Updated: Jan 11
Based on the framework for understanding sleeplessness described in the article ‘Why No Sleep?’, there are a three things you can do in-the-moment when faced with sleeplessness, in the following order:
1. If there isn't enough sleep potential, don’t try to sleep.
2. Deactivate if there is enough sleep potential (or there will be enough soon)
3. If nothing works, reframe the situation.
Step #1: If there isn't enough sleep potential, don’t try to sleep.
When you cannot sleep or you are not sleepy, the first step is to ask yourself the following questions:
Do I have enough sleep potential right now? Have I been awake long enough? Have I been physically active enough? Am I at a point of high alertness in my clock's current rhythm?
If you have enough sleep potential, move on to step #2.
If you don't have enough sleep potential, then don't try to sleep. It's not possible and actually makes things worse by creating an opportunity for worry, frustration, and behaviours that tend to perpetuate sleeplessness.
Instead of trying to sleep, use this time for something else that is enjoyable and/or productive. Just be careful to not get caught up in activities that are too activating. Anticipate when there will be enough sleep potential and try to deactivate by then.
Shift the meaning of the time before you have adequate sleep potential from 'wasted time not sleeping' to 'bonus time' when you can do something you wouldn’t have otherwise had time for.
Long periods of being unable to sleep due to low sleep potential can easily take on the false meaning that you are a 'bad sleeper', that sleeplessness is solely due to an overactive mind, or that you won't be able to sleep without medication.
Remember that you need both enough sleep drive and the right body clock signals for sleep to have adequate sleep potential.
To determine whether you have enough sleep drive, consider how long you have been awake (remember the 14-hour rule), if you have napped, and if you have been physically active enough that day.
To determine whether you are at a point in your body's 24-hour clock when you have sleep potential, consider your recent sleep patterns as well as the recent daily patterns of alertness and sleepiness to get a sense of your ideal sleep window (ISW) and the timing of your clock.
What are enjoyable and/or productive things I can do when I do not have enough sleep potential? What are activating cues or activities that I need to avoid during this time?
Step #2: Deactivate if there is enough sleep potential (or there will be enough soon).
If you think there is adequate sleep potential, the following questions are helpful:
What is the likelihood out of 10 that I will be able to fall asleep in the next 15 minutes? What DECODE factors are driving sleeplessness?
If the likelihood is an 8 out of ten or higher, it's reasonable to get into bed and attempt to sleep. If you have been awake in bed for more than 15 minutes, however, then try the recommendations below.
Otherwise, try the following recommendations (in the order listed) to help you deactivate.
To address cued high activation, get out of bed or, if you are not yet in bed, stay out of bed and do something else enjoyable and relaxing.
When you can’t sleep, getting out of bed is the best first step and, surprisingly, one of the most effective due. This is because it is very common for the bed to become a cue for a state of high activation.
Do something else relaxing and then only get into bed and attempt to sleep once you are deactivated and sleepy. You may find that out of bed, your mind quiets and you body becomes less tense, allowing sleepiness to come more easily.
Ensure that you a relaxing activity to focus on, as this will help to crowd out activating worries and thoughts.
Once sleepy and upon returning to bed, if you become reactivated, repeat this step.
A common trap is to return to bed too early. It is best to be right on the 'edge of sleep' before you return to sleep.
While this may seem simple on paper, in the moment, this is very difficult to do. It is essential to prepare a place to go and things to do ahead of time. More suggestions can be found in this article.
To address an overactive mind and open loops, capture thoughts.
If your mind is still very active out of bed, jot down anything and everything on your mind.
This includes to-dos, worries, problems, things to remember, ideas, plans, or memories. This practice can allow your mind to let go of things long enough to allow you to relax and become sleepy.
Have a notebook on hand so that you don’t have to go looking for one in the moment.
To take things a step further, process what you have written down the following day when you are alert and best able to choose the next step required to solve the problem, to complete the task, and/or to make good decisions.
Parents can use this technique by creating a worry box to capture their children's worries in the moment, then process the worries the following day together during a regular 'worry time'.
If you can make a habit of capturing and processing your thoughts daily, with time, your mind may learn that it can let go of these thoughts at bedtime. Your mind may start to trust that there will be a better opportunity to work on these thoughts during the day (when you likely have a more clear and effective mind).
For all causes of high activation, relax your body and mind with a relaxation strategy
If you are out of bed, have engaged in relaxing activities, and have captured all your thoughts but you are still too activated, try calming your body and mind with relaxation strategies.
While you may require additional support and practice to benefit from these strategies (as would be covered in a course of treatment), you can start to learn these strategies with free or inexpensive apps, books, podcasts, and programs.
A couple of my favourites include--
Other resources can be found here.
What has helped to deactivate me in the past? What other ideas, tools, or strategies could I try?
Step #3: If nothing works, reframe the situation.
What if nothing works?
Sometimes, there is simply no more to do.
You can, however, keep yourself from making an unfortunate situation worse.
In these situations, the best option is to redirect your attention away from trying to sleep and to accept that it may just be a poor night's sleep.
Again, shifting your view of 'wasted time not sleeping' to 'bonus time' can take the pressure off sleep.
It's also important to avoid attaching unhelpful meaning to a poor night's sleep.
It is very common to have the worry that you will not function the following day if you don't get enough sleep. This worry tends to be heightened by the frustration and stress of sleeplessness.
While you may feel the effects the following day and perceive yourself to be performing poorly after a poor night's sleep, this does not mean that you are objectively functioning at a lower level.
Remind yourself of past times when you did not sleep well but functioned well the following day.
If you have experienced a poor performance related to a lack of sleep, remember that our minds have a tendency to magnify these incidents and forget about the times when functioning was not compromised after little sleep.
Now that you have a plan for responding to sleeplessness, what steps can you take to reduce the risk of sleeplessness in the first place? For recommendations, go to the fifth and final article in this series on how to prevent sleeplessness.