ACT For Insomnia: a Roadmap For Recovery
Acceptance & Commitment Therapy for Insomnia (ACT-I), offers a ray of hope for:
insomniacs who haven’t had success with CBT-I
neurodivergent folks who need a more flexible approach
those who resonate with a mindful, less-is-more philosophy, or
those who just might snap if one more person gives them sleep hygiene advice.
Most mainstream insomnia recovery advice leans heavily into the narrative that sleep is a problem you need to fix. This sounds intuitive. In the depths of my insomnia, it sure felt that way. I just wanted relief. For those who have experienced it, you know what I mean. When you lose your ability to sleep decently, and it becomes chronic, you feel unmoored, helpless, and out of control. It’s only human to want to fix it.
The problem? Sleep is a passive process we don’t actually have control over. Have you ever noticed in life, that when you cling onto something you don’t have control over too tightly, it often doesn’t work out? When the fear is driving the behaviour, there’s a need to control the outcome. This is what perpetuates insomnia. It also explains why you can be exhausted yet unable to sleep.
Why You’re Exhausted but Can’t Sleep
Our survival brain is a magnificent protector, but it doesn't know the difference between the threat of a tiger in the wild and the 'threat' of being awake at 3:00 AM.
I can’t tell you the number of times my clients have shared the maddeningly confusing experience of feeling like they’re about to drift off, only to feel instantly wired as soon as their head hits the pillow.
It all makes sense though, when you understand how hyperarousal works. This is when your body goes into fight or flight mode. It’s very useful if you need to run for your life to evade danger. It’s not so useful when it’s time to sleep.
This happens when our fear gets conditioned. Before insomnia, you probably didn’t think a whole lot about your sleep. Maybe it was even something you took for granted. Then insomnia hits, and you’re stuck in 3 am greatest hits of worst case scenario anxiety loops. The insomnia continues, and now your brain and body remember all the nights you struggled.
That survival system that works so hard to protect you from immediate threats to safety starts to see being awake at night as a threat. It’s something that feels like it needs to be solved immediately. Your brain sounds the alarm, and brings you into hyperarousal, thinking that will help you fix the problem and evade danger.
That parasympathetic rest and digest nervous system state your body gets into for sleep becomes more and more elusive, as a result. And, the trigger isn’t escapable - you might experience it everyday, as the night approaches, once you get into your bedroom, or when you’re about to turn off the lights. But, insomnia isn’t a predator. It needs a different approach - this is where ACT comes in.
What Is ACT For Insomnia?
Sleep can't be forced. But, ACT-I teaches you how to drop the struggle of insomnia.
ACT-I tackles the root fears of insomnia - it’s not about fixing the sleep issues with controlling behaviours, or correcting distressing thoughts. It’s about learning to have a completely different relationship with sleep.
When people hear the word acceptance, they often think it means you have to enjoy it. This is not true. A more accurate way of conveying acceptance is an opening around, or making space for, distressing thoughts and feelings. It’s not about shutting down the discomfort. It’s about acknowledging it, allowing it, and learning not to get hooked by it. With insomnia, it’s about learning how to sit with the anxiety of not sleeping, instead of fearing the anxiety itself. When you learn to make space for the distress without getting sucked into it, it loses its intensity.
Commitment refers to living in alignment with our values, even if we are feeling scared, frustrated, or overwhelmed. The reality is, we don’t control our thoughts or emotions. But, we can choose how to respond to them. By making space around them, there’s room to:
engage with life in a way that matters to you
treat yourself with compassion
support your nervous system, even when sleep feels elusive.
It’s so common for folks with insomnia to stop doing some of the things they used to enjoy or to be hard on themselves, and in turn, get further stuck in fight or flight.
The Paradox of Effort: Why 'Trying' is the Problem
This is the most counter-intuitive part of insomnia. In almost every other area of life, effort leads results. If you want a promotion, you work harder. If you want to learn an instrument, you practice more. But sleep is one of the great exceptions. It is a biological process that thrives on passivity, not effort.
In ACT, we use the metaphor of the struggle switch. With insomnia, it’s like the switch flips to ON unintentionally and perhaps even unconsciously. When you try to sleep, you end up monitoring your breathing, checking the time, or forcing yourself to be calm. This then sends you further into hyperarousal, which is what keeps the cycle of insomnia going. So, the very act of trying to sleep becomes the thing that keeps you awake.
