Why Sleep Hypnotherapy Needs More Than Relaxation

You take on a client with chronic sleep issues and, after working with stress reduction, teaching them about sleep hygiene and offering positive sleep suggestions, there's no improvement.

I believe it's because we often approach sleep in too simplistic a way, and I want to talk you out of automatically linking sleep with relaxation.

After years of working with clients with sleep issues, and experiencing a sleep disorder myself, I've learned that one of the worst things we can do is approach all sleep disorders in the same way.

If we want to work effectively with sleep issues, we need to understand what we're actually dealing with.

Effective sleep hypnotherapy starts with understanding the type of sleep difficulty a client is experiencing. Insomnia, nightmares and circadian rhythm disorders involve different processes, so relaxation, sleep hygiene and positive suggestions aren't necessarily appropriate or sufficient for every client.

Why a One-Size-Fits-All Approach to Sleep Hypnotherapy Doesn't Work

You've experienced it, right? A client comes to you about their sleep issues, or perhaps they've come about something else entirely but sleep emerges as a major issue, and you do your best with them.

There's maybe an improvement for a short while, but pretty soon the old problems resurface.

And when I'm working with therapists, I always ask them the same thing: what kind of sleep problem does your client have?

And the answer is often, "I don't know."

I'll give you an example from a group discussion a while ago. The discussion had moved onto the subject of sleep, and the participants generally agreed that their results with sleep weren't that great. When I asked them what kind of sleep issues their clients were presenting with, I drew a blank.

Now here's one thing I've learned. To work effectively with clients with sleep issues, we need to understand why they're struggling to fall asleep or stay asleep. If we don't have that basic information, it's very difficult to help them.

Adopting the same approach for someone with insomnia as you would for someone with nightmares and sleep terrors just isn't going to work.

And when I explain this to students, there's sometimes a pushback. Surely helping people reduce their stress levels and learn to relax, along with some positive suggestions about knowing how to stay asleep during the night, is enough?

But someone who experiences nightmares might not have particularly high stress levels. They might feel very relaxed falling asleep. And teaching them sleep hygiene and helping bring their stress levels down might do next to nothing to help with the nightmares.

I'm not saying I've always known this. At the start, I adopted a one-size-fits-all approach. And even when it came to my own sleep issues, I simply assumed I had insomnia and only achieved limited success through self-hypnosis and relaxation.

Why Sleep Hypnotherapy Sometimes Doesn't Work

Here's the knock-on effect of adopting a one-size-fits-all approach. Sometimes it can be worse than doing nothing for your client.

It leads to more frustration. It reinforces a sense that there's something wrong with me, because I can't do this one thing that other people can — sleep.

And once you become frustrated around sleep, any issues you might have had to start with can get worse as they become tangled up with stress and self-judgement.

And if you keep using the same approaches over and over with clients, you're going to get the same results. Which can knock your confidence as a therapist, too.

Ask yourself this. If someone with a circadian rhythm sleep disorder left your practice, would they have had the same treatment as someone with insomnia?

Because if they had, it's unlikely that the treatment would have been equally appropriate for both.

I'm not saying that hypnotherapy can't help people with sleep issues. Apart from the results I get with clients, there's a growing body of research suggesting that hypnosis can improve sleep quality and help with some sleep difficulties.

Two major systematic reviews found positive sleep outcomes in approximately 50–60% of studies investigating hypnosis, although the quality of the research varied (Chamine et al., 2018; Wofford et al., 2023).

What I am saying is that we need to start by recognising that sleep issues are complex, and that different problems require different approaches.

Understanding Sleep Disorders Changed My Own Experience

It wasn't until I started researching sleep issues as a result of clients contacting me that I realised I had a circadian rhythm difference.

The signs were all there.

For me, 6 am has always been a long lie. Even as a teenager, when I was out clubbing all night, I'd be up at six, cleaning my friends' flats while they were sound asleep.

My preferred bedtime is about 9 pm, I get up around half three or four most mornings, and I have a nap in the afternoon.

When I learned about circadian rhythm differences, I began to understand and accept my sleep pattern as normal for me, rather than something I needed to fix. I started working with it instead of fighting against it.

The research made all the difference.

And that's why I encourage therapists to spend time learning about sleep, rather than assuming that all sleep problems are variations of insomnia.

