Can’t sleep? How to manage insomnia, according to psychologist Dr Lillian Nejad

Everybody understands the frustration of a poor night’s sleep and a lot of us have trouble sleeping sometimes.

But how do those of us who experience continuous sleepless nights overcome it?

Dr Lillian Nejad, clinical psychologist at Omnipsych, defines insomnia as difficulty falling asleep and/or staying asleep.

“In clinical terms, difficulty falling asleep, called sleep-onset insomnia, is when it takes more than half an hour to fall asleep. Difficulty staying asleep, called sleep-maintenance insomnia, can mean that you wake several times a night or you may wake up much earlier than usual and not be able to get back to sleep,” she said.

According to the Diagnostic Statistical Manual of Psychiatric Disorders, also known as the DSM-5, a diagnosable sleep disorder is when sleeping difficulties occur at least three times a week for three months, and cause significant distress and impairment to one or more areas of your life (e.g. social, work, relationships).

Chronic lack of sleep can impact your daily functioning, emotional wellbeing and physical health, Dr Nejad said.

Signs that sustained lack of sleep are impeding on your daily functioning include the inability to think clearly, decreased reaction time, inability to concentrate and make decisions, and feeling mentally and physically tired during the day.

A sleeping disorder can impact on your emotional health too, by increasing emotional distress, anxiety and risk of depression.

While more research is required to substantiate the impacts of insomnia on physical health, it is claimed to increase the risk of high blood pressure, heart disease, weight gain and Type 2 diabetes.

Therefore, it is important to address a sleep disorder to minimise the impacts on your overall health.

Here are some tips for managing insomnia:

Wake at the same time every day

While the method for treating insomnia often depends on the individual and identifying what is contributing to their sleeping problem, one rule of thumb that Dr Nejad sticks to is: wake up at the same time every day, regardless of how much or how little sleep you got at night.

It helps to keep your circadian rhythm consistent, and anchoring your wake-up time signals to your body when you should be awake and when you should be asleep.

Get your sleeping environment right

One thing that can contribute to insomnia is the sleeping environment, Dr Nejad said.

But you can do three simple things to improve your sleep zone: make sure the room is dark, have a comfortable mattress and pillow, and ensure your room is an ideal temperature, usually between 17 and 20 degrees Celsius.

Address unhelpful daily habits

What you do during the day can have an impact on the quality of sleep you get at night.

Dr Nejad advises against day-time napping, and recommends reducing or cutting out caffeine, and doing some form of physical activity.

Have a night-time routine

Have you given much thought to what you do before you go to bed?

Dr Nejad said developing a sleep routine can be helpful in aiding restful sleep – consider reading a book, doing a relaxation exercise or listening to soothing music.

Always avoid drinking alcohol before bed.

Avoid unhelpful thoughts

Thoughts like “I’ll never get to sleep” or “I won’t be able to function without sleep” are not helpful when tackling insomnia.

Dr Nejad suggests replacing unhelpful thoughts with a belief that you will be able to sleep, such as “I am working on getting a better night’s sleep”.

This approach is often linked to a lower severity of insomnia and better outcomes in treatment.

“Remember that resting calmly in bed is almost as restorative as sleep,” Dr Nejad said.

Ditch the screens

Screen time, including smart phone use, can interfere with sleep if you can’t tear yourself away from it.

“It’s important to go to bed when you feel sleepy even if it’s in the middle of a game you’re playing or a show you’re watching. Also, choose activities one to two hours before bed that are not too stimulating. Finally, try to keep your phones and other devices out of your room if they are distracting or emit too much light,” Dr Nejad said.

Other problems

For those experiencing high stress, Dr Nejad suggests accepting that you may not sleep due to the current situation or circumstances.

For anxiety and depression, she advises seeking professional help to treat the cause.

Those having difficulty with substance use should consult their prescribing doctor for medications and treat any dependence on licit or illicit substances.

Achieving success in managing insomnia

For optimum success, Dr Nejad said sleep strategies need to be implemented systematically and consistently, which requires a great deal of organisation, discipline and patience.

“Understandably, it can be difficult to apply these changes on your own. Because there are a number of emotional, cognitive, behavioural, physiological and situational factors that can affect your sleep, you would be forgiven for feeling overwhelmed and for not knowing where to start,” she said.

Dr Nejad said there are several benefits in seeing a mental health professional who specialises in sleeping problems – they can tailor a program to your specific difficulties and individual circumstances, and keep you on track to implement the strategies effectively.

Dr Lillian Nejad is a registered and endorsed clinical psychologist at Omnipsych and has more than 20 years’ experience in the field. She is also the author of Lifeblockers: The Sleep Edition.