Night naturally calls forth our shadowy inner life. Because we lose the visual input we depend on to define ourselves and our behaviors, we get lost in the dark. In more primitive settings and times, our ancestors faced the risk of unseen dangers lurking in the night. Many are familiar with Job's bleak description of his plight: "I go to the place of no return, to the land of gloom and deep shadow, to the land of deepest night, of deep shadow and disorder, where even the light is like darkness."
Who hasn't had at least a brush with the dread of darkness—perhaps swallowed by the pitch-black of a power outage, overwhelmed by the immensity of a frozen night sky, or, most commonly, lying alone and awake in the darkest hour of night? We're afraid of that nothingness—of being consumed by that unknowable void. And that's precisely where sleep takes us.
Traditionally, sleep and darkness have had more positive connotations. Nyx, the mighty Greek goddess of night, lived underground and ascended to the sky at day's close to bring dusk and darkness. Her son, Hypnos, the sweet-natured god of sleep, would accompany her each night, sprinkling sleep-inducing poppies over the earth below—a story prefiguring the more recent folktale of the sandman sprinkling sleep dust into the eyes of children. This ancient myth reminds us of two fundamental truths about sleep: it's born of night, and it's a divine endowment—a gift from the gods. To enter this blessed state, the myth suggests, requires acquiescence to darkness itself.
Yet many of us don't go gently into the night: we knock ourselves out with alcohol, sleeping pills, or sheer exhaustion. Our widespread fear of and disregard for darkness—both literal and figurative—may be the most critical, overlooked factor in the contemporary epidemic of sleep disorders. We suffer today from serious complications of a kind of psychological "nightblindness:" a far-reaching failure to understand the significance of night and darkness to our health and well-being.
Unfortunately, sleep medicine—that branch of the health sciences devoted to treating sleep disorders—offers little relief from our nightblindness. Sleep specialists pay virtually no attention to the larger cultural and natural milieu of night. Having made its bed with the pharmaceutical industry, sleep medicine offers us little more than a seductive array of knockout pills. Rather than an honest encounter with night consciousness, it encourages anesthetized unconsciousness.
William Dement, director of Stanford University's Sleep Center, believes that, because of its historical neglect of night biology, virtually all medical science is seriously askew. I think the same holds true for psychotherapy. With the exception of dreamwork, which offers an important but limited focus on dream content, psychotherapists don't usually explore their clients' "nightminds" in a meaningful way. Even though symptoms of sleep disorders present daily in psychotherapy offices, most clinicians are ill-prepared to address them. Nevertheless, psychotherapists, with their focus on shifting states of consciousness, as well as behavior and lifestyle, are ideally positioned to help address today's sleep epidemic. However, we must rethink our approach to night, sleep, and dreams. Approaching sleep primarily from a waking-consciousness framework is much like trying to understand darkness by using a flashlight to illuminate it. To help our clients sleep better, we ourselves must become more "nightminded," and less "nightblinded."
In our culture, daylight is dominant, overvalued, and even deified, while darkness is dismissed, devalued, and often demonized. From divine light to light beer, things associated with the metaphor of light suggest goodness. We want to shed light, see the light, and lighten up. Our associations with metaphoric darkness, in contrast, are suggestive of confusion, struggle, immorality, despair, and outright evil. We want nothing more than to avoid dark times, dark nights of the soul, and, of course, the dreaded "prince of darkness." It would seem that, even as adults, we're afraid of the dark.
At the same time, night and darkness free us from the constraints of the waking world. It's as if night is a psychological duty-free zone. While the social expectations of day tell us how we should be, night reveals who we really are. We take our clothes off at night. In loosening social constraints, night allows our shadows to emerge. Darkness inhibits us because it disinhibits us.
In times past, human activity naturally downshifted as dusk signaled the approach of night. There was no push to get home, since most people were already there. As daylight gradually receded, the world quieted and the chirping of crickets and trilling of night birds began, as all things darkened, slowed, and cooled.
