Goodnight Mind

“In
Goodnight Mind
, Colleen Carney and Rachel Manber have taken the complex processes needed to establish consistently good sleep and laid out a straightforward set of easy-to-follow guidelines. Nothing is left out of this book—from understanding your body’s sleep clock to relaxation and quieting your mind. Carney and Manber have drawn on their years of clinical research experience to develop a rich and accessible resource for those struggling with this tenacious problem.”

—
Donn Posner, PhD, CBSM
, clinical associate professor of psychiatry and human behavior at the Alpert Medical School at Brown University, and coauthor of
The Cognitive Behavioral Treatment of Insomnia

“We live in a busy, mentally challenging world, and keeping an alert and active mind throughout the day helps us cope with and effectively meet the challenges we face. Unfortunately for the millions of folks with chronic insomnia, persistent thinking, worrying, or more general sleep-disruptive mental arousal serve as the crux of their chronic sleep problems. Fortunately, there are a variety of effective strategies for ‘putting the mind to bed’ and regaining the ability to sleep normally once again. Those strategies are clearly and comprehensively presented in this new self-help guide by Carney and Manber, two renowned experts in the area of insomnia treatment. This easy-to-read guide provides ten simple steps for keeping one’s mind out of the way of a good night’s sleep. I am certain that this guide will be a great aid to those who read it.”

—
Jack Edinger, PhD
, professor and director of the behavioral sleep medicine program at National Jewish Health

Publisher’s Note

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought.

Distributed in Canada by Raincoast Books

Copyright © 2013 by Colleen E. Carney and Rachel Manber

New Harbinger Publications, Inc.

5674 Shattuck Avenue

Oakland, CA 94609

www.newharbinger.com

Cover design by Amy Shoup; Acquired by Jess O’Brien; Edited by Will DeRooy

All Rights Reserved

Library of Congress Cataloging-in-Publication Data

Carney, Colleen.

Goodnight mind : turn off your noisy thoughts and get a good night’s sleep / Colleen E. Carney, PhD, and Rachel Manber, PhD.

pages cm

Includes bibliographical references.

ISBN 978-1-60882-618-6 (pbk. : alk. paper) -- ISBN 978-1-60882-619-3 (pdf e-book) -- ISBN 978-1-60882-620-9 (epub) 1. Insomnia--Treatment. 2. Affective disorders--Treatment. 3. Cognitive therapy. I. Manber, Rachel. II. Title.

RC548.C364 2013

616.8’4982--dc23

2013006046

Contents

INTRODUCTION

1 KNOW THE RECIPE FOR GOOD SLEEP

2 BUILD A STRONGER DRIVE FOR DEEP SLEEP

3 FIND AND SET A PROPER SLEEP SCHEDULE

4 TRAIN YOUR ACTIVE MIND TO BE QUIET IN BED

5 PUT A BUFFER BETWEEN THE DAY’S ACTIVITY AND SLEEP

6 RELAX YOUR BODY TO QUIET YOUR MIND

7 MANAGE YOUR OVERACTIVE MIND WITHOUT COUNTING SHEEP

8 THINK LIKE A GOOD SLEEPER

9 FOCUS ON THE DAYTIME TO HELP DURING THE NIGHT

10 ACCEPT AND BE WILLING: WHAT YOU RESIST PERSISTS

Introduction

G
iven that you are reading this book, you may have difficulty sleeping or you may have difficulty shutting off your mind when you want to sleep. This is a very common problem, and luckily there are simple strategies to help. The most effective way to address these problems is with tools from cognitive behavioral therapy, or CBT. CBT is an approach to psychology that developed out of research into what causes sleep problems and fatigue. Knowing what causes these problems helped psychologists like us develop solutions to them. CBT is a very well tested, effective treatment approach with many tools that can be used to help you with your sleep problems.

What Causes Sleep Problems?

Many factors influence sleep. In particular, your behaviors, the way you think about sleep, and other factors exert a strong influence on how well you sleep. No matter what initially
caused
your sleep problems—stress, medication, or something else—the way you think or behave can have a negative effect on your sleep and become the primary factor in
sustaining
your sleep problems. If you understand this basic fact, you can make changes in your thinking, your habits, or your environment that will have a positive impact on your sleep. CBT has discovered the type of thinking and the type of habits that foster good sleep, and this book will teach you how to implement these CBT strategies.

Who Should Use This Book?

If your sleep problems have led to trouble during the day, such as difficulty with everyday activities, or if they cause you distress, you may have already been diagnosed with insomnia. Perhaps you have chronic insomnia—for at least a month now, it has taken you over thirty minutes to fall asleep most nights. Yet you need not have any diagnosis in order to benefit from the strategies in this book. If you simply have difficulty falling asleep or staying asleep, or you do not feel
rested
when you wake up, this book can help.

You may wonder whether this book will be helpful if you also have another condition, such as chronic pain, depression, or another medical problem. The good news is that CBT for insomnia is often effective even when there is another condition present.

Being more of a “morning person” or a “night owl” does not necessarily mean you have sleep problems. Many people have some degree of morning or evening tendency. But if the time at which you fall asleep varies from night to night (that is, sometimes you can fall asleep earlier and sometimes you can’t fall asleep until much later) even though you are trying to keep a regular schedule, this is suggestive of insomnia, and you can benefit from using the strategies in this book.