In ACT-I, we learn to drop the struggle. We shift our goal from trying to sleep to being able soothe ourselves while being awake. By giving up the fight, you finally create the quiet, low-pressure environment that sleep requires to show up on its own terms.
ACT-I provides the skills to be more mindful and grounded, even in the middle of the insomnia storm.
How Effective is ACT-I?
It is common to feel skeptical about any resolution for insomnia if you feel like you’ve tried it all. I know for myself, after trying various types of therapy, supplements galore, sleep hygiene, and all kinds of lifestyle changes, it felt like a lost cause. Had I not stumbled upon ACT-I though, It’s possible I’d still be caught up in my insomnia. While I can speak for myself, and the success I’ve seen in clients, that is where my experience ends. Luckily, there’s a body of research that backs ACT-I’s efficacy.
1. It is a Validated Alternative to CBT-I
For years, CBT-I was considered the only evidence-based non-drug treatment for insomnia. In 2020 though, researchers gathered 9 high quality studies, then reviewed and analyzed them (in research terms this is called a systematic review and meta-analysis).
Their review confirmed that ACT-I is comparable to CBT-I in effectiveness. ACT-I led to significant improvements in insomnia severity, sleep quality and daytime functioning. The review also concluded that it may be better suited to folks who struggle with rigid rules than CBT-I.
2. It Addresses the Insomnia Paradox
One of the biggest hurdles in insomnia is "sleep effort"— the things you do or avoid to try to get yourself asleep. It’s when the fix it part in you takes over. Research led by Jason Ong (2012) found that mindfulness and acceptance-based approaches specifically reduce the hyperarousal that drives insomnia. By learning to observe distress rather than battling it, participants in these studies saw a significant decrease in the time it took to fall asleep (sleep onset latency).
3. Long-Term Resilience Over Short-Term Fixes
Long-term follow-up studies, such as those discussed in Sleep Medicine Reviews, show that the benefits of ACT-I are durable. Because you are retraining your brain’s relationship with discomfort, the "relapse" rate is lower. You aren't just learning a trick to fall asleep tonight; you are building a resilient nervous system for the future.
4. Better Days, Regardless of the Night
A unique finding in ACT-I research is the improvement in daytime functioning. Traditional treatments focus almost entirely on the hours spent in bed. However, ACT-I studies consistently show that because patients stop letting their "sleep score" dictate their worth, they report higher energy and better moods during the day—even if their sleep isn't "perfect" yet.
How Does ACT for Insomnia Work?
You don’t need to like being awake at night, but by learning to be OK with it, you teach your body that nighttime wakefulness isn’t a threat. This, in turn, starts to break the insomnia cycle.
Welcoming Wakefulness
This is at the cornerstone of ACT for Insomnia. If you try to frantically fix, it’s like trying to scramble out of quicksand - you get pulled deeper into it. Welcoming Wakefulness is learning how to be OK when you aren’t sleeping. Like the quicksand, if you lay your body out rather than fight it, you become buoyant again. I do a deep dive into this concept here.
This may sound like an infuriating proposition for an insomnia. In the depths of my insomnia, had someone suggested that to me, I’d be fuming. Hear me out. It’s a way to face your fears of being awake at night, so that it no longer feels like a threat. Once being awake at night feels more neutral, there’s less pressure, less a sense of urgency to get sleep, and in turn, it becomes easier to drop the obsessive search for a solution. This doesn’t mean that you have to enjoy being awake at night, or try to force yourself to be awake. It is about practicing ways to support yourself at night to make the experience a bit more relaxing or comfortable, regardless of how much sleep you get.
A lot of insomniacs think they need to get their sleep back on track, and then all is well. I find, that if the core of the issue isn’t worked on, it’s easy for the insomnia to come back, because the fear is still running the show. Therein lies the beauty of befriending wakefulness. While I wouldn’t wish a sleepless night on anyone, it can be viewed as an opportunity to expose yourself to the fears, while relating to them differently.
When I’m working with clients, that might look like creating a menu of options to experiment with at night that can support you while awake. This might be watching tv, reading, listening to a podcast or audiobook, laying in bed with your eyes closed, having a snack, or journaling. Finding simple ways to make wakefulness more palatable takes the focus away from fixing, towards allowing, and well on your way to sleep.