In modern times, however, as dusk approaches, night begins with "the rush hour"—a massive, noisy, grinding, smoky movement of people and machines. Automobiles, buses, trains, and planes shuttle hoards of people from places of work, school, and daily activity back to their homes. Lost in this bustle, we typically thwart the onset of night.
As natural daylight recedes, artificial lights immediately come on everywhere—commercial signs, streetlights, headlights. When we reach our homes, more lights come on—porch lights, house lights, and television sets. We're clearly in denial that something hemispheric and profound is occurring in nature. If a divine being or angels or extraterrestrials were monitoring us, the most glaring global transformation they'd have witnessed in recent generations is the burgeoning, worldwide illumination of our nights.
The lightbulb, originally intended to extend the workday, has ignited the landscape and is burning out of control. Flying over the earth's populated areas at night, we see below us eerily illuminated enclaves of one species' hyperactivity. Everywhere else, life is slowing and quieting, in rhythm with the rotation of the earth.
Much of our use of light at night is gratuitous. Unnecessary for our welfare and safety, it primarily serves to import waking-world consciousness into the nighttime. Because 80 percent of sensory stimulation to the brain is visual, when the world darkens, we naturally go inward, relax, and rest. Our excessively illuminated evenings encourage excessive extraversion as our attention is drawn outward to activity. Most of my insomnia clients routinely remain active until bedtime. While the natural world around them is yielding to darkness, they turn on lamps, televisions, and computers, continuing the daytime hustle with projects, e-mail, errands, exercise, and entertainment.
But recent research suggests that merely being quietly awake in a darkened space produces beneficial effects on our bodies and minds. Just as light stimulates the release of serotonin, which energizes us, darkness encourages the production of melatonin, the key neurohormone in our nocturnal biology. There's mounting evidence that even minimal nighttime light exposure can damage our circadian rhythms and suppress the production of melatonin.
In our attempt to excise darkness from our lives, we've damaged the integrity and rhythm of our consciousness. With the loss of night, day loses its partner in the sacred dance of circadian cycles. Activity becomes dangerously devoid of rest. We lose our sense of the basic pulse of night and day—our awareness of life's natural rhythms. Ultimately, we lose our experience of the seamless continuity of consciousness, our sense of wholeness.
Damaged Sleep and Dreams
Christina, a married, 40-something accountant and mother of two teenage boys, self-referred to me after a six-month struggle with insomnia. She described evenings that were bustling with chores and activities, leaving her depleted at bedtime. At night, her body lay exhausted and limp under her comforter, but her mind flitted about ceaselessly in the dark. Thoughts scurried around her psyche like mice in the rafters—random, waking-world thoughts, which seemed to have a life of their own.
Christina was all too familiar with the desperation behind her incessant thoughts. Despite having her husband snoring softly at her side, she felt a deep sense of exclusion and isolation, stranded in a circadian limbo, trapped between the world of waking and the world of sleep.
She wasn't alone. At that very moment, in the seclusion of their own bedrooms, hundreds of millions of people in the industrialized world shared her ordeal. In simple numbers, sleep disorders are the most prevalent health concern of our times. A recent National Sleep Foundation poll found that 76 percent of American adults reported at least one symptom of a sleep disorder at least a few nights every week or more. The majority of these individuals struggle with insomnia: difficulty falling asleep, staying asleep, or obtaining healthy, restorative sleep. In any given year, from 30 to 40 percent of the adult population has insomnia. It's commoner in women and increases with age, medical problems, and psychiatric disorders. It's extremely common among adolescents, too.
Insomnia isn't simply about sleep loss—it's also about losing our dreams. Like many of my insomnia clients, Christina reported that she hardly ever remembered her dreams. Much of what we consider sleep loss is actually dream loss, leaving us at least as dream deprived as we are sleep deprived. To make matters worse, so many commonly used substances and medications interfere with normal dreaming. Using everything from alcohol to antidepressants and aspirin to tranquilizers, millions of people unknowingly suppress their dream lives nightly.
