What to do
Establish a sleep runway
As a high achiever and expert problem-solver, your mind is like a big powerful jet airplane, capable of soaring to impressive heights and moving at incredible speeds. But consider how airplanes land. Here’s what they don’t do: fly at 30,000 feet and 500 miles per hour until they’re directly over the airport, then nosedive toward the gate – that would end poorly for everyone! But this is how many high achievers approach sleep: they work non-stop right up until bedtime – maybe on actual work, such as checking emails, or on non-job-related but still effortful activities, such as serious discussions with their spouse or partner. Then they hop into bed and expect to fall asleep immediately.
But, just like a big 747 jet, your mind needs time to slow down and relax before it can arrive at its night-time destination. As any pilot will tell you, airplanes take a slow and gradual approach to landing: about 30 minutes before arrival, they gradually start descending and slowing down; and even once they’ve technically landed on the runway, they continue to slow down and eventually taxi at a snail’s pace to their gate. This is a good analogy for how high achievers should think about falling asleep: you need a dedicated time before bed that’s free of effortful or stressful activities so that your mind can slow down and relax before falling asleep.
Here’s what I recommend: dedicate 60-90 minutes of time before your ideal bedtime as your sleep runway. During this time, there should be no effortful, stressful or goal-directed activities. Be especially careful of checking and responding to work emails (which will immediately trigger a high-effort work mindset) and potentially stressful conversations with people. Both of these are seductive because they are objectively important activities, but if you get in the habit of doing them before bedtime, you will kick your mind into arousal and make an easy descent into sleep much less likely. Reading, watching TV, and listening to music are all excellent ways to transition out of your striving mindset and into relaxation, which is the gateway to sleep. And while you likely want to avoid any such activities that are extremely exciting or stimulating (eg, heart-racing thrillers and action movies maybe aren’t a great idea), the most important thing is that you stick to them and avoid the temptation to allow in other effort-inducing activities, such as stressful conversations or work tasks.
Now, you might be thinking to yourself: Wait, I thought you said doing nothing was the key to sleeping better… This doesn’t seem like nothing! While it does take some conscious planning and effort to establish a sleep runway initially, it leads to much less effort and thinking long term because it’s a routine you simply adhere to rather than deciding anew each evening what you’re going to do.
Finally, remember that the sleep runway is helpful only when it’s consistent. A couple nights of relaxing TV instead of work emails before bed won’t make much of a difference. But if you eliminate effortful, goal-oriented activities every single night for months, you’ll find yourself much more relaxed and sleepy before bed and, as a result, have a much easier time falling asleep.
Develop a midnight plan
If you’re a high achiever with sleep issues, you’re almost certainly familiar with midnight awakenings: you fall asleep initially, but two to three hours later you find yourself wide awake in bed – usually with a conveyor belt of thoughts and worries looping through your mind. And if you’ve struggled with sleep for a while, no doubt many of those worries are about sleep itself: ‘Ugh… If I don’t get back to sleep, I’ll be a wreck tomorrow!’ ‘Great, up again… now I’ll never get back to sleep!’ While these reactions are completely understandable, this frustration and anxiety about not sleeping only leads to more arousal, which in turn makes it harder to fall back to sleep at night.
Early approaches to persistent midnight awakenings (what psychologists call middle insomnia) emphasised two strategies: disputing unrealistic thoughts and worries, and stimulus control, which means getting out of bed until you feel sleepy again. Although these approaches can be helpful in certain circumstances, they tend to be unhelpful for many people because they unintentionally end up reinforcing sleep effort: trying hard to analyse and dispute your sleep worries tends to lead to more arousal (and less sleep); similarly, getting out of bed and waiting to get sleepy again often leads to more frustration and clock watching, which similarly tends to increase arousal. The more effective approach I’ve found is to develop and stick with a midnight plan, which is a simple relaxation-promoting routine you implement when you have a hard time falling back to sleep in the middle of the night.
For example: you find yourself awake at 1am and notice that you’re worrying a lot about not getting back to sleep. When difficult thoughts or worries pop into your mind, it’s best to briefly acknowledge and validate them but not engage further with them or elaborate on them. You might say to yourself: ‘I’m worrying about not sleeping enough. That’s understandable, but continuing to think more about it will only make it harder to fall back asleep.’ However, if after 5-10 minutes you’re not getting sleepier, that’s the point where you engage your midnight plan. So you pull out your Kindle and start reading a novel, for example. Or maybe your midnight plan involves putting in an earbud and listening to a playlist of your favourite relaxing music. Listening to an audiobook is another one that can be helpful. However, I generally do not recommend specific relaxation techniques such as breathing exercises or mindfulness meditation. While these techniques are great in the evenings or throughout the day, when used at night in bed they frequently lead to more arousal because they are being used with the intent to fall asleep, which easily becomes a form of sleep effort leading to arousal and not to sleeping. More passive activities such as reading or listening to an audiobook are better because they are less effortful and goal oriented.
