Sleep Part 5 – How to improve sleep

By Pete & Anna

 

 

So to recap, we’ve talked about what sleep is and why we do it. We thought about how much sleep we’re supposed to get, sleep difficulties and the things that can get in the way of our sleep. Now we’re going to focus on the things you can do to improve sleep.

We’ve split this section into two – the things you can do to promote your own sleep and the things that you could do to support others to sleep.

 

1) What can I do to promote sleep?

 

Sort out the Environment

In order to promote sleep your bedroom should be a place of calm, your own little sanctuary if you will. If you close your eyes now and think of your bedroom, what comes to mind? If peace and calm do not come to mind, then it needs some adjustments! Your bedroom should be for sleeping! So…

  • Reduce light in your sleeping space and keep the room between 16-18 degrees.
  • As much as you can, reduce noises and smells.
  • Get that blue light emitting tech (telly, tablet, laptop, phone etc) out of the bedroom and stop using it at least 1 hour before going to bed.
  • Get hold of a comfortable mattress and bedcovers.
  • I know it’s sad but if you can bear it… get those pets out too.
  • Remove things that disturb your sleep or find a solution. For example, if you have a partner that snores, get earplugs!... Or put them in the spare room!
  • Declutter! I’m serious, make it tidy, put the clothes away….

 

Wind down into Bedtime

Stop anything stimulating (physically or mentally) well before you go to bed. It can also help to do something calming such as taking a bath, listening to relaxing music or mindful mediation. It can be a good idea to also stop technology an hour before bed, but we appreciate that in this day and age that’s tricky!

 

Get your Routine Down

Try and go to bed and get up at roughly the same time every day. This will mean than, over time, your body will start to associate and ‘learn’ when it is time to sleep / be awake. It might take a few weeks to see any success from this but it can be worth the wait and patience.  Additionally, develop a routine that can signal to your brain that you are getting ready for sleep. For example, take your make up off, wash your face, brush your teeth, get into your PJs and read for a bit. If you do this every night, your body will learn the routine and respond to it. There are some really good sleep apps out there now with various noises and sounds to relax you and promote sleep. Some have relaxation practices with them that can help you unwind. Regular relaxation helps our bodies learn what it means to be relaxed and therefore have better sleep. Some apps Anna likes and uses include ‘Calm’, ‘sleep well’ and ‘relax melodies’. Doing one of these regularly in bed as part of your routine can be beneficial to help you get to sleep. If you wake in the night and cannot go back to sleep (if you’re like me, your brain kicks in immediately and that’s it, I’m wired for the day and its only 3am!) then popping one of these apps on can be great to help you refocus on resting.  Sleep headphones enable you to listen to these without disturbing partners and are soft enough for you to sleep with!

Only go to be when you feel tired enough to sleep. If you normally take ages nodding off to sleep it might also be worth staying up until the time you actually fall asleep normally, then get up at your usual time. In doing this you end up spending proportionately more time asleep when you are in bed which can help to improve your sleep pattern.

 

Time Zone Changes

Often people struggle with sleep and sleep routines because they are traveling – although this is improving with more modern aircraft. Generally the rule is, regardless of how tired you feel, try and stay awake until the ‘local bedtime’ and then get up relatively early the next day. This should help your body to adjust quickly.

 

Resolve or Manage Illness

Being in pain or having a physical health can negatively impact on your sleep. If at all possible, get these resolved or managed in the best way possible thought your GP. It can also be useful to develop skills to manage physical difficulties through psychological techniques (e.g. CBT or mindfulness).

 

Cut out Drugs

Most illicit drugs have a negative impact on our sleep. Avoid and it is likely that you sleep will improve.  

 

Medication

As mentioned in the last blog, it is definitely worth speaking to your GP about how any medication aimed to help you sleep (or other difficulties) might affect you. Generally though, if you are going to take meds to help you sleep, take them as prescribed and update your doctor as and when you need to.

 

Alcohol

Sorry, but if you want a good night’s sleep, cut out the boozing! It can disrupt sleep in a variety of ways (see previously blog). However, if you are going to drink, try to get the alcohol metabolised before bed and you’ll sleep better… So stop drinking early, drink water, dance and give yourself enough time to wind down before bed!

 

Caffeine

Reducing caffeine will help you fall asleep – ideally none after lunchtime. Caffeine can stay in your body for 24hours so the longer you give it to wear off, the better your sleep is likely to be!

 

Smoking

Just don’t smoke.. It’s awful for you!

