Not enough sleep can more than double your risk of cancer. That is one of the hard-hitting realities highlighted by Matthew Walker professor at Berkeley university in his book “Why We Sleep”. This is just one of the many health issues that arise when we fail to plug ourselves in at night to recharge ready for the next day, as well as safeguarding your health and quality of life.

In today’s blog, we’ll be looking at the key aspects of sleep and, as always here at The Helpful Clinic, we’ll look in all three dimensions of health: the biology, psychology and social context (this is the BioPsychoSocial model). We’ve also got some helpful tips and tools to help you to improve your chances of sleeping better.

This blog follows on from our last one on cracking the tiredness code, in which we looked at factors that contribute to tiredness and how to make choices that use your energy better. If you haven’t read that post yet, we highly encourage you to as it will make this post afford even more value.

Sort your sleep out now and set yourself up well for the autumn

While it might seem a little counterintuitive — especially as lockdown has eased and the weather is improving — right now is a good time to prioritise your sleep. August is a popular holiday month, especially with the kids off school and even though you’ve almost certainly had to adjust your holiday plans, you’re hopefully having some time off. Using this time to have a look at your sleep and upgrade to more helpful habits, you will set yourself up well for the autumn and winter ahead.

There are almost always at least a few contributing factors that mean that I sleep is not great or restorative. Here at The Helpful Clinic we always look at health in 3D and that includes sleep. This means from the BioPsychoSocial (3D) perspective that looks at how biological, psychological and social factors affect the experience you’re having. 

Let’s look at each dimension in turn.

What’s happening socially impacts your sleep

Throughout our lockdown blogs, we have talked about social stimulation and how much our interactions, or lack thereof, affect our wellbeing and energy levels. As we are building up our social stamina, it’s important to recognise that social stimulation plays a part when it comes to sleep. The bottom line is if you’re over-stimulated, you will find it harder to fall asleep.

Allow for landing before bedtime

It is helpful to give yourself some time to land after a social engagement whether that was in person or online before you try and go to sleep. The key here is to think about slowing down. It can be helpful to imagine coming down the gears of a car. Some find it helpful to have a shower or bath. Some find it helpful to change into more comfortable clothes and simply sitting down in a chair for a wee while to give your body and mind a chance to slow down before you try and sleep.

It can be helpful to take landing time into account when you make arrangements to meet up with people. If it’s a highly stimulating activity, it might be better to schedule for earlier in the evening or during the day if possible.

Rhythm and regularity matters

Having a regular bedtime and a rhythm of what you to before bed to set yourself up well is a key component in ensuring that you sleep well.

For those of us with kids, we know that a bedtime routine is essential. Guess what, grownups are not that different.  This could be checking the backdoor is locked before heading upstairs, wiping down kitchen surfaces or doing a few stretches before moving onto brushing teeth and settling into bed. These simple and consistent acts help to communicate to your brain and body that bedtime is approaching and time to transition from feeling alert towards feeling sleepy. What’s your rhythm? Is it consistent? Is it helpful? What would be more helpful?

This is known as behavioural conditioning, the focus of Russian physiologist Ivan Pavlov’s research and experiments. You may remember his experiments with dogs from your schooldays. This Psychology Today article on how classical conditioning can help your child sleep offers some fantastic insights into how associating sensations with common tasks can make transition from being awake to being asleep easier for grownups too.

Consider your environment

It’s important to consider the environment in which you sleep.

Go into your bedroom and look at the lighting, get a sense of the temperature, noise levels from outside and your bed both in terms of the mattress and the bedding. Are any of those tripping you up? What’s helpful and what’s not helpful. Think about what’s actually in your bedroom, the furniture, clothes and whatever else you have in your bedroom. Is your bedside table cramped with things? Is it helpful? What would be more helpful? Looking after these factors will contribute to a better night’s sleep.

Mary struggled with sleep. She often had agitated dreams of missing deadlines and being late and then woke up overwhelmed. One of the contributing factors turned out to be in her environment. She realised that the last thing she saw at night and the first thing she saw in the morning was a floor to ceiling stack of boxes from when she moved in three years ago.

The mental impact of the boxes in her bedroom kept triggering her overwhelm feeling hampering her sleep efforts and fuelling the feeling of being inadequate and never getting anything done. She enlisted help from a good friend and started by moving the boxes into the spare room. This had an immediate benefit on her sleep. She then gradually, one box at a time, worked her way through the whole lot, every emptied box affirming to her that with a slow and steady focus, she could accomplish any task.

Additionally, according to Harvard university limiting your use of gadgets before bedtime is helpful as the blue light is considered to affect your melatonin, a key hormone for sleep, and therefore will make falling asleep more difficult. 

