Are you feeling powerless to fight insomnia? Unable or unwilling to take drugs that may cause unpleasant side effects and possible addiction? A chronic insomnia therapy based on mindfulness could be the answer for you, or at least part of an answer.
In this article, we shall take a look at mindfulness and the way its principles apply to insomnia. We are answering the following questions:
- What is mindfulness? What is MBTI (Mindfulness-based Therapy for Insomnia)?
- How do the principles of mindfulness apply to sleep?
- The MBTI program.
- How can you practice mindfulness for your insomnia?
- What are the scientific underpinnings of these theories?
What is Mindfulness?
By definition, mindfulness is the focusing of one’s full attention on the experience of the present moment. As much as possible, this focus should be judgment-free. There is much more to mindfulness regarding sleep quality, however.
MBTI, on the other hand, is an acronym for Mindfulness-based Therapy for Insomnia. It is a complex program that applies the principles of mindfulness to sleep. Its goal is to improve sleep in “unconventional” ways. By “unconventional” we mean methods not usually explored by sleep professionals/insomnia sufferers.
To understand how MBTI works, we need to examine the principles of mindfulness.
- Beginner’s mind is one of the core tenets of mindfulness. What it means is that you view each night as a standalone entity/stage of your existence. As such, you embark on it without any preconceptions and judgments. You do not expect anything of it. Whatever you did nights past to promote sleep, no longer applies.
- Non-striving is self-explanatory. Do not strive to bring about sleep. Do not try to force anything. Just observe your thoughts and feelings, as if you were a third party.
- Letting go. You need to let go of your preconceptions concerning ideal sleep quality and quantity. Such rigid concepts lead to unrealistic expectations about sleep. They set you up for anxiety and worrying about the way your sleep unfolds.
- Avoiding judging. Chronic insomniacs constantly assess and judge their state when they go to bed. If they fail to fall asleep in what they deem to be proper time, they write it down as something negative. Such judgment leads to stress, staving off sleep further. Simply observe your state, do not draw any conclusions from it.
- Patience. Be patient with the mindfulness-based approach. It is not likely to bring about spectacular results immediately. It is a solution that needs time to kick in.
- Acceptance is yet another core tenet of mindfulness. Instead of fighting your condition, you should accept it and observe it impartially. Insomniacs often refuse to get out of bed, when unable to fall asleep. This usually exacerbates the problem. A person who accepts the fact that sleep is not likely to come about will find it easier to leave the confines of the sheets. Why is it a bad idea to stay in bed for long periods while awake? The practice will condition you to not associate being in bed with sleeping.
- Put your trust in your body. Many insomniacs feel betrayed by the sleep/wake regulating systems of their bodies. If you are such an insomnia sufferer, regain trust. Your body and mind can and will regulate your sleep/wake cycle. They will also make sure to pay off sleep debt. Trust the handling of your insomnia to your body/mind. Allow them to correct the imbalance.
Now let us define the objectives that mindfulness aims to accomplish, concerning sleep. The main objective of mindfulness is NOT to change the amount of sleep you get. Rather, it aims to change your relationship with sleep.
There are several stops on the path leading to that objective.
- You need to come to grips with the concept that not getting enough sleep is not a shortcoming. It is simply your present condition. It is not something you need to actively rectify either.
- Do not believe that letting go and accepting your current state means that you give up. You should practice these tenets actively. It is your choice to take a non-reactive stance.
- The mentioned principles of mindfulness allow you to take a much more flexible stance on insomnia. Thus, they will expand your arsenal of options to address the issue.
Does MBTI involve meditation? To a certain extent, it does. Be aware however that MBTI meditation is not a way of relaxation. Its goal is to have you paying attention without taking action. It aims to relegate you to an observer.
As such, MBTI meditation is not the practice of clearing your mind of thoughts. Instead, it aims to allow you to leave your thoughts as they are. Letting thoughts drift in and out of your conscious awareness without getting frustrated by them, is the best way to eventually let them settle.
As someone about to embark on MBTI, you will face, and eventually answer, the following questions:
- Is your inability to fall asleep according to a schedule you deem ideal for some reason, really a negative thing?
- Are there ways of responding to insomnia that you have not explored yet?
- Would the principles of mindfulness improve your situation?
- Is there a way for you to incorporate mindfulness-based techniques into your routine, without professional help?
The MBTI Program
As mentioned, Mindfulness-based Therapy for Insomnia is a complex program. It comprises several stages, for a multi-pronged approach to solving a complex problem.
Such a program is much more than simply applying the principles of mindfulness to sleep. It also incorporates behavioral education.
- The experiential section of the program consists of meditation. There are two meditation types recommended by MBTI: quiet meditation and movement meditation.
- The discussion and inquiry stage involves patients and professionals. The two parties discuss challenges and applications. They ask and answer questions.
- Didactic and behavioral strategies cover sleep restriction, stimulus control, and sleep hygiene.
- MBTI also gives patients homework, requiring them to practice its tenets regularly.
Let us break down some of these program elements.
Movement meditation is relatively straightforward. Practice some yoga, go for a relaxing walk, or practice qi gong.