If you insist, don’t smoke for a solid period before you go to bed to help you to fall asleep, reduce waking and lengthen sleep time. The research also suggests that cutting out smoking means you’ll feel less drowsy in the daytime.

 

Food & Nutrition

As mentioned in the previous post it is difficult to suggest an ‘ideal’ diet for sleep promotion. However, research suggests a varied diet containing fresh fruits and vegetables, low fat proteins and whole grains are best for sleep promotion. A solid, carby meal in the evening is recommended to help promote sleep (but not too late) – as are kiwi fruit (eat 2 right before bed)! Also, I know it’s sad but try and cut out the sugar – especially in the evenings.

In terms of when we eat, too much food before going to bed – particularly late at night – can also disrupt sleep patterns. Also avoid drinking too much liquid before bed as you’ll need a wee!

 

Get physically active

Regular physical activity, light or intense has been shown to help sleep – particularly if you do it outdoors. It can be anything that gets you moving for example, gardening, a walk or the hovering.

Just remember not to do it too close to bedtime as this can make it harder to get to sleep.

 

Catching up on missed sleep

If you have missed a lot of sleep it is very natural to feel really tired in the day. The temptation is often to have a nap during the day or sleep longer when you can (eg at the weekend) however, this can be really disruptive for your sleep pattern. The advice is generally to only sleep longer or take naps when you really have to (e.g. it would be dangerous for you to do your daily tasks if you didn’t). Also, if you are going to nap in the day, try and do it at regular times for between 30-40 minutes.

 

Don’t force it

People often try to force themselves to go to, or get back to sleep. This can be really counterproductive so if you find yourself in this kind of position you should try getting up and doing something different. For example, go to another room and do something soothing like listen to music until you feel tired enough to go back to bed. Some theories suggest that if you are still awake after 15-20 minutes of trying, then get up and do something until you feel sleepy then try again. However, the trick is also not to clock watch as this will also keep you awake!

Another technique if you are lying in bed awake, try to force yourself to keep your eyes open. If they try to close, keep trying to resist as open the more we try to stay awake, the sleepier we become.

You might also consider using a relaxation technique such as visualising a pleasant scene or place. You might also try doing mindfulness exercises.

 

Get some light in your life

Light has a significant impact on our sleep. Generally people sleep better if they have been exposed to natural daylight. If you have to stay inside for work etc, try to take breaks to go outside.. every little bit helps!

If you really can’t go outside you might consider a light box to help regulate your light exposure.

However, bright light can disturb sleep, so switch off that tech and turn the dimmer down. You can also try turning a side light on if you have to get up (eg for a wee) to reduce the intensity of the light.

 

Medication

We appreciate that this is not for everyone but medication can be really helpful, especially if used in the short-term to improve sleep. If this is up your street you should contact your GP to discuss the options.

 

Stress / Work / Life!

We appreciate that there are things in life that get in the way of our sleep no matter how well we try to manage them.. babies, bereavements, injuries etc…

However, there are also lots of life stresses that we can identify and get on top of and this can really make a big difference in terms of sleep. Noticing things that are ‘stressing you out’ (work, relationship, finances etc) and addressing (speaking to a friend, financial advisor, employer etc) them be really helpful.

You might consider trying an herbal remedy such as lavender oil to help reduce stress and promote sleep.

 

Getting on top of unhelpful thought patterns

Managing unhelpful patterns of thoughts, feelings and behaviours can also be really helpful in resolving the stresses in your life, and consequently have a good impact on your sleep. This is a bit of a big topic to go into in this blog but for more information you can check out the CBT and ACT pages on our website or contact one of the team at Avenue Therapies.

Using regular mindfulness can also help you notice when you are ruminating about things (or the fact that you cant sleep) and bring your attention back to relaxing or focussing on your breathe

 

Write away those concerns

There is some evidence to suggest that having a notepad and pencil by the bed can be helpful to just ‘empty’ your head of worries or concerns that come to you in the night. The theory being, if you’ve got them on paper you won’t worry about forgetting them and you can get back to sleeping. Obviously, the aim would be to actually resolve some of the things on the list so they won’t continue to come back (at least so many come back) night after night.

Many of us have busy lives and have to remember lots of things to do. We even try to convince ourselves that we can hold all of our ‘to do’ list in our heads. Sometimes, we can, but then our brain is working harder and it is typical that we remember something in the middle of the night/early morning which we desperately do not want to forget and, yep you guessed it, keeps us awake! A little technique recommended by Dr Ramlakhan (2010) is to get into the habit of writing our to do list at the end of the day. Yep, the end not first thing. This helps our brain to relax knowing that you have it covered and wont forget.