But our bodies and minds need to dream and will struggle to do so. Dreaming plays a critical role in consolidating learning and memory, facilitating emotional healing, assisting in problem-solving, and promoting creativity. Jung believed that the chronic suppression of dreams was a factor in cancer. Animal and human experiments that selectively inhibit dreaming result in a highly pressured dream rebound, displacing deep sleep and predisposing us to nightmares and insomnia.
Jonathan, a recently widowed and still grieving 52-year-old attorney, was morbidly obese, diabetic, and clinically depressed. Referred to me for chronic insomnia, which was increasingly interfering with his productivity, he acknowledged that he never dreamed. He routinely worked late into the evening, was able to fall asleep quickly, but could stay asleep through the night only with the aid of sleeping pills. Though he didn't know it, his medical problems and depression were likely linked to his chronic sleeplessness. Compelling evidence suggests that chronic sleep loss is a critical factor in a broad range of health concerns, including an increased risk for viral infections, obesity, diabetes, cardiovascular disease, and even cancer.
When I questioned Jonathan about the onset of his depression, he realized it trailed his insomnia by 8 to 10 months. The link between sleep and mental health is critical and complex. Approximately 80 percent of people with psychiatric disorders struggle with disturbed sleep. Insomnia, especially the inability to maintain sleep through the night, has long been known to be a classic symptom of depression. In recent years, sleep scientists have confirmed that it is itself a major cause of depression. In fact, a year of insomnia is the single strongest predictive factor for clinical depression.
Beyond being chronically sleep and dream deprived, we're deprived of healthy waking. Our failure to descend deeply into sleep and dreams compromises our ability to ascend fully into the waking world, leaving us in a kind of mental daze. The once naturally robust peaks and valleys of our circadian rhythms are in effect flatlining. Half-awake in our sleep and half-asleep in our waking, we're never completely at rest and seldom fully conscious.
To compensate for our sleep- and dream-deprived daze and maintain our frenetic drive, we spike our waking hours with counterfeit energies. We're a society of energy addicts, our lifestyles designed to provide us with quick fixes of stimulants, most notably caffeine and high glycemic, sugary foods on demand, or, more subtly, with dependence on drama-mediated adrenaline. Unfortunately, such energy spikes inevitably backfire with jittery withdrawals. Beyond damaging our waking consciousness, dependence on counterfeit energies damages our nights by disrupting nature's essential rhythm of activity and rest. Our need for rest is met only with a restlessness that conceals an underlying exhaustion.
So we take something for it. Evening appears to be our commonest period of substance and medication use. We consume vast amounts of alcohol, marijuana, antidepressants, sleeping pills, and tranquilizers to modulate our restless waking energies, and, even more, to blunt our uneasy encounter with dusk and darkness. These substances may help us temporarily negotiate our discomfort with night, but only at a terrible cost.
Not only do we fend off darkness at night, we avoid natural light during the day. Evidence suggests that sunlight is naturally stimulating, emotionally uplifting, and potentially healing, but most of us spend the bulk of our waking days indoors, under artificial lights. The average American adult gets about one hour of natural outdoor light exposure per day. Compared to dusk and night, indoor lighting is bright and overstimulating. But in contrast to natural daylight, even on cloudy days, indoor light is relatively dim and understimulating. In the end, we fully experience neither natural light nor natural darkness.
Most of my insomnia clients have used sleeping pills, some for many years. Consumers are now being barraged by an unprecedented campaign to promote these hypnotics as the solution to the insomnia epidemic. Nearly 50 million prescriptions for hypnotics were written in the United States in 2006, representing a 15-percent jump in only one year.
But the message in these campaigns—that sleeping pills are a safe, effective, long-term solution to insomnia—is erroneous. Sleeping pills don't provide natural, healthy sleep: they suppress the symptoms of wakefulness with a chemical knockout, providing counterfeit rest. Masking the symptoms of insomnia doesn't yield good sleep any more than masking symptoms of anxiety with alcohol or tranquilizers produces good mental health. When used as a primary treatment for chronic sleeplessness, sleeping pills can undermine our ability to allow sleep to come naturally.
