Stressed about sleep? Don't make these mistakes

Will I be able to show up for work? For my kid? For my partner? When you find yourself awake when you should be asleep, it’s easy to let those middle-of-the-night fears creep in. And failing to manage that anxiety can turn a few bad nights of sleep into a cycle of insomnia. Three sleep experts share strategies on minimizing sleep stress — from rethinking sleep trackers to ditching your bedtime. Follow us on Instagram: @nprlifekit https://www.instagram.com/nprlifekit/?hl=en Sign up for our newsletter here. https://www.npr.org/newsletter/life-kit Have an episode idea or feedback you want to share? Email us at [email protected] mailto:[email protected] Support the show and listen to it sponsor-free by signing up for Life Kit+ at plus.npr.org/lifekit http://plus.npr.org/lifekit See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

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• 0:23Marielle Segarra?

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• 1:03Marielle Segarra?

  I get this particular image in my head when I think about insomnia. I see somebody in a bathrobe, lying on the couch, lights off, TV on, staring like a zombie at a stream of late-night infomercials. I wonder what core memory I'm flashing back to here. It's definitely got a late '90s, early 2000s vibe. The scene might be a little different at your house. Maybe it involves a bottomless pit of scrolling on your smartphone, but the feeling is the same: desperation. You either can't sleep at all, or you can't stay asleep, and you keep looking at the time like, "Okay, only three hours until I have to get up, but I still haven't gotten down."

• 1:44Marielle Segarra?

  Recent estimates say 25 to 30 million American adults are dealing with insomnia at any given time. So bad sleep affects a lot of us.

• 1:54Speaker 02

  When you're up in the middle of the night and you know everyone else is sleeping, it's a really scary feeling and it's a lonely feeling. I feel like I'm the only one dealing with this, or mine is worse than everyone else's.

• 2:07Marielle Segarra?

  Steve Orma is a clinical psychologist who specializes in treating insomnia. This is a career path he found through personal experience when he faced a bout of sleeplessness for the first time in his early 40s. It plagued him for months. Before that point, Steve had had a bad night's sleep every now and then, but never a fully sleepless night. So when suddenly that just kept happening...

• 2:30Speaker 02

  I started getting into the frame of mind that most people get sucked into. You start to worry, oh, what's going on? Is there something wrong with me?

• 2:37Marielle Segarra?

  The longer it went on, the more he fixated on the issue.

• 2:41Speaker 02

  And this is the cycle that ultimately, if it continues, leads into insomnia, where it becomes more of a steady, consistent problem.

• 2:51Marielle Segarra?

  Now, whether you've dealt with this once or 100 times, that anxiety, that sleep stress...

• 2:59Speaker 02

  That's pretty universal. Oh, my God, what if I don't sleep tonight, or sleep at all, or get X number of hours? But that's not really the fear. The fear is the consequences of that. For me, it was, I'm not going to be able to perform well in my work. That was my biggest fear.

• 3:16Marielle Segarra?

  Maybe you're afraid you won't be able to show up for your kid, or that not sleeping is going to hurt your health. Without ever having to read the mountain of scientific evidence on the topic, we all feel how critical a good night's rest is to our bodies, our judgment, our emotions, our relationships, just every facet of our lives. But sleep, unfortunately, isn't something you can achieve, or can even try to do. It's something that happens to you. That can be hard to swallow in this era of constant self-optimization, but when it comes to sleep, doing less is often doing more. And in fact, there are a lot of ways you might be unknowingly messing with your sleep by trying to perfect it. So how can you do both things at once?

• 4:01Marielle Segarra?

  Both care deeply about your rest and not try to sleep?

• 4:06Speaker 02

  Put the focus on things that will result in sleep. You don't focus on trying to sleep directly. It's just like if you're trying to lose weight, you don't focus on the weight. You focus on changing behaviors that will result in the weight going down.

• 4:21Marielle Segarra?

  It might take time and patience, but it is possible. On this episode of Life Kit, reporter Andy Tagle talks to experts about the science of sleep, walks you through some of today's most common sleep stressors, and gives you tools for how to deal with them. That's after the break.

