The Frontal Cortex

Sleep

As a chronic insomniac, I’m always a little disturbed when I learn about the lingering cognitive effects of a bad night sleep:

In a study at the Walter Reed Army Institute of Research in 2003, for example, scientists examined the cognitive effects of a week of poor sleep, followed by three days of sleeping at least eight hours a night. The scientists found that the “recovery” sleep did not fully reverse declines in performance on a test of reaction times and other psychomotor tasks, especially for subjects who had been forced to sleep only three or five hours a night.

In a similar study in 2008, scientists at the Karolinska Institute in Stockholm found that when subjects slept four hours a night over five days, and then “recovered” with eight hours a night over the following week, they still showed slight residual cognitive impairments a week later, even though they reported no sleepiness.

Or this:

In a recent study for The Archives of Internal Medicine, scientists followed 153 men and women for two weeks, keeping track of their quality and duration of sleep. Then, during a five-day period, they quarantined the subjects and exposed them to cold viruses. Those who slept an average of fewer than seven hours a night, it turned out, were three times as likely to get sick as those who averaged at least eight hours.

My problem with these studies is that they make me less likely to fall asleep. To understand why, let’s play a simple game with only one rule: Don’t think about white bears. You can think about anything else, but you can’t think about that. Ready? Close your eyes, take a deep breath, and banish the animals from your head.

You just lost the game. Everyone loses the game. As Dostoevsky observed in Winter Notes on Summer Impressions: “Try to avoid thinking of a white bear, and you will see that the cursed thing will come to mind every minute.” In fact, whenever we try not to think about something that something gets trapped in the mind, stuck in the recursive loop of self-consciousness. Our attempt at repression turns into an odd fixation.

This human frailty has profound consequences. Dan Wegner, a psychologist at Harvard, refers to the failure as an “ironic” mental process. Whenever we establish a mental goal – such as trying not to think about white bears – the goal is accompanied by an inevitable follow-up thought, as the brain checks to see if we’re making progress. The end result, of course, is that we obsess over the one thing we’re trying to avoid.

What does this have to do with sleep? For me, insomnia is my white bear. My conscious goal is to fall asleep, which then causes my unconscious to continually check up on whether or not I’m achieving my goal. And so, after passing out for thirty seconds, I’m jolted awake by my perverse brain. It’s rather frustrating.

And this is why I can’t help but grit my teeth when I hear about how important a good night sleep is. I know it’s important, OK? I don’t need more reasons to try to fall asleep, because the more I want to fall asleep – the more intensely I’m trying to achieve my goal – the less likely I am to actually pass out. I’ll lie awake, haunted by thoughts of white bears and cognitive deficits.

Comments

  1. #1 llewelly
    November 4, 2009

    If you sleep, the white bear will eat you.

  2. #2 QoB
    November 4, 2009

    Dammit, I just lost the game!

  3. #3 royniles
    November 4, 2009

    When the white bear shows up, I shoot it, dig a hole, bury it, and stomp down the dirt. Really, that’s what I do, and it works. I put its revival out of the question.

  4. #4 david
    November 4, 2009

    Have you tried diphenhydramine (Benadryl)? I have a friend who says it made all the difference for him.

    Also, Jonah, even if you are not operating at your theoretically optimum cognitive level, I’m here to tell you that the cognitive level you are performing at is so far ahead of the rest of us that trying to improve it by sleeping more is only going to make the rest of us be even further behind. Be merciful.

  5. #5 J6M8
    November 4, 2009

    I actually have been experiencing the same problem recently, being a metacognitive insomniac, if you will. I find a huge help is learning something right before going to bed and then reviewing it and thinking about it as I lay in bed with my eyes closed. For two weeks or so, my food for thought was your book, “How We Decide”, but I finished it too soon (damn! I hope you’ve got another in the works!) so now it’s Mandarin Chinese.

    This seems like it would be rousing, but I find my active mind focusing more on that, and finally going to sleep after a while.

