Struggling to Sleep – Tools and Techniques

Author : Melanie Nelson, LCSW

Your own personal “toolbox” of techniques will help you fight any struggles with sleep. Some basic strategies are below but keep learning and adding more tools to your toolbox!

Deep Breathing Techniques

Deep breathing isn’t your typical meditation! Based in science, it has two main benefits:

  • Deep breathing provides a distraction when you are having trouble sleeping and are worrying about the fact that you are awake.
  • Deep breathing provides extra oxygen to your brain and triggers the relaxation of your parasympathetic nervous system, the part of your body that gets triggered under stress or danger.

When feeling stressed, your body naturally breathes more quickly and shallowly, your heart rate speeds up, and you feel anxious…like a caveman probably felt when faced with a sabertooth tiger. Most people with insomnia aren’t facing a beast like that, but they do feel stressed, and your body responds in the same way. Practicing slow, deep breathing tells your body that “Hey, it’s safe now,” and helps you return to being relaxed again. You can even use these techniques when getting connected during dialysis or having your blood pressure taken, as it lowers your blood pressure too!

Basic deep breathing: Put one hand on your belly, just above your belly button, and empty all the air from your lungs in a big sigh. Then, take a slow, deep breath in. Try and make your hand rise, not your shoulders. Breathe in through your nose and out through your mouth.

Square breathing helps you learn how to make your breathing longer and more even than your normal breathing does. You want to make each of the four parts of your breath equal, like a square. I find it helps to picture the square in my mind when doing this one.

  1. Inhale for 4 counts
  2. Hold for 4 counts
  3. Exhale for 4 counts
  4. Rest for 4 counts

Deep breathing with simple visualization: This one is rather fun, and good when you’re dealing with a “busy brain” that won’t shut off. What you want to do is add something for your mind to focus on to distract yourself from thinking or worrying too much. As you breathe in, think of something good, and as you breathe out, think of something bad. Some examples of this:

  1. Breathe in peace…breathe out worry.
  2. Breathe in love…breathe out hate.
  3. Breathe in joy…breathe out sadness.
  4. Breathe in relaxation…breathe out stress.
  5. If you’re more visual, try breathing in your favorite color…breathing out your least favorite color.

Finally, if your mind keeps thinking about other things and worrying, try:

Stop sign visualization: This is very simple. Pay attention as you’re doing your deep breathing, and every time you notice yourself thinking too much, picture a stop sign and tell yourself, “STOP!” And then mentally go back to your deep breathing. Easy, right?

Hopefully some of these techniques help! Learn them, practice them, and add them to your “toolbox” of things you can use to fight insomnia.

Note: This is the third of a three-part series titled “Struggling to Sleep.” Each article addresses how people with CKD and ESKD can improve their sleep quality and habits.

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