Sleep: Is it restoring or consuming you?

Are you getting not enough sleep or are you getting too much? One of the most widespread health issues that affects our mental and physical health is sleep (Buysse et al., 2006). Insomnia is a troubling health issue that occurs from habitual poor sleep quality, duration, onset, and or awaking early unable to return to sleep. Sleep is a vital component of optimum physical and mental wellbeing (Barlett & Junge, 2013) and sleep disorders have been shown to precipitate the degeneration of health and intensify mental disorders (Pollack et al., 1990). Those with chronic pain, anxiety or depression are also at increased risk of developing insomnia.

Have you ever found yourself worrying through the night that you have not gone to bed early enough? You find yourself looking over to the clock conducting a countdown every few hours of how little hours you have left to try and get some sleep? The more you calculate, the more you’re worrying increases your physiological arousal.

So what can we do to get a better nights sleep? Medication may be a short term effective solution, however, medications may affect sleep stages and intensify insomnia making it ineffective over time (Lockley et al., 2004). Greater health outcomes have been shown when behavioral and lifestyle modification interventions are utilised and evidence suggests that psychophysiological insomnia can be treated effectively with cognitive behavioral therapy (Morin et al., 1999; Siversten et al., 2006). Cognitive Behavioural Therapy for Insomnia (CBT-I) is recommended as it increases understanding of sleep and removes the perpetuating factors of the insomnia and addresses the precipitating factors (Espie, 2008).

So what is CBT-I and what can I do?

  1. Improve your sleep hygiene and ensure you have no access to clocks, keep your room dark, minimise bright lights, and above all keep your room for sleeping alone not working or worrying!
  2. Learn about your circadian rhythm, body clock, body temperature, and effects of caffeine and alcohol and the benefits of daily exercise and avoidance of daytime napping assist (Morin et al., 2006).
  3. Write down your thoughts and concerns in a thought diary earlier in the evening to let go of the thoughts before engaging in relaxing activities prior to bed. Addressing any unhelpful beliefs that are maintaining your belief that you will not sleep can be cognitively restructured.
  4. Remove any stimulus that do not trigger sleep such as televisions and computers. Recondition your body to differentiate between day and night environments (Bootzin, 1972).
  5. Use relaxation techniques to reduce anxiety about sleep including progressive muscle relaxation, mindfulness and diagrammatic breathing techniques. Mindfulness assists individuals to remain present in a non-judgmental state that research has shown benefits in improved ease to sleep, and improve dysfunctional cognitions about sleep (Ong, Shapiro, & Manber, 2008).
  6. Try change your focus and try and stay awake instead of forcing yourself to sleep to change your focus off forced effort can ultimately improve sleep (Morin et al., 2006).
  7. Sleep restriction can be introduced to calculate the average time spent sleeping and focus on reducing sleep time. This change can help limit bed time to strictly sleeping and increase sleepiness (Bartlett & Junge, 2013).

If you are still struggling you may benefit from getting some assistance and support from a professional psychologist. Sleep is a gift of restoration, there are ways to keep your mind in perfect peace there is help and hope. Reach out today so you can sleep well tonight!

References

Bartlett, D., & Junge, M. (2013). From insomnia to healthy sleep: Cognitive-behavioral applications. Applied Topics in Health

Psychology. Chichester, West Sussex: John Wiley & Sons.

Bootzin, R. R., Epstein, D., & Wood, J. M. (1991). Stimulus control instructions. In Case studies in insomnia, 19-28. Washington, USA: Springer.

Buysse, D. J., Ancoli-lsrael, S., Edinger, J. D., Lichstein, K. L., & Morin, C. M. (2006). Recommendations for a standard research assessment of insomnia. Sleep: Journal of Sleep and Sleep Disorders Research. doi: 10.1017/S0033291709006011

Espie, C. A., MacMahon, K. M. A., Kelly, H., Broomfield, N. M., Douglas, N. J., Engleman, M., … & Wilson, P. (2007). Randomized clinical effectiveness trial of nurse-administere small-group cognitive behavior therapy for persistent insomnia in general practice. Sleep New York Then Westchester, 30, 574. doi: http://s3.amazonaws.com/academia.edu.documents/39740816/Randomized_clinical_effectiveness_trial_20151106-28748 rxu6ij.pdf?AWSAccessKeyId =AKIAJ56TQJRTWSMTNPEA&Expires=1466821027&Signature=jcaf1TW0A Qcvrj3YgkNLJphsxNA%3D&response-contentdisposition=inline%3B%20filename%3DRandomized_clinical_effectiveness_trial.pdf

Lockley, S. W., Cronin, J. W., Evans, E. E., Cade, B. E., Lee, C. J., Landrigan, C. P., … &  Aeschbach, D. (2004). Effect of reducing interns’ weekly work hours on sleep and attentional failures. New England Journal of Medicine, 351, 1829-1837. doi: 10.1056/NEJMoa041404

Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: A randomized controlled trial. doi: 10.1001/jama.281.11.991.

Ong, J. C., Shapiro, S. L., & Manber, R. (2008). Combining mindfulness meditation with cognitive-behavior therapy for insomnia: a treatment-development study. Behavior Therapy, 39, 171-182. doi:http://dx.doi.org/10.1016/j.beth.2007.07.002

Pollak, C. P., Perlick, D., Linsner, J. P., Wenston, J., & Hsieh, F. (1990). Sleep problems in the community elderly as predictors of death and nursing home placement. Journal of Community Health, 15, 123-135. Retrieved from:https://link.springer.com/article/10.1007%2FBF0132 1316?LI=true

Sivertsen, B., Omvik, S., Pallesen, S., Bjorvatn, B., Havik, O. E., Kvale, G., … & Nordhus, I. H. (2006). Cognitive behavioural therapy vs zopiclone for treatment of chronic primary insomnia in older adults: A randomized controlled trial. Jama, 295, 2851-2858. doi: 10.1001/jama.295.24.2851.

Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J., & Merette, C. (2006). Epidemiology of insomnia: Prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Medicine, 7, 123-130. doi: 10.1016/j.sleep.2005.08.008

By | 2017-07-25T02:44:58+00:00 July 24th, 2017|Blog|