Clinical psychologist Steve Orma was in his early 40s when he developed insomnia — difficulty falling asleep or staying asleep.
He couldn't stop fixating on it. "I started getting into the frame of mind most people get sucked into. I worried, 'What's going on? Is there something wrong with me?'" he says.
That fear of not being able to sleep is a phenomenon called "sleep anxiety," says Orma, who went on to become a specialist in insomnia treatment. Left untreated, that anxiety can prevent people from actually falling asleep.
"The more you focus on it, the less chance you'll sleep, which then makes you more anxious. That's the cycle that spins," he says.
One of the most powerful ways to overcome sleep anxiety is cognitive behavioral therapy for insomnia (CBT-I). It's well studied, doesn't rely on sleep drugs and has been shown to be effective for clinical insomnia. Orma used this treatment to heal his sleep, and it's now the main focus of his therapy practice.
Typically, a CBT-I program lasts about six to eight weeks, and each week, you and a provider work on a strategy to reset sleep behaviors and restructure your thinking around rest.
But you don't have to be in an official program to benefit from CBT-I. Whether you're dealing with some sleep stress or just the occasional off-night, these CBT-I practices can help.
Wake up at the same time every day
Having a consistent wake-up time helps your body know when it's time to get sleepy, says Aric Prather, a sleep scientist and the author of The Sleep Prescription: 7 Days to Unlocking Your Best Rest. The sleepy cues are managed by your circadian rhythm, or your body's internal clock. A set wake-up time keeps your internal clock ticking on time.
Prather uses the analogy of a "sleep balloon." When you wake up, your sleep balloon is empty. Your balloon fills up with sleepiness throughout the day. Once it's full, you feel ready to sleep. Waking up at the same time every day, even on weekends, keeps your sleep cues consistent.
Focus on a wind-down time, not a bedtime
Instead of trying to force yourself to go to bed at a specific time, even though you're not sleepy, focus on winding down for bed earlier, says Dr. Ravi Aysola, director of the Sleep Disorders Center at the University of California, Los Angeles.
Pick a time to transition from daytime activities to nighttime activities. This can look like unplugging from screens, putting on comfortable clothes and dimming the lights in your home.
He says having a wind-down time instead of a strict bedtime can help lessen the feeling that you must get to sleep immediately — and can reduce the anxiety that can occur when you don't.
Schedule your "worry time"
If all your stress comes flooding in at bedtime, put some dedicated "worry time" on your calendar during the daylight hours, says Prather. "Use your brain space when you're more rested to do some worrying."
That way, if your brain starts to drift to tax season, child care troubles or that big mess in the garage while you're in bed, "you have a way of saying, 'I did this worrying already,'" he says.
Try taking just 10 or 15 minutes at the same time each day to write out what's bothering you. It can help your brain relax when your head hits the pillow, Prather says.
Be mindful when tracking sleep
Managing sleep anxiety means also being cognizant of how much information you're taking in about your sleep.
The prevalence of sleep-tracking devices and wearables has led to the advent of orthosomnia, a type of insomnia developed from anxiety over wanting to achieve perfect sleep data, says Aysola.
Sleep trackers can give you helpful information about how you slept, but it's important to have a healthy level of skepticism when it comes to the data and a plan for what you'll do with it, he adds.
If you use these devices to track your sleep, he says to ask yourself: "Is that information helping you make changes in your behavior or lifestyle, or is it stressing you out and making the insomnia worse?"
If you notice you've been waking up feeling more rested, for example, that could tell you that your new wind-down time and earlier morning alarm are starting to work for you.
If you tend to fixate on your sleep-tracker data, try tracking your sleep with a pen and paper instead. It can help you focus on how your sleep is feeling to you instead of the numbers.
Reshaping your sleep habits is only half the battle, Orma says. The rest of the work comes down to shifting your mindset. Sleep will vary from night to night and everyone has a bad night of sleep now and then, so adjust your expectations accordingly.
"When you have that frame of mind, your sleep starts to get better," he says.
The digital story was edited by Malaka Gharib, with art direction by Beck Harlan. We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org.
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