Calming the body
Lying in bed with a pounding heart, tight shoulders, and a mind that won’t settle is one of the most familiar parts of insomnia. Relaxation exercises work on the body’s side of that. None of them can make you fall asleep. They’re meant to lower the alertness that keeps sleep away.
What arousal does to sleep
The body has a built-in alarm system for handling stress and danger. When it switches on, the heart beats faster, muscles tighten, breathing gets quicker and higher in the chest, and the mind starts scanning for problems. That’s useful during the day. At night it works against sleep, which needs nearly the opposite.
Many people with insomnia carry some of this alertness into bed every night, and it can become a habit of its own. Worry feeds it. So does trying hard to sleep. “What insomnia is,” in Learn, describes this as hyperarousal. Relaxation gives the body a practiced way to come back down.
How the exercises work
The exercises in “Quiet a busy mind” come at arousal from different directions. It’s worth trying several to find the ones that suit you.
Breathing
“Slow breathing” and “Even breathing” both bring your breath down to about six breaths a minute. At around that pace, heart rate and breathing tend to rise and fall together, and the body’s calming side gets a bigger say.
“Slow breathing” makes each breath out a little longer than the breath in. “Even breathing” keeps them the same length. Breathe gently. Slow doesn’t have to mean deep, and if you feel lightheaded, go back to breathing normally for a few breaths.
“Belly breathing” has no count. It’s about where the breath goes, low into the belly instead of high in the chest, with a hand on each so you can feel the difference. A relaxed breath moves the belly without being a big one.
Muscles
“Progressive muscle relaxation” tenses and then releases one group of muscles at a time. Tensing first makes the letting go easier to feel, and with practice you learn to notice and drop tension you didn’t know you were holding. Edmund Jacobson developed the method in the early twentieth century, and it’s among the most studied relaxation methods for insomnia.
“Heavy and warm” comes from autogenic training, developed by the German psychiatrist Johannes Schultz. You repeat simple phrases, like “my arms are heavy and warm,” and let your attention rest on the feeling. There’s no tensing involved. Warmth in the hands and feet is also part of how the body cools itself before sleep, which “Your body clock” describes.
Attention
“Body scan” and “Mindful breathing” come from mindfulness practice. You notice what’s there, like the breath or sensations in the body, without trying to change it, and come back each time your mind wanders. This can ease the struggle with being awake, which matters because effort keeps sleep away.
In one small trial with adults who had chronic insomnia, people in two mindfulness programs reported less time awake at night and less arousal before sleep than people who kept a sleep diary alone.
“Leaves on a stream” comes from acceptance and commitment therapy. You picture each thought set on a leaf and carried off by the water, without pushing it away or following it, and you come back each time one pulls you along. You learn it sitting up during the day, and at night you use it out of bed, not lying awake in it.
“Up in the night” is a short practice for after you’ve gotten out of bed. You do it sitting in a chair in dim light, which keeps the stimulus control rule of not lying awake in bed. When you feel sleepy, go back to bed.
Pictures
“A calm place” guides you through picturing somewhere you feel at ease, in as much detail as you can, with its sounds, light, and temperature.
“Word pictures” is a game for bedtime. You choose a calm, ordinary word, then think of other words that begin with its first letter, picturing each one for a few seconds before moving on. When that letter runs dry, you go to the next one.
It’s meant for bed at lights out. If you’re still awake after what feels like about 20 minutes, or you start to feel alert or frustrated, get up and keep playing in another room.
Both are meant to hold the mind’s attention without stirring it up. In a small one-night study by Allison Harvey and Suzanna Payne, people with insomnia who were taught to use detailed imagery at bedtime reported falling asleep sooner and having fewer unwanted thoughts than people given no instructions. A specific, absorbing task seemed to be what made the difference. “Word pictures” builds on the same idea, though research on it in particular is still early.
How to practice
- Learn it during the day first. Relaxation is a skill. Practicing once or twice a day for a week or two, while you’re calm, makes it easier to use at night when you’re not.
- Make it part of winding down. A breathing or muscle exercise fits well near the end of your wind-down routine.
- In bed is fine. Do it gently, without checking whether it’s working. If you fall asleep partway through, so much the better.
- Watch for effort. If you notice yourself pushing to relax so that you’ll sleep, or getting frustrated, that’s the time to follow the stimulus control rules and get up for a while.
- Stop if it feels worse. A few people feel more on edge when they relax, and close attention to the body can stir up hard feelings, especially after trauma or for people prone to panic. Open your eyes, switch to another exercise, or stop. A therapist can help adapt these.
The American Academy of Sleep Medicine lists relaxation as an option for chronic insomnia. It’s usually taught alongside the other parts of CBT-I, not in place of them.
References
- Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2), 255–262. doi.org/10.5664/jcsm.8986
- Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., & Nissen, C. (2010). The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews, 14(1), 19–31. doi.org/10.1016/j.smrv.2009.04.002
- Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756. doi.org/10.3389/fpsyg.2014.00756
- Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353. doi.org/10.3389/fnhum.2018.00353
- Stetter, F., & Kupper, S. (2002). Autogenic training: A meta-analysis of clinical outcome studies. Applied Psychophysiology and Biofeedback, 27(1), 45–98. doi.org/10.1023/A:1014576505223
- Ong, J. C., Manber, R., Segal, Z., Xia, Y., Shapiro, S., & Wyatt, J. K. (2014). A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep, 37(9), 1553–1563. doi.org/10.5665/sleep.4010
- Harvey, A. G., & Payne, S. (2002). The management of unwanted pre-sleep thoughts in insomnia: Distraction with imagery versus general distraction. Behaviour Research and Therapy, 40(3), 267–277. doi.org/10.1016/S0005-7967(01)00012-2
Helpful links
Everyday Insight’s tools are for education and personal reflection. They are not therapy or medical care, and they are not for emergencies. In an emergency, call 911. If you are in crisis in the United States, call or text 988.
The exercises are in the app, under “Quiet a busy mind.” See them all