    Interesting note: there’s nothing more uncanny than waking up into a Lucid Dream speaking a foreign language… correctly.

    ~J

  6. #6 TEBB
    November 4, 2009

    Up to 10 mg of Melatonin is better than Benadryl. Benadryl is somewhat sedating so if you are on it and have to get out of bed for some reason you could end up falling down, getting in an auto accident (if you get up and have to drive somewhere).

    Melatonin doesn’t make you feel “out of it” and works well to prevent my waking up numerous things throughout the night.

  7. #7 Adrian Morgan
    November 4, 2009

    I blogged about insomnia recently, giving details of my favourite psychological treatment with absolutely no pretense of being scientific. I link to this not with an advisory motive (as I assume you’ve tried a very wide variety of treatments already) but just on the basis that personal perspectives can be interesting.

  8. #8 OftenWrongTed
    November 4, 2009

    Prior to self medicating, (other than with Cannabis), perhaps you should read a short piece, “The Imp of the Perverse Analysis,” by Edgar Allen Poe. Sleep on it.

  9. #9 Derrekito
    November 4, 2009

    I have found that mulling over the day’s lectures and readings help bring about paralysis – although I’m not sure if that counts as sleep. Be as it may, I believe OftenWrongTed is on to something.

  10. #10 Ryan Shewcraft
    November 4, 2009

    When going through a phase of insomnia, the best advice I got was a good friend’s own solution to the problem: accept the fact that you can’t fall asleep and go grab a good book. Read until you’re tired. If you don’t ever fall asleep, then at least you’ve gotten in some good reading time, hopefully counteracting the ill-effects of sleep deprivation as mentioned above.

    Inducing sleep with drugs or other external remedies will only cause tolerance and dependence, exacerbating the problem.

  11. #11 OftenWrongTed
    November 4, 2009

    The writer, Dorothy Parker, had trouble sleeping. In “The Little Hours,” Parker wrote:

    “How do people go to sleep? I’m afraid I’ve lost the knack. I might try busting myself smartly over the temple with the nightlight. I might repeat to myself slowly and soothingly, a list of quotations beautiful from minds profound; if I can remember any of the damn things.”

  12. #12 Marc
    November 4, 2009

    The link quoting the second paragraph doesn’t work properly.

  13. #13 Ben
    November 4, 2009

    Was this entire article a contrivance to get your readers to lose the game? If so, bravo!

  14. #14 Mark P
    November 4, 2009

    I think it may be possible to train your mind not to think of the white bear. When I was a little boy (I don’t remember how old, but probably 10 at the oldest), I played a mind game while waiting at the doctor’s office. The game was to forget for a while that I was playing the game, and then to remember the game. I got to where I could do it pretty readily. And apparently I am still playing it, because I remember the game.

  15. #15 Roga
    November 5, 2009

    “My conscious goal is to fall asleep, which then causes my unconscious to continually check up on whether or not I’m achieving my goal.”

    So change the goal. What could you change it to to help you fall asleep? Probably just about anything that would distract you from the fact that your not sleeping that could be transitioned into a dream. So next time you’re trying to go to sleep; try not thinking about keeping your eyes closed and falling into a deep sleep in which your mind slows down more and more and the darkness gets deeper and deeper.

    Or stated differently, stop trying and just do it (Nike was really onto something with this). Hypnotic theory suggests (pun intended) that the issue with “try not to think of a white bear” is that the word “try” implies failure. So just stop trying and use “whenever we try not to think about something that something gets trapped in the mind, stuck in the recursive loop of self-consciousness” to get something stuck in that loop that will lull you softly to sleep like slowing down your breathing, keeping your eyes closed and, thinking about falling into a deep sleep with no external stimuli to arouse you.

  16. #16 Sans Talbot
    November 5, 2009

    Jonah,

    You’re exactly right: new reasons to sleep more only cause your problem to worsen. In fact, the therapists I’ve read who’ve reported good results curing cognitively-driven insomnia all use the same method: prescribing the symptom.

