Night-time anxiety and insomnia: mindbody prescription

I have been waking up at 3 am like clockwork for at least 10 years.

I used to do the following:

1. Get upset
2. Start looking for something to distract me from feeling anxious (read or eat)
3. Look at the clock to see for how long I have been awake
4. Decide to take a pill or not, and if yes - which one of three types that I have
5. Stay awake and miserable thereafter, with pill or without - at least 3 times out of 4

What do I do now:

1. Do not get upset. Think about what is the reason for anxiety
2. Find a reason and attach emotion to the anxiety: fear, sadness, shame, excitement
3. Make myself FEEL the emotion
4. Talk to my inner child and walk it through the experience, focusing on a positive outcome
5. Go back to sleep - 3 times out of 4!

Thank you, Dr, Sarno!

 

This is very good advice. Self-nurturing. Thank you.

 

I also have had chronic insomnia and couldn't figure out how to get a good night's sleep. I would fight it, get up and read, take sleeping pills, warm milk, etc.. At my wife's suggestion I started going to bed with ear buds in my ears playing peaceful nature sounds like rain, thunder, waterfalls, even a campfire popping away. (I use Spotify and made some playlists by searching for "Peaceful sounds" "Night Ambiance" "nature sounds" ). This has made a world of difference for me. I now sleep through the night and feel totally refreshed. Just a little suggestion for anyone who continues to wake-up every night.

 

I wish that helped me... been through sounds, peaceful music, brainwaves, etc - never worked. I use John Kabat-Zinn's meditation CD and it helps a bit...

 

It helped me to go to bed between 9:30 and 10 or 10:30. You can read about the body cycles online. For women, our hormones repair supposedly between 9 and 11. I noticed that my "second wind" picks up if I don't go to sleep when I'm naturally tired at around 9:30. There's also a lot of info about being on a computer or phone screen past 8 p.m. or so. The light from the screen sends our brains "daytime" messages. I try to shut my phone and computer down 2 hours before I head to bed. You've probably read all of this before, but thought I'd send just in case.

 

Thanks! Yes, have been through behavioral therapy, do all the above, plus sleeping in a cold, dark room - still wake up. I have no doubts at this point that my insomnia is TMS.

 

Thank you all for this thread. I developed anxiety about 7 months ago. Using Dr. Sarno's methods, I improved about 85%. I still regularly wake up at 3am with a pounding heart (like TG957). I often make the mistake of searching for answers on Google. You can read all kinds of scary things and you can be pointed to all kinds of medicine. I know that it is TMS. Following Claire Weekes' advice of acceptance and not fear is key. It is just so easy to get wrapped up in it all. Waking up anxious at 3am for 7 months gets old. I appreciate all of the ideas I get on the forum. Thank you!

 

Your sleep pattern is normal and age old, the thought that we should all sleep a compacted eight hours of sleep is NOT normal, a product of the industrial age and the time clock. Read this article and don't worry about waking up in the middle of the night. Use the time productively.

http://www.bbc.com/news/magazine-16964783 (The myth of the eight-hour sleep - BBC News)

 

Thank you for reminding me of my own post! It has been a tough couple weeks for me and my insomnia is back, waking me up every night at 3 am. I am still not fearful, but for some reason it gets harder to go back to sleep following my own advice Good to know that I am not alone and that I have Dr. Sarno, Dr Weekes and all of you by my side!

 

TG957 - We know we need to accept vs fight our feelings at 3am. We know that it gets worse when we fight it or get upset about it. Coming to this forum reminds us all that we are not alone. Even though we know these things, it is so helpful to have a community where you can share your thoughts and experiences. Now, if I can just stop Googling about it ..... Thank you for sharing your experience. I hope your insomnia gets better!

 

AC45, thank you for your kind words! You know, obsessive tendencies is a trademark of a TMS personality. Something tells me that googling is a manifestation of TMS - maybe responsible for the remaining 15% of your insomnia? Best of luck to you!

 

It helped me to re-read this thread today. The 3am wake up anxiety has really been strong lately. I know it is TMS so I do not want to take sleeping pills. I've done months of journaling. I've come a LONG way but sometimes you will not always get at the supressed feelings. Patience and acceptance is what I know I need but sometimes it is hard! Waking up tired for 9 months in a row gets old .