Who Might Not Benefit

Those with sleep problems other than insomnia may not benefit from this book. If you doze off unintentionally during the day or evening, tell your doctor, as this can be a sign of another sleep disorder, such as sleep apnea syndrome or periodic limb movement disorder. An overnight study in a sleep laboratory is often needed to rule out these conditions.

If you have difficulty either falling asleep or waking up
at a conventional time
—meaning you are an extreme morning person or night owl—but still get seven to nine hours of sleep, this may be a sign of another disorder called a circadian rhythm disorder. Someone who does not feel sleepy until four in the morning and wakes up feeling refreshed at noon may have this type of disorder. So may someone who falls asleep around eight in the evening and wakes up ready to start the day at four in the morning. In other words, if you consistently go to bed and rise very early or very late but you do not have trouble falling asleep or staying asleep, consult with a sleep specialist to see whether you have a circadian rhythm disorder rather than insomnia.

This book is also not appropriate for those whose sleep problems are due to the fact that they work nights or rotating shifts. Shift work can create tremendous sleep and quality-of-life problems beyond the scope of insomnia, and an entire book would be necessary to deal with the complexities of those issues. If you are having sleep problems relating to shift work, seek professional help from a sleep center.

What to Expect in This Book

A noisy mind interferes with sleep. This book breaks down the problem of a noisy mind into ten steps, ten individual strategies that will help you quiet the mind and improve your sleep. The chapters are meant to be read in order, but some of the chapters may not apply to you, in which case you may focus on particular steps or strategies.

The first chapter will teach you how important it is to understand your sleep system. This chapter provides a simple explanation of how you can get sleep to work for you, rather than you working to get sleep. After reading this chapter, you will understand that a quiet mind is more likely if you
set the stage
for quality sleep. The next two chapters (2 and 3) provide direct instructions on how to start keeping a good sleep schedule and how to build a strong drive for deep, satisfying sleep. Chapter 4 will teach you how to train your active mind to be quiet in bed and how to search through your sleep environment to find any culprits that could be causing an overactive mind. Chapter 5 teaches you how to implement a Buffer Zone, or a time in which your mind can deal with the day’s events without getting in the way of sleep. Chapter 6 addresses a noisy mind that stems from tension and anxiety, by teaching you how to start a relaxation practice. Chapter 7 focuses specifically on proven techniques to manage mental overactivity characterized by worry. Chapter 8 will teach you to adopt the mental habits of a good sleeper. Chapter 9 will focus on how to think about and manage fatigue so that it doesn’t lead to a noisy mind or sleeplessness at night. Chapter 10 deals with the important role of acceptance in managing unwanted thoughts on troubled nights.

We hope that you enjoy the book, start working through the steps, and start getting the sleep of your dreams!

Chapter 1

Know the Recipe for Good Sleep

T
here are three key ingredients to getting a good night’s sleep. You may believe that all you need to do in order to sleep better is “quiet your mind”; however, your current sleep habits may be making it hard for you to sleep well on a regular basis, or you may be doing certain other things that get in the way of a good night’s sleep. These things are easy to change, and if you adjust your sleep system, your noisy mind may resolve itself.

In order to know whether you need to make an adjustment, it is helpful to know the recipe for good sleep and to understand the basic workings of your body’s sleep system. This chapter provides a simple explanation of how sleep is produced and an introduction to the idea of how you can get sleep to work for you, rather than you working to get sleep. A quiet mind is more likely if you “set the stage” for quality sleep and have realistic expectations for normal sleep.

Stop Trying to Sleep Well

Ask any good sleeper, “What’s your recipe for good sleep?” and you are likely to receive a puzzled look. Or perhaps he or she will say something like, “I don’t do anything. I get into bed, and eventually I fall asleep.” Ask a dozen
poor
sleepers about their recipe for sleep, however, and you will probably get a dozen different replies:

• “I use a white noise machine and a blackout mask.”
  
• “I drink a glass of wine.”
  
• “I go to bed early and watch television.”
  
• “If I’m not asleep within an hour, I take a sleeping pill.”
  
• “I drink a special tea that is supposed to make me sleepy.”
  
• “If I’ve had a bad night, I sleep in to try to catch up on lost sleep.”
  
• “I take a sleeping pill on most nights, but after a few bad nights I take a different type of sleeping pill.”
  
• “I listen to the sounds of whale calls and sleep in a separate room from my husband.”
  
• “I listen to a self-hypnosis CD.”
  
• “I sleep in on weekends to try to catch up on lost sleep.”
  
• “I exercise right before bed.”
  
• “I drink warm milk.”
  
• “I take a melatonin supplement.”
  

What do all of these strategies have in common?
Effort
. Those with sleep problems exert tremendous effort to set the stage for sleep, but this is unfortunately the opposite of what needs to occur for sleep. Your body has a built-in system that makes up for poor sleep, and you need not use any effort at all to sleep or make up for lost sleep. In fact, such efforts only interfere with this system and make it more likely that you will have continued sleep problems. Moreover, you may believe that your only problem is that your brain will not “shut down” at night; however, you may be unaware that the problem is rather with your sleep system, and your overactive mind occurs simply because you are already awake in bed. We will provide a recipe for good sleep so that you can identify anything that may be causing your problems. If you find that you have some of the problems described in this chapter, chapters 2 and 3 will provide more detailed, step-by-step solutions.