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• 5:02Speaker 00

  This message comes from Charles Schwab with their original podcast, Choiceology. Choiceology is a show about the psychology and economics behind people's decisions. Download the latest episode and subscribe at schwab.com slash podcast.

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• 5:32Speaker 04

  Okay, it's time for a quick wake-up call, worrywarts. Steve says he hears a common misconception at the office.

• 5:38Speaker 02

  My sleep is broken. I've lost the ability to sleep. That kind of thing, which is not true.

• 5:44Speaker 04

  That's takeaway one. Your sleep isn't broken, but it might need a professional reset. If the experience of sleeplessness is new to you, it might be helpful to know there are a few different flavors of insomnia, like sleep onset insomnia,

• 6:01Speaker 02

  difficulty falling asleep,

• 6:03Speaker 04

  sleep maintenance insomnia,

• 6:05Speaker 02

  it takes you a while, but you do fall back asleep. And then what's called early morning awakening, where you wake up significantly before your wake up time and you don't fall back asleep at all.

• 6:14Speaker 04

  You might have one, a combo, or hit the jackpot. And severity can range a lot, too. Most adults will suffer the occasional off night. Around a third will deal with acute insomnia, roughly understood as short term bouts of sleeplessness, ranging anywhere from a few days to a few months. And about one in 10 adults at any given time are dealing with chronic insomnia. Clinically, that's defined as trouble sleeping at least three days per week for at least three months. Understanding your particular brand can help you decide the best way forward. And depending where you are in the spectrum, that might require some course correction. See, Steve says often the go to advice for sleeplessness is practicing better sleep hygiene.

• 6:59Speaker 04

  And we are not knocking that. Sleep hygiene is all about establishing healthy routines, like not eating large meals too late at night, limiting naps, and creating a conducive environment for good sleep.

• 7:11Speaker 02

  Make your room dark, make your room quiet, make it cool. And all those things are great until you have insomnia, which is a set pattern. Sleep hygiene doesn't do anything.

• 7:20Speaker 04

  He says, think of it like dental hygiene. So like if you already have healthy teeth.

• 7:25Speaker 02

  Then it's good to brush your teeth, to floss, to see the dentist once or twice a year. But if you have a cavity, if you have like a broken tooth, that's not going to do anything, you know? And it'll keep getting worse.

• 7:39Speaker 04

  So insomnia is like a cavity for your sleep processes.

• 7:43Speaker 02

  And so you have to get to the root of the problem.

• 7:45Speaker 04

  To be clear, we still all need to practice good sleep hygiene in the same way we should all be brushing our teeth twice a day. But if you think you might be in that acute to chronic insomnia camp, you shouldn't expect sleep hygiene alone to be able to fix the issue because

• 8:00Speaker 02

  it not only doesn't work, it makes it worse because the person gets even more frustrated and anxious because they're doing everything their doctor is telling them or the internet or ChatGPT or whatever it is. And, you know, and then they're thinking, oh, my God, there must be really something wrong with me.

• 8:20Speaker 04

  When you've reached acute or chronic levels of insomnia, Steve says it's like your sleep system has been trained to wake you when you want to sleep. In order to break that backwards behavior loop, Steve works with patients using a treatment called CBTI, or

• 8:34Speaker 02

  Cognitive Behavioral Therapy for Insomnia.

• 8:39Speaker 04

  So CBTI is like the gold standard for evidence-based, non-pharmacological treatment for chronic insomnia. And it's also been shown to be effective for acute insomnia. Unlike more general talk therapy, CBTI is tailored to sleep anxiety specifically. And that's an important distinction. See, when you treat symptoms of more general anxiety,

• 9:00Speaker 02

  Usually you're worrying about stuff that actually isn't happening. With sleep anxiety, if you're not sleeping well, it's not in your imagination. You're actually not sleeping well, and so you have to actually improve the sleep to get rid of the sleep anxiety.

• 9:15Speaker 04

  Typically, a CBTI program lasts about six to eight weeks. And each week, you and a provider, we're going to scale or a strategy that can help reset sleep behaviors and restructure your thinking around rest. And while this kind of treatment does require commitment, it's not always a walk in the park. It can also be super effective.

