Skills for Anxiety Related Insomnia

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Now that you know how to do relaxation training (see prior articles), we want to talk about how it is used to build on other Anxiety management skills. 

Anxiety-Related Insomnia and Sleep Disruption

We have mentioned the fact that many cases of insomnia are associated with both anxiety and the curious conflict patients have about falling asleep.  With regard to the conflict, patients know rationally, that they need to get to sleep and their “wise, rational mind” truly wants to sleep.  On the other hand, it anxiety-related aspects of their thinking and brain truly don’t want them to sleep.  Patients experience a stream of continual thinking, worrying, problem-solving etc., that keep them awake.  For instance, they may feel the inescapable need to engage planning the events of the next day, worrying about unresolved conflicts or reviewing recent conversations, trying to “re-do” them, etc.  Patients typically report they, “can’t shut their brains off to fall asleep”. 

Relaxation training can be very helpful in helping patients interrupt anxious, insomnia-related thinking.  As I’ve just mentioned, the main challenge patients report is that they (rationally) want to sleep, but it seems that some part of their brain doesn’t want to let go of thinking, worrying or problem solving.  Therefore, when trying out any bedtime relaxation procedure designed to interrupt this anxiety-related thinking, patients invariably report that the powerful tendency to” keep on thinking” will tend to draw their mind away from the relaxation training activities, which aim to focus patients’ full attention on their breathing or relieving muscle tension in their bodies.  Patients report they have to pull their mind back to the relaxation training content repeatedly.   This effort takes “work” and is frustrating to many patients.  I honestly assure patients however,that with practice and persistence, they can gradually learn to spend more and more time engaged with the relaxation training procedures that promote sleep, and less time thinking, worrying, problem-solving etc.   The key point here is that focusing on breathing, relaxing different muscle groups etc., is incompatible with thinking, worrying, problems-solving; one cannot do both at the very same time.  Therefore, the relaxation procedure is a very important tool in disrupting repetitive, night time anxiety thinking.    

Copyright 2019  David M. Stein, Ph.D.  Readers are welcome to link to this article.   Copying this article without the written permission of the author is not permitted.  Copying the article and presenting it on another website without appropriately crediting the present author is considered plagiarism.  This action will be reported to state or provincial licensing boards as an ethical violation.