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Feeling Helpless About Your Sleep Issues?

Counselling Addresses Sleep Problems from Various Angles

In the past 10 years, research from medical and other academic fields found that more than 10% of Hong Kong people experience insomnia. Quality of life, work performance and interpersonal relationships can be affected not only by having no sleep at all throughout the night but also from being unable to sleep well and poor sleep quality. This is because these conditions make us easily be irritated and restless. If not addressed properly, sleeplessness can become more severe and affect our mental well-being in the long run. Living in a metropolitan city is stressful, but with counselling, we can identify the various causes behind one’s sleeplessness and address it. 

Eliminate Biological Factors First

The American Psychological Association’s DSM-5 defines insomnia based on eight criteria, which include experiencing difficulty in sleeping at least three times a week, experiencing significant impairment in daily functioning etc. What can be done if we are not serious enough to meet the criteria for medical insomnia but yet are not satisfied with our quality of sleep? Using medication may only a superficial solution as sleeplessness will persist if we do not find out the underlying causes that affect our sleep.

In the first session, experienced counsellors usually ask clients many detailed questions such as: How long have you experience difficulty in sleeping? How often does it happen in a week? Do you have difficulty sleeping well or wake up in the middle of the night? Do you wake up too early or experience frequent waking during the night? Do you often have nightmares? Do you feel groggy when you wake up every morning? Have you felt so sleepy in the day that you fall asleep while working…? We observed that some clients may be a bit relieved after getting through this questioning process as they realise their sleep problem is not as serious as they thought.

The detailed questioning process serves to help the counsellor identifies the possible underlying causes of the client’s sleeplessness. Can it be due to biological factors? Psychological factors? Or other factors? If the suspected cause is due to biological factors such as prostate problems in men, overactive bladder, sleep apnea, weak cardiorespiratory function or menopause etc., the counsellor will suggest the client to have a detailed health check. Once biological factors are eliminated as the cause, the counsellor will focus on the psychological factors. Strategies and plans will be developed specifically based on the client’s condition to identify the psychological causes and address them to improve his/her sleep.

Childhood Trauma Can Also Cause Sleeplessness

Sleeplessness can be due to many psychological factors, such as childhood trauma. Being sexually harassed as a child, being involved in a car accident or experienced a disaster etc. are past traumas that can bring about sleeplessness when negative emotions associated with these events are triggered. Other than past traumatic experiences, recent stressful events such as the beginning of a new school year, the nearing of childbirth, getting ready for marriage or divorce etc., may also cause sleeplessness.

There are cases where two factors mutually influence each other and further aggravate one’s sleep problem ( “double trouble”). For instance, people who cannot sleep well worry about their poor sleep. This worrying can keep them wakeful and further exacerbates their sleep problem. Another example is people napping at work after lunch because they are unable to sleep well each night. This affects their circadian rhythm and leads to a continuous vicious cycle of sleeplessness at night. People suffering from anxiety can also experience the physical symptoms of anxiety at night, which disrupt their sleep. Young children with sleep problems may realise that their parents are more attentive to them because of their condition, and thus consciously or subconsciously stay wakeful at night to seek their continued attention.

When working with clients facing sleeplessness, counsellors will usually first suggest some lifestyle changes, followed by addressing their emotional struggles. Most importantly, counsellors will also help clients address deeply-rooted issues that are troubling them. This is because such issues not only disrupt their sleep but also affect them in many other ways. It is thus best to address them early.

If you are experiencing short-term sleeplessness, which does not significantly affect you and those around you in a long-term context, one way to overcome it is to learn to relax. During sleepless nights, try to maintain a calm and positive mindset as this can ease you into getting a good night’s sleep. 

Develop Good Sleeping Habits

  1. Avoid watching TV and using mobile phones or other similar electronic devices before bedtime. 
  2. Avoid having arguments or fights with family, especially your partner, before bedtime.
  3. Eliminate light and noise in the bedroom.
  4. Sleep at a regular time.
  5. Have a balanced diet, avoid caffeinated drinks hours before sleep.
  6. Establish a regular exercise schedule.
  7. Express gratitude for the day and look forward to a better day tomorrow.

The Companions
KK Cheng