Enhancing Sleep with Cognitive-Behavioral Approaches: Challenging Cognitive Themes for Better Sleep

“Sleep disturbances are often maintained from maladaptive thought patterns. By challenging maladaptive thought patterns such as catastrophic thinking or fear of sleeplessness, we can significantly improve our sleep quality and well being.”

Prof. Guy Doron, Reichman University

Aron’s experience with dealing with sleep disturbances

As a fresh college grad, I was in a constant battle with sleep. Nights were spent wrestling with anxieties about tomorrow’s tasks and life’s pressures. Little did I know, my own thoughts patterns were messing with my sleep. My doctor suggested trying Cognitive-Behavioral Therapy (CBT) for my sleep issues. CBT helped me identify some messed up thinking patterns, like thinking everything would be a disaster if I didn’t get enough sleep, over monitoring of my sleep and craving for a perfect night sleep. Through CBT, I started challenging those maladaptive thoughts and found ways to relax my mind before bed, to reduce checking and stressing about the amount of sleep I get, and acknowledging that not every night would be with perfect sleep. Over time I saw improvements in falling asleep and how I felt about sleep. Even on not-so-great nights, I don’t stress anymore. I’ve embraced a calmer mindset and strategies that support restful sleep.

Types of sleep disorders

Sleep disturbances encompass a variety of issues that can affect one’s ability to obtain restful sleep. These disturbances can have an effect on an individual’s overall health, mood, and cognitive functioning. The most common types include:

Insomnia: Characterized by persistent problems falling and staying asleep. Insomnia can be acute, often triggered by stress or a specific event, or chronic, lasting for a month or more.

Sleep Apnea: A serious condition where breathing repeatedly stops and starts during sleep. Obstructive sleep apnea, the more common form, occurs when throat muscles intermittently relax and block the airway.

Narcolepsy: A chronic sleep disorder marked by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often experience disrupted nighttime sleep and abnormal REM sleep.

Circadian Rhythm Disorders: These involve disruptions in the circadian rhythm, the internal body clock that regulates the 24-hour cycle of biological processes. This can include delayed sleep phase disorder, jet lag, shift work disorder, and more.

Parasomnias: A category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, or dreams. Examples include sleepwalking, sleep terrors, nightmares, and REM sleep behavior disorder.

Treatments can range from lifestyle changes and behavioral therapy to medications and, in some cases, medical devices or surgery. Maladaptive cognitive themes contribute many times to the quality of sleep, and tackling them can bring great relief for many of those suffering from disturbed sleep.

Common cognitive themes related to sleep disturbances

Numerous individuals face sleep disturbances influenced by maladaptive cognitive patterns. Cognitive-Behavioral Therapy (CBT) offers tools and models for addressing these cognitive themes. By identifying and challenging maladaptive thoughts, individuals can improve their sleep quality. Let’s explore common cognitive themes related to sleep and how altering these can lead to more restful nights.

Anxiety and Worries: Anxiety and excessive worries, especially at bedtime, can activate the body’s fight or flight response, making it difficult to relax and fall asleep. This hyperarousal state disrupts the natural sleep process, leading to issues like insomnia.

Catastrophizing: The tendency to catastrophize, or imagine the worst possible outcomes related to sleep, can create a self-fulfilling prophecy. Believing that a single bad night’s sleep will ruin the next day can increase stress and hinder one’s ability to drift off peacefully.

Fear of Sleep Difficulties and Uncertainty about Sleep: Some individuals develop a fear of sleep difficulties, associating bedtime with stress and frustration. This apprehension can breed a cycle of sleep anxiety, where the fear of not sleeping becomes the very obstacle to slumber.

Striving for Perfect Sleep: The pursuit of perfect sleep can create unrealistic expectations that put pressure on the individual. When these expectations are not met, it can lead to dissatisfaction and a hyperfocus on sleep performance, rather than on sleep itself.

Sleep Monitoring: Excessive monitoring and scrutiny of one’s sleep can contribute to heightened awareness and anxiety about sleep patterns. This might include obsessive clock-watching or using sleep-tracking devices that might actually worsen sleep anxiety.

Overthinking about Sleep: Overthinking about the need to sleep can induce performance anxiety. When individuals become preoccupied with the mechanics of falling asleep, they paradoxically increase their wakefulness.

Preoccupation with the Negative Consequences of Sleep: Constantly focusing on the negative consequences of poor sleep, such as diminished cognitive function or mood disturbances, can amplify worries related to sleep, creating a negative feedback loop.

Belief in Change: Conversely, a lack of belief in one’s ability to improve sleep can be a barrier to making the behavioral or cognitive changes necessary to enhance sleep quality.

Constructive Tips for Improved Sleep Based on Challenging Cognitive Themes

Challenge Catastrophic Thinking: Replace catastrophic thoughts with more balanced views. Remind yourself that one poor night’s sleep is not catastrophic and that you can cope with the day ahead, even if you’re tired.

Address Fear of Sleep Difficulties: Gradually confront fears of sleep by challenging negative assumptions and establishing a soothing bedtime routine.

Revise Perfectionist Tendencies: Redefine your expectations around sleep. Understand that sleep varies naturally and that chasing perfection can be counterproductive.

Reduce Sleep Monitoring: Limit clock-checking and monitoring the amount and quality of sleep. Focus instead on your overall well-being and factors that contribute to good sleep.

Shift Focus from Negative Consequences: Emphasize positive sleep experiences and acknowledge that while sleep is important, humans are capable of functioning even when sleep is not ideal.

Cultivate a Belief in Change: Reinforce your confidence in improving your attitude towards sleep and developing a more realistic view and expectations from sleep.

Is it possible to change my sleep thinking habits?

Improving sleep through CBT tools entails a dedicated effort to identify, challenge, and shift maladaptive cognitive patterns. Using digital tools such as evidence based apps have also proven as an effective option to challenge these cognitive patterns and to help develop more adaptive thought patterns surrounding sleep.

By employing these strategies and tools and focusing on the role of thoughts and behaviors in sleep, individuals can foster a more tranquil relationship with bedtime and slowly improve their overall quality of sleep.