Sleep Problems May be Helped by Therapy

Why Therapy Works
March 1, 2019
Troubled Teens
June 25, 2019

Sleep Problems May be Helped by Therapy

Many of my clients report experiencing fear and anxiety associated with unusual sleep events, but often have trouble talking about their fears, even in therapy.  The fear is often related to unusual experiences before, during and/or immediately upon waking up. Parasomnias are undesirable experiences that are related to sleep, also known as disruptive sleep disorders.   Parasomnias include sleep paralysis, sleep walking, night terrors, illusions and hallucinations when falling asleep (hypnagogic) or waking up (hypnopompic), among other symptoms.   My clients also sometimes report assuming the experience was a paranormal event as evidence of the supernatural, and naturally that would be alarming.   Once my clients learn how the brain functions, especially during sleep events, my clients report relief. As my clients learn to relax, their symptoms also typically improve.    Therapy and good self-care can help reduce anxiety and fear related to sleep problems and may help reduce or even eliminate parasomnias. Bear in mind, it is important to have a medical check-up to rule out any medical conditions, including sleep apnea, allergies, asthma, and other medical conditions that can contribute to parasomnias.

Sleep States

When in a sleep state, we are running our brain on about 1-4 hertz of electrical current, a slow electric cycle.  At 0.5 to 1 hz, we are in a deep sleep state called rapid eye movement (REM) sleep and it is very difficult to awaken.   During sleep, we cycle through 1-4 hz. At 4 hz, we can awaken easily. It is the 4 hz that babies learn to ignore to be able to sleep through the night.   Upon waking up, we are transitioning our brains to running on 5 to 12 hz - or even much faster levels. When transitioning to sleep, we are slowing our brain waves from awake and alert, to a dreamy and calm state before falling asleep.  Why would those transitions be the most likely time to experience unusual brain activity? Our brain is switching gears from one function to another. If you think about how a car can glitch when switching from one gear to another, our brain can similarly experience a glitch when switching consciousness states.  If a sleep disorder is experienced, there is often associated anxiety and fear from experiencing an unusual and sometimes frightening event. In a partial sleep state, what we experience can seem very real. We are changing from one conscious state to another -- we are essentially changing gears from awake to sleeping, or from sleeping to awake.

Worry and Anxiety Can Lead to More Sleep Problems

Worry and anxiety about sleep tends to cause more sleep problems.  Anxiety starts the fight/flight response, making us ready for action.  Engaging the fight/flight response while also trying to go into a sleep state can be compared to revving your car engine while also braking to stop.   This would make a disturbing experience for any passengers in the vehicle. Similarly, a brain being engaged in two different directions increases the possibility of experiencing unusual events and can become a vicious cycle.  

Unusual incidents related to sleep can be the result of many factors, including medical conditions, medications, being sick with fever, being sleep deprived, being under stress, having a mood disorder, experiencing trauma, and/or the result of alcohol and drug use.  Parasomnias are most common in teenagers and young adults. Recognizing how the sleep cycle works, how our brain functions, having a strong support system, and practicing good self-care is essential for our overall functioning and can promote a restful night’s sleep.  Consider the difference between trying to run our car with a lower grade of gasoline than recommended or running past the time of regularly scheduled maintenance. A well-maintained vehicle will typically run with fewer glitches. Likewise, maintaining our health and well-being, and participating in therapy when needed, can be beneficial to find the motivation to adopt healthier lifestyles and improve how we cope with stressors, learn how to improve social functioning, or even learn to better accept what we cannot change.

Practice Good Sleep Hygiene

Adopting good sleep hygiene habits can be helpful when struggling with parasomnia.    Tips for practicing sleep hygiene can include:

  • Knowing how much sleep you need for your age
  • Going to bed at the same time every night
  • Limited screen time before you go to bed
  • Keeping your bedroom dark and comfortable
  • Doing a meditation or taking a warm bath before bed to relax your body and mind

Just like going to a chiropractor for an adjustment, or going to a massage therapist to get the knots out of muscles, counseling therapy can be beneficial to readjust emotionally, and learn to recognize and manage stressors that can help contribute to sleep disorders.

Amzica F1Steriade M., 1998, Electrophysiological correlates of sleep delta waves.  Electroencephalogr Clin Neurophysiol. 1998 Aug;107(2):69-83.  Retrieved June 3, 2019.

Barthlen GM, Stacy C., Dyssomnias, parasomnias, and sleep disorders associated with medical and psychiatric diseases.  Mt Sinai J Med. 1994 Mar;61(2):139-59.  Retrieved June 10, 2019.

National Sleep Foundation; Sleep & Your Lifestyle, Sleep Disorders, Sleep Tools and Tips; How Does Anxiety Affect Sleep?  2019.  Retrieved June 3, 2019.

WebMD Medical Reference Reviewed by Carol DerSarkissian on July 30, 2018, Understanding Sleep Problems -- The Basics; 2018 WebMD, LLC., Retrieved June 3, 2019.

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