Getting to Sleep and Panic Attacks at Night
Hello
As most doctors will tell you, there are two things that
disturb sleep: physical pain and worry. It's therefore
understandable that many people with anxiety report
frequent sleep disturbance as a major problem.
Not being able to sleep can actually be quite traumatic
for many people.
The first thing you need to understand about sleep
is this: it's not the amount of sleep you get that's
important, but rather the quality of the sleep.
Quality over quantity.
I am going to give you some quick tips to help tackle
any problems you are having with sleep.
Firstly, to break the insomnia cycle, begin by not
presuming you will sleep! That seems like the wrong
attitude, but if you approach each night as just a possible
opportunity to sleep, this helps remove the pressure you
are placing yourself under.
In a way, some people have performance anxiety
when they think about sleeping:
"Will I be able to make myself sleep tonight?"
The answer is maybe yes, maybe no. If you're going
through a period of sleeplessness, a good night's sleep
isn't guaranteed, for whatever reason, so you have to
accept that for the moment. If you get one or two hours' sleep,
that's well and good, and if you get nothing, then accept it
and move on. Each night, as you retire, say to yourself:
"I'm preparing for bed, but I won't try to force sleep.
If it comes, it comes. If not, I won't beat myself up over it.
This is a period I'm going through, but I'll soon
return to normal sleep patterns."
Every person goes through periods of sleeplessness from
time to time. It's very natural. You may not be aware of
why you experience sleeplessness, but at the very
least, you can accept it.
Let me emphasize the importance of surrendering to your
inability to sleep. Surrender to whatever may or may not
happen during the course of a night, and you'll put your mind
under less pressure. After a certain point, it's really the anger
and frustration that keep you awake most of the night.
physical workout each evening in the outdoors. This is very
effective because the mind may try to keep you awake,
but the sheer physical exhaustion brings on sleep quicker.
Couple that with a willingness to accept sleeplessness, and
you'll find yourself sleeping much easier
Remember that alcohol, caffeine, and nicotine should
be avoided several hours before sleep. You may be the type
who finds it initially hard to get to sleep as your mind races
with anxious thoughts. Should you find your mind racing and
you simply can't achieve sleep, keep a journal beside your bed.
Sit upright and start to write down how you feel:
"I'm feeling quite restless. I keep turning over and over,
trying to sleep, but I have worries on my mind."
Now write down all of your worries, for example:
"Tomorrow I have to do X, and I'm afraid I won't be
well rested, etc."
Continue to write down your worries until the exercise
actually becomes quite boring. Then your body and mind
will slowly want to return to sleep. Writing like this is a simple
tool for preparing your mind in a linear way to wind down
and return to sleep (an advanced form of counting sheep).
Don't be afraid of writing pages and pages of nothing in particular.
What you're doing is helping the conscious mind release
whatever is keeping it awake so it can stop obsessing and
return to sleep.
You see, one of the reasons we can't fall asleep is that our
mind feels these worries (whatever they are) are important
to analyze over and over; they need urgent attention and
therefore should be thought about all night long.
The more worked up you get by the worries, the more your body
gets stimulated and the harder sleep is to achieve.
Writing down all your worries on paper has the
effect of saying to your mind:
"Okay, mind, you think these are important. I've written
them all down in detail. They won't be forgotten, I promise.
I can come back to them tomorrow and deal with
them then-but RIGHT NOW, let's sleep."
The mind can be like a small child who just needs reassurance
that things will be dealt with and looked after. That's all it
needs to let go of these mental worries. You then discover,
in the morning, that almost all of the worries or
concerns aren't big issues. Many of our worries are the
workings or an overactive imagination.
Dr. Dennis Gersten of San Diego suggests an approach
that is effective for particularly restless nights. You may
want to experiment with it the next time you are very restless in bed.
Try the following:
-As you lie there in bed, start by remembering a time in your
life when you absolutely had to stay awake!
Maybe it was an important exam you were studying for and you had to
keep cramming through the night.
Maybe it was staying up all night nursing your baby to sleep.
Maybe it was when you were traveling through the night
on a bus and needed to stay awake in case
you missed your stop.
I am sure there have been many different occasions in your
life where you had to force yourself to stay awake.
