Sleep Disturbances in Grieving People

Grief, or bereavement, is usually the result of losing a loved one, and it invades all aspects of our lives, including sleep. Thinking about our loss can lead to different sleep problems.

The feeling of grief is one of the most basic human emotions. Everybody experiences it at some point in their lives, but it may be more frequent or more intense in some people.

Grief, or bereavement, is usually the result of losing a loved one. It can affect anyone, and it also invades all aspects of our lives. People are often occupied with their thoughts and feeling of grief, that they don’t have the will to do anything else. Our favorite food stops tasting good, things that we were looking forward don’t seem to interest us anymore, and we struggle to find the energy to do the most basic tasks and deal with everyday life.

Sleep is another important aspect of our lives that suffers while we are grieving. Thinking about your loss all the time often leads to the development of short-term insomnia, or our brains are so preoccupied that we don’t get enough quality sleep even if it seems that we are resting long enough. That leads to the feeling of fatigue and exhaustion during the day, making it even harder to do things.


What is Grief?

Grief is a feeling of distress and sadness that accompany the loss of a loved one. It could be a spouse, a family member, relative, friend, or any other individual that you thought dearly of, even a pet. That loss might be due to them passing, or it can be simply due to the current circumstances that they are gone from your life.

Symptoms of grief include:

  • Changes in appetite that can lead to weight gain or loss
  • Digestive problems
  • Sleep disturbances and insomnia
  • Daytime fatigue
  • Anxiety
  • Difficulty concentrating
  • Impaired memory and cognitive abilities
  • Headaches
  • Low energy and motivation to do everyday tasks
  • Depression

There are many emotional and physical symptoms to grief, but low energy and motivation, appetite problems, headaches, anxiety, and sleep problems are the most prevalent. Losing a loved one can lead to other issues. For example, if the passed person was a significant source of financial support, people might be afraid for their well-being and future survival. Or if somebody was a daily part of our lives, we might feel empty, lonely, and struggle to cope on our own.

When these symptoms exist for longer than six months, it can be diagnosed as a prolonged grieving period or complicated grief (CG). During this period, the person often saves the feeling of hopelessness, guilt or blaming themselves, depression, and some even think about harming themselves. If you are experiencing this, know that you are not alone, and maybe think about seeking a professional to help you cope with your loss.


Stages of Grief

Even though bereavement is present in all of the cultures around the world, there is a similarity in the way that we perceive those feelings. It has been observed that people who are grieving go through five phases:

  1. Denial and isolation
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

Despite the popular opinion that everybody must go through these stages, and in this exact order, that is not the case. Many people don’t go through them all, and can jump between the phases, feeling anger at one point, the next they may feel depressed, and then angry again.

Denial and isolation is usually the first reaction to losing somebody. It is a common defense mechanism where we try to run away from the facts and protect our feelings. This reaction carries us through the initial wave of pain until we are ready to face reality.

Anger when the denial slowly fades, and we are left to face with a reality of the situation. Our vulnerable core produces this intense emotion, and it can be aimed at anybody or anything, or everything at once.

Bargaining is a normal reaction to feeling hopeless and vulnerable. It is a try to regain control, and it is accompanied by “If only” statements, like “If only we had acted better towards them,” or “If they had only sought medical help earlier.” It is an attempt at a bargain, and it’s a line of defense to protect us from painful reality. Guilt is often a partner of the bargain, as we feel like there was something that we could have done to change the outcome.

Depression comes with the mourning. Sadness and regret are a part of this phase, that can last for some time. Usually, our friends and family are there for us in these times, which makes it easier to go through this stage.

Acceptance is how all the mourning should end up ideally. Unfortunately, that is not the case for all people. Our loss can be so sudden and unexpected that we never see beyond anger or denial. This stage is characterized by calm and withdrawal. It is not the state of happiness, and it is different than depression.

Keep in mind that dealing with loss is deeply personal and singular experience. No one can go through it but yourself, but the help of others can go a long way. Just knowing that you are not alone and that there are people there who support you is essential, so don’t push away your friends and family and isolate yourself. The best thing you can do is to face the grief and the feelings it brings. Running away from it and resisting it will only prolong the healing process and might even make in incomplete. Embrace your feelings, and know that you are not alone; however hopeless it seems, it does get better.


How Grief Affects Sleep

Sleeping during bereavement is tough. The person often has intrusive thoughts about their loved one, such as anxieties, worries, and regrets. There is a great sadness present due to the realization that the time spent with this person is passed. It can be particularly challenging if the lost person is someone who shared a bad with you.

The stress of losing someone important can lead to anxiety, post-traumatic stress disorder (PTSD), and depression. Each of these conditions negatively impacts sleep as well. As much as one-quarter of people who lost their spouse experience anxiety and depression during the following year after the loss.

Even without developing some more severe disorder, losing somebody is stressful enough itself. It often develops into sleeping problems and insomnia. Sleep onset insomnia represents difficulty falling asleep, while sleep maintenance insomnia refers to a condition where a person has a hard time staying asleep.

Thoughts about the loss often leave people laying wide awake for hours after entering their bed. Also, dreaming about their loved one can wake them up during sleep, and cause sleep fragmentation. Dreaming mostly happens during REM sleep, when our brain does cognitive processing, so it has been argued that dreams play an essential role in our emotion processing as well.

