Updated: Nov 15
Do you ever find yourself longing for the life you had before insomnia changed everything?
I just finished a training on grief and loss. Although I specialize in sleep, not grief, it has long felt to me very relevant to people living with the many losses of chronic sleep deprivation. So, it seemed a natural and important addition to my professional development as a sleep therapist. And it supported what I already knew: the grieving process can help people recover from insomnia.
The Grief of Chronic Insomnia
If the connection between insomnia and grief doesn’t immediately make sense to you, consider how many areas of your life may have been impacted by your ongoing loss of sleep:
Mood (think: anxiety, depression, irritability)
Ability to think clearly and function at work
Social life (check out my blog on How Quality Sleep Can Transform Your Social Life)
Relationships, both family and friends (check out my blog on Could insomnia be fuelling your relationship conflicts?)
Ability to make and follow through plans - and feel optimistic about your future
Am I missing anything? Perhaps, but that’s probably far more than enough. 😬
If you tell others about a new significant medical diagnosis, you may be more likely to get some warm sympathy and understanding than if you tell someone you have insomnia. Unless they’re living with the same struggle, they rarely “get it”. I mean, not really. I think, for this reason, most people struggling with chronic insomnia are suffering in silence, pushing through the days, and trying to “pass for normal”.
But you are not alone.
Studies find that up to 10-30% of people are living with “chronic insomnia disorder”. That means at least 3 nights per week for at least 3 months. And many more are suffering from bad sleep far too frequently. It doesn’t always have to meet the criteria for a sleep disorder before it significantly impacts quality of life. A client of mine once told me how she sat on a flight to Europe, chatting politely now and then to the woman seated next to her. It wasn’t until they were about to land 9 hours later that one of them confided about her long-term problems with sleep (maybe there was safety in knowing they’d likely never see the other person again?). It turned out they both shared that unwelcome life experience and instantly bonded over it.
There’s a reason grief support groups can be so therapeutic. I know insomnia support groups exist. I’ve been asked to run such a group. But I prefer to help people learn how to sleep well again, so they don’t need to keep suffering and grieving.
I certainly don’t want to diminish the excruciating pain of bereavement following the death of a loved one. But I do think the losses that tend to come with chronic insomnia often can be comparable to those typically accompanying loss of health.
There are a number of theories describing the grieving process. Perhaps the best known model is the five stages of grief first described by Elisabeth Kübler-Ross’s 1969 famous work, “On Death and Dying”. She outlined five distinct and linear stages:
However, this theory has been disputed by several decades of research since then – not because these responses to grief aren’t very common. They are. It’s because science has not found the grieving process to be a predictable, linear journey with such distinct stages that everyone must go through in order to process their grief in a “healthy” way. In fact, grief can look very different to different people.
But, when it comes to insomnia, I see many similarities – as well as some important differences – in the above-described grief experiences. Think of the last time you were awake in the night and unable to return to sleep. Does any of this sound familiar?
1. Denial: I should be able to make myself sleep. I must be doing something wrong. What is wrong with me? Reality: we can never make ourselves sleep. In fact, the harder we try to sleep, the worse it gets. (If you haven’t already, sign up for my newsletter to receive a free copy of “Why Relaxation Strategies for Insomnia can Backfire – and what to do instead".)
2. Anxiety: not entirely unlike “denial”, it’s a desperate sense of feeling out of control, like you should be doing something different to make yourself sleep. It usually comes with dreading how awful tomorrow will be, or perhaps feeling terrified about your future if you never manage to sleep “normally” again.
3. Anger: This isn’t fair! What did I do to deserve this?! Why does my partner get to sleep soundly beside me and I can’t sleep???
4. Bargaining: Dear god, pleeeeease pleeeeease pleeeeease let me sleep.😫🙏 (I know you’ve done this)
5. Depression: a sense of hopelessness; loss of control over your sleep – and your life.
6. Acceptance: Gig’s up. It’s too late to get a good night’s sleep. It is what it is; I might as well get up and read a good book. (That’s one example, but there’s a lot more to it than that – especially the how part.)
