Grief and Sleep: Coping with Insomnia After Loss

Grief is a complicated emotional reaction to loss or change that many of us have and will experience at some point during our lives. Because grief takes many forms, it can be hard to define.

Of itself, grief is not a mental illness, pathological condition, or personality disorder. Rather, grief is a completely natural emotional response that transpires differently in all people.

We experience grief when conflicting feelings caused by the end or change in a familiar pattern or behavior wage war over our emotional stability. This experience most commonly takes place after the loss of a loved one; however, we can also experience grief when a particular life stage comes to an end, such as, losing a job, ending a relationship, or moving to a new place.

Regardless of the cause, grief is a difficult emotion to grapple with. Oftentimes, grief feels “all-consuming” and infiltrates all aspects of daily life, including the hours we spend sleeping. Everyone grieves differently, but if your understand your emotions and the common ways grief transpires in certain people, you’ll be one step closer to healing.

What Are the Stages of Grief?

While grieving, your emotions come in phases. Doctors have identified five common stages of the grieving process. These stages do not happen in a linear progression, nor will every person experience all five.

• Denial – a defense mechanism that temporarily assuages the rush of intense emotion. You commonly feel numb or think thoughts like “This isn’t happening…” at this stage.
• Anger – facing the pain of your loss as reality sets in. Feelings of frustration and helplessness turn into anger.
• Bargaining – dwelling on what you could have done differently. Asking “If only…” and “What If…”
• Depression – beginning to understand the loss and what the impact it will have on your life. Feelings of intense sadness and loneliness are common in this stage.
• Acceptance – accepting the reality of your loss. Allows you to move forward.

Common Symptoms of Grief

Managing grief is extremely difficult.  In some cases, bereaved people struggle to get a hold of their grief and develop prolonged grief disorder, also known as complicated grief. That’s why understanding the common symptoms of grief can be extremely helpful for those in mourning.

There are physical, mental, and emotional symptoms of grief that are important to be aware of so you can identify if you develop complicated grief and get appropriate help if needed.

Emotional Reactions to Grief

• Agitation
• Anxiety
• Apathy
• Disbelief
• Guilt
• Helplessness
• Isolation
• Impatience
• Numbness
• Relief
• Sadness
• Shock
• Uselessness

Mental Reactions to Grief

• Obsessive thoughts over the loss
• Difficulty focusing
• Increased nightmares
• Self-destructive thoughts

Physical Reactions of Grief

• Disrupted sleep – too little or too much
• Changes in appetite
• Tiredness
• Muscle tension
• Headaches and stomach aches
• Weakened Immune System

All of these reactions are completely normal when grieving. However, if any become prolonged or go untreated, they can wreak havoc on your overall well being. One of the most important symptoms of grief to keep an eye on is sleep deprivation.

How Grief Affects Sleep

Troubled sleep is very common among individuals in mourning. In fact, many facets of bereavement contribute to sleep disturbance.

Some common reasons grievers might have difficulty sleeping include:  

• Anxiety and stress over situations that have occurred as a result of the death
• Increased nightmares
• Anxiety about having bad dreams
• Racing, intrusive thoughts
• Trouble sleeping in the bed they shared with their partner
• The development of disorders like depression, insomnia, and PTSD that are common during grief

All of these conditions impact our ability to either fall asleep, stay asleep, or wake up, maybe all three.

Difficulties Falling Asleep

One of the most common sleep issues bereaved individuals face is difficulty falling asleep. Oftentimes, this insomnia is due to racing thoughts of loss or anxiety caused by stressors that have occurred as a result of the death (i.e. financial or parental stress). When anxious thoughts consume one’s mind, it’s nearly impossible to relax and fall asleep.

For individuals that have lost a spouse, the emptiness of the other side of the bed can trigger painful memories and difficult emotions that plague their ability to fall asleep. You can try rearranging the room, getting a new bed, or sleeping in another room of the house, but for many, the sense of sleeping beside someone transcends their bedding and the arrangement of the objects in their room. While adjusting to sleeping alone, you might allow your pet to sleep with you to assuage feelings of loneliness.

Difficulties Staying Asleep

Once you do fall asleep, it can be hard to stay asleep.

Many people experience an increase in nightmares and dreams of a lost loved one after their death. This may seem strange, but fairly it’s normal. That’s because emotional and cognitive processing occurs during the same stage of sleep dreams do, the deepest stage of sleep, called REM sleep.

Nightmares and dreams of a loved one can be difficult to handle or process. When those grieving see loved ones in their dreams or nightmares, it can be unsettling because such dreams do not provide closure. In some cases, especially in the case of nightmares, the negative emotions associated with the dream may wake you up. The regular occurrence of such dreams can eventually cause an anxiousness to sleep itself because you fear to relive those unsettling feelings again.

