Traditionally, sleep and darkness have had 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.
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."
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.
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.
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, including breathwork. 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.
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."
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.
Rubin Naiman, PhD, is a psychologist specializing in sleep and dream medicine and clinical assistant professor of medicine at the University of Arizona's Center for Integrative Medicine. He's also the author of Healing Night, the software program The Sleep Advisor, and the audiobook Healthy Sleep.
This blog is excerpted from "Nightmind," by Rubin Naiman. The full version is available in the March/April 2008 issue, A Nation of Insomniacs: Reclaiming the Lost Art of Sleep.
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