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Grief is an essential human experience. We’ll all experience grief throughout our lives, some of us more than others.
Just as grief affects all of us, it also pervades all aspects of our lives. When we are grieving, our thoughts are consumed by our loss. Food doesn’t taste as good. We’re less motivated to do things we used to find fun. It takes everything just to keep going through the motions of daily life.
And it’s tough to sleep. When we experience grief, it’s common to experience newfound insomnia, or to feel exhausted even if you are getting sufficient sleep.
How does grief affect our sleep, and what can you do to sleep better during bereavement?
Grief, or bereavement, is the distressing experience and symptoms that accompany the loss of a loved one, such as a spouse, family member, friend, pet, or other individual.
Grief itself creates intense emotional and physical symptoms: low energy, anxiety, headaches, digestive issues, and sleep problems. Meanwhile, the person suddenly experiences disruptions to other parts of their daily life: they may have lost a major source of financial support when their loved one passed, bringing on new stressors, and everyday activities commonly undertaken with the person now feel drastically different and lonely.
When these symptoms persist past a six-month period, it is diagnosed as complicated grief (CG) or prolonged grief disorder. A person with CG may still experience symptoms of grief and depression, such as feelings of hopelessness or thoughts of self-harm, difficulty maintaining their daily routine, and feelings of guilt and blaming themselves.
It is difficult to sleep during bereavement. A grieving person may have distressing thoughts about their loved one, such as regrets, worries, anxieties, or sadness about their time together or how they passed. If they shared their bed with the deceased loved one, it can be especially heartbreaking to sleep without them.
The stress from the loss of a loved one can develop into anxiety, depression, or post-traumatic stress disorder (PTSD). In turn, each one of these conditions negatively affects sleep. One quarter of those who lost a spouse develop clinical depression or anxiety within the first year.
Even without it becoming something more, a loss is a traumatic experience all its own that creates disruptive physical symptoms for weeks to months at a time. One of the most common symptoms is insomnia.
Insomnia describes a difficulty falling or staying asleep. Sleep-onset insomnia refers to difficulty falling asleep, while sleep-maintenance insomnia refers to difficulty staying asleep.
Sleeplessness during grief is very common. Individuals in grief are often consumed with thoughts of the loss, which interferes with their ability to fall asleep. They may also wake up from dreaming about their deceased loved one, as their brain emotionally processes the loss (during the REM or “dream” stage of sleep, our brains perform emotional and cognitive processing).
When grieving individuals don’t get adequately restful sleep on a regular basis, they are going about their lives in a constant state of sleep deprivation. Being sleep-deprived worsens the intensity of many of the symptoms of grief, and makes life on the whole more challenging to manage.
In the long run, sleep deprivation is linked to heart disease, cancer, type 2 diabetes, and obesity. Unfortunately, when spousal bereavement develops into CG, the risk of adverse health outcomes also increases for some of these conditions, such as cancer and high blood pressure.
A 2008 meta-analysis comprehensively reviewed the prior research surrounding individuals suffering from CG or LLSB (late-life spousal bereavement) and their sleep. LLSB affects over 800,000 Americans every year. Significant findings include:
For many, grief is a natural process. You sort of have to just go through it to get to the other side.
However, that doesn’t mean you should experience it passively. Taking control and ownership of everything you can do to stay healthy and sleep well during this time gives you a sense of power. More importantly, it helps you recover from this loss with less pain than necessary, and lowers your risk developing complicated grief.
The evidence is strong that good sleep hastens recovery toward “successful” bereavement. This is especially true for the wide swath of individuals suffering from LLSB grief, who are more likely to be seniors. Their risk of morbidity can be significantly reduced by maintaining good sleep.
One study found that those who took 30 minutes or more to fall asleep had more than twice the death rate of their better-sleeping peers. Another study confirmed these findings. Individuals with poor sleep efficiency (spending less than 80% of their time in bed asleep) were nearly twice as likely to die as well.
Researchers have found that treating grief also improves sleep. However, sleep problems may still linger if they are not addressed directly themselves. Follow these tips to improve your sleep.
Are you or someone you care about grieving and experiencing sleep issues? If your symptoms and sleeplessness have persisted for 12 weeks or more, it may be time to get professional help.
Cognitive-behavioral therapy (CBT) is an effective form of psychotherapeutic treatment for anxiety, depression, insomnia, and more. Studies of individuals with CG or LLSB have found CBT effective for improving their sleep and daytime symptoms of insomnia.
During CBT, the patient works with their therapist to recognize the negative or blocking thoughts and behavior they have that make them feel worse, heighten their anxiety, or encourage insomnia. Then, they learn how to replace those thoughts and behaviors with healthier ones.