Whatever your chosen midnight-plan routine is, here’s the key idea: set it and forget it. You shouldn’t have to think about or decide what to do when you’re awake in the middle of the night as that just leads to arousal. Instead, you have a plan and stick to it – sort of like following a recipe. The advantage of this approach is that you give your mind something that is absorbing enough to keep it off of arousal-generating worries, but calming enough to allow your mind to relax and eventually fall back asleep. You can’t think your way out of overthinking. But you can engage your mind in relaxation-promoting behaviours that will indirectly avoid overthinking and allow sleep to find you.
Finally, while the midnight plan is typically used for middle-of-the-night awakenings, there’s no reason you can’t use your chosen activity from the midnight plan when you first get into bed in the evenings. But remember that the key in both cases is to choose an activity that is engaging enough to hold your attention but not so stimulating that it will generate arousal. Once you’ve found something that hits that sweet spot, do it consistently and unthinkingly.
Make time to worry on purpose
Much of insomnia and trouble sleeping is ultimately caused by worrying. When you worry, you get anxious, and when you’re anxious, your body gets ready for action, which directly inhibits relaxation and sleepiness. And to make matters worse, routinely worrying in bed – either as you’re trying to fall asleep initially or when you’re awake in the middle of the night – eventually teaches your brain to associate your bed with worry (this is the same classical conditioning process Ivan Pavlov discovered in his experiments with dogs who learned to drool at the sound of a bell previously paired with food). This means that, even if you weren’t worried before night-time, simply being in bed can become a trigger for worries and anxiety!
So, how can you break this cycle? The first thing is to get serious about developing and sticking with your midnight plan as I discussed before. But how do you convince your brain to worry less in the first place? Well, it turns out a lot of worrying, especially worrying in bed, comes from your talents as a high achiever and problem-solver. See, one of the things that makes high achievers so successful in their waking hours is that they’re extremely good at inhibiting or ignoring worries, anxieties and other difficult emotional experiences and staying focused on their tasks and goals. The downside to this self-control is that your brain still wants to communicate those worries and anxieties to you and the only time it has left is when you’re in bed and not distracted by other tasks or activities. It’s as if your brain is thinking: Yes, I’ve finally got their full attention! Here are all the things I tried to tell you about throughout the day that you didn’t want to listen to.
Luckily, there’s a simple if counterintuitive practice for retraining your mind’s tendency to deluge you with worries in bed. It’s called scheduled worry. It goes like this:
- Pick a worry time. Aim for a window of time that will work every day of the week. For example: Every evening at 7:50pm, after I put the kids down to bed but before I watch TV. Consistency is key, so choose a time you’re confident you can stick to most days. Just don’t schedule worry time during your sleep runway or immediately before bedtime.
- Set a timer on your phone for 10 minutes. Having a timer is important because you want to focus on your worry during your worry time, not how much time you do or don’t have left.
- Write your worries down on paper. Just start listing any and every worry you can think of. Doesn’t matter if it’s forgetting bananas at the grocery store, or nuclear war. Importantly, don’t try to solve your worries – just list them and move on. If you like, you can hang on to your worry list, review it at a later time, then add any solvable problems to your to-do list or other system for getting things done.
- Enforce good boundaries with your worry. During your scheduled worry time, worry hard! When your time is up, stop immediately and get back to your day. If you find yourself worrying throughout the day (or at night), remind yourself that you have a time for worry and will do it then, not now. From now on, you worry on paper, not in your head.
The logic behind this practice is that, by rewarding and reinforcing your brain to worry at the right time, it will be less likely to throw worries at you during the wrong time, like in bed when you’re trying to sleep. But, keep in mind, this is a practice, not a coping strategy. You do scheduled worry consistently every day so that eventually your mind learns to worry less at inopportune times. It is not meant to be done in the moment in response to a bout of worrying.
Try sleep compression
A common pitfall I see high achievers fall into with their sleep is spending too much time in bed. Of course, if you’re not sleeping well, it seems to make sense to try to get into bed a little earlier or maybe try to sleep in a little later. Unfortunately, this strategy almost always backfires because, as we discussed earlier, the more time you spend in bed not sleeping, the more likely your brain is to associate your bed with worry, anxiety and frustration, all of which produce more arousal and make sleep less likely. But you can reverse this effect by doing the opposite and intentionally spending less time in bed.
Sleep compression is an exceptionally effective technique for improving sleep quality and reducing anxiety and arousal around bed. In fact, in years of helping high achievers with insomnia, I have never – literally, never – seen this technique not work when it’s implemented correctly and consistently. It goes like this: by temporarily reducing the amount of time you spend in bed, you are forced to spend more time out of bed, which increases your body’s natural and powerful drive to sleep. Consequently, during the hours when you are in bed, you’re far more sleepy, more likely to fall asleep quickly and stay asleep and, as a result, train your brain to associate your bed with relaxation and sleep rather than arousal and anxiety.
