ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

I Can't Sleep and I Can't Stand It! Tips for Overcoming Sleep Problems

Updated on November 24, 2011
kimh039 profile image

Kim is licensed in mental health and addiction counseling. Her education is in business, counseling, and health administration.

John's sleep diary - week 1

“I can’t sleep. It’s awful. I can’t stand it. I absolutely have to sleep. I can’t afford not to sleep. I’m tired, so why can’t I sleep? I should be asleep. I can’t take this anymore. This is bulls#!t! What’s wrong with me? If I don’t sleep, I won’t be able to function tomorrow. I have to be alert to do my job. If I don’t sleep, I’ll lose my job. I’ll have an accident on the job. I won’t be able to work. If I lose my job, what will happen to my family? I’m going to lose my job now. My family will live in poverty. I’ll get bags under my eyes. I’ll look like a zombie and a freak. No one will hire me. I’ll be irritable. I won’t be able to handle stress. I have to be calm, cool and collected – and I won’t be. If this keeps up, I won’t get that promotion. I have to get the promotion. I’ve worked too hard to screw it up now. It figures though. That’s just like me to screw up another good opportunity. I always screw things up. I can never go the whole yard. I’m pathetic. I’m a useless failure. I give up. It’s no use. I’ve tried everything. Nothing works. I can’t help it. What’s the point? No wonder I’m so depressed. F?#k it! It’s over now! I’m done. I’m losing my mind. I’ll get sick next; crazy and sick. I’m headed for the insane asylum, the psych ward, the loony bin. Soon I’ll start seeing things and hearing things. That’s what happens to people who don’t sleep. Sleep deprivation! Then I’ll get sick; pneumonia, cancer, stroke, heart attack. People who don’t sleep are more prone to illness. This really pisses me off! I should be sleeping! What’s wrong with me? There must be something wrong. The rest of the world is asleep. It’s a pretty simple thing to do; go to sleep. Yet, I can’t do it. What does that say about me? OMG! I’m a pathetic loser.”

This is John’s sleep diary from six weeks ago. Since then he has learned a lot about sleep behavior and about his thoughts about sleep. Last week, when he found himself awake for ten minutes, he calmly got up out of bed and went downstairs to journal. After thirty minutes of journaling and reading, he was tired again and went back to bed. He fell asleep for the night. He woke up after 7 hours of sleep feeling fully refreshed and restored. Here is his journal entry from that night:

John's sleep diary - week 6

“I’m writing in my journal because I am not sleeping. I learned not to lie in the bed for more than 20-30 minutes if I am awake. It’s ok that I am not asleep. It’s not the end of the world. It’s inconvenient, perhaps but hardly a big deal. I know how to handle this situation! When I’m tired again, I’ll go back to bed. It’s quite common for people to have times when they are not able to sleep. While I prefer to get 8 hours of sleep, I know it’s not absolutely necessary. I will do just fine. The world will not end because I am awake right now. I’ll use this time to catch up on some reading I haven’t had time to do. When I get tired, I’ll go back to bed. I caught myself starting to think I am a loser for not sleeping, but I know that not sleeping does not make me a loser!”

Notice how angry and upset John was six weeks ago, and how much more calmly and confidently he handles a sleep situation now. He has learned a lot about sleep in the last six weeks. In addition to learning some more accurate facts about sleep, some behavior techniques, and good sleep hygiene, he learned how his thoughts and beliefs about sleep can help or worsen his sleep. His thoughts six weeks ago led to his feeling angry, anxious, upset and depressed. Now his thoughts help him remain calm and increase his chances of getting back to sleep. He has regained a sense of control and reduced his emotional distress.

Perceptions about Sleep

Studies show that people with insomnia perceive that the time it takes to fall asleep is longer than it actually is, and report getting less sleep than they actually did. They overestimate the time it takes to fall asleep and underestimate the amount of sleep they are getting. John thought it took him at least two hours to fall asleep, and estimated that he was sleeping a total of 3.5 to 4 hours of disrupted sleep each night. It actually took him 45 minutes to fall asleep and he was sleeping 5 hours each night.