 

been a year at least for me, probably longer?, that I wake up for an hour or two at about 3-4am. when I'm feeling fairly content and keep to my normal routine this happens less for sure. have had insomnia issues most of my adult life as I worked a lot of shift work in my twenties and I'm not sure you body ever forgets that. I am accepting of the early morning wake up now and don't fight it or let it drag me down if possible, as even on one occasion woke up in a total rage and sweating profusely and realized I was meeting my repressed emotions!which in itself was super healing after I digested all that darkness and acknowledged them and told them they could f*off now. I've tried all the techniques but mostly just stay calm and accept it works best. any anxiety real or imagined (like a long drive in the morning knowing I have to be up at a certain time) and I sometimes get zero sleep as once I miss the first 15 minute REM drop off I cannot get to sleep at all, the next day is always a challenging one, staying alert to drive and staying positive. once at my destination I'm able to crash and sleep from exhaustion. a little jumbled story telling here but again love that I know I'm not alone and can share thoughts and experiences on this forum. happy nights to all!

 

Hi Brant,

Thank you so much for sharing your story. It does help me to know that I am not alone. I too and trying hard not to get upset about it. I know the easy way out would be to get into sleeping pills but that just isn't a future I want to get into. I know my 3am anxiety is TMS but I admit that I do not know what the repressed emotions are. I've journaled for 9 months, gotten much better with my TMS overall but this pesky sleep stuff remains. Thanks again so much. It really helps to have this peer support.

-AC45

 

Magazine

The myth of the eight-hour sleep
By Stephanie Hegarty BBC World Service

• 22 February 2012
• From the section Magazine
• comments

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Image copyright Other

We often worry about lying awake in the middle of the night - but it could be good for you. A growing body of evidence from both science and history suggests that the eight-hour sleep may be unnatural.

In the early 1990s, psychiatrist Thomas Wehr conducted an experiment in which a group of people were plunged into darkness for 14 hours every day for a month.

It took some time for their sleep to regulate but by the fourth week the subjects had settled into a very distinct sleeping pattern. They slept first for four hours, then woke for one or two hours before falling into a second four-hour sleep.

Though sleep scientists were impressed by the study, among the general public the idea that we must sleep for eight consecutive hours persists.

In 2001, historian Roger Ekirch of Virginia Tech published a seminal paper, drawn from 16 years of research, revealing a wealth of historical evidence that humans used to sleep in two distinct chunks.

Image copyright bbc
Image caption Roger Ekirch says this 1595 engraving by Jan Saenredam is evidence of activity at night
His book At Day's Close: Night in Times Past, published four years later, unearths more than 500 references to a segmented sleeping pattern - in diaries, court records, medical books and literature, from Homer's Odyssey to an anthropological account of modern tribes in Nigeria.

Much like the experience of Wehr's subjects, these references describe a first sleep which began about two hours after dusk, followed by waking period of one or two hours and then a second sleep.

"It's not just the number of references - it is the way they refer to it, as if it was common knowledge," Ekirch says.

During this waking period people were quite active. They often got up, went to the toilet or smoked tobacco and some even visited neighbours. Most people stayed in bed, read, wrote and often prayed. Countless prayer manuals from the late 15th Century offered special prayers for the hours in between sleeps.

And these hours weren't entirely solitary - people often chatted to bed-fellows or had sex.

Between segments
Image copyright AFP
Some people:

• Jog and take photographs
• Practise yoga
• Have dinner...

Ten strange things people do at night

A doctor's manual from 16th Century France even advised couples that the best time to conceive was not at the end of a long day's labour but "after the first sleep", when "they have more enjoyment" and "do it better".

Ekirch found that references to the first and second sleep started to disappear during the late 17th Century. This started among the urban upper classes in northern Europe and over the course of the next 200 years filtered down to the rest of Western society.

By the 1920s the idea of a first and second sleep had receded entirely from our social consciousness.