    This takes guts, but it works wonders: don’t let yourself sleep.

    Force yourself to stay awake as long as possible while lying in bed. Don’t think about interesting things, don’t read, watch TV, or surf the internet. Under no circumstances, however, allow yourself to fall asleep. Actively monitor and ward off any signs of encroaching sleep. Stay alert for wooziness, drowsiness, or comfort, and stamp them out the moment they rear their ugly heads.

    The trick, however, is congruence, and it’s not always an easy one. If you’re trying to stay awake in order to fall asleep, you’re still dealing with your white bear. You have to congruently stay awake in order to stay awake. Willpower devoted, not to sleeping, but to defeating sleep.

    The three insomniacs I know of who’ve personally used this technique all ultimately fail to ward off sleep.

    Bummer.

    I’m not an insomniac: I usually let myself stay awake, thinking in bed as long as I like. I like using that time to collect my thoughts. Sometimes this lasts over an hour. That’s something I’m comfortable with. I ‘sleep’ nine hours to compensate.

    However, sometimes my mind stays restless longer than that, or I know I can’t sleep in, in which case, I personally find this technique gets me to sleep in a few minutes:

    Do you have any memories of what your mind is like in the moments you’re falling asleep? Maybe you’ve dozed slightly, then come back out of it. Generally, for me, my thoughts have become nonsensical, dreamlike in their randomness, and my interior dialog has similarly become nonsensical. Also there’s a strong feeling of numbness and floating.

    All I do when I want to fall asleep rapidly is remember the feelings of being at that moment of dozing, while intentionally disrupting my interior dialog and imagery in favor of highly ‘random’ free association.

    I’m usually asleep before I know it. (Cough.)

    Results may vary.

    Let me know if you try either method.

  17. #17 Sue Borchardt
    November 5, 2009

    More fodder to keep you awake is in social neuroscientist John Cacioppo’s excellent talk on loneliness and health. In it, He covers research on vigilance, sleep disruption, and social interaction, among other things.

    you can watch it here:
    http://www.contemplatethis.org/2009/11/02/dynamic-relationship-between-health-and-loneliness/

    on getting to sleep, have you tried yoga nidra? it’s a flat-on-your-back form of guided meditation. While its purpose is not to put you to sleep, it works really well for just that. in fact, nidra means sleep in sanskrit.

    keep the posts coming – so entertaining.
    thanks,
    sue

  18. #18 Stan Carey
    November 5, 2009

    Falling asleep is a very weird event. Sometimes somehow you have to almost trick yourself into doing it — because, as you point out, you can get in your own way by wanting it too much or too consciously. It’s akin to the paradox of seeking enlightenment through certain esoteric disciplines: desiring it immediately undermines it!

    I suffered chronic insomnia for years, though many of the usual strategies helped at least partially: physical exercise, reading to exhaustion, relaxation techniques, dietary tweaks, ambient or drone music, etc. etc. But to conquer insomnia in the long term, a more substantial change was required, and it occurred, and in recent years I’ve slept consistently like the proverbial baby. But this came about as a sort of by-product.

  19. #19 marilove
    November 5, 2009

    I can’t stay asleep to save my life. This is a problem that’s plagued me for as long as I can remember. I dream constantly, but I can’t sleep. It’s frustrating.

  20. #20 Ron
    November 5, 2009

    I’ve always felt there was a fallacy with this challenge. You can immediately begin fixating on a brown bear (or a brown dog, or a black cat, or your last sexual encounter, etc.). You can create an immediate other object to focus upon.

  21. #21 catgirl
    November 5, 2009

    If thinking about falling asleep is distracting you from falling asleep, you might have some luck by distracting your mind with something else, as other commenters have suggested.

    I always play repetitive mind games to fall asleep. Sometimes I will pick a category (like “fruits”), and go through the alphabet, listing a fruit that begins with each letter. It’s challenging enough to take my mind off everything else, but repetitive enough to bore me to sleep.