Concerns about Consequences

People with sleep problems often have concerns about the consequences of poor sleep. John’s concerns were that he would lose his job, miss out on a promotion, become mentally and physically ill, and not be able to provide for his family. These concerns about the consequences of poor sleep lead to anxiety which increases arousal and interferes with a person’s ability to relax and go to sleep. Learning to change concerns and beliefs about sleep prevents this arousal and promotes better sleep. By changing their thoughts about sleep, a sense of control is restored and emotional distress is reduced. John learned to compare his beliefs about what would happen with what actually happened the day after a restless night. He discovered that no one ever said anything to him the next day about his performance or not doing his job or behaving differently.

Cognitive Distortions and Myths about Sleep

John learned about “cognitive distortions” or faulty ways of thinking. He learned some general distortions that can lead to anxious, depressed, angry and upset feelings that can interfere with sleep. He also learned about specific beliefs about sleep, sleep myths, which interfere with sleep. He used a sleep journal to help him recognize these false beliefs and change his beliefs to more accurate and helpful beliefs that reduce arousal and promote better sleep.

Cognitive Distortions:

Black and white thinking: always (sleep or do poorly) and never (sleep or do well).

Absolute thinking: “I must sleep 8 hours.” “I have to get 8 hours of sleep.”

Unrealistic expectations - should statements: “I should never wake up at night” and “I should be asleep.”

Perception of consequences: “I cannot work/function without 8 hours of sleep.”

Catastrophic thinking: “I can’t stand it” and “It’s awful or horrible.”

Negative prediction: “I’m losing control of my sleep” “I’ll never get to sleep.”

Hopelessness: “There is little chance of getting better.”

Helplessness: “There is nothing I can do.” “I can’t…..”

Negative or derogatory self talk: “I’m worthless” and “I can’t do anything right.”

Myths and Facts:

Myth: If I go to bed earlier, I’ll have a better chance of getting more sleep.

Fact: Going to bed earlier decreases the chance of falling to sleep. The body has a natural sleep rhythm and a window of time that is optimal for sleep onset. Trying to fall asleep outside of this window creates frustration and anxiety, which worsens insomnia.

Myth: I need at least 8 hours of sleep to feel rested.

Fact: Most people do need 7.5 to 8 hours of sleep each night. There are individual differences with some people needing only 4 hours of sleep and others needing up to 10 hours. If a person only requires 5 hours of sleep but believes he needs 8 hours, he will try unsuccessfully to get 8 hours of sleep. The perception that he is “losing sleep” creates unnecessary stress.

Myth: I should stay in bed and try harder to fall asleep.

Fact: It is poor sleep hygiene to continue to lie in bed hour after hour looking at the clock. Good sleep hygiene involves getting out of bed after 20 minutes, engaging in a sleep promoting activity such as reading or meditation, and returning to bed when tired. Keep the alarm set, but cover it or put it under the bed. Looking at the clock doesn’t help promote sleep, but does increase anxiety about not sleeping.

Sleep Hygiene

John also learned about sleep hygiene and the importance of maintaining good sleep hygiene. Sleep hygiene refers to positive and negative behaviors and routines that can affect ability to sleep. Positive sleep hygiene includes behaviors and routines that promote good sleep. Negative sleep hygiene involves behaviors that interfere with the ability to sleep. Increasing positive sleep behaviors and eliminating negative ones can enhance other efforts aimed at improving sleep.

Positive Sleep Hygiene

  • Create a relaxing routine before bedtime: diary writing, hot bath, meditation, muscle relaxation
  • Limit activities in bed to sleep and sexual activity.
  • Improve coping skills so sleep is not used as an escape or to avoid problems.
  • Keep the bedroom dark, cool and quiet.
  • Maintain a regular sleep and meal schedule.
  • Exercise regularly: but not right before bedtime.
  • Avoid naps.
  • Reduce alcohol and caffeine in the evening.
  • Learn and practice relaxation techniques.
  • Maintain good health and seek treatment for health problems.