Quiet meditation, on the other hand, may require some directions. The method is simple but if you practice it regularly, it can yield surprising results.
- The first step is to find a quiet location, where you can relax undisturbed. Sit down and unwind before you begin the exercise. Make sure no bright lights are interfering with your meditation.
- Sit in an upright position. Do not lie down. Make sure your back is not touching the back of your chair. Using a stool is on option as well.
- Close your eyes and mentally tune into your body. Take note of any areas that may be stressed. Zero in on such areas and melt away the tension through a simple breathing exercise. Inhale and with each exhaling, visualize the tension melting away.
- Focus on your breathing next. Note the sensation of the cooler air flowing in through your nostrils and the warmer air rushing out as you exhale. Stay focused on your breathing for at least five minutes.
- Deepen your focus. Try to mentally follow the path of the air as you breathe. It flows in through your nostrils, down the airways into your lungs. It then completes its job of oxygenating your blood and flows back up the airways and out through your nose.
- During the exercise, thoughts will drift in and out of your mind. Do not be preoccupied with these thoughts. Acknowledge their existence, but do not attribute any meaning to them. Whenever you get distracted by these thoughts, aim to re-focus on your breathing.
- Keep this up for the remainder of your meditation.
- When you are ready to wrap up the session, take a few abdominal breaths and open your eyes. Re-adjust yourself to your surroundings and its physical realities. Do not rush anything. Take as long as you need to feel comfortable.
- As part of MBTI, you should perform this type of meditation daily. Doing it in the evening, before you go to bed, can be especially beneficial.
The discussion/inquiry stage will allow professionals to assess the progress their patients make. It will also reinforce patients’ resolve to stick with MBTI. During discussion, essential questions will likely gain answers as well. Those involved will address individual challenges during this stage of the program too.
As far as didactic and behavioral strategies go, experts like Dr. Jason C. Ong, have defined three areas of focus.
- Sleep hygiene is about eliminating activities/practices that are potentially detrimental to proper sleep. Such activities include the consumption of alcohol and caffeine, as well as the use of mobile devices before going to bed.
- Sleep restriction focuses on tweaking sleep timing, to improve sleep quality/depth. One such goal may be the reduction of the time spent in bed. Such an approach may consolidate sleep.
- Stimulus control aims to do away with conditioned arousal and its various triggers. The aim of this MBTI element is to re-associate the bed with sleep, thereby promoting a sound sleep schedule.
Such practices aim to address the daytime/waking symptoms of insomnia, an area often neglected by sleep specialists and insomnia sufferers alike.
The homework part of the program hands the reins to the participants/patients. It accomplishes that by requiring insomnia sufferers to go through the mentioned behavioral strategies and to practice meditation regularly. Dr. Jason Ong’s version of the program requires participants to meditate for 30 minutes per day, six times a week.
What is the Scientific Backing of MBTI?
Surely, a program as complex as MBTI is predicated upon sturdy scientific pillars…
A 2014 Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia, by Ph.D. Jason C. Ong, Rachel Manber, Zindel Segal, Shauna Shapiro, and others, took aim at 54 adults struggling with chronic insomnia. The study subjected its participants to mindfulness-based stress-reduction, MBTI, or a self-monitoring condition for eight weeks.
It found that MBTI proved viable for the treatment of insomnia. Thus, it could be viewed as an alternative to traditionally accepted treatments of the condition. The specialists conducted the study in an academic medical center.
A 2011 study by Cynthia R. Gross, Mary Jo Kreitzer, Melanie Wall, Robert Patterson, and others, took a look at mindfulness-based stress-reduction (MBSR). It matched up MBSR with traditional pharmacotherapy for the treatment of chronic insomnia.
30 chronic insomnia sufferers took part in this study, randomized 2:1 into an MBSR and a pharmacotherapy group.
The results of the study provided initial evidence for the efficacy of MBSR as a chronic insomnia treatment. MBSR significantly decreased sleep latency, improving total sleep time as well as sleep efficiency. The efficiency of MBSR was comparable to that of pharmacotherapy.
Another 2014 study by Cynthia R. Gross, Mary Jo Kreitzer, Amber Hubbling, and others, looked at MBSR and its impact on chronic insomnia.
This time, the study sample consisted of 18 insomnia sufferers. The participants underwent a randomized, controlled clinical trial. At the end of it, first-person accounts of the perceived impact of MBSR on sleep quality were collected.
According to these accounts, MBSR did not significantly impact sleep time. It did, however, improve sleep quality. Participants also reported being less bothered by insomnia and being able to deal with it better when it reared its head.
Complex mindfulness-based programs such as MBTI are viable alternatives to traditional treatments of chronic insomnia.
Not only do such programs “tame” insomnia, but they are also useful for several other medical conditions. Researchers have successfully used such techniques on disorders such as:
- Chronic pain.
- Generalized anxiety disorder.
- Medical conditions such as cancer and psoriasis have also positively responded to MBSR treatment.
In regards to anxiety and depression, the treatment reduced the severity of symptoms, as well as the risk of relapse, in patients with three or more previous bouts.