    In another game, I will start by thinking of a dot. Then I’ll think of drawing three more dots around the first one to make a square. Then I’ll think of drawing three more sets of four dots to make a bigger square, and continuing squaring until I fall asleep or lose track. I actually invented this game as a child, and it really helped me when I learned about exponents in school.

    I like to think of all kinds of lists, or just see how far I can count in a foreign language. Sometimes I will go through all they lyrics in a song over and over until I get it exactly right. Or, I will see how long I can go without moving any muscles.

  22. #22 teiana
    November 5, 2009

    Ok, here’s a trick to try. Imagine you’re a baby. Be specific. Use memories of the way things felt if you can remember, and if you can’t, fake them (borrow a baby blanket, feel it, pretend to remember it). For example i know the feel of a terry towel babygro, the cover on a mothercare pushchair, the way my cot blankets felt, etc.. Don’t think about anything else apart from being a baby again. Imagine yourself in a pram or cot or somewhere else safe, and just think about your hands touching the things around you.
    If this works for you, after a few minutes, you can think about your breathing. You should have by now automatically shifted into baby-belly-breaths, rather than chest breathing that adults do. If you’ve succeeded at the baby role play, it should have been automatic, but if not, now just think about the belly breathing, and carry on trying to be a baby.
    Another trick is to remember that your body and mind Both need sleep. And it’s ok for the body to snatch a bit extra/ So instead of lying awake thinking, ‘i’m awake’, allow your body to get there first. Lie there, very still, gradually relaxing your whole body, and if your minds still awake, so what? just think about how your body is enjoying the rest.
    Both these techniques work for me, although i empathise with the sleeplessness thing because i have trouble staying asleep, not getting to sleep.

  23. #23 Metsox
    November 5, 2009

    My advice. Buy yourself a copy of the CFA code of ethics and read that when you get into bed at night. You will be sleeping soundly within minutes…

  24. #24 gines
    November 5, 2009

    Cool!

    Let us add all the things we must not to think about and we have a super-insomniac-brain-thinking.

    - Am I doing the right thing?
    - I will stop thinking!
    - To see if im doing it right, i’ll test if I’ve stoped thinking?
    - So i’ve already broken myself again!

    As the fish biting its tail.

    So what to do?

    I don’t know for sure, but some people are saying, when sleeping, the brain orders daily events because there are many unresolved issues. That’s why the dreams are used to close all these open questions. A recommended exercise is to close all the items, during the day, in the same moment they occur, but apparently for this we must to be great experts. Another more simple way: is to get used to do an inventory before sleeping. It seems that aside from physical exercise this brain excercise greatly enhance sleeping on insomniacs.

    Apparently dreaming is not good, because, if the body has all its issues resolved, it will use that time we use to dream, to regenerate, rejuvenate, keep fit and live forever ¿? instead of solving everyday inconclusive affairs.

  25. #25 Zoasterboy
    November 5, 2009

    I already did the white bear activity in a book about cognition.

    Just think about global warming and the white bear goes away.

  26. #26 GrayGaffer
    November 5, 2009

    I think the key issue with the conundrum is that the inunctive to one’s subconscious includes a negative. Drop the ‘not’ and the image comes, as before, but dismissing it is easy.

    A much more insidious example of this effect is bound up in nicotine addiction and attempts to get free of it. The “common knowledge” is that it is a choice to smoke each cigarette, so therefore one just has to _not_ smoke to quit, i.e. it is supposedly a matter of will power. But the harder one tries to think about not smoking, the stronger grows the desire for a smoke.

    So I don’t do that. I just forget to smoke.

    White bears, however, are a different story. They’re in the process of going extinct up in the Arctic, we need to think about them, not to not think about them.