For example: suppose a good night’s sleep for you is about seven hours – which, by the way, is completely healthy and normal, despite what you may have read in sensationalised headlines about the necessity of at least eight hours. If you’re seriously struggling with insomnia and have a lot of anxiety, stress and frustration around sleep, you could temporarily restrict yourself to no more than six hours in bed – either by going to bed later, waking up earlier, or a combination of the two. Note that this is not six hours of sleep; no matter how much you actually sleep or not, you only stay in bed for a maximum of six hours. In the short term, you will likely feel even more sleepy and tired than usual. But precisely because of this – because you’ve compressed your sleep window – your biological sleep drive will be higher, meaning your odds of falling and staying asleep go up. After a week or two of this, you will find yourself getting much better sleep quality – falling asleep faster with fewer midnight awakenings. Then, once you’re consistently sleeping well for six hours (falling asleep relatively quickly and no extended midnight awakenings), you increase your sleep window to six-and-a-half hours. And once you are sleeping consistently well within that window for a week or two, you return to your normal seven-hour window, having broken the association of bed and arousal, and established a new association of bed and sleep.
As a rule of thumb, a six-hour time-in-bed window is a good place to start with sleep compression, although if you want to be more aggressive, five or five-and-half often leads to quicker results. Then add time back in 30-minute increments once, and only once, you are consistently sleeping well within that window of time for a week or more.
Because this technique makes you sleepier and more tired in the short term, it can be quite difficult to stick with consistently. But the long-term rewards are almost certainly worth it: by temporarily trading sleep quantity for sleep quality, you can break many of the bad habits that cause insomnia, and then relatively quickly get back to the best of both worlds – sufficient quality and quantity of sleep. Combining this approach with the earlier steps, such as scheduled worry time, will increase your chances of success still further.
Gain hope from Ava’s story
After a couple of introductory meetings with Ava, we got to work on her sleep struggles. We began, as I do with most clients, with the simplest modifications, then worked our way up as necessary. The biggest benefit to this approach is that it builds sleep confidence. As I described to Ava some of the more ‘intense’ approaches, such as sleep compression, I could tell she was getting anxious, which obviously would only exacerbate her sleep struggles. So we started simply by creating a sleep runway and a midnight plan. And after a couple weeks of doing both, Ava was already sleeping much better – some nights, she fell asleep within 5-10 minutes and didn’t wake up at all in the middle of the night. But, more importantly, she was feeling more confident in her ability to sleep well, something she had almost completely lost.
Of course, Ava was still having some struggles. While she had a lot more good nights, she still had one or two ‘bad nights’ per week. And because these bad nights were correlated with intense bouts of worrying – usually worrying about not being able to sleep – we implemented a scheduled worry routine. For 10 minutes immediately before her sleep runway, Ava did scheduled worry, listing out all her worries. Initially, she was concerned this would make her even more worried and anxious. But within a few days of doing scheduled worry, she commented to me: ‘It’s funny, instead of making me more anxious, by writing down my worries on purpose, they actually start to feel kind of boring.’ After a couple weeks of daily scheduled worry, Ava reported that she was experiencing substantially less worry and anxiety before falling asleep. And when she did wake up in the middle of the night, the ‘storm of worries’ tended to be less intense, which made it easier to fall back to sleep.
Still, for all the success of these new habits – the sleep runway, the midnight plan, and scheduled worry – Ava still had a handful of bad nights every few weeks. Additionally, she was still fairly preoccupied with sleep and worried about it more than she wanted, even though she was obviously sleeping much better overall. So I recommended we try a little sleep compression. Because of the success she’d had with the other approaches, she was confident about giving this one a try even though it seemed a bit scary. So, we designed a schedule where Ava did not get into bed until 11pm, and got out of bed at 5am. After a week of this, she told me: ‘I mean, it sucks. But not nearly as much as I thought… I’m a little more tired during the day but, honestly, I don’t think I was getting much more than six hours of actual sleep [before starting this exercise].’ Importantly, I talked to Ava a lot about how, despite not feeling 100 per cent rested, she seemed to be performing just as well. This was a key part of her mindset shift from sleep anxiety to sleep confidence, and what ultimately led her to overcome insomnia for good: she learned to believe that she could sleep despite the occasional bouts of poor sleep. And, sure enough, after a few weeks of sleep compression, Ava was back to sleeping seven hours a night and feeling much more confident about her future sleep.
About a year and a half after working with Ava, I got an email from her saying: ‘I can’t thank you enough for what you taught me. I still have bad nights of sleep every once in a while, but I don’t stress about it. And best of all, I just don’t think much about sleep anymore. I even break “the rules” from time to time and don’t sweat it.’
It was a perfect ending to her journey, not only because she had maintained her progress, but because she had so clearly internalised a new mindset around sleep. Instead of good sleep being a goal she strived for and worried about, Ava had learned – in part because of the exercises and experiments we did together – that she wasn’t broken, there was nothing wrong with her, and that sleep was something her body could and would take care of, once she got out of the way.