Negative Sleep Hygiene

  • Use of alcohol to sleep.
  • Watching scary movies before bedtime.
  • Staying in bed for 12 hours.
  • Irregular sleep schedule.
  • Daytime napping.
  • Drinking fluids before bedtime.
  • Drinking caffeine before bedtime.
  • Eating chocolate before bedtime.
  • Overly rigid bedtimes.
  • Exercise right before bedtime.
  • Going to bed hungry or right after eating.
  • Eating and watching TV in bed.
  • Sleeping in to make up for lost sleep.
  • Too much noise, heat and light.
  • Too much physical or mental activity right before bedtime.

Behavioral Techniques for Improving Sleep

Finally, John learned some behavioral techniques that helped him establish a consistent sleep-wake cycle. He learned ways to relax more and reduce tension as well.

John used Stimulus Control techniques to help him associate the bed and bedroom with sleep and sleepiness, and to reduce the association with activities that interfere with sleep or are incompatible with sleep. These techniques helped him establish a consistent sleep-wake rhythm. He followed these strict instructions:

  • Lie down to go to sleep only when sleepy
  • Do not use the bed for anything except sleep
  • Do not read, watch TV, eat or worry in bed.
  • Sexual activity is the only exception to this rule
  • If unable to go to sleep, get up and go into another room until ready to go to sleep.
  • Repeat as many times as necessary.
  • Set your alarm and get up at the same time every morning regardless of how many hours slept
  • Do not nap during the day.

Like many people with sleep problems, John had begun to spend excessive amounts of time in bed to compensate for sleep loss, especially on the week end. He used Sleep Restriction techniques to limit the amount of time spent in bed to time actually spent sleeping. John was sleeping 5 hours a night, so he limited sleep to 5 hours a night at first. He set and maintained the same “sleep window” (sleep time to wake time) 7 days per week at first. He needed to wake at 5 a.m. so he slept from midnight to 5 a.m. every night. This was difficult at first because he felt tired and not fully alert during the day. He maintained this schedule for a week, then gradually added more sleep time to 7 hours each night. He continues to sleep from 10 p.m. to 5 a.m. each night. He finds that he is alert during the day and sleeps well at night.

John is learning more about relaxation techniques now. He has troubles with anxiety and mind-racing. He is often tense and has a hard time relaxing. He is learning about progressive muscle relaxation, deep breathing, guided imagery and meditation. He uses progressive muscle relaxation and has ordered some guided imagery CDs and a DVD on yoga breathing.


    0 of 8192 characters used
    Post Comment

    • kimh039 profile image

      Kim Harris 5 years ago

      I see, WVBards. I like your emphasis on fibromyalgia and sleep problems. I like the part about human growth hormone.

    • WVBards profile image

      Fibromyalgia Daughter 5 years ago from Seattle

      Definitely a vital article in the conversation about the health of sleep! I wrote one, as well, in its relation to major diseases, but I think you've inspired me to delve even deeper into sleep itself.

    • kimh039 profile image

      Kim Harris 6 years ago

      Thank you MisaLeonessa. I work with someone who is on a gluten free diet. When she first found out she needed to avoid gluten, she didn't know what she could eat. Now she understands it better and is eating better. You make a good point about pain being a hindrance to good sleep for a lot of people; different pains for everyone but still poor sleep as a result. I hope you persist in getting treatment that will help, so you can sleep better:)

    • MisaLeonessa profile image

      MisaLeonessa 6 years ago

      Great article, kimh039! Well researched and written. I have sleep problems but mine are more connected to food sensitivities. I react to gluten, dairy, and legumes, and if I get any of these in any amount or form I get really bloated and my stomach hurts all's the pain that keeps me awake. I have done much reading on the subject of insomnia and your article and links ring true. I've learned to get up when I'm not sleeping. Still trying to address the food sensitivities, since that is the underlying problem. I am considering doing some EEG Neurofeedback for this and other issues.

    • kimh039 profile image

      Kim Harris 6 years ago

      well said. I work with people who often haven't slept for days and are having serious psychiatric symptoms as a result. I also work with someone who recently was treated for insomnia and sleep apnea. She used to miss work a lot from headaches and depression. Now she is so much more alive!

