How Grief Affects Sleep

Grief is our natural emotional, physical and social response to a significant loss and it often affects our sleep. Grief is often associated from the death of a loved one but can also come from the loss of a job or career, a relationship breakdown and also from a chronic illness. Grief is an intense emotion of sadness bringing a wide range of feelings such as shock, anger, guilt, and anxiety. 

A common model of grief, ‘The five stages of grief’, also known as the Kübler-Ross model, describe a framework for understanding common emotional reactions to loss.

The five stages of grief:

• Denial: Disbelief that the loss has occurred.

• Anger: Feeling frustrated and asking "why?"

• Bargaining: Making deals or requests to reverse the loss.

• Depression: A period of sadness and withdrawal.

• Acceptance: Coming to terms with the reality of the loss and adjusting to life without it. 

The complexity of grief may not mean that we experience each phase as a linear process, on the contrary, we may experience only a few of these stages and move back and forth between the stages.

The emotional processing of grief can disturb our sleep due to our body's heightened stress response making it both difficult to fall asleep and to maintain sleep.

Waking up 3-4 times during the night is a natural part of our sleep pattern. At the end of each sleep cycle, normally lasting 90-120 minutes, there is a brief awakening or arousal which we don’t tend to remember.

Our circadian rhythm, that controls our sleep/wake cycle, releases cortisol to wake us up from our nocturnal slumber for the day. However, if our cortisol levels from stress and anxiety spike from grief, this can prematurely pull us out of sleep, keeping us awake.

What can Help

Firstly, it is ok for our sleep not to be normal when we are grieving. Trying to cope with bereavement can involve a significant change not just in our life but those around us too. It is better not to have the expectation that sleep will bring the restoration it once did initially and allow some acceptance that sleep may be fragmented and disturbed as we adapt our lives.

Difficulty in falling asleep, as the distractions in the day fade, can lead to added anxiety of not sleeping, especially in the quiet of the night when ruminating thoughts have a free run on our emotions!

Conditioned Arousal

Look to your bedroom as a sleep room rather than a space and time for reflection. Taking our troubles to bed can condition our brains to become awake and anxious on entering the room. If we are lying awake unable to sleep this only enforces this conditioning which can in turn disrupt our natural sleep/wake cycle (circadian rhythm).

Stimulus Control

To help strengthen the association between bedtime, bedroom and  our bed for sleep only, go to bed when you feel sleepy enough to fall asleep. If you are laying awake this will only weaken the ‘sleep-bed’ connection.

If you find yourself awake after 15-20 minutes then get up and out of bed. It can be that our mind just isn’t ready for sleep, but our bodies are. Remember, our brains control our sleep. Go to another room and only return when you feel sleepy again. This will help build the natural sleep drive adding us to fall asleep.

Your Sleep Grief Guide

Ask “What can I do for my sleep” and not “What I expect sleep to do for me in this difficult time”.

• Timing, try keep to the same wake up time each morning, even after a disturbed or fragmented night of sleep.

• Keeping to a regular wake up time helps anchor our circadian rhythm. Exposing ourselves to early morning sunlight switches off melatonin and switches on cortisol.

• This is why early morning sunshine exposure helps us feel more alert, energised and ready to start our day, early morning sunshine is natures cup of coffee, enjoy it! 

• Starting our day, this way helps us to be active increasing our sleep pressure for the nighttime.

10 Point Sleep Plan

Following a simple 10 point Sleep Plan can help:

Reaching Out

Grief counselling can help you process grief by providing a safe space to explore your feelings with a professional trained to help with loss. A counsellor can help you understand and normalise your emotions, develop coping strategies, and begin to adapt to life after the loss. 

How grief counselling helps:

• Provides a safe space: You can talk about your feelings and the person you lost without worrying about upsetting others. 

• Helps process emotions: A counsellor can help you understand and make sense of your grief, which may include sadness, anger, or frustration. 

• Develops coping strategies: You can learn ways to cope with your feelings in the short and long term. 

• Supports adaptation: It helps you begin to adapt to life without the person who has died. 

• Facilitates communication: A counsellor can help you have important conversations with loved ones, whether it's before or after a death

Chronic Insomnia

Cognitive Behaviour Therapy for Insomnia or CBT-I, is the recommended first-line treatment for chronic insomnia, effective for adults of all ages. It is a behavioural and cognitive therapy that addresses the thoughts and behaviours causing sleep problems, along with assessing for underlying sleep disorders. The benefits of CBT-I last after the treatment ends, unlike medication and with the sleep education you gain, you will be better placed to manage any further acute disruptions preventing them from becoming a chronic state.

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