Both prescription and over-the-counter sleeping pills commonly result in dependence, anterograde amnesia, altered sleep architecture, and a residual daytime hangover. Long-term use, which is increasing, is associated with significant rebound insomnia upon discontinuation. Furthermore, reliance on sleeping pills disregards the critical role of lifestyle, as well as personal responsibility, in sleep problems. Some sleep specialists believe that long-term use is also associated with increased mortality.
In fact, sleeping pills have limited effectiveness. Recent analyses suggest that, at best, they result in no more than 25 minutes of additional sleep per night, often less. They function in large part by producing amnesia for nighttime awakenings, leaving users with the impression that they're sleeping better than they actually are. All over-the-counter sleeping pills with the designation "PM" contain benedryl, which has a long half-life and suppresses dreaming. Those that contain acetaminophen can lead to liver damage.
I don't mean to suggest that taking something to sleep is never an appropriate response to insomnia. The short-term, periodic use of effective sleep-inducing substances can be helpful in managing personal and medical crises. But the idea of "taking something to sleep" is deeply rooted in our collective consciousness: it's associated with a sense that we don't have direct control over falling asleep, and it's conflated with the misguided notion that we need to be knocked out by some outside force.
Nightmindedness is a psychological state—a practice of accessing and expanding one's sense of night consciousness. In contrast and as a complement to waking consciousness, which is driven largely by intention, night consciousness is informed primarily by a posture of reception. It isn't simply about utilizing sleep-promoting techniques, but about encouraging an integration of consciousness. Being nightminded is about extending awareness into arenas that we believe lie outside of our awareness. It's a way of seeing in the dark—a kind of third-eye vision.
Ultimately, cultivating nightmindedness is less about getting to sleep than letting go of waking intention—learning to untether oneself from one's daytime consciousness. To help clients achieve this, we need to explore their personal sleep stories, evaluate their daily habits and activities, and help them become aware of the ways in which they unknowingly import waking consciousness into their night worlds, or undermine their ability to sleep in other ways.
Rest and Rhythm. As part of my evaluation of Christina, I asked what she believed was causing her insomnia. Although I knew the question was as tired as she was, I believe it's helpful to understand the attributions clients make about the causes of their sleeplessness. She paused and said, "I'm really not sure. At different times, I've thought it might be caffeine, stress, my mattress, my antidepressant, and on and on. I have to admit, I don't really know. What I do know is that when night comes, I'm just not sleepy enough."
Contrary to popular belief, people don't usually suffer from insomnia because of insufficient sleepiness. Given our poor sleep patterns, most of us are probably excessively sleepy much of the time, and we still suffer from insomnia. In fact, the etiology of insomnia is commonly associated with generalized biological and psychological hyperarousal—a kind of excessive wakefulness.
Christina's days were filled with the extraordinary demands of ordinary life. Like most insomniacs, she'd become habituated to an accelerated pace of life, which left her with virtually no time for herself; no time to rest. She routinely carried waking-world activity—work-related reading, household finances, and other chores—into her nights. She didn't even begin to try to rest until she got into bed—a bit like not hitting the brakes until the car is already in the garage.
I believe that rest and sleep occur on a continuum—we must learn to rest before we can sleep well. But true rest is a rare experience in modern life. For many, rest is about watching a movie, going hiking, playing tennis, or socializing. Although obviously worthwhile activities, these are examples of recreation, not rest. For others, the notion of rest conjures up thoughts of a martini, a joint, or a stupefyingly oversized meal.
Christina quickly realized that she was confusing rest with recreation. Sensitizing clients to such distinctions is essential. We then examined her rest-impeding beliefs, such as her anxious conviction that she absolutely needed to complete certain tasks before she could rest. The tension in her face eased as she considered letting go of this dysfunctional attitude. We continued with a discussion of formal rest practices, particularly the 4-7-8 breath (see sidebar page 37). Implicit throughout our discussion was my offer of permission and encouragement for her to rest.
