From the Docs

Quiet, Brain — I’m Trying to Sleep!

Sleep deprivation is a common issue among law enforcement personnel, especially with shift work, ongoing staffing shortages and increased overtime. Occasionally not sleeping well is OK; however, chronic sleep deprivation poses serious health consequences if not addressed long-term.

Picture this scenario: You worked a double shift and must be back at work in less than eight hours. You are tired and finally make it home. You get into bed, only to have your brain keep your tired body awake. This scenario sums up a common complaint that I hear from employees who struggle with sleep. Their bodies are tired, but their brains just won’t turn off at bedtime. The overactive mind is a common issue among people who experience sleep difficulty, and research has shown that the brains of people with insomnia are overactive in areas where they should be less active when falling asleep.

Overactive thinking generally involves thoughts that elicit either neutral or negative emotions. Some examples of thinking that involves neutral emotions include thinking about “to do” items, your schedule for the week or seemingly random thoughts. Conversely, thoughts that involve negative emotions are accompanied by unpleasant feelings such as worry, anger, frustration, sadness or anxiety. The strategies for calming an overactive mind look the same for both neutral and emotionally charged thinking; however, you may have to use a few additional techniques when distressing emotions are involved.

Here are a few techniques for quieting an overactive mind at bedtime that are rooted in cognitive behavioral therapy for insomnia (CBT-I). CBT-I involves multiple components, including education about the impact of thoughts, feelings and behaviors on sleep, and techniques to restructure sleep-interfering thoughts and promote relaxation at bedtime. Studies have demonstrated CBT-I to be as effective as medication therapy for adults who have insomnia, and the American Academy of Sleep Medicine gave CBT-I its highest rating (strong recommendation) for the treatment of chronic insomnia in adults.

Wind-down time: Develop a pre-sleep routine that helps your body and brain wind down before bedtime. For example, you can get your clothes ready for the next day, meal prep, take a hot bath or shower, listen to relaxing music, stretch to relax your muscles, drink a cup of non-caffeinated tea or write down any thoughts you have about the day or a particular situation.

Constructive worry: Worry is an attempt at problem-solving but often increases our anxiety as we think about things we cannot control. Bedtime is the least appropriate time to worry, and the anxiety it creates will keep you awake. Two techniques I like to use are “worry time” and “worry dump.” The first involves scheduling time (typically 10–30 minutes is sufficient) to worry each day. This may sound counterintuitive, but it helps you gain control over intrusive worry and rumination. During this time, your task is to worry dump — that is, write down your worries and start generating solutions. Draw two columns and label one “Concerns” and the other “Solutions.” Think of any concerns you have that day that may cause you to worry or keep your brain awake at night and write them down. For each concern, write down some concrete steps you can take to address or solve the issue. This can also include identifying which actions you can take versus which things are out of your control (in which case, the goal is to learn how to manage the associated emotions). If you are unsure what to do about a concern, write down information that you need to help you identify ways to address the issue. When your worry time is up, place the worry dump list on your nightstand and intentionally tell yourself that you are done with your worries for today and will address things again tomorrow, if needed. If your brain begins to worry at bedtime, remind yourself that you have already dealt with things for that day and you will continue working on the concern tomorrow.

Change your perspective: Our thoughts influence how we feel and can also impact how we sleep. Learning how to change your thoughts from sleep-interfering to sleep-promoting can help quiet an overactive mind that is worried about sleep or thinking about trauma. Some examples of sleep-promoting thoughts to counter worry about sleep include “One night of poor sleep is not the end of the world,” “I can tolerate this” or “I can learn to manage my thoughts.” Some examples of sleep-promoting thoughts to counter thinking about trauma include “Nightmares are disturbing but not real and I am safe now,” “I know I’m in a safe place even though my mind is telling me something else,” “My body is reacting to a memory, and I am safe right now” or “This feeling will pass.”

Relaxed body, quiet mind: The body and brain like to be on the same page. For example, when we experience distressing emotions, our body tenses up and our stress response is activated. Likewise, it is difficult to sustain a quiet mind at bedtime when the body is stressed out. Learning to relax our body promotes sleep. Common techniques include relaxation breathing, progressive muscle relaxation, guided imagery, body scan and meditation.

If you are struggling with sleep due to an overactive mind, free and confidential help from a licensed psychologist, trained peer supporter or chaplain can provide you with additional tools and resources. Call Psychological Services Bureau at (213) 738-3500. You can also contact a peer supporter or chaplain via our free and anonymous Lighthouse PSB Wellness mobile app.