  27. #27 Shawaii
    November 5, 2009

    Jonah,
    Deep breathing, where you focus only on your breath filling up your entire body. Practice at balancing and/or silencing a very active mind throughout the day (i.e. meditation). Balance makes deep breathing more effective at bedtime. Having an atypical (creative), overactive brain produces prolific, awesome blogs/books, but impedes silence. Since you defined yourself as “chronic” try something different, for a meaningful amount of time. Balance…oh if you are like most writers I know: caffeine has an average half life of 4.9 hours.

  28. #28 marilove
    November 5, 2009

    teiana, have you been able to find a way to keep yourself asleep? Because I, too, have problems staying asleep. Most insomnia help is geared toward those who have problems falling asleep.

  29. #29 Naomi smith
    November 5, 2009

    Try raw milk. Gently warmed (not in microwave) mixed with a teaspoon of raw honey.

  30. #30 Meryl
    November 5, 2009

    As long as you are functioning 100% despite only having slept 4 hours, it should be fine, shouldn’t it?

    Is it possible that not everyone needs 8 hours of sleep a day?

    I wonder if this works – that if you spend time actually thinking about why/what/etc that you are trying to avoid thinking of, you get so bored that you actually fall asleep!!! It works for me splendidly.

    In any case, daily physical exertion in the likes of bikram hotyoga, or 2 hours’cycling, or 1 hour’s jogging…can improve sleep for me. Over the years I’d realised that I’m a high-octane energy person, and if I don’t dispense of the energy via physical exertions, wakefulness assails!!!

    I am not a fan of drug-induced stupor of semi-slumber. Apologies!

    Enjoy enjoy snoozing~!!!!

  31. #31 OftenWrongTed
    November 6, 2009

    This provided fascinating material for me to think about for most all of last night.

  32. #32 laura
    November 6, 2009

    I love this quote from Macbeth about the lovely, rejuvenating qualities of sleep, and I hope that you’ll enjoy it, too.

    Macbeth:
    Methought I heard a voice cry ‘Sleep no more!
    Macbeth does murder sleep,’ the innocent sleep,
    Sleep that knits up the ravell’d sleave of care,
    The death of each day’s life, sore labour’s bath,
    Balm of hurt minds, great nature’s second course,
    Chief nourisher in life’s feast, -

  33. #33 Lindsey
    November 6, 2009

    I couldn’t agree more with the “white bear” theory… I’m also someone who has had bouts of insomnia since I can remember, and it’s so true that the more you think about wanting to sleep, the more you can’t sleep.

    I’ve seen a few mentioned on melatonin here, it really helps! I big part of sleep is getting your cycle adjusted (our circadian rhythms run on a cycle of about 23 hours), and that is really difficult, since if you get to bed at 3, the idea of waking up at 7 or 8 is difficult and sometimes impossible. I’ve found that when I need to fix my clock, taking melatonin before bed REALLY helps. I’ll then just go about my evening routine and I am suddenly out.

  34. #34 Charnbarn
    November 6, 2009

    I find pushing myself to physical exhaustion (yard work, biking, weight training etc.) sometime during the day is the only guarantee that I’ll sleep for more than 7 hours that evening.

  35. #35 Jason
    November 7, 2009

    Try meditation. It taught me how to conciously decide what I want to be thinking of, and what I don’t want to be thinking of.

  36. #36 Astrid
    November 8, 2009

    Very interesting discussion here. I read in my college clinical psychology book that insomniacs on average have more of the “monitoring” (the white bear thing) while trying to fall asleep than non-insomniacs, because they focus so much on the need to fall asleep, the possible consequences of poor sleep, watch the clock more often (“OMG it’s already 2:00 AM, I have only six hours to sleep!”), etc. They also underestimate their actual duration of sleep, and might report that they were awake while they were actually sleeping. This is quite interesting, cause it all explains how what might’ve been mild, transient, non-clinical insonia that everyone has at times, could turn into clinical insomnia by the thoughts we have about sleep and the lack thereof.

  37. #37 Sleeping Insomnia Cures
    November 9, 2009

    Sleep is really integral to our health and it’s interesting how people only ever take this seriously when they see the studies to show something for it. Thanks for the great post.

