Home > Aches and Pains > Vitality and Well-being

Getting the Sleep You Need

By Marcia Albert, Ph.D.

Desperately Craving Sleep

It is 2:00 a.m. The house is quiet, your mind is not! You want sleep. You need sleep. Though tossing and turning in an attempt to find the perfect position, sleep still doesn't come. Even if you sleep like a log under normal conditions, the stresses of having cancer can create havoc with a pleasant nights rest.

I know all too well what it is like to desperately crave sleep and not be able to fall asleep. When I was going through treatment, it was a terribly difficult and depressing period of my life. During this time I filed for divorce, was faced with a defiant adolescent who was in jail and was forced to work three part-time jobs to survive; consequently I had a great deal of responsibility. Fears about survival did not help!

It didn't help to have a sleep disorder as well. I was constantly fatigued. Fortunately, I was seeing a therapist weekly and explored a variety of methods to help me sleep better. I share them (and a few other suggestions) in the hope they will help you sleep better. Some may seem very simple, but over time they can have dramatic results.

Break the Association Between Wakefulness and Bed

Plan to go to bed only when sleepy and avoid reading or watching television in bed. If you are glancing at the bedroom clock every couple minutes, place it so you cannot see it. If you cannot fall asleep within approximately 20 minutes, leave the bedroom and do something relaxing until you feel sleepy. I found reading in another room or looking at photos to be very relaxing. Then, rise in the morning at a fixed time, no matter how little you have slept!

In fact, you might want to sleep even less than usual so that no time in bed will be spent awake. For example, if you sleep about four hours a night and need to wake at 7 a.m., don't go to bed until 3:30 a.m. but continue to rise at 7 a.m. As you develop the habit of associating bedtime with sleep, you can gradually go to bed earlier. This method works, but you need to be patient with yourself.

Use Sleeping Pills Sparingly

Sleeping pills have only limited uses. For example, they may help during an overnight airplane ride and, when taken in a crisis, might prevent an acute problem from turning into chronic insomnia. After consulting with a psychiatrist, I decided not to use them.

Obvious—But Often Overlooked—Advice

A vicious cycle is often established when a person uses caffeine or other stimulants heavily during the day because of drowsiness after a sleepless night. This was a particularly difficult problem for me because I was always tired and I wanted coffee. However, I learned to drink decaffeinated coffee after 3:00 p.m. so that I would be able to sleep that night. In fact, no one with a sleep problem should consume caffeinated drinks after 3 or 4 in the afternoon. Also, using alcohol as an aid to sleep because you've had too much coffee only makes things worse; better to bite the bullet and eliminate both if possible.

Empty Your Mind of Stressful Thoughts

If you don't sleep well because of many worries, you can set the stage for a night of restful sleep by learning how to meditate, a state of mind that produces physical and mental conditions incompatible with anxiety. When practiced just before going to bed, it can produce a wonderfully relaxed state of mind and body. I recommend it heartily.

Here is how I learned to meditate.

Sit in a comfortable chair in a quiet room away from noise or interruptions. Pay no attention to the world outside your body. Focus on a single word (called a mantra) and repeat it over and over to yourself. It can be a neutral word with no particular significance or a word with pleasant connotations, such as peace, love or joy. You can also use a peaceful scene of some place you have been or would like to visit.

When you first sit down and begin to relax, you will notice thoughts coming into your mind. After a minute or two, begin to say the mantra in your mind. Do this slowly, in a passive way. As you say the mantra to yourself, other thoughts will come. As a matter of fact, after a while you may realize that you're been so busy with these thoughts that you haven't said your mantra in several minutes. When you become aware of this, just return gently to the mantra. Don't fight to keep thoughts out of your mind; instead, let them drift through. This is not a time for working out solutions to problems or thinking things over. Try to keep your mind open, so that as thoughts other than the mantra drift in, they drift out again as smoothly as the flowing of a river. The mantra will return and you will relax with it.

It is important to make this experience a gentle process, a relaxing time. Don't fight to keep thoughts out of your mind. Don't get upset if you are distracted. Merely let the mantra return. If used as soon as you begin to feel tense, it is a good coping reaction.

Another image is that of a feather which you imagine in your mind is gently drifting down to the floor. Notice how the feather gently drifts in your mind. This image was very calming for me.

Relax Your Body With Breath Relaxation

Many relaxation techniques cast off nervous tension and anxiety with a simple approach: integrative breathing. This quiet contemplation of your breathing allows the whole body to relax effortlessly.

To do this, experience your breath -- not the "thought" of the breath, but the "doing" of it. Notice the passage of air through your nose and into your lungs and the swelling of your chest. Forget all else. Consider only the air and the quiet. As you breathe out, feel the air flow gently over your lips. Imagine it moving a feather softly and gently. You are your breathing. Forget all else. Concentrate on the breath moving easily in and out. You have nothing to do but breathe. Feel the air refreshing you. Forget all else.

Use this relaxation method just before you expect your anxiety to begin, as you are preparing to fall asleep. 

Peaceful Rest is Almost As Good As Full Sleep

Often someone will swear she "didn't sleep a wink" when, in fact, electrodes taped to her head in a sleep laboratory will show she was sound asleep. It is quite possible to dream you aren't sleeping. Thus, another method which would seem to contradict a previous suggestion is to allow yourself to remain in bed if you awaken during the night but don't fight it.

Instead, use meditation and gentle relaxation techniques. Avoid giving yourself a "guilt trip" because you (a) aren't sleeping as you think you "should" and (b) aren't following someone's suggestion that you are supposed to get out of bed if you are not sleeping. Even if you aren't actually sleeping, you can relax peacefully.

Deal with Stressful Problems During the Day 

One of the best methods for creating a climate in which the possibility of sleep is enhanced is to take one day at a time. When you are awake, do your best to resolve whatever is bothering you. Join a group. Talk with your pastor, priest, rabbi or other spiritual leader. Go to a therapist. Get someone to come in and help with the work you can't do as well as you could in the past.

Then when you go to bed and worries and anxieties force themselves into your mind, stop and say very quietly to yourself, "I have done the best I can. Tomorrow is another day." If you have a belief in a supreme being, you may want to add, "I leave my worries to God. I will not carry them with me during the night." Then practice meditation or relaxation techniques. Gradually you will train yourself to replace the worried thoughts with peaceful rest and sleep.

Conclusion

Getting the sleep you need is a real challenge, especially with the anxieties and stresses that accompany cancer and follow-up treatment. However, I found myself sleeping when I used a variety of these techniques. Good luck. Let me know if they help.  Please contact us.

© Copyright 1997, Marcia Albert, Ph.D.