11/02/2020
SLEEP- so important for good mental health!
An irregular sleep pattern can disrupt the body clock and lead to the loss of certain cues such as feeling tired in the evening and alert in the morning.
Daytime Inactivity can make it more difficult to go to sleep. .
Sleeping in the day will lead you to needing less sleep at night.
Drinks and other substances such as caffeine containing drinks (coffee, tea, cola), alcohol, ci******es and certain medications can affect sleep by making it difficult to go to sleep or waking you up in the night.
An uncomfortable sleeping environment such as an uncomfortable mattress, being too hot/cold, a restless partner or excessive noise may keep you awake at night. Studying or other paperwork in your bedroom may make it more difficult for you to “switch off” at night. Long periods of wakefulness in your bed may lead you to associate your room or bed with being awake, therefore making it more difficult for you to go to sleep.
An overly active mind or worries at bed time can lead to tension, restlessness and an inability to relax making it more difficult to fall asleep.
Sleeping too much can make you feel constantly tired, as the sleep is often “light” and non-refreshing.
STRATEGIES TO IMPROVE YOUR SLEEP
Sleep diary
In order to build up an accurate picture of your sleep, it can be helpful to keep a sleep diary for a week or two. Complete the diary on waking. It may be difficult to give exact times of going to sleep or how long you are awake in the night (if applicable) but an estimate will be fine.
Establish a routine
The aim of establishing a routine is to help your body clock to get used to a set routine. Establishing a routine will help to regulate your body (circadian) rhythms so that you begin to “feel” things at certain times each day and establish a regular sleep-wake cycle. We do not recommend that you should go to bed at the same time every evening, as you may not feel sleepy at that time. However, you may find that when you start getting up at the same time each day you get “more” tired at a particular time of the evening and therefore naturally start going to bed at a similar time each day.
The guidelines below will help you to establish a routine. If your sleep pattern is very erratic, you may find it difficult to put them into practice all at once. Short sharp shock treatment works for some people, i.e. implementing all the guidelines at once, whereas a more gradual approach works for others.
In order to establish a routine:
Get up at the same time each day even if you have not had much sleep the previous night. It may be helpful to set your alarm clock.
Do not nap during the day even if you feel very tired.
Do not go to bed early even if you feel very tired, or to make up for lost sleep.
How to associate your bed and bedroom with sleep rather than being awake
If you have had poor sleep for a long time, you may find that when you get into bed, instead of feeling sleepy, you feel wide awake or restless which will make it harder for you to fall asleep. Subconsciously, you may therefore associate your bed/bedroom with being “awake” rather than being “asleep” which may make it harder to fall asleep.
The following guidelines aim to help you to associate your bed and bedroom with sleep rather than being awake.
Avoid using your bedroom during the day if at all possible. If you live in a bed-sit or in one room in a house or student accommodation, try to have a separate work area in your room, so that you just use your bed for sleep.
Do not read, study, watch television, or sort out the day’s problems etc in bed, as these are waking activities.
Go to bed when sleepy rather than at a time you think you should go. For example, if you think that you should go to bed at about 11.00, but do not feel sleepy, wait until you feel sleepy.
Do not be tempted to go to bed very early (e.g., before 9.30pm), even if you feel very sleepy, as you may wake in the middle of the night or early in the morning.
Turn the light off straight away when you get into bed.
If you are not asleep within 20 minutes, go to another room and sit and relax or read until you feel sleepy again.
Repeat the previous step as often as is required, and also if you wake up for periods of more than about 20 minutes in the night.
Try to follow this programme rigidly. It can take several weeks to establish an efficient and regular pattern.
Establish an optimal sleep pattern
An optimal sleep pattern is one that provides you with good quality sleep, few wakeful periods and a short time to fall asleep.
Your sleep pattern is optimal when it is both efficient and regular. By efficient, we mean that the more time you are asleep when in bed, the more efficient your sleep is. To establish your optimal sleep pattern, you will reduce the amount of time you are in bed; in order to increase the amount of time you are asleep. This can be done in conjunction with the guidelines in the above two sections, or alone.
Calculate your total time asleep on an “average” night.
Stay in bed for the time that you are usually asleep only.
For example: If you are usually in bed for 10 hours a night, but are only asleep for 6 hours in total, you should only stay in bed for 6 hours.
You may feel more tired for a while, but the slight sleep deprivation you may experience will in turn produce faster sleep onset, reduced broken sleep and a deeper sleep.
The time in bed can be gradually increased as your sleep efficiency improves (if applicable).
Reduce your sleep at night, if you sleep too much.
