As therapists, we understand that a good night's sleep is crucial for recovery, resilience, and overall health. Struggling with sleep is an all-too-common issue many therapy clients face, often impacting their mental and physical well-being. So this month, I’m going to give you some tips to help your clients get a better night’s sleep.
There is limited space here so it’s impossible to cover
everything there is to say about sleep, but I’ll give you a sort of checklist, and if you want more
detail you are welcome to sign up for my free CPD course on sleep issues.
Insomnia and sleep deprivation
Both ‘insomnia’ and ‘sleep deprivation’ refer to not having
had enough sleep They have similar symptoms and problems attached, but they
refer to different situations where this might occur.
Insomnia is when someone is unable to sleep, despite having
plenty of chances to do so. They go to bed but either can't fall asleep in the
first place or fall asleep but wake too early or too often, and they may find
they are unable to get back to sleep.
Sleep deprivation is when someone hasn’t had enough sleep
because they didn’t get the opportunity to do so. It includes things like
staying up all night to party or study for exams, getting up frequently to look
after a baby or sick relative, or working non-standard hours.
The difference matters because people don’t generally choose
to have insomnia; it’s often due to factors over which they have little or no
control (at least without medical intervention) such as a sleep disorder. But
sleep deprivation is frequently due to lifestyle choices which need to be
identified and perhaps addressed as part of your therapy. Typically these
choices may be around:
- Alcohol, which helps you get to sleep but is a diuretic
(creating an increased need for urination) which can be the cause of early
waking and dehydration.
- Caffeine, which increases dopamine production, which has the
effect of increasing alertness, and takes up to six hours to be processed by
the body, so coffee drunk at 6 pm could still keep you awake at midnight.
- Shift work, especially if shift times keep changing, which
creates a long-term or permanent form of jet lag and causes sleep disruption,
tiredness, mood swings and changes in bowel habits.
- Smoking, which causes a loss of just over a minute of sleep
for each cigarette smoked in a day, so a 20-a-day smoker could lose up to half
an hour's sleep each night just because of their habit.
And even the weather is said to affect our sleeping habits.
Sleep disorders and health
Most professional bodies have something in their Code of
Ethics to the effect that therapists with no medical qualifications should not
treat medical conditions. That seems obvious but it bears some consideration
here. There are so many physical and psychological issues which can get in the
way of a good night's sleep, you should always take a thorough medical history.
If there is, or may be, a medical issue, refer them to their doctor, as it will
need dealing with before or alongside any therapy you offer.
Health issues associated with sleep disturbances include:
- Anxiety
- Depression
- Restless Leg Syndrome
- Narcolepsy (though this is very rare)
- Night sweats
- Sleep apnoea
- Sleepwalking and night terrors
- Age-related changes such as menopause
What sort of sleep disturbance does your client have?
- Do they find it hard to go to sleep?
- Do they wake frequently during the night?
- Do they still feel tired after waking?
It’s wise to check which of these your client is
experiencing, as they may need addressing separately.
Help your clients get a good night’s sleep
Once you know whether your client is experiencing insomnia
or sleep deprivation, and how it affects them, you can start to plan your
approach. A Lifestyle and Sleep Questionnaire is useful for this and you are
welcome to ask me for one to use with your clients. It is also included, along
with other resources, in the free CPD course mentioned above.
It’s often wise to start with sleep hygiene, which doesn’t
refer to whether clients wash themselves or their bedclothes (although that
helps!) but is a term used to refer to developing behaviours and routines that
help to promote good sleep. These could include:
- A dark, safe, comfortable, slightly cool, and preferably
quiet, bedroom.
- Avoiding electronic devices in the bedroom and for at least
thirty minutes before bedtime, unless they have a blue light filter – blue light
from screens is associated by the brain with daylight.
- Possibly banning pets from the bed or bedroom if they snore,
wriggle or move around frequently.
- Developing a healthy bedtime routine, which is consistent
over workdays and non-workdays. This could include avoiding vigorous exercise
in the runup to bedtime; stopping intake of alcohol, nicotine and caffeine
earlier in the day; avoiding heavy meals just before bed, though a light snack
is fine; using aids to relaxation such as self-hypnosis, a warm bath,
aromatherapy oils, or listening to soothing music.
- Clients should avoid napping during the day, or, if this isn’t
possible, limit naps to thirty minutes at most, as early in the day as they
can.
- Getting some exercise daily, to create natural tiredness.
Hypnotherapy can, of course, be used to support the client
as they make these changes, address any resistance and boost motivation.
Therapy to support clients with sleep issues
The most-studied psychological approach to insomnia is CBT
(Cognitive Behavioural Therapy) which has a good evidence base to support its
use. CBT, in general, relies heavily on education and the re-shaping of
thoughts and behaviours. You’ll find plenty of information online about CBT-I (CBT
for Insomnia), and six to eight sessions are said to be as effective as
medication, and sometimes more so because the effects continue after the
therapy stops.
Even if you’re not a CBT therapist, you can take plenty of ideas from this approach to integrate with your own favourite approaches. If you know NLP, for example, use a ‘swish’ or ‘collapsing anchors’ to help the client anticipate a good night’s sleep. If you are a hypnotherapist, you can work with suggestions and metaphors to reduce negative thought patterns or unhelpful habits and to promote good sleep hygiene and restful sleep.
You can also teach the client relaxation techniques, such as controlled breathing, visualisations, self-hypnosis, meditation or similar to use to help them relax before bedtime so they are more likely to fall asleep. If you are a hypnotherapist, the widely used ‘peaceful place’ technique can be a good one to use.
Regression has also been used to help those with insomnia,
although my research has found mostly case studies of the ‘past life’ variety,
rather than age regression. If you are trained to do this kind of work, there
is nothing to stop you from searching either within the client’s early
experiences or their past lives to identify a cause for sleep disturbances and
work with whatever you find.
Overall, we’ve had a very quick tour through the landscape
of helping with sleep disturbance, and there is more to be said. But I hope
these strategies and ideas will help you to support clients overcome sleep
challenges, whether they're dealing with insomnia, anxiety-driven restlessness,
or disrupted sleep patterns, enabling them to enjoy the restorative rest they
need for a balanced life.
Further information –
FREE CPD course from YHT on helping clients with sleep issues.
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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of Anxiety to Calm: a Practical Guide to a Laid-Back Life, The Hypnotherapist's Companion, Their Worlds, Your Words, and The Metaphor Toolbox, all available from Amazon or direct from the author. Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi-accredited hypnotherapy practitioner training, taster days and foundation levels.
CPD Expert - accredited CPD and other therapy training (online and workshops options), expert and qualified hypnotherapy supervision
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