When you don’t get sufficient sleep daily, it can lead to sleep deprivation. This condition worsens symptoms of grief and makes it even harder to deal with our everyday life, as it affects us in a very negative way. Sleep deprivation leads to:

  • Cognitive impairment. Sleep is essential for processing memories, and our learning ability. Lack of it leads to decreased focus and concentration, impaired ability to learn and form memories, and lack of sound judgment. If you haven’t slept long in a long time, you are much more likely to make a bad decision or behave rashly.
  • Emotional instability. Sleep deprived individuals have a tough time balancing their mood and positive outlook on life. These people are more negative, easily irritated, less friendly, less emphatic, and generally have a low tolerance for frustration. They are easily overwhelmed, and these feelings can even lead to being angry and hostile towards others. All of this could lead to feelings of isolation and depression.
  • Disrupted appetite. People who sleep less tend to eat more and sleep deprivation also affects their metabolism and the way they react to food. Lack of sleep disrupts the production of ghrelin and leptin, two hormones that are in charge of feeling hungry, full and satisfied after a meal. Missing rest will make you more hungry, and when you mix that with impairment judgment, you are much more likely to go for that junk food full of sugar, instead of a healthy meal.
  • Weakened immune system. Lack of sleep affects us physically as well, so it might make it harder for our body to fight off colds and infections, and makes us more likely to get sick.

Long-term sleep deprivation may lead to faster skin aging, higher obesity risk, stroke, heart disease, type 2 diabetes, cancer, decreased bone density, and shorter life expectancy. Lack of sleep in combination with complicated grief leads to even more severe symptoms of both of these conditions.


How to Sleep Better While Grieving

Grief is a natural process that you sort of need to get through to get to the other side. However, that doesn’t mean that you should experience it passively. Embrace your emotions, try to understand them, and it will help you heal faster. Getting control of some parts of your life such as your sleep can lead to more feeling of power and less hopelessness. Good sleep helps you recover faster, and it also makes complicated grief less likely to happen. That is particularly true in seniors who have LLSB (late life spouse bereavement). Spending a good chunk of your life with a person, and then losing them is extremely hard. Maintaining good sleep can however help with the symptoms a little bit, and also decrease chances of morbidity in seniors.

Here are some tips that should help you improve your sleep quality:

  • Consider cognitive-behavioral therapy (CBT). If your grieving symptoms and lack of sleep persist for more than three months, maybe it is the time to seek professional help. CBT is an effective treatment for anxiety, depression, insomnia, and many more disorders. During the therapy, a patient works with their therapist to recognize the negative emotions that are making them feel worse, and lead to worse sleep, and increased anxiety. After that, they learn how to deal with those emotions, and how to substitute negative thoughts and behaviors with healthier ones. Facing your feelings, and going through the pain with the therapist’s help is shown to improve sleep in people who decided to try CBT.
  • Follow a regular sleep schedule. This consistency will help you fall asleep faster, and not to wake up during the night, so you’ll get better quality rest. Try to go to sleep and wake up at the same time, even during the weekends when it is more tempting to stay up late, and also spend some more time in bed in the morning. Make sure to manage your daily naps, so don’t take them at least 8 hours before bedtime. Keep naps brief, and set the alarm to wake up after 30 minutes tops. Napping for longer than that might lead to entering the deep stage of sleep, feeling of grogginess after waking up, and also a hard time falling asleep in the evening.
  • Make your bedroom comfortable. Your bedroom might be full of things that remind you of a passed loved one, and that can trigger your grief and make it harder to sleep. Consider removing those items from the bedroom, at least temporarily, until you can cope better with your loss. You can take time to redecorate as that will make your mind of mourning for a little bit. Paint the walls in a beautiful, relaxing color, consider getting blackout curtains if a street light is too bright, and consider investing in a smart bulb. Keep your bedroom dark, at an optimal temperature, and also quiet. To block any outside noise, you might get a white noise machine, or maybe a set of earplugs. Ban all the screens from your bedroom, as they emit blue light that can disrupt your sleep. Perhaps it’s even time to look for a new, more comfortable mattress, pillow, or bedding.
  • Develop a soothing bedtime routine. There are some things you can do to help you fall asleep faster. Reading a book, doing light yoga exercises, meditation, breathing exercises, taking a hot bath, drinking a non-caffeinated herbal tea or a glass of warm milk can all help, you need to figure out what works best for you. Tending to a hobby can also be very helpful to direct your thoughts away from grief, and to help you relax before bed.
  • Eat well and exercise. These can be extremely hard to do while grieving due to lack of motivation and energy but do your best. Eating healthy and exercising also helps with your sleep. Avoid drinking caffeinated drinks after 4 pm as they make it harder to fall asleep. A lot of people even try to soothe their pain with drugs and alcohol, but this is not a way to go. They make things worse, and harder to deal with in the long run.
  • Spend time with your friends and family. It is so important to spend time with people who love and care about you during this period. Don’t isolate yourself, and enjoy some activities together.

If your sleep problems persist, and these tips don’t seem to work for you, you should see a sleep specialist. In combination with CBT, they might discover if any underlying disorder might be preventing you from getting a good night’s sleep. A sleep specialist will assess your situation and recommend melatonin supplements or some other kind of treatment.


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