When Sleep Won’t Come: How Counselling Can Help.

If you’ve been lying awake at 3am, you’ve probably already tried a lot. Magnesium, melatonin, herbal teas, blackout curtains, a new mattress, maybe a prescription from your GP. If you’re still struggling, you might be wondering what’s left.

One option many people overlook is talk therapy. Sleep isn’t only a body problem. It’s closely tied to how we think, feel and cope with stress, and that is exactly what counselling works with.

Why a busy mind keeps you awake

Sleep needs the mind to quieten down. For many people, that’s the part that has stopped working. Researchers describe two kinds of repetitive thinking that get in the way. Worry is repetitive negative thinking about things that might happen in the future, while rumination is repetitive negative thinking about past events or current distressing feelings. whiterose

A systematic review of the research on thoughts at bedtime found that insomnia is associated with more interfering thoughts, worry, unhelpful ways of trying to control thoughts, and heightened mental arousal. In cognitive models of insomnia, repetitive negative thinking is thought to make insomnia worse and help keep it going. em-consulteuniroma1

That might sound familiar. You get into bed exhausted, and suddenly your mind switches on: tomorrow’s to-do list, a conversation from last week, a worry about money or health, and then worry about not sleeping. Supplements and sleeping pills can’t easily reach this part of the problem. Counselling can.

What counselling offers

In counselling we can work on the things that tend to sit underneath sleepless nights:

• Stress and overwhelm, by finding out what’s weighing on you and what can change

• Anxious or looping thoughts, by learning to notice them and loosen their grip

• Unprocessed emotions, such as grief, anger, loneliness or pressure that gets pushed aside during the day and arrives at night

• Relaxation and settling skills that help your body and mind wind down

• Your relationship with sleep itself, including the pressure and dread that can build around bedtime

Many clients tell me that as their stress eases and they feel more heard and supported, their sleep starts to improve too.

What the research says

Research on talk therapy and sleep is strongest for approaches that help people relate differently to their thoughts and stress, such as mindfulness-based approaches.

A meta-analysis of randomised controlled trials looked at mindfulness meditation and sleep quality. It found moderate strength evidence that mindfulness interventions improved sleep quality compared with other active comparison programmes, both straight after the programme and at follow-up. The same analysis found that mindfulness meditation had a similar effect on sleep quality to evidence-based sleep treatments. qigonginstituteki

Sleep trouble often comes alongside low mood or anxiety. A meta-analysis of 10 randomised controlled trials with 541 adults found that mindfulness-based interventions improved the sleep quality of adults with depression or anxiety disorders. examine

The research is still developing, and results vary between people and between types of therapy. Counselling isn’t a guaranteed fix for sleep. But for people whose sleep is tangled up with stress, worry or difficult emotions, working on those things directly is a well-supported place to start.

Is it time to give it a try?

You might consider counselling for your sleep if:

• you’ve tried supplements, sleep tips or medication and still aren’t sleeping well

• your mind races or you feel anxious as soon as you lie down

• you spend a lot of time worrying about not sleeping

• stress, grief, low mood or big life changes seem tied up with your nights

• you’d like support beyond “just relax” and “have a warm bath”

  
  

You haven’t failed at something simple, and you haven’t run out of options. At Resilience Counselling, I draw on Solution Focused Therapy, Client Centred counselling, Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help clients feel calmer, more supported and better rested. I hold a Bachelor of Counselling and am a provisional member of the NZCCA. If you’d like to talk it through, https://www.resnz.com/book-counselling.

This article is for general information and isn’t a substitute for medical advice. If you have ongoing sleep difficulties, it’s a good idea to see your GP to rule out other causes, and please speak with your prescriber before changing any medication.

References

• Rusch, H. L., Rosario, M., Levison, L. M., Olivera, A., Livingston, W. S., Wu, T., & Gill, J. M. (2019). The effect of mindfulness meditation on sleep quality: A systematic review and meta-analysis of randomized controlled trials. Annals of the New York Academy of Sciences, 1445(1), 5 to 16.

• Effects of mindfulness-based intervention programs on sleep among people with common mental disorders: A systematic review and meta-analysis. (2022). World Journal of Psychiatry, 12(4), 636 to 650.

• Lemyre, A., Belzile, F., Landry, M., Bastien, C. H., & Beaudoin, L. P. (2020). Pre-sleep cognitive activity in adults: A systematic review. Sleep Medicine Reviews, 50, 101253.

• Clancy, F., Prestwich, A., Caperon, L., Tsipa, A., & O’Connor, D. B. (2020). The association between worry and rumination with sleep in non-clinical populations: A systematic review and meta-analysis. Health Psychology Review.