Imagine a Dr said to you, ‘Right then Mr. Jones, you are engaging in something that is shortening your life and increasing your risk of every medical condition. Not only that, you are doing a range of things that are making it worse everyday’. What would you say to the Dr? Would you be a little concerned? What if the Dr then said that with a few changes and a few nuggets of information you’d be able to make some positive changes, not only that, you’ll improve your memory, longevity, lower chances of every serious illness, boost recovery from exercise and decreased chances of depression etc…Surely you’d be begging to know what he was on about? ‘What do I need to do Dr!’
It’s sleep, you need to sleep. Depending on what your source is, anything from 20-70% of us are sleep deprived. Furthermore, a sizable chunk of these people are seriously sleep deprived.
If you read my other blogs, you likely know I speak to and assess a lot of people about their mental health. Now this is very anecdotal and just my personal experience, but if there is one thing that is abundantly clear and almost a given with the majority of people I speak with, it’s this; we aren’t getting enough sleep. Not only that, there are countless little traps that we all fall into. These traps are things that we are doing that are likely making things worse. Within our Stand Tall wellbeing workshop on sleep, I tell participants that if you want to improve your mind and body and getting good sleep isn’t in the equation, it’s like trying to train for a triathlon without a bike. In my day job I often have conversations where I say something like;
‘You are going through a lot of stress in your life and are clearly struggling with anxiety/depression/stress. There is one thing that you could try and improve that is really important and might make a difference. That is sleep, and you are not getting enough and are doing X, Y and Z which is maintaining poor sleep’.
My conversations are all an attempt to get people to take sleep as seriously as anything else that ensures their safety. Maybe we still live in a society that admires sleep deprivation. Do we look up to those individuals who are the last person up and first out the door? Ignore them. In a world full of billions of people, some of those individuals are going to be the uber productive, zero sleep workaholics. You or I probably aren’t that. Are you getting 7.5+ hours of sleep a night? If you are not, I really believe that you should start trying. Looking after sleeping should be as important as wearing a seatbelt. Talking about seatbelts, the microsleeps that people often slip into when sleep deprived are a big cause of road traffic accidents. At least if your reflexes are slowed with booze and you’ll at least still attempt to break, albeit a bit late, but if you’re asleep you are driving full force into something or someone.
Every metric of your life will be improved with a good night’s sleep and a consistent sleep routine.
If your sleep has been pretty bad for 3+ months and there is no obvious reason for it that you can think of, it’s definitely worth speaking with a professional. In the more severe cases, referrals to specialists might be an option. Sometimes it also helps to find ways to deal with indirect issues, such as anxiety/depression/stress. Also, there are lots of different sleep issues, different diagnostic criteria most of which are way over my head, so definitely worth speaking to someone if poor sleep is impacting your life.
So, some tips right? Other than going camping in the wilderness for a few weeks, there are lots of little ways to bring your sleep rhythm into sync with your life. A lot of this boils down to motivation, finding a routine, and sticking with it. Even trying to stick to it most of the time, even on weekends. So, what things should you know and do about sleep?
‘Why can’t I just get off to sleep!?’ This is usually followed by ‘I wake up and don’t feel refreshed’. A common cause of this is that your 24 hour sleep rhythm, aka the circadian rhythm, is off. Circadian rhythm is a set of chemical processes that means that in a 24 hour period there is a sweet spot, your sleep window. A time where your body wants to sleep. This window should be somewhere between the setting and rising of the sun, ish. All life on this planet revolves around the rising and setting of the sun. We are no different to our ancient ancestors or the animals we inhabit this planet with. Our circadian rhythm does not reset every 24 hours and changes pretty slowly. Sometimes it’s pushed either way. Think about reasons this might be happening? Are you feeling depressed, are you scrolling through your phone into the early hours, are you smashing caffeine all day to function? Are you awake in bed feeling stressed, worrying, tossing and turning, overthinking, stewing in the past? When I’m stressed I’ve personally got a habit of playing games a bit too long, clinging onto that little hit of dopamine and escapism. Even things that we find helpful, like exercise, can harm sleep. If you’re exerting yourself in the gym before bed, you’re alerting your body, it might be a bit harder to sleep. All these little behaviours and worries mean that your sleep rhythm is just getting pushed around a little. So come bedtime, it might mean your balance of chemicals and sleep hormones just mean you simply aren’t ready to sleep. Then you get up in the morning for work and now you’ve woken prematurely. You return home that night and engage in the very behaviours that pushed your rhythm out in the first place and months down the line your sleep is poor and it’s knocking on the door of insomnia. Adding to that, come the weekend what do you do? Stay up later and wake up late, further adding to the problem. You are then in a routine that is at odds with what your body needs. Say hello to the realm of sleep difficulties.
