Restoring peace: Finding sleep after the death of a spouse

When your loved one has died and your world has fallen apart, disruption to your sleep isn’t something that you are likely to worry about or prioritise. However, chronic sleep deprivation can make coping with loss even more difficult and it can have a cumulative, long-term impact on your health. Therefore, it’s important to address the issue. 

In this article, I will discuss some of the reasons for bereavement-related insomnia and why it is important to deal with this. I will also make suggestions for re-establishing healthy sleeping habits. While my focus is on losing a partner, husband or wife, many of the points are also relevant for other close losses.

Grief and sleep, understanding the connection

Whether the death is expected or sudden, peaceful or traumatic, it is often accompanied by intense emotions such as sadness, confusion, anger, loneliness, guilt and panic. Grief may manifest physically, leaving you fatigued, achy, and restless or struggling with headaches. Grieving is exhausting and this can persist for weeks or even months. Unfortunately, grief is also often accompanied by difficulty sleeping—taking longer to get to sleep and/or waking up in the middle of the night and struggling to fall back asleep. 

There are many reasons for bereavement-related insomnia, for example:

• The initial shock of the death will be treated by the body as a major stressor, a threat that results in the production of adrenaline and other chemicals. They prepare you for fight or flight but less well for sleep.
• If the person who died was the person you shared everything with, then the loss of someone to talk to can mean your thoughts may race and decisions go round and round in your head leading to increased worry, anxiety and difficulty with decision-making, confidence and sleep.  
• Grieving individuals may find their minds preoccupied with thoughts and memories related to the loved one and these can be persistent and intrusive, making it challenging to fall asleep.
• Grief often disrupts our regular routines and this can lead to irregular sleep or insomnia particularly following the loss of a partner or spouse. Going to bed alone after years of shared bedtime routines and sleeping alongside each other can result in feelings of emptiness and a sense of reduced security. 
• If you have been a carer then you may have become used to sleeping lightly, remaining alert for sounds that your loved one needed support or you may have been used to waking regularly to help with medication. 
• The loss of someone close is a significant life event. Bereaved people may experience heightened stress, anxiety and depression, all of which can negatively impact sleep. Secondary losses, such as worrying about finances, and coping alone with the home and childcare bring additional anxieties. 
• Some of the physical symptoms associated with grief, e.g. tension, headaches or gastrointestinal issues, can affect the ability to sleep comfortably.
• Grief is a complex emotional process that involves lots of big feelings and some bereaved people experience vivid dreams or nightmares related to the loss. This can lead to distress, disrupted sleep and even fear of going to bed.
• Use of stimulants can have an impact. The emotional burden of coping may lead to an increase in the use of alcohol or nicotine. While alcohol may help someone go to sleep, it impacts how well you sleep and means that you wake up sooner and more often. Alcohol is also a depressant so if you are struggling with mood and emotions, it can make things worse rather than better. If you turn to caffeinated drinks such as tea and coffee to cope during the day, then this can create a vicious circle, making it harder to get to sleep at night.

Why sleep matters

While the odd night of poor sleep is unlikely to have a severe impact, a more prolonged period of sleep deprivation, can have a noticeable impact on both physical and mental health and our general quality of life. 

Cognitive functionscan be impaired, for example, poorer concentration, memory decision-making, problem-solving and processing of information as well as slower reactions. This makes it harder to manage work or the many death-related tasks we need to organise.

Sleep loss can negatively impact on our mood and emotional well-being, leading to increased irritability, emotional reactivity and mood swings, greater susceptibility to stress and anxiety and an elevated risk of depression and thoughts of suicide.

Prolonged sleep deprivation will also affect our physical health, for example weakening our immune system, elevating blood pressure, and negatively impacting metabolism, hormone balance and tolerance of pain. Over time, if the insomnia is not addressed, we are more susceptible to illness, weight gain, and are at risk of developing chronic conditions such as diabetes and heart disease.

How to sleep better

In this section, I will suggest some strategies for improving sleep. However, it's important to note that these may not bring immediate results. If sleep difficulties persist or worsen, it is advisable to seek professional help. This may include speaking to your GP and finding a  bereavement counsellor who can support you in processing your grief in a healthy way. A counsellor is particularly useful if rumination and racing thoughts are key elements of your disrupted sleep.

Here are some suggestions for better sleep: 

Improve sleep hygiene (the habits and the environment in which we sleep)

• Establish a consistent sleep schedule. Even if you have lost sleep during the night, stick to set times so that you go to bed and get up at the same time every day, even at weekends. This helps regulate your body's internal clock.
• Create a new relaxing bedtime routine to signal to your body that it's time to wind down and prepare for sleep. For example, read a book, take a warm bath (two hours before bedtime is ideal), or practice relaxation exercises. 
• Try to avoid activities that get your brain churning or make you emotional just before bedtime, for example watching the news or looking at photographs. 
• Create a comfortable sleep environment. A bedroom that is cool, dark, and quiet is most conducive to sleep. 
• Limit screen time at least an hour before bed as the blue light emitted can interfere with the production of the sleep hormone melatonin and delay falling asleep. 
• Practice deep or mindful breathing and relaxation techniques to calm your mind and body before bedtime. Gentle yoga or stretching can also promote relaxation.
• Reduce or eliminate the intake of stimulants like caffeine and nicotine in the hours leading up to bedtime. While alcohol may initially induce sleep, it can disrupt sleep patterns later in the night. 
• Think about mealtimes and avoid eating anything substantial within three hours of going to bed.
• Engage in regular physical activity. Exercise can help alleviate stress and improve sleep quality, although try to avoid intense exercise close to bedtime — afternoons are the most effective time to aid better sleep at night. 

Process your feelings

It is important to process your feelings related to the death of your loved one. Reach out to friends or family, find a bereavement counsellor or consider starting a bereavement journal. 

Following a bereavement, sometimes we ruminate, that is we struggle with repetitive and intrusive thoughts about the person who died, how they died, the relationship, what we might have done differently, etc. This can be challenging to manage and can be very disruptive for sleep. There are self-help activities that can help with rumination at night:

• Engage in relaxation or mindfulness exercises: Focus your attention on the present moment, on your breath, bodily sensations, or a specific anchor to help redirect your thoughts away from rumination. This will help to calm your mind and reduce anxiety.
• Set aside designated worry time: Allocate a specific time during the day to allow yourself to engage in focused worrying or rumination. Outside of that time, gently redirect your thoughts to more positive or neutral subjects.
• Express your thoughts: Write down your thoughts and feelings in a journal. This can provide a healthy outlet for expressing and processing emotions, clearing your mind before sleep and reducing the need for mental rumination. 
• Challenge your negative thoughts: use a journal to identify and challenge negative thoughts that contribute to rumination. Ask yourself if these thoughts are based on facts, and consider alternative, more balanced perspectives.
• Practice self-compassion: Be kind to yourself and treat yourself with the same compassion and understanding that you would offer to a friend.

If these techniques don’t seem to work with rumination, then consider talking to a bereavement counsellor. A counsellor can help you to work through difficult thoughts and feelings and can support you with guidance and tools to manage intrusive thoughts effectively.

If you would like to talk to a bereavement specialist about your loss, please don’t hesitate to get in touch with me by email or book an introductory call.