He attributes the initial shift to improvements in street lighting, domestic lighting and a surge in coffee houses - which were sometimes open all night. As the night became a place for legitimate activity and as that activity increased, the length of time people could dedicate to rest dwindled.

When segmented sleep was the norm

• "He knew this, even in the horror with which he started from his first sleep, and threw up the window to dispel it by the presence of some object, beyond the room, which had not been, as it were, the witness of his dream." Charles Dickens, Barnaby Rudge (1840)

• "Don Quixote followed nature, and being satisfied with his first sleep, did not solicit more. As for Sancho, he never wanted a second, for the first lasted him from night to morning." Miguel Cervantes, Don Quixote (1615)

• "And at the wakening of your first sleepe You shall have a hott drinke made, And at the wakening of your next sleepe Your sorrowes will have a slake." Early English ballad, Old Robin of Portingale

• The Tiv tribe in Nigeria employ the terms "first sleep" and "second sleep" to refer to specific periods of the night

Source: Roger Ekirch. Visit Roger's website.

In his new book, Evening's Empire, historian Craig Koslofsky puts forward an account of how this happened.

"Associations with night before the 17th Century were not good," he says. The night was a place populated by people of disrepute - criminals, prostitutes and drunks.

"Even the wealthy, who could afford candlelight, had better things to spend their money on. There was no prestige or social value associated with staying up all night."

That changed in the wake of the Reformation and the counter-Reformation. Protestants and Catholics became accustomed to holding secret services at night, during periods of persecution. If earlier the night had belonged to reprobates, now respectable people became accustomed to exploiting the hours of darkness.

This trend migrated to the social sphere too, but only for those who could afford to live by candlelight. With the advent of street lighting, however, socialising at night began to filter down through the classes.

In 1667, Paris became the first city in the world to light its streets, using wax candles in glass lamps. It was followed by Lille in the same year and Amsterdam two years later, where a much more efficient oil-powered lamp was developed.

Image copyright bbc
Image caption A small city like Leipzig in central Germany employed 100 men to tend to 700 lamps
London didn't join their ranks until 1684 but by the end of the century, more than 50 of Europe's major towns and cities were lit at night.

Night became fashionable and spending hours lying in bed was considered a waste of time.

Stages of sleep
Every 60-100 minutes we go through a cycle of four stages of sleep

• Stage 1 is a drowsy, relaxed state between being awake and sleeping - breathing slows, muscles relax, heart rate drops
• Stage 2 is slightly deeper sleep - you may feel awake and this means that, on many nights, you may be asleep and not know it
• Stage 3 and Stage 4, or Deep Sleep - it is very hard to wake up from Deep Sleep because this is when there is the lowest amount of activity in your body
• After Deep Sleep, we go back to Stage 2 for a few minutes, and then enter Dream Sleep - also called REM (rapid eye movement) sleep - which, as its name suggests, is when you dream

In a full sleep cycle, a person goes through all the stages of sleep from one to four, then back down through stages three and two, before entering dream sleep

Source: Gregg Jacobs

Gregg Jacobs' site - CBT for Insomnia

Find out more about the science behind sleep

"People were becoming increasingly time-conscious and sensitive to efficiency, certainly before the 19th Century," says Roger Ekirch. "But the industrial revolution intensified that attitude by leaps and bounds."

Strong evidence of this shifting attitude is contained in a medical journal from 1829 which urged parents to force their children out of a pattern of first and second sleep.

"If no disease or accident there intervene, they will need no further repose than that obtained in their first sleep, which custom will have caused to terminate by itself just at the usual hour.

"And then, if they turn upon their ear to take a second nap, they will be taught to look upon it as an intemperance not at all redounding to their credit."

Today, most people seem to have adapted quite well to the eight-hour sleep, but Ekirch believes many sleeping problems may have roots in the human body's natural preference for segmented sleep as well as the ubiquity of artificial light.

This could be the root of a condition called sleep maintenance insomnia, where people wake during the night and have trouble getting back to sleep, he suggests.

The condition first appears in literature at the end of the 19th Century, at the same time as accounts of segmented sleep disappear.

"For most of evolution we slept a certain way," says sleep psychologist Gregg Jacobs. "Waking up during the night is part of normal human physiology."