Sleeping for longer than you need may contribute to feelings of tiredness in the morning.
Cut down your sleep time gradually- either by going to bed 1/2 hour later, or getting up 1/2 hour earlier.
Be consistent in either getting up earlier, or going to bed later.
Do not compensate by getting up later or going to bed earlier, even if you feel more tired.
Review your sleep-pattern weekly, and continue to reduce your sleep time gradually until you are more “refreshed” on waking.
You may feel more tired for the first few weeks after changing your sleep routine, but in the long run you can expect the quality of your sleep to increase as the quantity of your sleep decreases.
Sleep Hygiene
Sleep hygiene refers to lifestyle and environmental factors that may be beneficial or detrimental to sleep.
The following guidelines may help to promote an improved sleep pattern
Exercise: Avoid exercise within 3 hours of bed-time, as this may waken you up. Exercise in the late afternoon may deepen sleep.
Diet: A light snack before bed-time may be sleep inducing, but a heavy meal too close to bed-time will interfere with sleep. Fluid intake should be limited.
Caffeine is a central nervous system stimulant and is associated with delaying sleep onset and it can cause wakefulness. Substances containing caffeine, e.g. coffee, tea, chocolate and coke should be avoided 4-6 hours before bed-time or during the night if you waken up. Coffee may contain twice as much caffeine as other caffeinated drinks depending on its preparation.
Ni****ne: is also a central nervous system stimulant and although many people say that ci******es help them to relax, the overall effect is one of stimulation rather than relaxation. Smoking ci******es should therefore be avoided near bed-time and during night time wakings.
Alcohol: is a central nervous system depressant, although it may speed up sleep onset, it often causes disrupted sleep later in the night as it is metabolised. A milky drink before bed can help you to feel sleepy.
Environment: Your bed and mattress should be comfortable. Minimise light, noise and excessive temperature during your sleep period. Your room temperature should be around 18[Symbol] C. Use blinds if necessary, ear plugs if you live in a particularly noisy place and are unable to get used to it and use a fan/ heating to control temperature.
Preparing for sleep
Establishing a set routine will help you to prepare both mentally and physically for going to sleep.
Try to wind down in the hour or so before you go to bed.
Include relaxing activities such as watching television, having a warm bath, listening to music in your schedule.
Avoid stimulating activities that may keep you alert; for example work, studying or planning.
Develop a regular order of doing things, e.g. locking up the house, turning out the lights, brushing your teeth etc. This will act as a signal to your body that it is preparing for sleep.
Problem solving strategy for reducing worries at night
Lying in bed at night worrying about problems can make you feel tense and prevent you from going to sleep. The strategy described below may help you to reduce worries at night, therefore helping you to feel more relaxed and allowing you to get to sleep more quickly:
Set aside 20 minutes in the early evening.
Write down problems or loose ends that you have not dealt with during the day
Write down possible steps to resolve the problems, or to tie up the loose ends; allocate time to do the actual work.
Consider other longer term problems which may intrude on your sleep, for example, emotional, financial or other worries.
Write down the first or next positive step of action to take and when you will take it.
If you cannot go to sleep or wake up worrying about a problem, remind yourself that you have the matter in hand, and that worrying about it now will not help.
If new worries occur to you at night, write them down on a notepad or a piece of paper, and ‘deal’ with them the next day.
How to deal with frustration about not being able to sleep
If you become frustrated about not being able to fall asleep, and worry about the possible ‘negative’ consequences the next day, it is likely that you will inhibit sleep further by trying harder to fall asleep.
Do not try too hard to fall asleep.
Tell yourself that `sleep will come when it is `ready'', and that `relaxing in bed is almost as good.'
Try to keep your eyes open in the darkened room and as they (naturally) try to close tell yourself to `resist closing them for another few seconds'. This procedure "tempts" sleep to take over.
Visualise a pleasing scene using senses of sight, sound, smell, touch and taste.
Try repeating a neutral word (such as "the") every few seconds.
A Relaxation Programme may be helpful. This should be carried out in bed at night. It can also be practised at other times of the day.
Relaxation programme
Concentrate on your breathing- Try to breathe deeply and slowly.
Repeat silently the words `in' and `out'- in time to your breathing.
Try breathing in to the count of `three', and out to the count of `four'.
Tense and then relax each of the following parts of your body for a few seconds
a. Arms
b. Neck
c. Shoulders
d. Legs
e. Stomach
Tense each part of your body for a couple of seconds, but relax them for ten seconds.
When you are able to distinguish between tension and relaxation, try relaxing, without tensing first.
Relaxation is a skill which takes time to master. However, it is worth persevering in order to gain benefit.