 

Keep a sleep diary

Lots of people find it helpful to keep a ‘sleep diary’. This means recording aspects of your life and also your sleeping habits to look for patterns. Often diaries include information like:

  • When did you go to bed / wake up?
  • How long did it take to get to sleep?
  • How many times did you wake up?
  • How long did you sleep for?
  • How would you rank the quality of your sleep (1-10)?
  • Did you sleep during the previous day (if so how long for)?
  • Did you do anything to try and promote sleep?
  • Did you consume any caffeine / alcohol / drugs / medication and when?
  • Did you do physical activity that day?
  • What did you drink and eat?
  • What happened the previous day (particularly pleasant or distressing events)?
  • How would you rate you mood overall the previous day?

You could make your own but there are also loads available free online.

However, just to confuse you, some people will say that checking the clock will just serve to keep you awake. When you think “oh no its 4am, Ive got to get up in 3 hours and Im so tired…”, then you try to get to sleep but end up looking at the clock again 5 minutes later and worrying more and so on! So, try these things out, but be aware that clock watching will NOT help you sleep.

 

Previous experiences & Trauma

If we have had bad experiences previously (eg night terrors) it makes sense to feel a bit worried about going to sleep. However, managing these unhelpful patterns (which are likely to make us feel more stressed) can ‘break the cycle’ and help to improve sleep. You can think about managing them by considering many of the techniques above but particularly mindfulness or relaxation strategies.

As mentioned in the previous blog, people who experience Posttraumatic Stress Disorder (PSTD) or have experienced trauma in their lives can experience flashbacks and vivid nightmares / terrors. This can be extremely distressing and can increase reluctance to sleep. However, there is a good evidence base to successfully intervene these difficulties through CBT and EMDR. You can contact the team for more details if you are interested or speak to your GP.

 

2) What you can do to help someone else

Right! There endeth what you can do for yourself.. Now we’ll think about what you can do to help other people.  First and foremost – help sorting out any of the above!!!

On top of this there are also things that you might want to consider such as…

 

Considering if you might be contributing to the sleep difficulty

It’s not nice to think that we might be making someone else’s life more difficult but pragmatically, if people snore, wake frequently, ‘thrash about’ in their sleep, go to bed / wake up at different times etc etc it can have a massive impact on other people’s sleep. If possible, try and resolve anything that might be causing or worsening the problem. This can be tricky when one of you likes a hard mattress, the other a soft one, one of you is a night owl, the other is a lark etc. Compromises here are needed and there is no harm in separate bedrooms at times!

 

Support positive changes

It can be really helpful to just be supportive when people are trying something new (eg like a new routine or trying out mindfulness). In fact, you might even consider doing it with them – to help support but also to improve your own sleep!

Being patient and understanding can make a huge difference – especially if someone’s feeling a bit grumpy because they are not sleeping well! More arguments / disagreements can cause more stress so being a bit more kind can be an intervention in itself J (see more on compassion in the next blog series!)

 

Be pragmatic

If there are practical things that you can do to help (eg helping to create a good sleeping environment) do it! You might also offer to help with tasks that are causing stress or sleep in a different room to help the other person catch up a bit.

 

Help to work out the pattern

If you can, helping to work out the things that might be causing or worsening the sleep problem can be really helpful – especially if you have a different perspective, to see the wood for the trees.

 

Encourage and support if people seek help

Helping and supporting people to access care can be really important!

 

Wishing you all good sleeping!

So that’s it really. We’ve thought about what sleep is, why we do it, what sleep difficulties are, what can get in the way of sleep and what you can do to promote it. We hope you’ve found the series interesting and helpful. All’s that’s left to do is to give some of this stuff a whirl!

Happy sleeping!

 

Below are some more links that you might find useful…

Relaxation:

Mediation:

Books:

  • Tired but wired: How to overcome sleep problems: the essential sleep toolkit. Nerina Ramlakhan (2010).

Apps:

  • Calm.com:
  • Sleep Well
  • Relax Melodies

References

American Psychological Association – http://www.apa.org/topics/sleep/index.aspx

NHS Live Well - http://www.nhs.uk/LiveWell/sleep/Pages/sleep-home.aspx

(American) National Sleep Foundation - https://sleepfoundation.org/

Mind (charity) - http://www.mind.org.uk/information-support/types-of-mental-health-problems/sleep-problems/

Pinel, J. P. (2011). Biopsychology. Boston, MA: Pearson.

Ramlakhan, N. (2010). Tired but Wired: How to overcome sleep problems: The essential sleep toolkit. Souvenir Press Ltd.