• 9:35Speaker 02

  I've seen people that have had insomnia for 30 years and overcome it. So it's not like certain people are doomed with this, like you can always overcome it.

• 9:44Speaker 04

  And no matter where you are on the insomnia spectrum, CBTI practices can boost sleep, which is why we'll be breaking down a few to help you start stressing less and sleeping more. Takeaway two, wake-up call number two, have a set one every day. Yes, you heard that correctly. Set the same morning alarm seven days a week. Yes, that includes days off and holidays.

• 10:07Speaker 05

  And this is hard. You know, it's hard to kind of convince people of this, like they want to sleep in on the weekends, and I get that.

• 10:12Speaker 04

  Eric Prather is a professor and sleep scientist at the University of California, San Francisco, and the author of the book, The Sleep Prescription: Seven Days to Unlocking Your Best Rest. And he doesn't just study this stuff. You can tell he's a sleep enthusiast.

• 10:28Speaker 05

  Sleep has this, it's just this kind of deliciousness for our body, right? It does so much for our heart, for our immune system, for our emotions. When people get the sleep they need, they really are kind of the best version of themselves.

• 10:43Speaker 04

  One of the best and easiest ways to be that best you. Set that alarm to fill up your internal sleep balloon in a timely manner. What's a sleep balloon? Is that not just a thing everybody says? Okay, so there are two primary processes that control sleep in our body. The first I'm sure you're familiar with is your circadian rhythm, also called process C, that internal clock that gets a jump start from sunlight in the morning and ebbs and flows throughout the day. The other is process S, or our sleep drive.

• 11:18Speaker 05

  I do think of it as kind of like a balloon. Like you wake up in the morning and your balloon is flat. And then as you kind of go throughout your day and use energy, it fills up. It kind of gets bigger and bigger with sleepiness.

• 11:29Speaker 04

  When that balloon gets big enough, your eyelids get heavy, you begin to yawn.

• 11:35Speaker 05

  You go to sleep and then you kind of drain out that sleep. And it's kind of like you let the air out of a balloon. And when your process S and process C are well aligned, then it often predicts kind of a restorative sleep.

• 11:46Speaker 04

  It's common sense, right? If you wake up at seven most days, but then you sleep until 10 on Saturday morning, not only is your circadian rhythm thrown off, essentially inducing some minor jet lag, but also...

• 11:57Speaker 05

  Your balloon's not going to start building up until that time. And then, you know, no surprise, you may not feel those same sleepy cues at night.

• 12:05Speaker 04

  Now, why focus primarily on wake up time? It goes back to the idea of controlling the controllable from the top of the episode.

• 12:14Speaker 05

  We can't control when we get sleepy, right? But we can control when we wake up.

• 12:18Speaker 04

  So, setting that morning alarm and doing your best to stick to it, painful though it may be on some days, can be a first step in unburdening a bit of that sleep stress by offering you some agency and giving your body some predictable cues to work with. In CBTI speak, this is a stimulus control practice, AKA making deliberate choices about when you're getting in and out of bed that can help to address conditioned arousal. Which is just the fancy, scientific phrase for when someone's relationship with their mattress gets turned upside down from too many nights of sleeplessness. So instead of the bed being a cozy, comforting cue for the brain and body to drift out to dreamland, Eric says often people will tell him,

• 13:01Speaker 05

  You know, I feel sleepy before I go to bed and then I get in bed and my brain wakes up. Or they wake up in the middle of the night and they look at the clock and their brain is just activated. The bedroom tells your body to be awake.

• 13:13Speaker 04

  Completely breaking that association between your bed and anxiety will likely require some retraining and rearranging, both inside and out of the bedroom. But I promise, it's not all a chore. For example, the next task on our conditioned arousal checklist,

• 13:32Speaker 04

  takeaway three, go on, stay up late. Get out of bed when you feel like it. Just give yourself enough time to power down before bedtime. It sounds a bit counterintuitive, working on your sleep by spending less time in bed. Right? But do you remember fighting against your bedtime as a kid? Or do you maybe have a kid who fights against theirs now? You know, like, Mom, I'm not sleepy yet.