-Remember the weariness and the effort just to keep your
eyes open. Remember how your eyelids felt like lead weights
and you wished you could close them, even just for a minute.
At that time, you could not give in to your urge to fall asleep;
you had to fight hard to stay awake. Relive those memories
and really try and remember exactly what that felt like.
-Now think about right now, and how good it feels to actually
be in bed with no pressing need to stay awake. Think how much
you would have given to be where you are now, lying in your bed
with your head resting on the pillow and the complete freedom you
have to fall asleep. It feels really good to actually have full permission
to fall asleep right now.
There are no demands on you to stay awake. With your eyes
closed spend a few more minutes remembering that time.
-End of exercise.
Night Panic Attacks
People with anxiety disorders can sometimes be awakened
at night by panic attacks. We know that most nighttime panic
attacks aren't caused by dreams. Records of sleep polysomnographia
show that most panic attacks take place during the early sleep
phase (phase II), not during the REM phase associated with dreams.
This is different from nightmares. Nightmares happen during
the second half of the night, so we're often able to
remember the content of these dreams.
It's important not to go to bed fearing you might have a
panic attack. Go to bed confident that if one should arise,
you'll successfully deal with it. That way, you don't put yourself
under pressure to NOT have a panic attack. Many panic attacks
are experienced at the very moment of falling asleep.
If you wake with a panic attack, implement the One Move Technique
as outlined in my course Panic Away. (See end of email)
Here's a description a woman recently gave of her experience:
"Getting to sleep is a real problem. Just as I'm about to
drop off to sleep, my body seems to jolt awake,
like an electric shock, which then frightens me
and keeps me awake for hours."
This jolt is called a hypnic jerk, or hypnagogic massive jerk.
A hypnic jerk usually occurs just as the person enters sleep.
People often describe it as a falling sensation or an
electric shock, and it's a completely normal experience.
It's most common when we're sleeping uncomfortably or
overtired.
There's been little research on the subject, but there are
some theories as to why hypnic jerks occur. When we drift
off into sleep, the body undergoes changes in temperature,
breathing, and muscle relaxation. The hypnic jerk may be a
result of the muscles relaxing. The brain misinterprets this as a
sign of falling, and it signals our limbs to wake up,
hence the jerking legs or arms.
People turn hypnic jerks into panic attacks because they
already feel nervous about their condition and the jolt scares
them into thinking something bad is happening.
Again, it's a fearful reaction to a sensation. Usually when
these people wake up, they gasp for air, and this can
also turn into a fear of a breathing problem while sleeping.
If you jolt awake with panic, then simply understanding the
nature of a hypnic jerk can strip away
the anxiety from the experience.
Reassure yourself that you're safe and that the jerk isn't
something to worry about. It doesn't disrupt your bodily
functions, and it doesn't put you in any danger.
I hope you have been able to take something
from it. I want to leave you with a few last comments.
All too often people with anxiety are pressurized to end
their anxiety. People pass remarks like:
"I wish you could just snap out of your anxiety".
Although people mean well, these type of comments
are not helpful. People don't just think one thought and
snap out of anxiety. There is a step by step process of
removing the illusion that anxiety creates and for some
this can take time where the anxiety has been present for
many years.
As this is the last of the mini email series I really want
to impress upon you that anxiety is curable. What you must never
stop doing is searching for the right approach for you. By the way
I hope I have not come across too strong in pushing my
course Panic Away. I am excited by the results it gets and
that is why I talked about it frequently.
After many years working in this area I am now more
convinced than ever that every single person, regardless
of how severe, can end their anxiety problem. If you have
a thought that is telling you different then you need to lose
that thougth.
Never stop trying, never give up.
That is the best you can do.
Best Wishes
Joe Barry
If you want to learn more about my work then visit
the following link:
PanicAway.com
If you missed any of the previous newsletters visit :
http://www.panicaway.com/newsletter/index.htm
All material provided in these emails are for informational or educational purposes only.
No content is intended to be a substitute for professional medical advice,
diagnosis or treatment. Consult your physician regarding the applicability
of any opinions or recommendations with respect to your
symptoms or medical condition
Panic Away
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