According to Kübler-Ross' theory, acceptance is the ultimate goal. Here’s the big difference: When hit with the pain and suffering of grief and loss, whether it’s the death of a loved one, the end of a relationship, or loss of health, to name a few types of loss, acceptance can ultimately improve your quality of life in ways that likely seem impossible in the early stages. BUT, it is never going to bring back your loved one or your health.
On the other hand, when it comes to chronic insomnia, acceptance not only can improve quality of life while you’re still suffering from the physical and mental impacts of sleep deprivation, it can also be a powerful force to help you overcome chronic insomnia for the long term – and all those wonderful things that tend to accompany restorative sleep: more energy, better mood, improved productivity and ability to work, enjoyment of life, better relationships – basically all those things that tend to suffer when struggling with ongoing sleep problems. You might even find you appreciate the small things in life even more.
When it comes to suffering from insomnia, acceptance is not the goal; it’s a means to an end. Better sleep and better life are the ultimate goal! And acceptance and self-compassion can definitely be an important part of the journey. If you’re in the early stages of insomnia, acceptance can go a long way towards quelling the anxiety and hyperarousal that guarantee a bad night of sleep.
Once insomnia becomes a chronic problem, however, acceptance alone may not be enough. That’s because our sleep regulation systems can become physiologically disrupted over time. And then it’s usually not just about anxiety.
Consider this analogy: Imagine insomnia as a leaky boat riddled with numerous holes. Simply plugging one or two, or even three or four holes won't prevent the boat from sinking if other leaks remain. But when paired with the practical techniques of CBT-I (Cognitive Behavioral Therapy for Insomnia) to restore sleep regulation systems, acceptance can be the icing on the cake. Yes, easier said than done. But once the other holes are plugged, acceptance is a powerful force to help alleviate the anxiety and hyperarousal that fuels a relentless vicious cycle of chronic insomnia.
Next time you’re lying awake in the night, give yourself permission to “indulge” in the grief of chronic insomnia. Validate that, yes, it sucks! It’s ok to acknowledge that you desperately want to sleep and to have that good day you were hoping for tomorrow. It’s ok if it feels anything but ok, at least, for a while. But the sooner you allow yourself to go through whatever stages of grief arise, the sooner you might get to the stage of acceptance. And the sooner you’ll get your sleep back on track – whether that’s tonight, or tomorrow, or ... just as soon as it happens.
Ever noticed how the harder you try to sleep, the worse it gets? Imagine if you stopped trying. If you could wave a magic wand and stop desperately hoping and praying for sleep. If you could somehow give up and not care if you slept or not. What do you think that might do for your sleep?
And to be clear, acceptance doesn’t mean doing nothing. It means controlling the things you can (there may be a lot more concrete things you can do than you realize) and letting go of trying to control the things you can’t. In part, it means feeling the fear and the exhaustion and continuing to live your life as best you can, while also working on the concrete evidence-based strategies for developing healthier sleep patterns. The irony is that by giving up trying to control sleep, we can start to regain “control” over our sleep once again.
"It may be that when we no longer know what to do
we have come to our real work,
and that when we no longer know which way to go
we have come to our real journey."
Wendell Berry (American author, poet)
Learning how to accept the unacceptable is easier said than done, of course. It’s a process; a grieving process. Whether it feels like “mini” grief in the night, or full-on life-destroying loss of virtually every aspect of your former life, there is a way out. And it’s never too late.
I love helping people recover from insomnia. When combined with learning the concrete strategies of CBT-I to fix the physiological disruption to sleep regulation systems, it is possible to learn how to grieve – and reclaim the losses – with self-compassion and acceptance. Time and again, I see this beautiful recipe for a future filled with better sleep and a rich and meaningful life.
Looking for more help to get your sleep back on track? Send me a message to join the waitlist for one-on-one CBT-I or our new therapist-guided digital CBT-I program. Or get started right away by signing up for my online self-paced program on Effective Natural Strategies for Chronic Insomnia.
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