• 13:58Speaker 06

  People may hope to get in bed and be asleep by 9:30 and instead they're spending more time in bed getting frustrated that they're not getting sleep. And that really aggravates the issues.

• 14:11Speaker 04

  Dr. Ravi Isola is a physician, a clinical professor of medicine and the director of the Sleep Disorder Center at UCLA. He and Eric are going to walk us through a few other CBTI practices. Namely, only go to bed when you're sleepy and get out of bed when you're not. You don't have to cease all activity to better support your sleep. Just don't actually get into bed until you're sleepy. Like, can barely keep your eyes open. I'm sleepy, ideally. That'll help reinforce that positive association between the bed and sleep. Now, to be able to get to that level, Robbie says, instead of focusing on a bedtime.

• 14:50Speaker 06

  Focusing on kind of an off time. When I've decided that, okay, at 9:00 PM, doesn't mean I'm going to, you know, be on my computer and do work until 9:00 PM, shut it off and then jump into bed and expect that it's gonna happen, I'm gonna flip a switch.

• 15:05Speaker 04

  As Eric says, our brains are predicting machines, constantly trying to take in context clues and figure out how to use our metabolic resources to keep us alive and thriving. And that's why you need to give yourself a long off-ramp from all the excitement of the day.

• 15:21Speaker 05

  So, you know, when people go to bed, they often have these rituals, whether they know it or not, that they do each night as they begin to go to bed. And the more consistent things you make that, the more your body understands it's like, oh, now we're gonna transition to sleep.

• 15:34Speaker 04

  To start to downshift your brain and body into rest mode, dial down your environment as best you can, too. For example, at home, Robbie dims all the lights when the sun goes down in keeping with the natural rhythm of the body.

• 15:46Speaker 06

  And I find that that makes a difference. But I think a bigger part of it, or as important, is the attention we give to the things that we're looking at.

• 15:55Speaker 04

  And obviously, you don't want to put on the most thrilling movie in your catalog or plan to hate scroll preposterous Reddit threads. But your nighttime ritual doesn't have to be completely screen-free.

• 16:04Speaker 05

  Some people watch TV before they go to bed with their loved ones, or maybe they have a conversation, or maybe they're reading, or they listen to a podcast, maybe they're like super NPR Life Kit fans, and that's awesome.

• 16:17Speaker 04

  Eric says, if you are going to consume content, shoot for things that are calming and slightly positive. So chef's choice here, put on that favorite lighthearted TV show, read your favorite comic book, or there are a ton of resources specific to sleep out there, like the Calm or Headspace apps. You could go for a favorite chill playlist and a cup of soothing, non-caffeinated tea. Just aim to-

• 16:40Speaker 05

  Provide something for yourself that is supportive and puts you on the path to sleepy town.

• 16:48Speaker 04

  And these are the same tools you can turn to if you find yourself up in the middle of the night unable to go back down. Because trying to force sleep is only going to up your stress levels.

• 16:58Speaker 05

  When people are awake in bed, we don't want them to kind of stew there. We often have like a cutoff of like 20 minutes.

• 17:06Speaker 06

  You hit that threshold where you have that internal feeling that kind of, ugh, that internal sigh that tells you it's not happening, or I'm getting to that frustration point. Get out of bed and I say a dull book in dim light. And, and the reason I mention a book is because books have endings.

• 17:22Speaker 04

  As opposed to say, the endless black hole that is doom scrolling.

• 17:28Speaker 04

  A warm shower has been proven to encourage sleep too. But don't be too rigid about it. Whatever best soothes you, distracts you from your worry, is the right thing. One final pro tip here. Eric says, if fully getting out of bed feels hard or scary for you, sometimes just switching up your positioning can be enough to jolt your brain circuitry. Like, give you the change you need to miss your specific corner of sleep space.

• 17:54Speaker 05

  If you go and lay at the foot of the bed, you'll be shocked at how different of experience it is. And that really just reinforces like how powerful like the bed and your usual routines are for supporting your sleep.

• 18:08Speaker 04

  So now we have some solid nighttime strategies. After the break, we'll move into daytime hours.

