As therapists, we understand that a good night's sleep iscrucial for recovery, resilience, and overall health. Struggling with sleep isan all-too-common issue many therapy clients face, often impacting their mentaland physical well-being. So this month, I’m going to give you some tips to helpyour clients get a better night’s sleep.

There is limited space here so it’s impossible to covereverything there is to say about sleep, but I’ll give you a sort of checklist, and if you want moredetail you are welcome to sign up for my free CPD course on sleep issues.

 

Insomnia and sleep deprivation

Both ‘insomnia’ and ‘sleep deprivation’ refer to not havinghad enough sleep They have similar symptoms and problems attached, but theyrefer to different situations where this might occur.

Insomnia is when someone is unable to sleep, despite havingplenty of chances to do so. They go to bed but either can't fall asleep in thefirst place or fall asleep but wake too early or too often, and they may findthey are unable to get back to sleep.

Sleep deprivation is when someone hasn’t had enough sleepbecause they didn’t get the opportunity to do so. It includes things likestaying up all night to party or study for exams, getting up frequently to lookafter a baby or sick relative, or working non-standard hours. 

The difference matters because people don’t generally chooseto have insomnia; it’s often due to factors over which they have little or nocontrol (at least without medical intervention) such as a sleep disorder. Butsleep deprivation is frequently due to lifestyle choices which need to beidentified and perhaps addressed as part of your therapy. Typically thesechoices may be around:

Alcohol, which helps you get to sleep but is a diuretic(creating an increased need for urination) which can be the cause of earlywaking and dehydration.

Caffeine, which increases dopamine production, which has theeffect of increasing alertness, and takes up to six hours to be processed bythe body, so coffee drunk at 6 pm could still keep you awake at midnight.

Shift work, especially if shift times keep changing, whichcreates a long-term or permanent form of jet lag and causes sleep disruption,tiredness, mood swings and changes in bowel habits.

Smoking, which causes a loss of just over a minute of sleepfor each cigarette smoked in a day, so a 20-a-day smoker could lose up to halfan hour's sleep each night just because of their habit.

And even the weather is said to affect our sleeping habits.

 

Sleep disorders and health

Most professional bodies have something in their Code ofEthics to the effect that therapists with no medical qualifications should nottreat medical conditions. That seems obvious but it bears some considerationhere. There are so many physical and psychological issues which can get in theway of a good night's sleep, you should always take a thorough medical history.If there is, or may be, a medical issue, refer them to their doctor, as it willneed dealing with before or alongside any therapy you offer.

Health issues associated with sleep disturbances include:

Anxiety

Depression

Restless Leg Syndrome

Narcolepsy (though this is very rare)

Night sweats

Sleep apnoea

Sleepwalking and night terrors

Age-related changes such as menopause

 

What sort of sleep disturbance does your client have?

Do they find it hard to go to sleep?

Do they wake frequently during the night?

Do they still feel tired after waking?

It’s wise to check which of these your client isexperiencing, as they may need addressing separately.

 

Help your clients get a good night’s sleep

Once you know whether your client is experiencing insomniaor sleep deprivation, and how it affects them, you can start to plan yourapproach. A Lifestyle and Sleep Questionnaire is useful for this and you arewelcome to ask me for one to use with your clients. It is also included, alongwith other resources, in the free CPD course mentioned above.

It’s often wise to start with sleep hygiene, which doesn’trefer to whether clients wash themselves or their bedclothes (although thathelps!) but is a term used to refer to developing behaviours and routines thathelp to promote good sleep. These could include:

A dark, safe, comfortable, slightly cool, and preferablyquiet, bedroom.

Avoiding electronic devices in the bedroom and for at leastthirty minutes before bedtime, unless they have a blue light filter – blue lightfrom screens is associated by the brain with daylight.

Possibly banning pets from the bed or bedroom if they snore,wriggle or move around frequently.

Developing a healthy bedtime routine, which is consistentover workdays and non-workdays. This could include avoiding vigorous exercisein the runup to bedtime; stopping intake of alcohol, nicotine and caffeineearlier in the day; avoiding heavy meals just before bed, though a light snackis fine; using aids to relaxation such as self-hypnosis, a warm bath,aromatherapy oils, or listening to soothing music.

Clients should avoid napping during the day, or, if this isn’tpossible, limit naps to thirty minutes at most, as early in the day as theycan.

Getting some exercise daily, to create natural tiredness. 

Hypnotherapy can, of course, be used to support the clientas they make these changes, address any resistance and boost motivation.

 

Therapy to support clients with sleep issues

The most-studied psychological approach to insomnia is CBT(Cognitive Behavioural Therapy) which has a good evidence base to support itsuse. CBT, in general, relies heavily on education and the re-shaping ofthoughts and behaviours. You’ll find plenty of information online about CBT-I (CBTfor Insomnia), and six to eight sessions are said to be as effective asmedication, and sometimes more so because the effects continue after thetherapy stops.

Even if you’re not a CBT therapist, you can take plenty ofideas from this approach to integrate with your own favourite approaches. If youknow NLP, for example, use a ‘swish’ or ‘collapsing anchors’ to help the clientanticipate a good night’s sleep. If you are a hypnotherapist, you can work with suggestions and metaphors to reduce negative thought patterns or unhelpful habitsand to promote good sleep hygiene and restful sleep.

Parts work is among my favouriteapproaches, speak to the part that controls sleep, ask about its intentions andlook for strategies that allow it to reach its goals and the client to have agood night’s sleep. The six-step reframe approach will help identify effective coping strategies 

You can also teach the client relaxation techniques, such ascontrolled breathing, visualisations, self-hypnosis, meditation or similar touse to help them relax before bedtime so they are more likely to fall asleep.If you are a hypnotherapist, the widely used ‘peaceful place’ technique can bea good one to use.

Regression has also been used to help those with insomnia,although my research has found mostly case studies of the ‘past life’ variety,rather than age regression. If you are trained to do this kind of work, thereis nothing to stop you from searching either within the client’s earlyexperiences or their past lives to identify a cause for sleep disturbances andwork with whatever you find.

 

Overall, we’ve had a very quick tour through the landscapeof helping with sleep disturbance, and there is more to be said. But I hopethese strategies and ideas will help you to support clients overcome sleepchallenges, whether they're dealing with insomnia, anxiety-driven restlessness,or disrupted sleep patterns, enabling them to enjoy the restorative rest theyneed for a balanced life.

Further information – 

FREE CPD course from YHT on helping clients with sleep issues.

Working with parts (paid course) 

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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of Anxiety to Calm: a Practical Guide to a Laid-Back Life, The Hypnotherapist's Companion, Their Worlds, Your Words, and The Metaphor Toolbox, all available from Amazon or direct from the author. Find out more about Debbie's services on
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