Sleep problems and ACT

What can be defined as a sleep problem?

Sleep problems, also known as insomnia, are characterised by difficulties in falling asleep, staying asleep, or experiencing poor sleep quality. It is a common problem that can affect people of all ages, although it becomes more prevalent as individuals age. Sleep problems can have various causes, including stress, anxiety, depression, certain medications, medical conditions, lifestyle factors, and environmental factors. Persistent sleep problems can have negative effects on physical health, mental well-being, and overall quality of life. It can lead to daytime fatigue, decreased cognitive function, mood disturbances, weakened immune system, and an increased risk of accidents.

Core characteristics of sleep problems

Generally speaking, sleep problems can include:

• Difficulty falling asleep at night
• Waking up frequently during the night
• Trouble returning to sleep after waking up during the night
• Waking up too early in the morning
• Feeling tired or fatigued upon waking
• Daytime sleepiness or drowsiness
• Irritability, mood disturbances, or difficulty concentrating
• Impaired performance at work or school
• Increased errors or accidents
• Worrying about sleep and its impact on daily functioning.

Can there be any advantage to issues with sleeping?

Sleep problems can be very common, affecting 1 in 3 people in the UK (NHS Inform) with numerous negative effects on physical and mental health. While some people believe there can be advantages to less sleep, these are generally only beneficial for a short time. If continued for longer periods of time they can start to cause physical and mental health problems which may need some sort of intervention.

Sleeplessness, can vary in severity and duration. While occasional restless nights are common and often resolve on their own, persistent, or chronic insomnia may require additional help. Here are some general guidelines for when intervention could help:

• Duration: If the sleeplessness lasts for more than a few nights or persists for several weeks, it may be necessary to seek intervention. Chronic insomnia is typically diagnosed when sleep difficulties occur at least three nights per week for three months or longer.
• Impact on daily functioning: If sleeplessness significantly affects daily life and functioning, such as impairing concentration, mood, work performance, or relationships, it may be a sign that help is needed.
• Health consequences: Sleeplessness can have adverse effects on physical and mental health. If fatigue, daytime sleepiness, decreased immune function, increased risk of accidents, or worsening of existing health conditions are experienced due to lack of sleep, seeking support is advisable.
• Psychological distress: Persistent worry about sleep or excessive efforts to control sleep can exacerbate the problem and lead to a cycle of sleeplessness. If sleeplessness causes significant distress, anxiety, or depression, it may be appropriate to seek help.
• Underlying causes: There may be identifiable causes contributing to sleeplessness, such as medical conditions (e.g., sleep apnoea, chronic pain), medication side effects, substance abuse, or psychological disorders.
  Adequate and restful sleep is crucial for overall well-being, so recognising and addressing sleep problems is important to maintain optimal health and functioning.

How ACT can help to treat sleep problems

Treatment for sleep problems often involves addressing the underlying causes. Lifestyle changes such as maintaining a regular sleep schedule, creating a sleep-friendly environment, avoiding stimulants (e.g., caffeine) close to bedtime, and adopting relaxation techniques can sometimes improve sleep quality. In some cases, cognitive-behavioural therapy (CBT) or medications may be recommended to manage sleeplessness too. It’s important to note that while ACT can be beneficial for managing sleep problems, it’s always advisable to consult with a qualified mental health professional who can tailor the therapy to your specific needs and circumstances. They can provide guidance and support throughout the process.

Here’s some ways that Acceptance and Commitment Therapy (ACT) can support people who suffer from sleep issues:

• Consciously observing: ACT emphasises mindfulness, which involves being fully present and impartially aware of the present moment. By practicing mindfulness, individuals can develop an accepting attitude towards their thoughts, feelings, and bodily sensations related to sleeplessness. This can help reduce the tendency to struggle against or get caught up in negative thoughts and emotions about sleep. Cognitive defusion techniques can help individuals recognise that thoughts such as “I’ll never fall asleep” or “I need to sleep or else I’ll be exhausted” are just mental events and not necessarily be very useful. By defusing from these thoughts, individuals can reduce the impact of such thoughts and mitigate the distress that has been caused by their sleep problems.
• Self-compassion: ACT encourages individuals to develop self-compassion and treat themselves with kindness and understanding. Lack of sleep can be frustrating and self-critical thoughts may arise such as; “I must get to sleep”, “What’s wrong with me?!”, “Everyone else gets good sleep” etc. By practising self-compassion, individuals can reduce self-judgement, promote self-care, and create a more supportive internal dialogue e.g,“this is difficult and I’m doing my best here”.
• Values clarification: ACT therapy encourages individuals to clarify their values and identify what is truly important to them in life. By aligning behaviours and goals with values, individuals can establish a sense of purpose and meaning. This can help reduce the significance and preoccupation with sleep problems, allowing individuals to engage in fulfilling activities even when sleep is challenging.
• Commitment to lifestyle changes: ACT emphasises taking committed action towards one’s values, even in the presence of difficult thoughts and emotions. In the context of sleep issues, this means focusing on adopting healthy sleep habits and a consistent sleep routine, regardless of the immediate outcome. It involves making lifestyle changes, such as creating a sleep-friendly environment, practicing relaxation techniques, and establishing a regular sleep-wake schedule.

For individuals:

If you’re experiencing sleep problems and it is significantly affecting your daily life, it is advisable to consult a healthcare professional who can provide a proper diagnosis and suggest appropriate treatment options. Our trained therapists can provide guidance and tailored support in applying ACT principles to managing sleeplessness.

For professionals:

We offer a range of live training and on-demand courses covering ACT therapy and various disorders including sleep problems. Also take a look at our free resources and blog for additional reading and insight.

Reference:

NHS inform. (2023). Insomnia. Retrieved from https://www.nhsinform.scot/illnesses-and-conditions/mental-health/insomnia