• 18:17Speaker 00

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• 18:21Speaker 03

  This message comes from Google Workspace with Gemini. One subscription that does it all. Personalized AI and premium business versions of Gmail, Google Docs, Drive, and more. Try it free for 14 days at g o o dot g l e slash workspace with Gemini. This message comes from Charles Schwab with their original podcast, Choiceology. Hosted by Katie Milkman, an award-winning behavioral scientist and author of the bestselling book, How to Change. Choiceology is a show about the psychology and economics behind people's decisions. Hear true stories from Nobel laureates, historians, authors, athletes, and more about how to make better decisions to help avoid costly mistakes.

• 19:03Speaker 03

  Download the latest episode and subscribe at schwab.com slash podcast or wherever you listen.

• 19:13Speaker 04

  So now we have some nighttime strategies. Let's move into the daytime hours. Takeaway four. Don't save your worry for your pillow. Destress in the daylight. Quick thought exercise for you. When you lay your head down at the end of the day and your mind starts to run back the highlight reel, is it the good stuff? Small wins, things you're proud of or looking forward to?

• 19:36Speaker 05

  I mean, it happens, but it's often around worries. And that time is kind of misplaced.

• 19:42Speaker 04

  It's true. I mean, have you ever even once been like, I am so glad I stayed up that extra half hour to relive that embarrassing moment from work? Or all those mommy mishaps? Or, man, I wish I spent just a little more time last night having that fantasy argument with that rude salesperson from earlier. All your stressors will be there in the daylight, too. And in fact, we'll probably be better served by a well-rested brain. Enter worry scheduling. Take that 10, 15, 20 minutes, whatever you think you can realistically spare, and...

• 20:16Speaker 05

  Put it in your schedule where you sit down and you just do your worrying.

• 20:20Speaker 04

  Eric says he thinks this practice works best if you write out what you're worried about. It just gives that nebulous worry monster more of a distinct, tackleable form. But speaking them aloud or, say, recording them on your phone could work, too.

• 20:34Speaker 05

  And it's been shown that when people make this a consistent schedule, it does seem to lead to less of that same worrying at night. So it's like giving your brain a space to do it, doing it in a consistent way.

• 20:46Speaker 04

  Because, as we all well know at this point, stress is the enemy of sleep. So building in breaks, doing just a little something for your mental health throughout the day can make you better equipped to face challenges as they come, which in turn can lighten your mental load come bedtime.

• 21:03Speaker 05

  And like, I get it. Like, you know, some people listening might be like, oh, that would be great. But I...

• 21:08Speaker 04

  Sure.

• 21:08Speaker 05

  How am I gonna do that?

• 21:09Speaker 04

  Yeah, must be not, yeah.

• 21:10Speaker 05

  Good tip. But, but, but I mean, I think we can't let perfection be the enemy of like, good enough. Right? I think any steps that people can make, even just beginning to make those like, small changes, can, you know, certainly kind of chip away at what might be getting in the way of their sleep.

• 21:30Speaker 04

  One big stressor that might be unknowingly tripping up your rest? Your sleep tracker.

• 21:37Speaker 06

  We have a phrase now that is commonly mentioned at our sleep conferences called orthosomnia, where I think all sleep physicians have experienced this. A patient comes in and, "Well, what's the reason you're coming in today?" "Well, my tracker tells me I'm not getting enough XYZ sleep, you know, slow wave sleep, or deep sleep, or REM sleep."

• 21:55Speaker 04

  Orthosomnia. This is a recently developed form of insomnia that we absolutely needed to shed a little daylight on. Robbie says sleep trackers can be helpful for logging sleep. In fact, it's another aspect of CBTI therapy that can help identify patterns and tailor treatment. But for the average unassisted consumer, he says it's important to approach this data with a healthy level of skepticism. So if you must track, he says do so with purpose and a specific goal in mind.

• 22:25Speaker 06

  You know, measurement without guidance is where we run into problems. How are you using that information? Is that information helping you make changes in your behavior or your lifestyle that are helpful? Or is it stressing you out and making the insomnia worse?

