A Geographical cure for insomnia

‘travel and change of place impart new vigor to the mind.’ – Seneca

My second blog post aims to provide you with another idea about coping with insomnia that you won’t find anywhere else; to physically leave or change your everyday surroundings for a while. When you have been through traumatic events you live in a perpetual state of tension and worry – unable to fall asleep sometimes even though you are exhausted. These feelings leech into your everyday environment; home can start to feel like a prison; you fear the phone ringing, a knock on the door, the mailman or who you might run into at the mall. Familiar stimuli acquire a negative vibe.  One very effective solution is to get away physically. Being somewhere else, preferable somewhere nice, triggers a psychological shift. A chronic PTSD sufferer with terrible insomnia was suddenly able to sleep soundly for hours on end when she went on a cruise. The knowledge that she was far out to sea where no one could get to her, the gentle rolling of the ship, the safety of her cabin, all instilled a sense of safety and peace that enabled her to relax (and fall asleep) in a way she could never at home.  A burned-out government employee noticed a dramatic improvement in her sleep when she relocated to the country. The sound of running water from a nearby creek interspersed with birdsong, the sight of wild animals, the smell of the air all acted as a balm to her jangled nerves.

You don’t necessarily have to travel far; Winston Churchill simply slept in a different bed when he had trouble falling asleep. Getting away doesn’t just help with your sleep –  by creating distance it can also lead to new perspectives. A traumatized emergency worker found that going camping in a wood not far from his home not only had a positive effect on his nerves – it also stimulated a realization that despite all the bad things he had witnessed, life goes on. So try a change of scenery – it will not only help you sleep better, it might also help you see things differently. ff

Stress, Sleep and EMDR

Seeing how many of my clients suffering from PTSD, stress and chronic pain also struggle with insomnia, I’ve long wanted to create a resource to help them. Sure there are meds, but they seem to create more problems than they solve and lose effectiveness over time. I  also haven’t found the traditional sleep hygiene strategies  to be of much help. I know there is some research for IRT (Image Rehearsal Therapy) being helpful with PTSD-related insomnia but I prefer approaches which require less effort on the part of my clients, who are often tired and unfocused, which is why I like EMDR . For example yesterday I treated a boat accident survivor with unresolved PTSD (15 months) whose trauma literally melted away after a few sets of bls (bilateral stimulation) leading him to comment incredulously, “how can it be that easy?” If you’re new to EMDR bilateral stimulation is a core treatment element of this method which involves instructing the client to focus on the traumatic memory whilst simultaneously tracking a visual or auditory stimulus and “just noticing.” With simple PTSD this usually leads to a relaxation response and a permanent change in the way the memory is stored.

I’ve also noticed that many of my client’s report feeling drowsy following EMDR, particularly after sessions involving heavy emotional processing. They make comments like “if you kept doing that (bls) I think I’d fall asleep.” Many report sleeping soundly after the session and generally sleeping better following successful EMDR. One of the most popular theories about how EMDR works is that it activates processes similar to those involved in REM sleep (Stickgold, 2002). Consistent with this bilateral stimulation (bls), a defining treatment element of EMDR, has been found to stimulate a synchronization of cortical activity in the delta range (associated with deep restful sleep (Paganini et al 2017). EMDR has also been found to improve sleep in PTSD sufferers (Robonini et al 2014).

This led me to think that an app incorporating bls could be helpful for insomnia sufferers, particularly those affected by stress, trauma and pain. work. Digital apps are one of the fastest growing areas of health technology and there are over 60 sleep apps at this time (April 2018). Most sleep apps however, do not appear to have been designed with any consideration of the role of stress in insomnia. So, I made one. ‘Sleep Restore based on EMDR’ is specifically designed for sufferers of stress-related insomnia, (eg; PTSD, chronic medical conditions). The app features;

  • 6 – 18 sessions (premium) of guided meditations, music and nature sounds, combined with bilateral stimulation.
  • Different sessions to address worry and tension, the 2 main causes of insomnia
  • Different sessions for ‘getting to sleep’ and ‘getting back to sleep’
  • Sleep assessment questionnaire and progress feedback
  • Individualized recommendations based on user’s responses to the questionnaire
  • Ability to create individualized playlists, repeat and loop sessions indefinitely
  • Unique sleep hacks to help improve sleep (premium version only)
  • IOS and android versions available

Responses to the questionnaire will be collected and analysed with a view to publishing some research regarding the efficacy of the app, probably in early 2019.