If I Can't Sleep Should I Get Up or Stay in Bed?

It’s the middle of the night and you are tossing and turning AGAIN. What do you do? CBTi says to get up but ACTi says stay in bed. Who is right?

Get Up or Stay in Bed....
In life, choosing the correct answer often begins with asking the right question. In this case, a more accurate inquiry would be “What is right for me now?”

Last week we spoke about whether or not to use a sleep tracker and I told you about hyper (or paradoxical) sleep which often happens when you are under stress, it also goes hand in hand with being tired and wired.

In hyper sleep, light sleep and wakefulness blend into a mishmash of circular thoughts and disturbed dreams, the body frequently yoyoing between wakefulness and sleep.

If you experience hyper sleep and are not tracking your sleep with an accurate sleep tracker, then it can feel as if you have laid awake, tossing and turning all night.

If You Exprience Hyper Sleep How Do You Know if You Were Asleep or Awake?

It is in relation to hyper sleep that CBTi can become problematic. This is because a main premise of CBTi is that it is important to get out of bed if you have been lying awake for 20/30 minutes or more.

Now this makes sense for many people as it is very common for people who experience chronic sleep disturbances to begin allocating more and more time for sleep.

They badly want to get in their 7-8 hrs and, in an attempt to do so, they begin spending large amounts of time in bed, essentially chasing sleep.

The Problem With Chasing Sleep

This behavior is problematic as:

1. It is important to move and be active during the day because it helps to burn off extra stress and boost sleep drive.
2. The more time you devote to thinking about sleep the more stressed about sleep you become which (ironically) makes it harder to sleep.
3. If you are spending hours in bed stressed about sleep then you begin to build up a habitual stress response to your bed, kind of like Pavlov’s dog.

In case you are unfamiliar with this experiment, a dog was fed every time a bell rang. By the end of the experiment the dog began slobbering every time it heard the bell, whether food was present or not, because he had been trained to eat when the bell was rung. This same phenomenon occurs with sleep.

CBTi Can Be Helpful

 If you spend hours lying in bed stressing about sleep, then eventually the body associates’ bed with sleep stress. This is why many people complain about feeling exhausted and then being wide awake the minute they get into bed.

For individuals who are caught in a vicious cycle of putting life on hold (calling in sick to work, avoiding social activities etc.) in order to lie in bed and chase sleep, CBTi can be extremely helpful.

 CBTi Doesn't Work For Everyone

But what if you are experiencing hyper sleep? Maybe you have in fact been sleeping, you briefly wake, don’t realize that you were just asleep, and (because you mistakenly assume that you have been lying awake) you force yourself out of bed for 20 minutes or so because that is what you have been told you “should” do.

For these people, following a strict CBTi regime can be one of the worst things they could try for their sleep.

I say can because everyone is different.

Do You Try Too Hard?

Many people struggle with motivation, because practitioners know this, they set up strict black and white guidelines (such as get out of bed after 20 minutes) knowing that a majority of their clients will hem and haw and procrastinate before loosely following this rule some of the time.

Unfortunately, this strategy does a disservice to all of us rule followers out there!

Many of my clients tend to be over achievers who put a high value on following instructions and “getting things right”.  They want to “win” at sleep. For these people a strict CBTi plan can be detrimental because they tend to follow programs too stringently.

These are the people most likely to notice they are awake, not realize they were just asleep, and jump out of bed (further disturbing sleep) because CBTi told them too.

I am also one of these people. By the time I decided to try tracking my sleep I was getting up 6x a night or more. It wasn’t until I saw the data and noticed “hey, I was actually asleep right before I got up” that my sleep began to normalize.

In my attempt to follow the rules and do everything right I had innocently been making my sleep 10x worse!

What is ACTi?

It is in situations like this that ACTi can be extremely helpful. ACTi (Acceptance and Commitment Therapy for Insomnia) guides clients to stay in bed when they wake in the night.

The premise is to try and accept wakefulness (as we can’t control sleep anyway and any attempts at control only make insomnia worse). By lying in bed and accepting being awake, you begin to relax back into sleep, and this restructures the brain to associate bed with relaxation instead of stress.

A relaxed state sets the stage for sleep, so it is in important distinction when working with insomnia.

Now we know about both CBTi and ACTi and the differences in their philosophies so who is right? That honestly depends on the person and the night.

The way I guide clients is to decide in the moment based on how they feel. If you are lying awake, try to relax into being awake. If this does not feel possible and you begin to feel stressed, then it can be more helpful to get up.

 You Are Unique. So is Your Solution

The most important question to ask yourself in the middle of the night is “do I WANT to get up or would I prefer to stay in bed?” keeping in mind that there is no right answer. Trust in your body and allow it to guide you knowing that if you would prefer to stay in bed you will likely sleep but this is not a state that can be controlled and there is no point in making yourself miserable over some arbitrary rule.

It doesn’t matter if you get up in the night or not as long as you do make sure you get up in the morning and participate in a normal day instead of cancelling plans and languishing in bed, waiting for the next disturbed night of sleep to come.

If you would like to learn more or book an individual session, please visit the Memberships page.

In the meantime, I would like to leave you with this important message. You are not broken! You are whole, perfect, and healthy exactly as you are, and you CAN sleep!