Assessing Sleep Problems Before Hypnotherapy

If different sleep issues need different approaches, then we need to know what we're working with. And that affects how we approach our client intake.

Many people don't have an official diagnosis. I've certainly never been to a GP about my own sleep, even though it's caused very severe problems when I've been stuck in nine-to-five jobs.

And your job as a hypnotherapist is not to diagnose sleep disorders. But you can gather important information, recognise when medical assessment is needed, and use what you learn to inform your approach.

In addition to your usual intake form, find out what's actually happening with your client's sleep.

Do they struggle to fall asleep? Are they waking up during the night? Have their sleep problems started during menopause or after experiencing a health condition? Have they always woken at 4 am, or has this only happened since they've felt more stressed?

And are there signs of a condition, such as sleep apnoea, that needs medical investigation rather than simply a different hypnotherapy technique?

Finding out as much as you can about your client's sleep issue before you design a treatment plan will help you personalise your approach and work with the individual in front of you.

A More Individualised Approach to Sleep Hypnotherapy

When I'm working with a client with sleep issues, I'm asking myself: what's really happening for this client?

Not simply, how can I treat sleep disorders?

And that's at the root of adopting a holistic, evidence-informed approach to sleep.

One that has the capacity to bring in various hypnotherapeutic tools and approaches, rather than relying on the same relaxation script and positive suggestions for everyone.

One that allows a client with circadian rhythm differences to develop greater understanding and acceptance of their natural sleep pattern.

One that helps someone experiencing PTSD-related nightmares work towards feeling safer and experiencing fewer disturbing dreams.

And one that means clients feel heard, understood and leave your session feeling hopeful rather than frustrated.

Of course, this also means recognising the limits of hypnotherapy and understanding when other treatments, such as CBT for insomnia or specialist sleep services, may be more appropriate.

Before You Work With Your Next Sleep Client

If you're reading this and thinking about the times when you've gone in with a bit of sleep hygiene information, some positive suggestions and an attempt to help your client relax more, hoping that it'll solve their sleep issues, that's what I did at the start.

And sometimes it worked. Other times it didn't.

Most of us don't realise just how complex sleep is until we start exploring it in more depth.

So the next time you work with a sleep client, take some time to do some research.

What is their sleep issue? What does the hypnosis research tell us? What other treatments might be relevant? And how can you work effectively with this individual in front of you?

Because effective sleep hypnotherapy isn't simply about helping people relax. It's about understanding sleep, recognising the different reasons people struggle with it, and knowing how to adapt your approach accordingly.

Frequently Asked Questions About Sleep Hypnotherapy

Can hypnotherapy help with different sleep disorders?

Research suggests hypnosis can improve some sleep difficulties, including insomnia symptoms and poor sleep quality. However, different sleep disorders have different underlying mechanisms, and the evidence for hypnosis varies between conditions. Understanding the client's particular sleep problem is essential before deciding whether hypnotherapy is appropriate.

Why doesn't relaxation always improve sleep?

Not all sleep problems are caused by stress or an inability to relax. Circadian rhythm differences, nightmares, sleep-related breathing disorders and other conditions can disrupt sleep for different reasons. Relaxation may be helpful for some clients, but it doesn't necessarily address the underlying problem.

What should hypnotherapists ask clients about their sleep?

Start by finding out what actually happens when the client tries to sleep. Ask about difficulties falling asleep, waking during the night, early waking, nightmares, daytime sleepiness and changes in sleep patterns. Explore when the difficulties began, whether they relate to health conditions or medication, and whether medical assessment may be needed.

HypnoSomnia: Sleep Hypnotherapy Training

If you'd like to explore this further, you can find out more about HypnoSomnia, my evidence-informed sleep hypnotherapy training programme.

HypnoSomnia explores the neuroscience of sleep, different sleep disorders and how to develop individualised hypnotherapy approaches for clients experiencing sleep difficulties.

References

Chamine, I., Atchley, R., & Oken, B. S. (2018). Hypnosis intervention effects on sleep outcomes: A systematic review. Journal of Clinical Sleep Medicine, 14(2), 271–283. https://doi.org/10.5664/jcsm.6952

Wofford, N., Snyder, M., Corlett, C. E., & Elkins, G. R. (2023). Systematic review of hypnotherapy for sleep and sleep disturbance. International Journal of Clinical and Experimental Hypnosis, 71(3), 176–215. https://doi.org/10.1080/00207144.2023.2226177