Sleeping Too Much

Grieving doesn’t always mean you will experience insomnia or sleep deprivation. Sometimes excessive sleeping is common as well. Every person faces their grief in different ways; however, the amount and quality of your sleep is commonly affected and is symptomatic of grief. Some people actually sleep more, where people who are facing overwhelming emotions are often reluctant to get out of bed and face the realities of everyday life. Retreating to bed can be an escape when you are working through so many exhausting emotions, but often in these cases, the quality of sleep is still low.

Consequences of Sleep Loss While Grieving

Sleep deprivation is a nasty cycle for the bereaved because lack of sleep intensifies the symptoms of grief, making life even more difficult to manage.

Cognitively, sleep loss impairs the brain’s ability to process memories and make sound judgments. Emotionally, losing sleep throws hormones out of whack increasing the likelihood of mood swings. Additionally, a lack of restful sleep weakens the immune system, making it more likely for the individual to fall ill. Finally, fatigue has an impact on emotional outlook. This can prolong one’s ability to reach acceptance.

Because sleep loss while grieving poses such a threat to one’s overall health and wellbeing, it’s important to do everything in your power to protect your sleep when in mourning. Although this may feel impossible, there are a number of small adjustments we can make to our day to help prepare our mind and body for restful sleep despite the challenges against us.

Tips for Getting a Good Night’s Sleep While Grieving

Avoid Self-Medicating

When struggling to get proper rest, our first solution tends to be self-medication. Whether they be over-the-counter sleep aids or another drug, many of these substances only make you sleepy enough to fall asleep, they don’t actually improve sleep quality. Additionally, substances of this kind can lead to addiction and permanent changes in your sleep architecture when abused. Before using any type of sleep aid, talk to your doctor or opt for a natural remedy to sleep. In any case, sleep medication should only be used as a temporary solution.

Consider Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) is a type of psychotherapy that challenges negative patterns of thought about the self and.or world in order to alter unwanted behavioral patterns or treat mood disorders like depression. This type of therapy is commonly used in grief counseling so the bereaved individual can talk through their negative emotions to uncover which ones are leading to unhealthy behavior, such as anxious thoughts and insomnia. Studies have found the use of CBT effective for improving sleep and daytime symptoms of insomnia.

Follow a Regular Sleep Schedule

As hard as it may be to fall asleep, it’s important to try and keep a consistent bedtime each and every night. Keeping a steady schedule will help you get a more regular amount of sleep on a nightly basis. Do you best to avoid naps and caffeine during the day that makes it harder to fall asleep at night. We are creatures of habit. The more we stick to our bedtime the faster our body will learn to follow suit.

Craft a 30 Minute Wind Down Routine

As part of creating a sleep schedule, you should also consider crafting a wind-down routine you implement 30 minutes to an hour before bed each night. At the end of the day, our brains don’t automatically shut down. Rather, they need to be primed for sleep. This is especially true for individuals struggling with anxious thoughts that keep the mind racing. Some of the best ways to power down before bed are drawing a hot bath, unplugging from all technology, dimming the lights, and picking up a book. This will help quiet and relax your mind for sleep.

Go for a Short Walk Daily

Try exercise as a natural remedy to sleep. Physical activity releases endorphins which help improve mood and physical well-being. Additionally, working out helps to physically tire your body so you can sleep better at night.

What To Do If You Can’t Sleep

When you struggle to fall asleep or wake up in the middle of the night, here are a few tips from Dr. Robert Oexman, Sleep Medicine Specialist:

• If you wake, turn your alarm clock around and don’t look at the time. This can increase anxious thoughts about the following day and how little time you have left to sleep.
• Lay still for 20 minutes. If after that time you aren’t getting sleepy, get out of bed. You don’t want your bed to be a place associated with restlessness.
• With the lights off (don’t turn them on!) go into another room and pray, meditate, stretch, breathe, anything relaxing that may help relax you. Whatever you do, don’t go to another room or the couch to sleep.
• When you begin to get tired, go back to your bedroom and try to fall back asleep. If that doesn’t work, lay still for another 20 minutes and then repeat the above exercise. Repeat until you finally go back to sleep.

Keep in mind it can take 2-3 weeks of this type of discipline to be able to fall back asleep upon waking.

Although grief is a natural process that has to run its course, that doesn’t mean you have to sit idly by and let it wreck you from the inside out. There are a number of ways to take ownership of your grief so you can stay healthy amidst your time of struggle. Sometimes the best way to do that starts in bed.