The idea that we must sleep in a consolidated block could be damaging, he says, if it makes people who wake up at night anxious, as this anxiety can itself prohibit sleeps and is likely to seep into waking life too.

Russell Foster, a professor of circadian [body clock] neuroscience at Oxford, shares this point of view.

"Many people wake up at night and panic," he says. "I tell them that what they are experiencing is a throwback to the bi-modal sleep pattern."

But the majority of doctors still fail to acknowledge that a consolidated eight-hour sleep may be unnatural.

More from the Magazine
Image copyright Rex Features

• Margaret Thatcher was famously said to get by on four hours sleep a night
• That put her in a group of just 1% of the population

Can we really get by on four hours of sleep?

Weird things people do in their sleep

"Over 30% of the medical problems that doctors are faced with stem directly or indirectly from sleep. But sleep has been ignored in medical training and there are very few centres where sleep is studied," he says.

Jacobs suggests that the waking period between sleeps, when people were forced into periods of rest and relaxation, could have played an important part in the human capacity to regulate stress naturally.

In many historic accounts, Ekirch found that people used the time to meditate on their dreams.

"Today we spend less time doing those things," says Dr Jacobs. "It's not a coincidence that, in modern life, the number of people who report anxiety, stress, depression, alcoholism and drug abuse has gone up."

So the next time you wake up in the middle of the night, think of your pre-industrial ancestors and relax. Lying awake could be good for you.

Craig Koslofsky and Russell Foster appeared on The Forum from the BBC World Service. Listen to the programme here.

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Related Internet links

• 
  Dr Gregg Jacobs - CBT for Insomnia
• 
  Sleep A Very Short Introduction - Oxford University Press
• 
  Craig Koslofsky - University of Illinois

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Tom, this is very good information and very helpful to understanding our sleep patterns. However, it is not the duration of the sleep that matters, it is the feeling refreshed and energetic when we wake up - basically, the quality of sleep. Only those who have had chronic insomnia for years can understand the mental fog and exhaustion that comes with the lack of quality of sleep, much more so than from the short hours of sleep.

When I wake up at 3 am, I wake up not because I have had enough sleep, but because my brain cannot rest. There are days when sleep like a log from 11 pm until 5 am - and then I get up and go through the day with full energy. But the 3 am wake-up usually results in all-day misery, whether I end up going back to sleep or not. People here who complain about sleep interruption, me included, have an issue of not getting rest or dealing with unbearable anxiety that prevent us from sleeping normally. I often do get 8-9 hours after the 3 am waking time, but all day after I am a tired mess.

 

The article Tom posted assumes that one can go back to sleep after being awake a couple of hours (segmented sleep). When I wake up in the middle of the night, I'm not able to go back to sleep. Thus, I end up with only 3-5 hours of sleep, which is not enough for me to function well. String several nights like that together and I am in very bad shape, and then resort to using a sleeping medication for some relief.

 

Are you getting enough exercise or physical work to get yourself bodily tired. The "new-age" has made many of us very sedentary paper-pushers-mind oriented, throwing the balance of the bodymind energy equation heavy into a MINDbody imbalance for urban-suburbanites. It's gotten to the point we have to join gyms or do exercise that we would have gotten naturally a century ago by doing manual work. If you're not getting a minimum of aerobic exercise a day, you will not get naturally physically tired enough to go into deep-sleep. Eventually you will sleep.

 

Tom - good try. But, I am a hiker and backpacker. I had very bad nights after a 10 mile hike in the mountains with elevation gains of 2500 feet with a heavy backpack. Completely physically exhausted and still not able to sleep more than 3-4 hours. I would run 3-4 miles and after then not able to sleep.

 

That is the case for me, too. There is no correlation between being physically tired and being sleepy for me. My fight/flight mechanism gets stuck in the "on" position. I suspect it is due to my high ACE score. I am hypervigilant and unable to feel safe enough to let myself go into sleep. Occasionally I can fall asleep without medication and sleep 7-9 hours without waking up, but lately never more than 2 nights in a row. Most difficult TMS equivalent for me to get a handle on.