    • RealHousewife profile image

      Kelly Umphenour 6 years ago from St. Louis, MO

      Unfortunately, I used to hear about how people never could have imagined how much better they feel after getting treatment....but it's so true. Sleep affects your every day waking life so much! People get used to waking up feeling tired so they don't realize it is NOT normal! While it becomes their norm - it's still terrible and could be better:).

    • kimh039 profile image

      Kim Harris 6 years ago

      Well thanks RH...for the applause and for your contribution of additional information from the R-PSG-T hands-on perspective. Like you say, people don't realize there is help. Also, like molometer points out, a lot of people make jokes about sleep problems and don't take them seriously. I think most of us take sleep for granted....until there is a problem....and even then we don't think we have a problem so we don't even realize the need for help! Thanks for coming back RH.

    • RealHousewife profile image

      Kelly Umphenour 6 years ago from St. Louis, MO

      Hi Kim 039 - this is excellent. I am an R.PSG.T - your advice is perfect!

      Caffeine can stay in your body for up to like 10 hours - so it's a major contributor to many people. If these tips don't help - then people should see a sleep specialist to determine if they are having PLMS or maybe apnea, whatever else could be going on. Anxiety can destroy sleep but sometimes it's impossible to tell if there's an underlying cause for the frequent awakenings.

      Sleep stage misperception is also really common....lots of people can eventually get into the lighter stages I.e. 1 and 2 - but it's super easy to be woken up from fuses stages and so it feels as if they never went to sleep when in really they are having trouble achieving the deeper sleep stages which make you feel more rested.

      Super up and awesome - the main problem with sleep issues is education! People do not realize there is help! I applaud you for doing a fabulous job!

    • kimh039 profile image

      Kim Harris 6 years ago

      Definitely pass it on to your Dad. Couldn't hurt to get checked out. I used to be a purrrfect sleeper; not so much lately:( Thanks for reading and commenting hailei. I really appreciate it.

    • hailei profile image

      hailei 6 years ago from Romania

      Very interesting hub. I'm gonna translate it for my father who has always been a poor sleeper. It's not that he sleeps for only a few hours, he wakes up a lot during the night.

      Fortunately, I adore sleeping and I'm very good at it :)) But I had a period of a few weeks when I had problems sleeping and it was terrible. I was s cranky and tired.

      thanks you!

    • kimh039 profile image

      Kim Harris 6 years ago

      Hi molometer:) Your hub mentions how frequent urination during the night is related to snoring and sleep apnea. I just recently learned that that has to do with stress hormones our body produces to protect the heart because the heart works so hard in a person who stops breathing while snoring! Snoring is a very serious condition. I wrote another hub on "Sleep Apnea Increases Risk of Stroke" that you might also be interested in. I'm glad you are understanding sleep problems better...and I assume you are getting treatment. I appreciate the link and will include yours here as well. Thanks for your kind comments and pushing all the buttons, molometer:) May your sleep be peaceful.

    • molometer profile image

      molometer 6 years ago from United Kingdom

      A very detailed hub on the many problems associated with sleep.

      I think you might want to have a look at a hub I wrote on snoring.

      I am going to link your hubpage to my one so that all the bases are covered.

      You can add my link to your hub too which would make sense.

      I have suffered with sleep problems and associated issues that you cover well in this excellent hub.

      My whole life has been a battle with sleep and only recently have I had a new look at the real causes of disturbed sleep. Something so simple and yet deadly.

      Thanks for a writing a very important hub.

      Voted up and all the buttons except funny

    • kimh039 profile image

      Kim Harris 6 years ago

      smiling:) Hi Melovy. I'm glad I left a comment on your hub too.... well, a novelette really! Thanks for finding your way here in spite of my long windedness. I think everyone has been in John's slippers - which was b. Malin's point I suppose! It is funny and frustrating. From now on we'll all wake up at 3 am rolling on the floor laughing!!! We'll be too busy laughing to worry about sleeping!