The intentional introduction of rest practices into one's life helps reinstate our lost sense of rhythmicity. Even brief rest practices by day—gazing out the window aimlessly, sitting quietly or meditating, taking a stroll—modulate the incessant buzz of common waking consciousness and help us diminish excessive wakefulness, to slow down and truly relax as a transition to healthy sleep.
Dusk Simulation. Dusk is disorienting. It's that sudden, anticipatory hush that settles upon an audience when the house lights start to dim. Drawing our attention from the scattered din of daytime concerns, dusk invites us inward, to the focused, quiet performance of night. If we're willing, dusk will gently reorient us from daytime consciousness to a nighttime consciousness.
Falling asleep is a gradual process, which begins long before bedtime. An honest encounter with dusk teaches us that it's the environmental analogue of sleep onset. By nature, we go down gradually with the sun. Dusk and darkness are natural sedatives: they serve to draw our attention from the waking world, slow us down by diminishing visual stimulation, and trigger the production of melatonin. Darkness itself is the best sleep medicine.
Many of us are familiar with melatonin, the neurohormone that mediates night, sleep, and dreams. Melatonin is a primordial molecule released when the pineal gland— Descartes's "third eye"—senses darkness. It's the essential biological mediator of night consciousness. It plays a powerful role in managing our night biology, informing the body and brain of the arrival and presence of night. Our melatonin levels rise steadily through the night, peaking out in the early-morning hours and dropping off with awakening. Peak levels of it are associated with increased REM sleep or dreaming.
Even small amounts of light at night will suppress melatonin, impeding night consciousness and sleep. The most natural way to restore normal melatonin levels is through exposure to dusk and darkness, a technique referred to as dusk simulation. I encourage most of my insomnia clients to simulate dusk by dimming the lights in their homes for a couple of hours before bedtime. If they wish to read or write, I suggest they use low-wattage book lights. Dusk simulation also requires avoiding televisions and computer monitors, both of which radiate significant amounts of blue wavelengths of light—a potent melatonin suppressant.
In addition to easing the transition to sleep, dusk simulation encourages us to process backlogged psychological material. So much of what we rebuff, deny, suppress, and project throughout our driven days gets relegated to our nights. Night becomes a repository for everything from unresolved daily stress to lingering shadow issues. Like a self-storage space packed to capacity, this material bulges and threatens to break out when our inner watchman dares to rest or sleep.
In a sense, dusk simulation provides us with an opportunity to process some of our anxieties and nightmares before getting into bed. Avoidance of this kind of evening review can drive the material farther into the night, where it commonly erupts as insomnia at sleep onset or in the middle of the night. I frequently remind my clients that we certainly don't have to resolve all of our anxieties to get to and stay sleep—we simply need to be willing to release them.
Although most of my clients readily understand the benefits of dusk simulation, it can be challenging to implement because it requires a willingness to let go of common nighttime activities, many of which function to protect us from encountering ourselves more deeply. I discussed dusk simulation with Jonathan, whose industrious evenings were ablaze with lamp and television light. "What?" he asked. "Dim the lights?" He paused. "That's impossible. I've got too much freakin' work to do at night! Besides," he continued, "I have no trouble falling asleep. I go out like a light when my head hits the pillow."
Faulty Beliefs About Sleep
Our contemporary take on sleep onset is that it's achieved by crashing, conking out, dropping off, or knocking oneself out. We expect sleep to come on our terms, at the flick of a switch. We declare ourselves great sleepers when we can "go out like a light" the moment our heads hit the pillow.
In actuality, though, a persistent pattern of falling asleep in less than 5 or 10 minutes isn't a sign of being a good sleeper. Because it suggests that one is already excessively sleepy at bedtime, it may actually be a sign of an accumulated sleep debt—a symptom of a sleep disorder.
At bedtime, most people find themselves sitting up reading or watching television. Frequently, even though their eyelids are heavy and they're beginning to nod out, they actually resist going down. Despite being sleepy, they apparently want to become even sleepier, to crank their sleep load way up so that when they lie down, they'll go out like a light. I've come to believe that many people are quite reluctant to spend 10, 15, or, God forbid, 20 minutes alone . . . with themselves . . . in the dark. And this is exactly what natural and healthy sleep onset requires.