Routine, routine. Keep a routine that for the time being fits reasonably around 15 minutes before you usually fall asleep (not try to sleep) and roughly when you wake up. Typically, about 8 hours later. Keep that routine, adjust if necessary, narrow the time if you find you’re spending a lot of it awake. In this window of sleep try and get as close to 100% of it asleep. Then when you’re sleeping regularly and you need to adjust the routine, slowly adjust the margins of your sleep window, 10-15 mins here and there and aim for around 8 hours. There is not a great amount of evidence that sleep hygiene works in itself, but no harm in doing things to make sure our environment is good for sleep such as a dark and cool room. Anything, that is going to tell your body; ‘it’s time to sleep’.
Bed is for sleep and sex. That is all. Not for social media and not for worry. Ditch the past and future at the door. Write a little to do list and/or your worries down and say to yourself you’ll check the list the next day. When you think of sleep and bed, it should be a nice warming thought of comfort and rest, not dread and distress.
Waking up absolutely smashed? Trying to work out why the hell your alarm is going off? A possible reason for this is you’re waking up mid sleep cycle. A sleep cycle is the various stages of sleep through light sleep, non rem, deep sleep and rem sleep then back into light sleep. This cycle is around 90 mins. Often when people wake up through the night it is usually at the end of a sleep cycle and if you’re particularly stressed or anxious about something, your body will wake you up given the chance, and usually this is when you return to light sleep toward the end of a sleep cycle. So, try setting your alarm a little later or a little earlier. Or go to bed a tad later or earlier and see what happens. I usually wake up at 6ish naturally and will often go to the gym. However, when I don’t go to gym, I force myself back to sleep until my 7 o’clock alarm wakes me up and I feel an absolute shambles. Sound familiar? It’s because it’s mid sleep cycle and your body really doesn’t want to wake up. Tinker and adjust times.
The 15 minute rule. Try this. Been lying there awake for 15 minutes? Notice some worries? Getting a little restless? Get out of bed and sit on a chair or on bed. Engage in a gentle task that will just gently hold your focus without being too stimulating or distracting. Something like an audiobook or a podcast is perfect. If your body wants to sleep, as soon as you divert your thoughts that are causing a little spike in stress, your stress will reduce, and you’ll start drifting off. Then return to bed. Repeat again if needed. I owe this tip to Colin Espie, book link below. I do this, it works well for me.
Good carbs at dinner. Might sound counterintuitive and might not be applicable to everyone, however eating good slow releasing carbs before bed aids your sleep cycles and process. No sweets/chocolate/sugar. Something wholesome and a fibrous whole food. A banana is a very good shout as it also contains lots of other good stuff for sleep. I once tried keto and couldn’t work out why I couldn’t sleep. Your brain requires quick, easy energy through the night in order to power the range of amazing active processes it does while you sleep. If you’re watching the carbs or eating low carbs, make sure to eat some of your allocation of carbs at dinner.
Caffeine use? Coffee is very good for us, better when it’s fresh and without sugar/syrup. Just cut it right back to before midday if you can. Caffeine plays havoc with suppressing your hunger to sleep and will make it harder to sleep and more likely to feel anxious and restless. Energy drinks of some description = definite no no. Caffeine doesn’t necessarily impact our circadian rhythm directly, but instead impacts another cycle called the adenosine cycle, it stops us feeling tired when we should really feel tired and makes getting off at your usual time harder. When the adenosine cycle is messed up, it all gets a bit messy. For example, your circadian rhythm is saying sleep, but the suppression of adenosine is saying no. Again, welcome to the realm of sleep difficulties.
What I have personally found improves my sleep the most is 2 things; early morning exercise and early morning sunlight on the skin and in the eyes (don’t look at the sun though). Sunlight and early exercise can help anchor our circadian rhythm. I’m not going to pretend I know how exactly, but it works a treat. All I will say about this is just check out the Huberman Lab podcast on sleep.
I don’t pretend to be a sleep therapist, but have learnt a little through my professional practice. I owe most of my knowledge to reading and listening to Colin Epsie and Matt Walker. I really recommend Matt Walker’s podcast and book; ‘Why We Sleep’. Although I wouldn’t recommend the book as a therapeutic tool because if you are struggling with sleep, it’ll scare you to death and you’ll be in bed worrying about not sleeping! If you are looking for a self-help book and sleep has been an issue for a little while, the book that I keep on my desk in the office is by Colin Espie, a professor of sleep medicine whose book is called ‘Overcoming Insomnia’. It’s based on CBT techniques for treating insomnia that are pretty well tried and tested. I’ve also looked a bit into other options and other courses, sadly a lot of which come with a hefty price tag so DYOR. If in doubt and been longer than 3 months, see your GP.
About the author
Paul Regan
I have been working as a mental health nurse since 2016 and have been around the block working in a lot of different areas. At present I work in a service where I assess people and provide interventions. I love my job, I love learning and talking to people about mental health and wellbeing. This article represents my personal opinion and is certainly not medical advice. If you have concerns about your mental health please speak with a GP or health professional.
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