20 13 I lost sleep because of the pressure of doing my doctoral thesis for a long time. I didn't fall asleep the other night, and I haven't felt any problem yet. I have been lying in bed, forcing myself to fall asleep, but the more I lie down, the more I can't sleep, and suddenly I start to worry.

Soon, sleep problems caused psychological problems, suffering from anxiety and depression, not interested in anything, just worrying about sleep all day. The doctor asked me to take sleeping pills and anti-anxiety drugs. After a long time, the effect of sleeping pills became worse and worse, which affected my memory. I had to drop out of school and go home.

During that time, I was seriously anxious, thinking about how to let myself fall asleep all day, worrying about whether I could fall asleep tonight. At the worst, there were several panic attacks, so that I was afraid at the sight of the bed and anxious when I entered the room. I go back to work normally, mainly to keep up with the normal pace of life. I tried to wander around outside, afraid to go home.

I went to many hospitals, and the doctors basically prescribed some medicine and sent me away. Finally, I met a better psychologist in the provincial mental health center. I was most worried about whether I would go crazy like this. I was relieved when the doctor told me that I would never. Psychologists have given me some inspiration and comfort, but they still can't fundamentally solve my problems. I'm still anxious, and I still can't sleep well. I am determined to take the initiative and solve the problem by myself. So I began to teach myself about psychology and sleep, and gradually reduced the dose.

Cognitive behavioral therapy for insomnia

The first book I found was Cognitive Behavioral Therapy for Insomnia. I started practicing according to the steps in the book in May, 20th/KLOC-4th. After more than a month, sleep slowly began to improve, but it was still unstable. I watched Farewell to Insomnia and Why didn't the psychiatrist tell me. After my continuous study and repeated experiments, I summed up the lessons of success and failure. Finally, I successfully got rid of sleeping pills, and my sleep began to improve and gradually stabilized.

Now, I have successfully cured my insomnia. I can have more than 6 hours of deep sleep every day, without waking up, and I am in good spirits during the day. Most importantly, I'm no longer anxious and depressed, I'm in a good mood, I'm back to my former good state, and I'm starting to live a normal life.

In order to treat insomnia, I took many detours and suffered a lot. After groping in the dark for a long time, the light finally came. Now, I write what I have learned from books, combined with my own experience and lessons, for your reference, hoping to be useful to you.

In fact, insomnia caused by non-physiological factors is mainly treated from psychological and behavioral aspects, and basically no medicine is needed. Foreign research in this field is very mature, and domestic clinical research has just started. Psychotherapy is very important. The purpose of psychotherapy is to change the incorrect cognition of sleep, and then eliminate emotional disorders such as anxiety and depression. Behavioral therapy is to correct the wrong sleep behavior and establish reasonable sleep habits and schedules. Combined with certain physical exercise, insomnia can be cured without drugs.

Cognitive behavioral therapy has been widely used to treat insomnia in Europe and America for decades. This therapy combines stimulation control, sleep restriction, sleep hygiene education and psychological cognition education. And treat acute and chronic insomnia. The short-term effect is equivalent to or even better than sleeping pills. The long-term curative effect is better and more stable, and recurrence is not easy. The core theory of this therapy is stimulus control and sleep restriction.

Stimulation control

According to this theory, the improper behavior of insomniacs (such as taking a nap during the day, or taking a nap on the sofa before going to bed at night, doing things unrelated to sleep in bed or bedroom, etc.). ) it causes the mismatch between sleep opportunity and sleep ability, which leads to bad conditioned reflex, which leads to the awakening of the body before going to bed and interferes with sleep.

For example, because patients are unwilling to get up and try to sleep even if they can't sleep in bed in order to expand their sleep opportunities. One possible consequence of this is that the more patients want to sleep, the more they can't sleep, so they are more upset.

In this way, the normal conditioned reflex between bed, bedroom and sleep is weakened and replaced by a conditioned reflex of fear of sleeping. When the patient is sleepy on the sofa, as soon as he walks into the room, he may automatically think of his previous failed sleep experience in a conditioned way, which will lead to anxiety, which will lead to the body waking up again and insomnia.

Therefore, the stimulus control theory holds that these inappropriate behaviors should be eliminated as much as possible, the intensity and frequency of physical awakening should be reduced, and the positive conditioned reflex between bed, bedroom, time and sleep should be re-established, thus helping patients to relieve their fear of sleep.

Sleep restriction

According to this theory, everyone has a fixed sleep time. If patients supplement their sleep by taking a nap or taking a nap during the day, it will inevitably lead to difficulty in falling asleep at night and disrupt the normal sleep rhythm. For example, it is difficult for many people to fall asleep on weekends or the last night of holidays, because they sleep irregularly during holidays. Therefore, the treatment of insomnia, first of all, by limiting the patient's sleep time, so that sleep time and sleep timing are consistent.

If the patient's daily sleep time is limited, such as 5.5 hours, then the patient's bedtime and wake-up time can also be fixed. For example, patients sleep at 1 o every day, get up at 6:30 in the morning and stay in bed for 5.5 hours. At this time, the patient may actually only sleep in bed for 2-3 hours because of insomnia, but whether he is asleep or not, he has to get up at 6:30 the next morning, and no measures should be taken to make up his sleep the next day.

This creates a? Sleep stress? , or call? Sleep motivation? And accumulate a certain amount of sleep debt. Because the human body has its own repair system, when the sleep debt accumulates to a certain extent, it will inevitably shorten the sleep latency of a certain night and make it easy to fall asleep.

That is to say, it is easy to fall asleep, gradually establish sleep confidence and gradually improve insomnia symptoms. Sleep restriction can not only shorten the sleep latency, but also make deep sleep more stable. In the long run, it can continue to increase the benefits of sleep.

When the patient's sleep efficiency reaches more than 90% during 1:00-6:30 (the specific time depends on his own situation), upward titration can be considered, that is, 10- 15 minutes before going to bed. So stable for a period of time (for example, one month), and then go to bed 10- 15 minutes earlier. Go on like this until a reasonable situation is reached.

Sleep restriction theory requires patients to stay awake before the prescribed bedtime, and not to take a nap or nap, otherwise it will destroy their sleep rhythm. It is worth mentioning that, according to theory, this therapy has a small benefit ratio to patients' sleep in the short term, but it can greatly shorten the sleep latency and make the whole sleep more stable.

Cognition and behavior

Cognition and behavior are two schools of thought in psychotherapy, each with its own strong points, and psychological counselors often combine them. American statistics show that the effective rate of cognitive behavioral therapy is 90% and the cure rate is 70%.

1. The principle of behavioral therapy is the connection between stimulus and response. You can do a small experiment yourself to understand this principle. Take a small mirror so that you can see your pupils. Choose a night time, turn on the light first, turn off the light after 5 minutes, turn on the light after 5 minutes, pinch yourself when turning on the light, and feel pain. This process is repeated five or six times, and I only pinch myself when I turn on the light.

In this process, you can look at your own pupils. Every time the light is turned on, the pupil will gradually enlarge and then remain the same. After repeating it for five or six times, don't turn off the light, just pinch it yourself, and you can see that the pupils will also become bigger. This shows that the stimulation of pain is related to the movement of the pupil. Behavioral therapy for insomnia tries to link various stimuli with sleep. When you receive stimuli, you will feel sleepy.

2. Cognitive therapy means that people with insomnia usually have many wrong ideas. These thoughts are the chief culprit of our insomnia. For example. There are two people. One thinks that if you don't sleep for one night, you will be very tired the next day, you will definitely fail to do well, you will be criticized by your boss, and this month's bonus may be gone.