What to do when insomnia makes you afraid of sleep

Our circadian rhythms also shift as we get older, especially past age 60, when our bodies tend to want to go to bed and wake up earlier; those new bodily rhythms can conflict with our

established lifestyles. Another culprit: caffeine. It can take up to 10 hours to completely clear caffeine from your bloodstream, and half of what you drank in that coffee is often still

circulating six hours after consumption, according to the Cleveland Clinic. And we metabolize food more slowly as we age, says Michael Breus, a sleep specialist and clinical psychologist

based in Manhattan Beach, California. To make sure caffeine isn’t affecting your sleep, avoid caffeinated drinks after noon, Breus suggests. Many of us turn to a glass of wine or beer in the

evening for its sedative effect, but alcohol backfires, too, says Jennifer Mundt, assistant professor of neurology at Northwestern University Feinberg School of Medicine. “While it may help

you feel sleepy at first,” she notes, “it will result in poor-quality, disrupted sleep as the alcohol is metabolized.” According to the Sleep Foundation, two drinks for men or one drink

for women can decrease sleep quality by 24 percent. BREAKING THE CYCLE OF INSOMNIA The cornerstone treatment for sleep anxiety is cognitive behavioral therapy for insomnia (CBT-I), which

addresses a patient’s habits and thought patterns. With the cognitive part of CBT-I, the therapist — one who specializes in sleep — explores your sleep-related anxieties. When clients tell

Tal they’re afraid they’ll never sleep well again, for example, he challenges their assumptions and helps them reframe their fears. “I ask clients, ‘Is it true that, after a bad night, you

won’t sleep well the next night?’” Then he points out what science says: “You’re actually more likely to sleep well the next night. But it’s the anxiety that makes it worse.” Elaine Harris

has experienced this phenomenon. A retired French teacher in Chicago, Harris, 86, struggled with sleep for decades. She would often wake up in the middle of the night and grow increasingly

anxious, thinking, _How am I going to get through the day on four or five hours of sleep?_ Last year, Harris started working with Mundt, who begins by asking her patients to keep a sleep log

and to record sleeping times. Over a period of seven or eight months, she talked with Harris about her sleep-related anxieties and stressors, while gradually helping her develop a healthy

sleep routine — the behavioral part of the CBT-I program. It sounds counterintuitive, but sleep therapists often improve your sleep by restricting it. The object is to create so much sleep

deprivation that you conk out and sleep through the night without awakening. Once you start sleeping for a solid block of time, say midnight to 6 a.m., the next step is to hit the sack

earlier, in 15-minute increments, until you reach a schedule where you are tired enough to fall asleep — and stay asleep — but are not exhausted when you wake up, Breus says. (Forget about 

melatonin supplements: They don’t usually help with sleep anxiety, Tal says.)