Your thoughts and emotions affect your sleep

The second dimension to look at sleep from is the psychological one. There is a well researched link between sleep and mental health issues. So let’s look at sleep from the psychological dimension; you may not realise it, but what you think about and how you feel during the day affects your sleep at night. This includes how easily you fall asleep, the quality and duration of your sleep as well as your frame of mind when you wake. That’s why it is helpful to look after your feelings and thoughts throughout the day as they are important for sleep.

Look after your experience during the day

In terms of feelings — both emotions or physical sensations — if you are in a state of distress and struggling during the day, chances are you will take this forward with you in your sleep. While you might fall asleep from exhaustion, the quality of your sleep will be poor and more likely to be broken and your dreams are more likely to be difficult, like Mary’s. 

Having strategies to support your feelings  — both emotions or physical sensations – will be helpful and likely to  improve your sleep. This is where knowing how to deal with your feelings and your First Aid for Feelings is so important. If this is something that you struggle with or you would like to be better at, think about doing a course like the 10 day First Aid for Feelings meditation. Click here to find out more about this course where you will learn the ABC of First Aid for Feelings which is helps you look at what you are thinking, feeling and doing and make more helpful choices.

How fast are you thinking?

In terms of your thinking, see if you can have a sense of the speed of your thinking. Imagine your thinking is like a car, how fast are your driving? If you are thinking at 100mph all day long, slamming on the brakes before bedtime can make it difficult to wind down ready for sleep. That kind of speed means a significant breaking distance. In the same way that a car has to go from fifth gear down to first gear sequentially, so too does your mind and your body. Without a more gradual slowdown, you will likely find it difficult to fall asleep, which is why many individuals with fast-thinking jobs rely on medication, wine and/or TV to help them nod off. While medication isn’t necessarily bad, always be curious about whether it is actually helpful. If it is, then great. If not, consider a different approach.

If your speed of thinking throughout the day is fast-paced, incorporate some gear changes during the day. This will help you more easily wind down in the evening and better prepare you for sleeping.

Mindfulness of brushing teeth

You can also take brushing your teeth before bed to another level by being more mindful as you’re doing it. All you need to do is concentrate on the act of brushing your teeth and nothing else while you are doing it. Before you even begin to start brushing, take a moment to consider your posture in the mirror. Focus on how you’re cleaning each tooth and what the brush feels like against your gums. As your mind wanders (as it will) to what’s happened during the day or what’s happening tomorrow, gently bring your awareness back to the actual experience of brushing your teeth. The recommended brush time is only 2 minutes. It’s highly unlikely that any thought is so urgent that it can’t wait 2 minutes. Be aware of the tendency to start tidying things around the sink or sorting out the towel rail. You’d be surprised at just how challenging it can be to hold that single focus for just two minutes.

Downloading your day

Finally, consider downloading your day in the evening before you try to sleep. This will help alleviate some of the pressure in your mind and allow you to get everything off your chest ahead of bedtime. You can do this using a pen and paper or a helpful app like Penzu.

Pent up energy blocks good sleep

How physical you are during the day has an impact on how well you sleep. This doesn’t necessarily mean that you’ve have to be vigorous or active. Your activity levels need to be in line with your health and energy levels. But if you’re not physically active enough, especially if you do a lot of thinking during the day, chances are it takes you a long time to slow down enough to fall asleep. This is especially true for those of us who have a thought-based job, especially if it’s fast paced thinking.

Some simple physical activity is often enough to remedy this, like a walk or tai chi or even putting some good music on and dancing around the kitchen for a track or two before you start dinner. Even something as basic as climbing up and down the stairs a few times will help relieve the pent up energy, boosting your chances of having a good night’s sleep.

Listen to your body

We often ignore the signs that we’re ready to sleep because it’s not bedtime yet. This means that we push through what our body needs, ignoring the signals that we need to sleep and take our cue instead from the clock. The confusing thing that can then happen is that we get what many call our second wind and feel more alert and can stay up for a few more hours. This can give us a false sense of energy and we don’t realise that we’ve just tipped into the body’s overdraft, using adrenaline to keep us going and guess what adrenaline is designed to keep us awake. Adrenaline is one of the key hormones for the survival response which is designed to keep us alive because if we’re under treat, falling asleep would be high risk.

This in turn means that it’ll take us longer to then eventually slow down enough for sleep or if we do drop off from sheer exhaustion, it’ll mean that we are more likely to wake in the early hours of the morning, have agitated dreams or wake up feeling unrefreshed because we don’t manage to drop into deep sleep I often think of it as an animal sleeping with one ear cocked to listen out for potential threats.

