Could trying to stay AWAKE be the secret to curing insomnia?

Could staying AWAKE be the key to beating insomnia? Experts reveal how to use the ‘paradoxical intention’ technique to break the cycle by facing your fear of not being able to sleep

  • Paradoxical intention is a technique that challenges people to face their fear
  • In the case of insomnia, this means encouraging an individual to stay awake
  • Reasoning is this helps reduce the anxiety around the behaviour, aiding sleep   
  • Experts reveal a step-by-step guide to practising paradoxical intention at home 

Anyone who struggles with insomnia knows the hugely detrimental affect it can have on daily life. 

Causes can include physical conditions like long-term pain, lifestyle changes like shift patterns, mental health conditions like depression or anxiety, or a combination of factors. 

One study found 36 per cent of UK adults struggle to get to sleep at least on a weekly basis. Nearly half of British adults have trouble falling asleep at least once a month. 

Some experts champion a psychotherapeutic technique called ‘paradoxical intention’, which encourages an individual to engage in his or her most feared behavior. In the case of insomniac, this behaviour is staying awake. Stock image 

And it can be difficult to know how to tackle the problem. 

Some experts champion a psychotherapeutic technique called ‘paradoxical intention’, which encourages an individual to engage in his or her most feared behavior. In the case of insomniac, this behaviour is staying awake. 

The argument is that by facing the fear head-on, it is possible to reduce the anxiety surrounding it. In the case of sleep, less anxiety means an individual is more likely to fall asleep. 

Hussain Abdeh, clinical director and superintendent pharmacist at Medicine Direct, explained: ‘Paradoxical intention is a therapeutic procedure that encourages patients to stop obsessing over trying to fall asleep and instead staying awake for as long as possible.

Tackle insomnia at home: How to practise paradoxical intention 

There are many techniques that Phil advises to practise paradoxical intention. Here is a simple method to consider:

  • Go to bed and lie in a comfortable position
  • Attempt to keep your eyes open
  • Make sure to stay awake but don’t put too much pressure on yourself
  • Give up any effort to fall asleep
  • Give up any fears about still being awake
  • Set a target for how long you can stay awake, it might be 5 minutes, and then 10 minutes
  • Avoid your phone or any stimulating activities
  • Continue to lie in bed and repeat the motions
  • When your eye lids feel heavy encourage yourself to stay awake a little bit longer
  • Say to yourself: ‘I will fall asleep when it feels right for me in my own time’
  • After some time you should feel calmer
  • If you can change your mindset from focusing on falling asleep you will find that sleep will occur more naturally

‘Through attempting to stay awake, sleep may occur more easily. This is a form of challenging your normal mentality and sleep thought process to reduce the pressure and anxiety that you have about falling asleep. 

‘Often when we have anxiety about something we over think the problem and this can exacerbate the problem and in turn form more anxiety.

‘Therefore, if a person stops trying to fall asleep and deliberately keeps themselves awake for as long as possible, the performance anxiety will be significantly lessened because they will feel too tired to be anxious. 

‘This makes it easier for them to fall asleep and enjoy a quality sleep. 

‘The belief being that, although they will need to stay awake, the sleep they eventually get will help to replenish their energy levels and will be of greater benefit than the broken or short sleep they would otherwise get.’ 

This is a different form of treatment to getting out of bed when you can’t sleep, which is about breaking a negative association between the bed and the habit, or the same as distracting yourself through reading.   

While medics advise seeking assistance from a GP for a persistent issue with sleep, it is possible to practise ‘paradoxical intention’ at home. 

Speaking to Glamour, Dr Katharina Lederle, sleep scientist at sleep therapy programme Somnia, explained: ‘It means that you challenge your ‘go to sleep’ thoughts, instead telling yourself to stay awake.

‘You might keep your eyes open while lying in bed, comfortable and quiet, even telling yourself: “Just keep your eyes open a moment longer.” In doing so, you’re flipping the goal from falling asleep to staying awake. 

‘By giving up on the aim to fall asleep, you stop putting in the “effort” to fall asleep, and that means the pressure to “perform” (i.e. fall asleep) disappears. Physiologically, this means the body and brain can finally calm down and relax.’

Hussain noted that insomnia ‘is often better treated with behavioural interventions like paradoxical intention compared to pharmacological interventions.’

However Phil Lawlor, a sleep expert at Dormeo UK, noted paradoxical intention is most effective when practised with the guidance of a therapist who might be able to advise on a combination of sleep treatments. 

He added: ‘Paradoxical intention is known to be effective in the long run. The long-term effect is that it reduces anxiety during bedtime and may even improve sleep quality in most patients.’ 

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