Tired but can't sleep- a case study.

I saw Sarah in my clinic as she had reached breaking point and had found our details online. Sarah is a 42 year old working mum who was feeling tired and exhausted all day due to broken sleep each night. She was going to bed around 10pm but taking a few hours to fall asleep and then felt shattered when her alarm went off at 6:00am.

Sarah had always been a poor sleeper but the stress of launching her own business selling soft furnishings alongside caring for her children had made her sleep problems so much worse.

After our first assessment I wanted Sarah to understand what we need in order to sleep well and how her body had ‘un-learnt’ how to do this. I explained how stress had triggered her poor sleep and started a cycle where she was trying too hard to catch up on lost hours. By trying herbal remedies, relaxation tapes in bed and napping in the day she had essentially forgotten how to sleep well. The few bad nights led to worry that she wouldn’t sleep well the next night and then she continued to try and fix the problem with more incompatible sleep behaviours. During the sessions I explained that worrying about sleep is one of the major factors in insomnia as once a worry takes hold it can become hard to drop off, we then end up tossing and turning all night. Once this pattern is repeated our bed becomes connected to worrying and then the cycle of poor sleep is born.

Sleep is like breathing, something we do naturally, so when we focus on it too much it becomes impossible.

I was able to treat Sarah by helping her establish a new bedtime routine that increased her ability to fall asleep faster and achieve a better quality of sleep. I also taught her to avoid distractions such as checking emails and watching TV in the bedroom and I encouraged her to go to bed when she is actually tired enough too sleep, instead of tossing and turning for several hours.

Sarah learnt some cognitive behavioural therapy techniques to help deal with stress better during the daytime and learnt to stop worrying so much about her sleep and instead enjoy being awake!

After four sessions Sarah was going to bed at 11.00pm, falling asleep within 10 minutes and achieving seven hours of quality sleep the vast majority of nights.

I became interested in working with sleep disorders during my work as an NHS Psychological Practitioner and I saw that many people were suffering with poor sleep and simply not getting the correct advice. Even for someone like Sarah who had been suffering a long time and sleep was affecting every area of her life, it is possible to fix the problem within just a few sessions.

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