When you’re not getting that deep sleep your body clock is affected (the technical term is Circadian Rhythm). This is roughly a 24-hour cycle of all your body’s functions, including making sure we feel tired and sleepy at night and alert when we wake up. The current understanding is this is an overall body clock that synchronises a variety of specialised clocks, such as the sleep clock and sleep cycle.

Your sleep cycle

There are four stages in the Sleep Cycle:

  • STAGE 1: This is Light sleep – muscle, eye and brain activity decreases
  • STAGE 2: This is Deeper sleep – muscle and eye activity stop and brain activity reduces further.
  • STAGE 3: This is Deep sleep – brain activity slows down significantly. If woken from this stage a person will feel disorientated.
  • STAGE 4: REM sleep is when dreaming occurs. Heart, breathing and blood pressure rise, there is no or little muscle activity, but eye movement and brainwave frequency increase significantly.

Out of all the four stages, stage three is the most important as this is when physical functions are repaired and maintained, such as your immune, nervous, skeletal and muscular systems and the human growth hormone is released. Studies show that people who are under psychological (e.g. anxiety) or physical (e.g. viral infection) stress often miss out this stage.

Food and water matter, a lot!

Another biological factor that can have an impact on your sleep is how much and what you’ve eaten. You need to ensure you aren’t going to sleep hungry, but at the same time you don’t want to feel engorged while you are trying to doze off. Being reasonably consistent with your meals times supports the body clock and your ability to fall asleep, stay asleep and wake up refreshed. During this last week, when are you usually having your evening meal? Is it consistent? Is the meal enough or do you find that you’re snacking into the evening or nipping down for a toast at midnight. What you eat and when you eat affects your insulin levels which directly affects your body clock. So have a look at your current habit, is it helpful? Are you having enough protein? Are you using wine or beer to ‘help’ you sleep not realising that you’re inadvertently snookering yourself as alcohol is actually detrimental to good sleep? As always, remember that it’s more helpful to be curious than critical. Same goes for water, drinking plenty of water throughout the day is another factor that will encourage better sleep.

Be consistent with your bedtime routine and the time you go to bed. While it does not need to be done with military precision, reasonable consistency is the key to ensuring your body clock doesn’t end up all over the place, your body will thank you for it.

Conduct your own sleep study

Here at The Helpful Clinic, we always start by creating a map of where you are at right now before looking at where you want to go. It’s something that we often mention and you can read more about map making in our Here before there blog post.

Now, I’d like to invite you to conduct your own sleep study, so you can identify which areas are particularly challenging. To do this, you need to consider five key areas:

  1. Onset – How long does it take you to fall asleep?
  2. Duration – How long do you sleep for?
  3. Quality of sleep – How well do you sleep?
  4. Feeling on waking – How do you feel when you wake up?
  5. Dreams – Did you dream?

Over a period of a week, aim to track five nights, using this handy sleep diary to record your sleeping experience in relation to the five key areas outlined above:

It can be helpful to print this out and keep it by your bed so you can fill it in each day when you awake.

With your map in hand, look at which area(s) you are struggling with e.g. onset, quality, etc. be specific. Then, get curious about what would help in each of the three dimensions.

Your greatest gift to yourself: sleep!

While it may not seem that obvious, getting regular, good quality sleep is important for pretty much every aspect of your life. Oftentimes, we sacrifice sleep to make way for other things in our life, such as social commitments and work deadlines. But doing so actually impacts your ability to function.

In fact, the impact of less sleep can be profound. Take this example from the American Automobile Association (AAA). Its research in 2019 revealed that losing just an hour of sleep — like through Daylight Saving Time adjustments — can actually increase your risk of having a car crash. Miss two or more hours sleep and that risk doubles! Now imagine what impact your lack of sleep is having on your productivity and ability to think while at work.

Invest the time now to sort your sleep out and you will reap the rewards going forward. The holidays provide a great opportunity to really focus on this and treat yourself to some much-deserved, good quality sleep, setting you up well for the autumn and winter ahead.

One way you can improve your sleep is by investing in a dedicated sleep course, like Linda Hall’s How To Restore Sleep on Insight Timer. I’ve worked with Linda on numerous occasions over the years and have found her insights in this area invaluable and aligned with our approach.

Good sleep doesn’t happen by chance. It happens as a result of those three dimensions complementing each other. Get sleep right and everything else will benefit.

N.B. Individuals with underlying conditions/psychological challenges/ traumas that affect their ability to get a good night’s sleep are likely to need additional advice, tailored specifically to their experience.

Go gently, hold steady, stay the course.

All the best, Thor

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