For many, the brief interlude between turning the lights out and falling asleep is a period of heightened vulnerability to the upwelling of psychological material that wasn't dealt with earlier. Falling asleep in a flash provides assurance that we won't have to face ourselves at sleep onset. If we aren't sufficiently sleepy or drugged, we run the risk that this material will interfere with sleep onset. But even if we manage to override it at bedtime, we run an even greater risk that it'll emerge to disrupt our sleep in the middle of the night.
In exploring his resistance to an honest encounter with dusk and sleep onset, Jonathan recalled that he and his late wife routinely spent evenings together, luxuriating over a fine dinner and enjoying each other's company before bedtime. Now evening had become a trigger for these grief-laced memories, which he avoided by escaping into light and activity. With this realization, he began to address his grief and sleep issues. He modulated his evening pace and light exposure and experimented with a slower, more gradual approach to sleep onset. A couple of weeks into his treatment, he reported having his first decent night sleep in a long time without sleeping pills. "I can't believe it," he said. "Actually, I cried myself to sleep. But I slept through the night."
Ultimately, we need to understand that it's impossible to "go to sleep," as if we're proceeding intentionally toward some destination. We can go to bed, but, as anyone who's had even a single night of insomnia will attest, we can't instigate sleep of our own volition. In fact, any effort we direct at doing so will activate the intentional mind and increase our wakefulness.
Like most of my insomnia clients, both Jonathan and Christina readily came to understand that importing waking-world intentionality into the world of sleep simply wouldn't work. Rather than trying to "go to sleep," I encouraged them to begin a practice of letting go of waking. Letting go of waking is a simple, yet sometimes elusive, process of surrendering our waking sense of self—the person we believe we are during the day.
What Is Sleep?
I think it's useful to look at sleep onset as a personal spiritual practice. Such a practice addresses specific questions about what one needs to feel safe enough to surrender one's waking self. Recognizing the psychological threat associated with this process, sacred traditions around the world offer special bedtime prayers and rituals to create a sense of safety at this juncture. Letting go of our waking self is, in one sense, a profound act of complete surrender to something outside of our selves. It's a kind of dying.
The relationship between sleep and death is archetypal. Tibetan Buddhism teaches that the experience of falling asleep is psychologically equivalent to dying. It's interesting to note that Hypnos's twin brother was Thanatos, the god of death. And, of course, the sleeping are commonly described as being "dead to the world." But this latter notion reflects a waking-world bias, in that it defines sleep strictly in terms of the absence of waking. What are we actually surrendering to when we "die" into sleep? Is there more to sleep than un-(waking world)-consciousness?
Sleep scientists generally say no. It's widely accepted that we can't have any conscious awareness of non-REM or dreamless sleep. Growing empirical and anecdotal evidence, however, is now challenging this belief, suggesting it may well be possible to cultivate awareness of sleep itself. Some accomplished meditators, for example, can generate EEG activity that's reminiscent of deep sleep while they're wide awake. More commonly, people aroused out of normal sleep states report being aware of their sleep.
The popular Beatles lullaby "Golden Slumbers" reminds us of an age-old conviction that sleep is "a way to get back home." I believe that sleep delivers us nightly to an exquisite, sublime state of serenity—a place so still and deeply peaceful that most of us have little or no waking-world frame of reference for retaining it in memory. Being able to achieve this mentally and physically renewing state of complete relaxation is the ultimate reason for cultivating nightmindedness.
Rubin Naiman, Ph.D., is the sleep specialist and clinical assistant professor of medicine in Dr. Andrew Weil's Program in Integrative Medicine at the University of Arizona and the director of sleep programs for Miraval Resorts. His publications include Healing Night: The Science and Spirit of Sleeping, Dreaming and Awakening and Healthy Sleep with Dr. Andrew Weil. Contact: firstname.lastname@example.org. Letters to the Editor about this article may be e-mailed to email@example.com.