No amount of effort can guarantee a good sleep, but learning to let go of those efforts that aren't serving you is a big step towards insomnia recovery.
Less Effort, More Sleep
Just as you learn to become more comfortable with being awake at night, you also learn to let go of the behaviours that are feeding into the fear of not sleeping. I recall the obsessive things I would do to help my chances of shuteye. This could look like - trying to tire myself out with a lot of exercise even when my body needed rest, cutting out certain foods from my diet, having a strict routine I had to do every night, trying a store’s worth of supplements, and sticking to rigid sleep hygiene rules.
When I look back on it, of course that didn’t resolve my chronic insomnia. They were compulsive behaviours I was doing to escape from the anxiety of not sleeping. It also didn’t feel in alignment with who I was striving to be. My days became more and more governed by my insomnia, and my world kept getting smaller as a result.
Sleep hygiene also only added insult to injury for my neurodivergent brain. After 20 minutes of being in bed at night, if I don’t sleep, I’m supposed to get out of bed? Then do that process all over again? How am I supposed to know when 20 minutes have passed if I am not supposed to be looking at the time? Why does it feel like I’m playing musical chairs by myself? I also need to get my exhausted self out of bed first thing to get some daylight on my face? As you might guess, these rules only made me more obsessive. I felt like I was doing everything I was told I was supposed to do, but failing with flying colors. My sleep diary sure said so.
Now, there’s nothing wrong with supporting your nervous system, and please don’t suddenly stop or change medication (Talk to your doctor). It’s about learning which efforts are adding to the problem, and can be let go, so that you can make more space for actually recovering. I wrote a full blog post on sleep efforts, and what to do instead here.
It’s easy to stop doing the things you used to enjoy when you’re exhausted. But, by re-engaging with those things—even in small ways—insomnia starts to lose its power.
Living Your Values
For a lot of insomniacs, sleep becomes the most important thing in the world. There is this sense that once you get your sleep back, everything will be fixed - you can live your life then. But, that just gives insomnia more power. You don’t have to put your whole life on hold. It’s important to reflect on hobbies, socializing, sports, creative projects, or anything else you’ve given up or minimized, as a result of insomnia.
This doesn’t mean you need to fill your schedule up to the brim, or force yourself out when your body is screaming for rest. But, by taking inventory, you find ways to re-introduce some of what matters most to you back into your life, while allowing rest when needed. Learning this balance of knowing when to treat yourself gently and when to push yourself a bit out of your comfort zone is an important part of the process.
It is sometimes surprising how the day after a sleepless night can be meaningful, productive or even enjoyable. This won’t happen all the time. I’m all too familiar with the half alive trance state that follows a sleepless night. But, when you commit to engaging in life in meaningful ways irrespective of your insomnia, the pressure to sleep drops. You’re teaching yourself through committed action, that you sleep, while important, doesn't have to shrink your world to a pea size suffer chamber.
It also allows you to focus on what you do have control over. As I mentioned earlier, we don’t have control over our sleep. But, it’s a lot easier to accept that when we’re committing to action that matters to us.
When you get hooked by your thoughts, sleep anxiety takes over. ACT-I teaches you how to have a more mindful relationship with your anxious thoughts, so when they do show up, they don’t have the same power over you.
Address Sleep Anxiety
While behaviour changes are powerful, comprehensive insomnia recovery also involves learning how to deal with distressing thoughts and emotions. When they hook you in, it’s easy to spiral for hours, or even days. It feels like a full body and brain take-over that you never signed up for. Unhooking is an ACT term for a skill-set that supports you to experience the thoughts and feelings from a more grounded place. This lessens the intensity of them, and allows you to notice them mindfully. The thoughts and feelings can be there, without you getting sucked into them.
There are different strategies for unhooking in ACT. The first step towards unhooking is to learn to name and notice thoughts and feelings as they come up. It’s so intuitive for us to identify with our thoughts and emotions that they can even take over without us realizing in the moment. One of my favorite ACT tools for this can be surprisingly powerful on its own.
Every time one of those familiar worries or frustrations comes up, you reframe it as ‘I’m having the thought that…’ instead of I'm so anxious about not sleeping tonight. The subtle language shift is a helpful reminder to then be able to enter into a mindful dynamic with the thought or feeling.
ACT contains a repertoire of unhooking strategies. Some are more meditative, some are more visual, and some are more playful. The versatility allows someone to explore and experiment, so they can find what resonates best with them.