    • Melovy profile image

      Yvonne Spence 6 years ago from UK

      I’m so glad you left a comment on my hub, because I’m delighted to have found yours! This hub is great. Like Happyboomernurse I laughed at that first journal entry of John’s. I’ve been there too, and gave up caffeine years ago because of it. I usually have no trouble getting to sleep nowadays, but often wake in the night and sometimes stay awake a while. A few months ago I read a Paul McKenna book that gives similar advice to yours (though there are few suggestions here he didn’t make). Like you he also pointed out that most insomnia is caused by worrying about insomnia. It’s hilarious and frustrating at the same time! I’m definitely guilty of lying in bed instead of getting up after I’ve been awake a while (usually listening to relaxation exercises on my ipod). I will need to try getting up instead and see how it goes. But maybe after reading this I’ll be so relaxed I’ll get straight back to sleep.

      Thanks for this hub.

    • kimh039 profile image

      Kim Harris 6 years ago

      Alastar Packer, I think I'd want to see a sleep specialist then. The docs in the video suggest thinking of sleep problems as a symptom of another problem - in which case you'd have to get treatment for the other problem in order for sleep to improve. It could be a medical problem like sleep apnea or separate mood or anxiety problems. I have definitely heard of people getting psychotic symptoms from not sleeping for a few days. I never heard of a disease like you describe. I would hope a person could get help before it got that bad - and put in a coma or something! Thanks for reading and commenting, Alastar Packer. I hope you find relief soon.

    • kimh039 profile image

      Kim Harris 6 years ago

      Thanks bangingbeauty. I found myself awake last night and applied a few of these tips myself. 1) I decided not to kick in frustration as that would be arousing. 2) i resisted the urge to look at the clock. 3) I reminded myself that I wasn't really awake forever and that it is ok to wake up at times. It worked:) Hope you find it helpful too.

    • Alastar Packer profile image

      Alastar Packer 6 years ago from North Carolina

      Hi Kim. I've had trouble with sleep for a few years now and its mostly about the anxiety that comes with worrying about sleep; that and waking up every two hours or so. I've asked the doctor and others about waking up every couple hours but no one can say why. The MD just pushes new sleep meds that don't work so well. Your article brings up some good ideas and explanations and I thank you for that. Have you ever heard of a very rare disease where a sufferer can't sleep at all and eventually the brain just shuts down?

    • bangingbeauty profile image

      bangingbeauty 6 years ago

      Great information, I do tend to have trouble falling asleep occasionally and will bear your tips in mind. Thanks for this!

    • kimh039 profile image

      Kim Harris 6 years ago

      Hi gracenotes. I'm glad it was helpful. Now sleep walking is another hub! Insomnia is about not sleeping and when a person is sleepwalking they are definitely asleep. Our daughter sleep walked one night from her bedroom, through the living room and into the dining room. It was kind of scary because she could have walked right out of the house or fallen down the stairs! She was a very deep sleeper. I hope you're safe gracenotes:) Thanks for reading and commenting.

    • kimh039 profile image

      Kim Harris 6 years ago

      I think that's part of one of the points is that to some extent we do all have problems sleeping at some times, and the expectation that we should always get 8 hours of sleep and never have a sleepless night is unrealistic. Some people do have severe sleep problems though that can be very distressing. Thanks for the comments b. Malin.

    • gracenotes profile image

      gracenotes 6 years ago from North Texas

      This was very helpful, Kim. I will take some of these suggestions to heart. Sometimes lately, with some stressful situations in my life, I do not sleep very soundly, or miss some sleep. I'm pretty sure that I have been walking in my sleep as well. I understand that this can occur with insomnia.

    • b. Malin profile image

      b. Malin 6 years ago

      Don't we all have these nights Kimh. I've certainly had my share. Sometimes I think it's more a "Woman" thing". Most men hit that pillow and off they go. Great useful Information my friend. I loved some of the techniques. Thank you.

