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Insomnia in Private Practice

As I began writing this blog 4am last night, I wondered what therapists did at 4am before mobile phones and the internet. Did they get up to write down these thoughts? Did they count sheep? Did they just lie there in the dark, thinking about work?

Then I wonder how that impacted them. Were they more thoughtful, evolved, interpretative? Were they more anxious? Did they feel groggy in session the next day?

Not being able to fall asleep or waking multiple times is frustrating. Not being to relax or wind down or stop thinking can be concerning. If you have a weekend or holiday, it may be manageable because you can sleep in or catch up with a nap. But if we have a full practice the next day? What can we do?

Scheduling

Firstly, if you are exhausted, cancel a few sessions or space them apart. We all have different symptoms of being too exhausted to work, so you might like to jot down yours as it is tough to define on the actual day. Mine are feeling “spaced out”, losing my train of thought, my eyelids closing involuntarily and my body not wanting to move. What are yours?

We can often hold it together for one session, but six sessions in a row with less than six hours’ sleep is disregarding our bodies’ needs and shortchanging our clients. When I worked as an insurance broker, I could manage it because nobody was continuously looking at my eyes and expecting my full attention and presence for 50 minutes at a time. As a therapist, we have to be really honest with ourselves about whether we can be our best when we woke up at 3am for the day. 

Food and Drink

I gave up real coffee years ago and honestly, no matter how much science tells me otherwise, tea makes me feel sleepy so I can’t use it as a pick-me-up. When I have had a real caffeinated coffee occasionally, or by accident, I feel wired, overanimated and slightly panicky. If you do not know your tolerance level for caffeine, best to avoid it. It does not help with insomnia in the long run either. 

Eating regularly can help, although when I am tired I will fall asleep more readily following a fast carb loaded meal or snack. I try to stick with snacks of fruit, salad, avocado, nuts, seeds, oatcakes and veggie sticks for maximum energy and focus. And I drink cold water, OFTEN. 

Movement

In between sessions, moving around, stretching, doing a gentle twist sitting in the chair and a few shoulder squeezes can refuel. Some yoga or pilates poses may rejuvenate you. Ten minutes in between clients of walking around the building or popping to the loo is helpful to stimulate your metabolism and help you focus. Dancing, shaking limbs out and doing squeezes on your arms and legs can all provide short term relief. 

Microsleep and Meditation

If you have time, you might like to take time to have a mini nap or do a short guided meditation. If you meditate with clients, be deliberate in choosing how to do this to ensure you don’t fall asleep with them! 

Delay

Can you delay a couple of clients 15 minutes so you can relax in between? Can you do your session notes tomorrow? Can you move a session until next week?

If we know we have the occasional bout of insomnia or regular insomnia phases, we can plan accordingly, and avoid scheduling back to back sessions without space for food, movement and rest. 

Share Your Sleepless Nights With Us

This blogpost is mostly about short-term, morning-after-you couldn’t-sleep bandaids.

In the long-term, developing good sleep hygiene, self-knowledge and psychoeducation around sleep practices is important for many of us.

You are invited to pop into our Facebook group and share your Insomnia solutions with us.