[speedwalker]

Hi everyone,
My anxiety and insomnia has been the worst it’s ever been this month and I am now finding that my bedtime routine actually makes me more anxious leading up to my sleep window. I have been trying to read before I go to bed (not in bed) and I fall asleep so easily reading in my chair, but when I get into bed, the anxiety comes flooding back and I can’t fall asleep for hours. It’s hard to stay out of bed and read when I know I’ll just fall asleep within 10 minutes of getting back up. Do you have any advice on what I should do before my sleep window or as my nighttime routine? Thank you!

[Martin Reed]

Hello speedwalker — and sorry to hear about the heightened anxiety and insomnia you’ve been experiencing this month.

There’s nothing you can do before the sleep window begins to make sleep happen because sleep cannot be controlled. So, I simply suggest doing things that you personally find relaxing and enjoyable. This is going to be different for everyone.

If you can fall asleep really easily in your chair but then find it really hard to sleep when in bed, this suggests that (through repeated experience) you’ve learned to associate your bed with unpleasant wakefulness. So, to protect you from this unpleasant wakefulness, the body activates the arousal system as soon as you get into bed and this, understandably, makes sleep quite difficult.

The good news is that since this association has been learned, it can be “unlearned” — and one way we can do that is by ensuring that we only allow ourselves to sleep in our bed and that we get out of bed whenever being in bed doesn’t feel good. This is part of a cognitive behavioral therapy for insomnia (CBT-I) technique known as stimulus control.

Just as it took time for that conditioned arousal to develop, it will take time to address. It can be challenging (especially in the short-term) but if you only allow yourself to be in bed when conditions are right for sleep (or you are actually asleep) your mind will — once again — form a strong association between the bed and sleep.

As this happens, you will likely start to find that you can maintain sleepiness as you transition from being out of bed to getting into bed (especially when combined with an appropriate sleep window).

I hope this helps.

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