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Pandemic was a sleep thief; cognitive behavioral therapy can help

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As the coronavirus pandemic seized the world over the past 14 months, sleep became elusive for many.

According to a meta-analysis by the Journal of Clinical Sleep and Medicine, roughly 40 percent of the global population had trouble sleeping in 2020.

The pandemic delivered a perfect recipe for insomnia: Stress, anxiety, and depression brought on by prolonged isolation and uncertainty.
FILE PHOTO
  • FILE PHOTO
In the past year, Gloria Dancause of Gorham, Ontario County, said she’s been up all hours of the night worrying about her family’s business and not being able to see friends and family members.

"Generally, around 3 a.m. it would kick in,” she said.

Racing thoughts are also usually what keep Ty Gagnon of Rochester awake.

"A lot of my insomnia has to do with just not being able to shut my brain down," he said.



Often, his thoughts aren't even anxious ones.

"Sometimes it's just like, I'm thinking of how many animals start with the letter 'b,' " he said with a laugh. "It can be dumb stuff like that."

Unlike Dancause, Gagnon's insomnia didn't start during the pandemic. The 38-year-old has been having trouble sleeping through the night since he was 12 or 13.

"Those were nights where I'd sleep maybe an hour or two," he recalls of the worst stretch of sleeplessness during his mid-20s.

Gagnon was working in an office doing computer work then. He said it was difficult to stay awake and be present for his co-workers and clients when he was so tired all the time.

He tried a lot of things: melatonin supplements, eliminating caffeine from his diet, and finally hypnotherapy and cognitive behavioral therapy, or CBT.

"CBT, for me anyway, has been the most helpful," he said.

Cognitive behavioral therapy is considered a gold standard of insomnia treatments.

It has several components. One of them is sleep hygiene. That includes things like keeping the bedroom at a relatively cool temperature and practicing consistent pre-bedtime routines.

"Those factors certainly make sense to address for most individuals with insomnia," said Wil Pigeon, director of the University of Rochester's Sleep and Neurophysiology Research Lab. "But in and of themselves, they aren't typically going to make a huge impact for most people."

But combined with other components, cognitive behavioral therapy has been shown to improve sleep quality better than and for a longer period of time than sleep medications.

People receiving the therapy learn how to control the stimulants in their sleep environments, such as eliminating time spent on the phone, watching television and the big one: worrying while in bed.

Pigeon said that’s probably been especially tough for people who’ve been working remotely.

“It’s not just the office is home, but the office might be in the bedroom,” he explained. “If office is in the bedroom, now my bedroom is a place where I really have work stress.”

He recommends taking time during the day to write a “worry list,” so your troubles don’t follow you to bed.

Another strategy is using self-talk to eliminate or control the negative thoughts and worries keeping you awake.

This helps Gagnon get a better night’s sleep.

"You know, when my brain is just buzzing, to tell myself that it's OK to slow down, that it's OK to relax, that it's OK to not be having any thoughts and just go to sleep," he said.

Another key component of CBT is restricting sleep. It sounds counterintuitive to limit sleep as a treatment for insomnia, but Pigeon said there are long-term benefits to getting out of bed if you're tossing and turning and doing something relaxing for 30 minutes or an hour until you get sleepy again.

"If you do that over time, the brain and the body become more accustomed to being asleep in the bedroom as opposed to being awake and frustrated and anxious in the bedroom," he explained. "It won't happen in one or two nights, but there will be a shift from the brain thinking the sleep environment is anxiety-producing or worrisome or frustrating and shift to, 'Oh, this is where I sleep.' "

Dancause figured this out on her own. Sometimes, in the middle of the night, she gets up and folds laundry or walks around the house.

"Or else do some exercising or deep breathing,” she added. “You know, things that help a person's mind calm down."

With the help of CBT, Gagnon has reclaimed his once-evasive sleep. He said he now averages six or seven hours a night.

A psychotherapist or a sleep center can provide cognitive behavioral therapy for insomnia.

There are also free apps that deliver a CBT program including Insomnia Coach.

It was developed by the Department of Veterans Affairs and it's based on their CBT program, which Pigeon, a nationally recognized CBT expert, helped create.

There are books on the subject, too. Pigeon said anyone wanting to learn more about the insomnia treatment can learn about the basics by reading them.

"There are dozens, and they're all great," he said. "Even if they're 10 years old, this stuff doesn't get dated."

Beth Adams is a reporter for WXXI News, a media partner of CITY.

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