleepy – like having a cup of herbal tea. While you may be tempted to grab your electronic device, the blue light emitted from these devices can inhibit your natural melatonin production. Melatonin is a hormone involved in our internal circadian sleep clock.

  • Reframe the way you think. According to the Sleep Health Foundation, solving sleep problems may involve changing the way we think about sleep. They suggest that changing the way we think about sleep might help reduce our anxiety about sleeping. For example, try to be less perfectionistic about our sleep habits. When we have a few nights of poor sleep, we start to dread going to bed. To help reduce anxiety, it might be helpful to reframe our anxious thoughts to something like, "I might be tired tomorrow, but I will be fine." Over catastrophizing the impact of the lack of sleep can be more damaging than missing a couple nights of sleep.

  • Ask for help. Sometimes managing anxious worry and improving sleep is more complicated than implementing the suggestions listed here. If you have tried these and other techniques and are still experiencing sleep difficulties, ask for help from your physician or a counselor. Sleep problems and anxiety are highly treatable, so consider where you can seek help for your sleep issues.

Here are a couple of exercises that might also help you get a good night’s sleep.

References

Clancy, F., Prestwich, A., Caperon, L., Tsipa, A., & O’Connor, D. B. (2020). The association between worry and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health Psychology Review, 1-22.

Cropley, M., Rydstedt, L. W., Devereux, J. J., & Middleton, B. (2015). The relationship between work-related rumination and evening and morning salivary cortisol secretion. Stress and Health, 31(2), 150-157.

McGowan, S. K., Behar, E., & Luhmann, M. (2016). Examining the relationship between worry and sleep: A daily process approach. Behavior Therapy, 47(4), 460-473.

Nota, J. A., & Coles, M. (2015). Duration and timing of sleep are associated with repetitive negative thinking. Cognitive Therapy and Research, 39(2), 253-261.

Ottaviani, C., Thayer, J. F., Verkuil, B., Lonigro, A., Medea, B., Couyoumdjian, A., & Brosschot, J. F. (2016). Physiological concomitants of perseverative cognition: A systematic review and meta-analysis. Psychological Bulletin, 142(3), 231-259.

Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Tasali, E. (2015). Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: Methodology and discussion. Sleep, 38(8), 1161-1183.