• 22:44Speaker 04

  So understand the abilities and limits of your specific device, like if it's known to be internally consistent with sleep scores or duration, say. Then, check in with your body before you check your scores, rather than letting your tracker tell you how you feel.

• 23:00Speaker 06

  Like, "This told me that I had a bad night last night, and I remember waking up X number of times and tossing and turning, and I feel terrible today. And then, on a different night, that, for whatever reason, you slept better and feel better in the morning, and the tracker kind of confirms that." I think that is meaningful information to at least tell you that this is matching up with how I feel.

• 23:26Speaker 04

  Maybe that leads to some action, like a conversation with your doctor, or a consultation with a specialist like Steve. Or maybe it can just help reinforce your beliefs about sleep.

• 23:37Speaker 04

  And that brings us to our final takeaway, takeaway five: reframe your sleep story, a little at a time.

• 23:48Speaker 04

  All right, we've loaded up your pillowcase with lots of tools to help sweeten your dreams, but as any insomniac up all alone at 4 a.m. knows, reshaping your sleep habits is only half the battle. The rest of the work comes down to shifting your mindset.

• 24:02Speaker 02

  Like, one night at a time. Expectations are a huge part because it's not like a linear process. The sleep kind of just varies. So, the people that handle it the best just have the right frame of mind. And it's this learning to change your relationship with the sleep. And when you do that, your sleep starts to get better because you're not being reactive to it.

• 24:27Speaker 04

  In CVTI, this is called cognitive restructuring. Recognizing and replacing your negative sleep thoughts with more accurate and positive thoughts. For example, instead of fixating on how bad your last night of sleep was, you could look ahead and remember...

• 24:43Speaker 05

  Your body will take care of you, right? Like, it's like, you know, when we deprive people of sleep in the laboratory, and we let them sleep the next night, they immediately drop into deep sleep, right? That restorative sleep. It's like your body's like trying to eat it up as quickly as possible because there's a lot of compensatory mechanisms to keep us healthy.

• 25:03Speaker 04

  That doesn't mean you have to find an answer to every question in your mind. Like, maybe your insomnia fear has been further out. Maybe you're worried about how sleeplessness might affect your long-term health.

• 25:14Speaker 06

  You know, right now, I can't necessarily tell you exactly what the consequences are going to be, you know, 20 years from now. But I can tell you that it's not helping that you're worrying about that right now. And so, reminding ourselves that insomnia occasionally is normal, that the world is not going to end, that I don't have to get eight hours of sleep every single night.

• 25:36Speaker 04

  And when all else fails, Robbie says, "Return to your breath." There's safety there.

• 25:41Speaker 06

  People have to feel safe when they go to sleep. You're okay, you're breathing, you're able to regulate your reaction to the world. And that ability to start self-regulating brings some reassurance.

• 25:59Speaker 04

  All right, sleepyheads. Let's recap.

• 26:03Speaker 04

  Takeaway one: Your sleep isn't broken, but it might need a professional reset. Takeaway two: Have a set wake-up time every day. Takeaway three: Don't go to bed until you're sleepy and do your best to set up your sleep environment for success beforehand to get you there. Takeaway four: Be deliberate about de-stressing in the daylight. Schedule your worry, build in breaks, and if you must, track, track with purpose. Finally, takeaway five: Reframe your sleep story. Everybody has bad sleep now and then, and I promise, sleep will come. When it does, we wish you sweet dreams.

• 26:43Marielle Segarra?

  That was Life Kit reporter Andy Tagle. Hey, quick question: Are you looking to get stronger this year? We have a special newsletter series that'll help you start a strength training routine. You can sign up at npr.org/stronger.

• 26:59Marielle Segarra?

  This episode of Life Kit was produced by Lennon Sherburne. Our visuals editor is Beck Harlan, and our digital editor is Malika Gharib. Megan Kane is our senior supervising editor, and Beth Donovan is our executive producer. Our production team also includes Claire Marie Schneider, Margaret Serino, and Sylvie Douglas. Engineering support comes from Kwesi Lee. Fact checking by Tyler Jones. I'm Marielle Segarra. Thanks for listening.

• 27:33Speaker 03

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