When I’m coaching my insomnia clients, I’ll often start with basic naming, noticing and grounding, to then make space to explore further strategies.
It’s empowering to learn to relate to insomnia anxiety in a diametrically different way. And, if the anxiety also shows up in other areas of your life, these skills will work there too. It also means that you can feel less anxious about the anxiety. The anxiety will come up, it’s a normal part of this recovery process, and yet, you now have tools to not let it carry you away into a spiral of dread.
Insomnia is hard enough without the added weight of self-judgment. Learning how to hold yourself through the ups and downs with grace is an important part of the recovery process.
Self-Compassion
Insomniacs can be pretty hard on themselves. After all, if everyone around them seems unbothered about their sleep, it’s easy to fall into the ‘what is wrong with me’ story, or the ‘I’m a failure’ story. Then, there are all the efforts made to fix your sleep that have failed, further adding fuel to these unhelpful narratives.
There’s a gentleness inherent in the flexibility and mindful philosophy of ACT that beautifully supports a compassionate relationship with self. While CBT-I works well for many people, for me, there is a harshness to the process that only made me feel like a greater failure. If you are not interested in sleep restriction, sleep diaries, and strict sleep hygiene, ACT-I offers a gentler path.
In ACT, self-compassion isn’t just about being kind to yourself. It’s also about acknowledging your pain. If we can’t acknowledge our pain, we can’t contain our whole experience with compassion. This is not about positive thinking or emotional bypassing, or else it would be leaving out an important part of the human experience.
If you think of someone in your life you love with your whole heart, you don’t just accept them at their best, you have compassion for them at their worst. This means learning to extend some of that love to oneself. It doesn’t mean you need to have skyrocketing self-confidence. The toolkit in ACT is structured to support a compassionate relationship with the self at each step of the way, even if it is particularly challenging when your brain is operating on minimal sleep. I would argue that dealing with insomnia is the most important time in your life to learn how to be more self-compassionate.
Recovering from insomnia doesn’t mean you’ll never have a bad night again. It means that when you do, it won’t suck you back into the cycle. Once this happens, sleep often stabilizes all on its own.
Moving Beyond Insomnia
If you’ve been caught up in the insomnia struggle, like I was (for nearly a decade), the idea of befriending wakefulness or learning to be with your anxiety might sound terrifying. This is completely OK. ACT-I isn’t about suddenly feeling an all-encompassing zen-like gratitude. It’s about having a roadmap at the pace of your nervous system so you can gradually shed the layers of fear around sleep.
Through the process, you learn to have a different relationship not only with insomnia and anxiety, but also with yourself.
The path to recovery often isn’t linear. There may be a difficult night or two just when you feel like you’re making progress. That’s expected. The beauty of the ACT-I approach is that better sleep isn’t the only measure of progress. Sleep often stabilizes when the fear of being awake at night dissolves, as you regain confidence in your body’s ability to rest.
If this approach resonates with you, and you’re interested in the possibility of working together, I offer insomnia coaching internationally. You can find more about that here, or reach out.
More on Insomnia Recovery
References
The Comparison Study (Section 1)
El Rafihi-Ferreira, R., Hasan, R., Toscanini, A. C., Linares, I. M. P., Suzuki Borges, D., Brasil, I. P., Carmo, M., Lotufo Neto, F., & Morin, C. (2024). Acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 92(6), 330–343. https://doi.org/10.1037/ccp0000881
Salari, N., Khazaie, H., Hosseinian-Far, A., Khaledi-Paveh, B., Ghasemi, H., Mohammadi, M., & Shohaimi, S. (2020). The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review. BMC Neurology, 20(1), Article 300. https://doi.org/10.1186/s12883-020-01883-1
Jansson-Fröjmark, M., Alfonsson, S., Bohman, B., Rozental, A., & Norell-Clarke, A. (2022). Paradoxical intention for insomnia: A systematic review and meta-analysis. Journal of Sleep Research, 31(2), e13464. https://doi.org/10.1111/jsr.13464
The Mindfulness Study (Section 2/3)
Ong, J. C., Manber, R., Segal, Z., Xia, Y., Shapiro, S., & Wyatt, J. K. (2014). A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep, 37(9), 1553–1563. https://doi.org/10.5665/sleep.4010