Psychological approaches for insomnia

Among the most common psychological techniques used to help with a sleep problem are relaxation training, meditation, hypnosis, and cognitive restructuring. These techniques are similar to those used for stress management as well as chronic pain management, and rely on a common set of skills:

• Deep muscle relaxation
• Focus elsewhere rather than on the pain
• Visual, sound, or other relaxing sensory imagery
• Distancing oneself from the chronic pain

These skills, coupled with the deep breathing technique discussed next, can be very beneficial in improving sleep and decreasing the perception of pain by retraining the brain. Many of these skills are coupled with exercise in techniques such as yoga and Tai Chi.

Deep breathing technique to help with sleeping
Most psychological techniques begin with controlled deep breathing. Although there are a great many relaxation exercises, the following is a simple example of a deep breathing technique that can help one fall asleep:

1. Lie down in a comfortable position on the back with legs straight and slightly apart. Allow the toes to point comfortably outward and let the arms rest at the sides without touching the body. Place the palms up and close the eyes.

2. Focus on breathing. The hand can be placed on the spot that seems to rise and fall the most as one inhales and exhales. Notice the position of the hand. Is it on the chest, abdomen or somewhere in-between?

3. Now, gently place both hands on the abdomen and again focus on breathing. Pay attention to how the abdomen rises during inhalation and falls during exhalation. Try and make the hands rise and fall.

4. Breathe through the nose during this exercise. If needed, one may clear the nasal passages prior to doing breathing exercises.

5. If one experiences difficulty breathing into the abdomen, press the hand down on the abdomen during exhalation and allow the abdomen to push the hand back up during deep inhalation. The hand pressure will help create awareness of the action of the abdomen during breathing.

6. Notice if the chest is moving in harmony with the abdomen, or if it appears rigid. Take a few minutes and let the chest follow the movement of the abdomen. This is done by continuing to focus on the abdomen moving up and down as one breathes and simply allowing the chest to follow its motion naturally.

7. If a person has difficulty breathing abdominally with the above exercises, one might try the following exercise. Lie on the stomach with the head rested on folded hands. Take deep abdominal breaths so that the abdomen can be felt pushing against the floor during breathing.

8. As one practices abdominal breathing for five or 10 minutes, scan the body for tension.