  38. #38 Tim
    November 9, 2009

    I recall reading some time ago that the way you interpret a negative is to first construct its positive and then negate it. That would explain why the white bear is an inevitable failure.

    One can have marginally better success by constructing a thought of anything else. But the trick then is to keep reinforcing it to ward off the white bears.

    I have the same sleep problem. For me, getting to sleep initially isn’t to hard, because I’m usually so exhausted. But if I awaken after 6 hours or so of sleep, it’s almost impossible to return to sleep. My body and brain will start to relax, but as soon as I realize it, my conscious mind brays about the success, dooming me to return to wakefulness.

    I’ve had some measure of success through self-hypnosis and hypnosis recordings. I’m teaching myself how to relax more completely, which is allowing me to at the very least have some relaxing downtime, if not literal sleep.

  39. #39 curiousgeorgie
    November 10, 2009

    I wonder if the white bear thing would work on Tibetan monks…I have some practice with clearing my mind from the martial arts I did for years. The thing that I found to work was to allow thoughts to float past without grasping at them.

    It’s difficult though. When you mentioned the white bear, I didn’t visualize a white bear. I did, however, immediately see a pink elephant. I suppose my unconscious must’ve suppressed a reaction to the white bear the way that most people try to do with their conscious mind, but the somewhat related pink elephant was able to make it through the filter.

    I also wonder if being able to do that affects creativity, because the ideas fly under your radar. But I guess if you can control your genius as Elizabeth Gilbert says, it shouldn’t be a problem:
    http://www.ted.com/talks/lang/eng/elizabeth_gilbert_on_genius.html
    (Fascinating TED talk, by the way, for those who haven’t seen it!)

  40. #40 Chris
    November 14, 2009

    Jonah, I have found that some techniques from cognitive behavioral therapy have helped with my insomnia. First, you can examine the evidence and debunk the inaccurate beliefs that feed your anxiety. For example, the commonplace belief that everyone needs 7-8 hours of sleep per night is not supported by much, if any, research. In reality, some people simply need less sleep than others. Second, you can challenge your own negative thoughts. For me, insomnia is often triggered by the recurring thought that if I don’t get enough sleep, I won’t be productive the next day. In fact, most people function just fine after one night of less than perfect sleep, and usually sleep much better the next night. Third, many people underestimate the amount of sleep they actually are getting. This can be counteracted by keeping a sleep journal and noticing that you actually sleep more than you probably think you do. I have found all of these techniques to be very useful because they challenge the very same recurring “rational” thoughts that cause anxiety keep me awake. Lots of exercise and less alcohol and caffeine also help. Also, when I feel insomnia coming on, I don’t just lie in bed and stew. I either read something until I feel tired again, or get up and so something until I’m ready to sleep again. That helps disassociate lying in bed from the anxiety that keeps you up and stops the endless loop of thoughts as you lie awake.

  41. #41 bryan
    December 1, 2009

    i used to frequently experience this same abrupt jerking as i am trying to fall asleep, which ultimately wakes me up and causes a generally poor night’s sleep when i finally do manage it. i found the the problem is caffeine, and if i had to guess, you do not avoid the substance. a small espresso in the morning per day was enough for me to have these effects. thats about 40mg in the morning and there are approximately 12 hours minimum to get out of my system, and i still noticed these effects. my proof that caffeine in fact was the problem, was that when i stopped, of course, the sleep problems went away. i also noticed that i had a MUCH easier time waking up. i only mention this, and the very small, relatively speaking, amount of caffeine that i would consume, because i find almost all people that self-diagnose themselves with some sort of insomnia (im not challenging clinical insomnia) are often caffeine fiends. the problem is, such addicts can seldom will themselves into doing the experiment and quitting caffeine…but i could be wrong.

The site is currently under maintenance and will be back shortly. New comments have been disabled during this time, please check back soon.