For example, a person receiving CBT-I (CBT for insomnia) may learn that their haphazard sleeping schedule is contributing to their insomnia, and work out a consistent sleep schedule with their therapist. A person in grieving, however, may develop a phobia or anxiety that they won’t fall asleep because they’re suddenly having trouble sleeping, and they don’t recognize that it’s a normal reaction to a loss. They may think negative thoughts about never being able to recover from the loss, which heighten anxiety, depression, and lead to restless sleep. CBT can help tease out these thoughts and encourage the individual to face and overcome them.
Taking a cue from the CBT recommendation above, a consistent sleep schedule can help you get a more regular amount of sleep on a nightly basis. Go to sleep and wake up at the same time every day, including weekends.
Avoid napping during the day, as this will only make it tougher for you to fall asleep at night. If you are absolutely exhausted, limit your nap to 20 to 30 minutes at the most. This short nap length will prevent you from falling into deep sleep, from which it’s quite difficult to wake up from.
During this time, it is important that you spend time with people who love and care about you. Find people who will allow you to share your stories, your grief, and your tears without judgment, but who will also know when to help distract you by doing an activity together.
If you are feeling lonely, ask friends or family to spend the night. You might invite your pet to sleep in bed with you. If you shared your bed with the person who’s passed on, try sleeping on their side – it may be less painful to see your side empty. You may also use a body pillow to remind you of them.
While they may help you fall asleep initially, many of these substances actually disrupt the quality of your sleep – and they can lead to addiction and permanent changes in your sleep architecture when abused.
You may ask your doctor about melatonin, which is a natural supplement that can help promote sleep. Even sleeping aids should only be used as a temporary solution. Instead, focus on the behavioral strategies outlined here to improve your sleep to the best extent possible.
Exercise gets your endorphins going and helps you feel physically better. It provides a distraction from the pain you are going through, and it also helps you sleep. By physically tiring your body, you will fall asleep more easily by bedtime.
Just take care to complete your exercise in the morning or earlier part of the day. That activating energy can wake you up, so you want to avoid doing it too close to bedtime. Also try to exercise in the sunshine if possible, for an extra lift in energy and mood.
Just like exercise, what you eat affects your mood and your sleep, too. It may be more challenging than ever to get out of bed and avoid indulging in bad foods during this time, but it only makes it that much more important.
Do your best to eat healthy foods and avoid overly sugary, junky, or fatty foods. The same foods that don’t make you feel great emotionally or physically also disrupt your sleep. Instead, incorporate more of these healthy, sleep-promoting foods into your diet.
Also, even though caffeine is fine for some people, limit your intake past the afternoon and overall. It activates your nervous system, keeping you alert and potentially anxious.
Walking through the steps of your bedtime routine will train your mind to recognize that it’s time to go to bed, and while also clearing your mind of sad thoughts. When we lose someone close to us, it disrupts our daily routine. Establishing a bedtime routine can also help give you a sense of control again, bringing a sense of order back into your life.
Include relaxing activities in your bedtime routine. These will calm your anxious spirit and nervous system, preparing your body for sleep. Options include:
If you wake up during the night, don’t stress. Disrupted sleep is a common part of grief. If you can’t fall back asleep after 10 minutes or so, get out of bed and go into another room. This part is key – you don’t want your mind to start viewing your bed as a place where you lie awake and frustrated.
In the other room, you might again try one of the relaxing activities from your bedtime routine. You might also take the time to journal. Write about happy thoughts and memories, calming your mind and giving you something to focus on besides the fact that you can’t sleep.
Electronics like our smartphone flood our eyes with strong bluelight. Our brain perceives this as sunlight, and accordingly tries to keep us up and awake.
Beyond the physical reaction, electronics often provide stressors of their own, even though many of us view them as leisure devices. Dramatic TV shows can affect our nervous system, social media notifications may remind us of our lost loved one, and emails may arrive from the funeral home.
Avoiding electronics in the 60 minutes before you go to bed helps you mentally break away from these distressing reminders, while avoiding confusing your brain about what time of day it is.
It’s possible you have items that remind you of the loss in your bedroom, whether it’s a photo of you and your pet, a memento of the person. You may even have shared your bed with the person you’ve lost. It may be easier for you to cope if you remove reminders of that person from your room – at least temporarily. Seeing their face or clothes may trigger your grief.
Also be thoughtful of how else your bedroom is helping or hurting your sleep. You may take this time to redecorate your room, giving you something to focus on that provides hope. Choose calming, relaxing colors and clear your bedroom of clutter. A calmer bedroom environment makes for a calmer mind, more conducive to sleep.
It might also be time for you to get a new mattress. Sleeping on a high-quality, comfortable mattress makes it easier for you to fall asleep, and the new one may remind you less of your lost loved one.
Finally, avoid doing anything besides sleep or sex in your bedroom. Work, fun, and other activities wake up your brain. You want your brain to see your bedroom as a place solely for sleep.
Grieving is an experience we all go through. Lean on family, friends, and even strangers for support. Below we’ve listed several online resources for finding online support forums, in-person support groups, blogs, non-profit organizations, and education about grief.