We have recently completed an in-house clinical study to evaluate the effectiveness of The Sleep School approach. We tracked the sleeping patterns of 14 chronic insomnia sufferers for one year, after attending a one- day workshop in central London. The results showed significant improvements across a wide range of sleep measures, with the majority of individuals reaching ‘Normal Sleeping’ status, despite previously suffering insomnia for over two decades. In this blog I will briefly outline what we did and what we found and will offer some scientific rationale for the effectiveness of The Sleep School approach.
What We Did
14 participants attended a one-day workshop in central London. The group included 8 females and 6 males, with an average age of 46 years ±7, all of who had suffered insomnia for an average of 10 years ±7 years.
Life stress, anxiety and work stress were reported as the most common their insomnia triggers. All had tried a range of other approaches prior to the workshop, none of which had worked. These included drug therapy (87%), traditional Cognitive Behavioural Therapy for insomnia (57%) and hypnotherapy (27%). Over half the group (52%) were still taking medication at the start of the study.
To establish a baseline level of the participant’s insomnia severity a series of sleep, mindfulness and acceptance measures were taken 1 week before the workshop and then at 5 & 10 weeks and 6 & 12 months following the workshop.
What We Found
Significant improvements in all self-recorded sleep measurements were reported for the group,
30% increase in total sleep time (4.8hrs to 6.8hrs)
75% decrease in the time taken to fall to sleep (50 mins to 15 mins)
72% decrease in the time taken to fall back to sleep (90 mins to 25mins).
The changes in sleep data were also supported by significant reductions in self-recorded insomnia severity levels, with the average severity halving from pre-workshop levels (*Clinical Insomnia) to 5 weeks (*Sub-threshold Insomnia) and then continuing to drop to ‘Normal Sleep’ levels from 10 weeks to 1 year.
Over the year the attendees level of mindful awareness increased significantly from baseline by 43% reaching a level considered to above the normal population. Their attitude towards insomnia also shifted from highly agreeing with ‘avoidance’ statements before the workshop such as “I need to concentrate on getting rid of my insomnia” towards more ‘acceptance’ statements such as “I am getting on with the business of living no matter how I sleep”. The ‘acceptance’ attitude increased significantly by 60% and the ‘avoidance’ attitude decreased by 41% over the year.
What Does This Mean?
The results demonstrate significant improvements in sleep quality within 5 weeks with further improvements occurring over the year.
In line with The Sleep School approach, the underlying mechanisms for this change appear to be related to participants increased willingness to experience their insomnia, whilst getting on and living valued lives. This was achieved by regularly practising mindfulness and acceptance-based tools, as well as setting and acting upon valued based goals.
Based on neuroimaging research it is possible to speculate that the shift towards accepting behaviours could have also elicited various structural changes within participant’s brains. These include reductions in the volume of the Amygdala, the brains worry centre and increases in the volume of the pre frontal cortex, the area responsible for rational thought and emotional regulation. If such changes occurred, the associated lowering of arousal levels could explain the reported significant improvements in sleep.
This research joins a growing body of initial clinical research from around the world proving the effectiveness of Acceptance and Commitment Therapy for adult Chronic Insomnia.
Top Tips from The Sleep School Five-Step Approach
Discover – Sleep is a natural physiological process that can’t be controlled and having a reliance on unnatural nighttime rituals or props (e.g. warm baths, pills and alcohol etc) can fuel sleep anxiety and further sleeplessness. Follow a normal and regular wind down each night to retrain your brain to sleep.
Accept – Worrying about poor quality past sleep or imagining how bad things will be in the future if you don’t sleep only helps to increase nighttime arousal levels. Whilst noticing things objectively and without judgment in the present moment like the touch of your duvet on your toes or the gentle movement of air in and out of your nose can actually promote sleep.
Welcome – Fearful thoughts or strong emotional reactions, such as anxiety at night can keep you more awake. Learning to change your relationship with such thoughts and feelings by getting to know them and even welcoming them when they arrive will reduce arousal levels and lessen your sleep struggle.
Build – Go to bed and get up at ‘roughly’ the same time each night – this will help to keep your body clock on time and promote your natural drive to sleep. If you are awake at night choose to stay in bed and conserve your energy by lying still resting and being mindful of whatever shows up.
Live – The fear of not sleeping drives us to stop living our lives such as avoiding going out at night with friends or sleeping in the spare room. Commit to making small actions every day that take you closer to what is important to you in your life. A happy and contented brain is a sleepy brain.