    • kimh039 profile image

      Kim Harris 6 years ago

      Hi Mentalist acer:) Best ever?! Thanks! I did notice there were a lot of articles that said a little, but none really that said a lot about insomnia. Thanks for reading and commenting.

    • kimh039 profile image

      Kim Harris 6 years ago

      Thanks RH! That's right. You're one of those PSG techs they talk about in the research - like the ones that told our friend John he was sleeping 5hrs! Thanks for reading and commenting RealHousewife.

    • Mentalist acer profile image

      Mentalist acer 6 years ago from A Voice in your Mind!

      This is the best insomnia advice piece I've ever read...very informative Kim.;)

    • RealHousewife profile image

      Kelly Umphenour 6 years ago from St. Louis, MO

      Excellent hub and tips! So many people who suffer from insomnia have sleep stage misperception. They will swear they weren't sleeping even when I watched them sleep and the graphs show sleeping brainwaves!

      Fascinating hub!

    • kimh039 profile image

      Kim Harris 6 years ago

      Oh. Night shift. I'll get to work on the quiz! Have a good night:)

    • profile image

      femmeflashpoint 6 years ago

      No worries Kim - I work the night shift, lol.

      When I'm 'not sleeping' during daylight hours, I'm writing, or reading, or editing, or interviewing, and usually YAWNING through most of it!! (Grin!)

      You can bet, when things settle down at work this evening, then I'll be right back to this article and taking notes!!

    • kimh039 profile image

      Kim Harris 6 years ago

      Your comments are music to my ears, femmeflashpoint:) ... oh, but not in the sense of being glad you're struggling with sleep, of course, but glad you find it useful and helpful:) Let me know how it goes. Thanks for reading, bookmarking, thumbs upping and voting. I appreciate it. Although, that is a lot of activity before bedtime:)

    • profile image

      femmeflashpoint 6 years ago


      I'm sooooo bookmarking this!!!

      I don't even wanna get started on poor-sleep, no-sleep, interrupted-sleep, being sleepy, worried that I'm not going to sleep at all (and many of my 'nights' I don't) ... this is wonderful information, and yes indeedy, I do plan to make use of it!

      Thumbs up and voted up!

    • kimh039 profile image

      Kim Harris 6 years ago

      Hi truthfornow. Kind of a performance anxiety:) I find that that anxiety helps me wake up on time though - which is more of an issue for me. I have had trouble sleeping when I go somewhere for the first time or the night before starting a new position. Thanks for taking a few minutes to read and comment, truthfornow:)

    • truthfornow profile image

      truthfornow 6 years ago from New Orleans, LA

      Very useful tips. I seem to have more trouble sleeping when I know I have to get up early ~ more anxiety around sleeping when I know I really need to get to sleep by a certain time. Setting a sleep schedule seems like a good idea.

    • kimh039 profile image

      Kim Harris 6 years ago

      (smiling) Yes she would have. It sounds like you did too:)

    • Happyboomernurse profile image

      Gail Sobotkin 6 years ago from South Carolina

      We had a lot of rain yesterday but today was crisp and sunny which was great because the annual Sea Witch Festival was held in Rehoboth Beach. There was music, magic and lots of kids and pets who looked so cute in their Halloween costumes. Sophie would have loved it.

    • kimh039 profile image

      Kim Harris 6 years ago

      Thanks HBM:) ....then throw in traffic and poor road conditions due to snow,an accident or construction! It can be easy to stress and worry, even when we know it's better not to. Thanks for stopping in to read, comment and rate. I hope you are not getting that early snow that CT is getting - even if you don't have a commute:)

    • Happyboomernurse profile image

      Gail Sobotkin 6 years ago from South Carolina

      Very comprehensive and well researched hub about overcoming sleep problems. I love the way you used an actual case scenario and was laughing when I read the first paragraph because I used to stress out over not being able to get to sleep especially if I had to wake up very early for work or to attend a seminar or lecture that required early morning travel.

      I like the tips you suggested and the cognitive therapy approach.

      Voted up, useful and interesting. This article should be very helpful for anyone currently having sleep issues and is a much healthier way to cope than relying on sleeping medication.