This is my inaugural post so I hope you’ll bear with me as I find my voice and figure out how this works. Your feedback is most welcome! Each of the posts that you will find will be on a mental health topic. The information that you will find will be a combination of my experience as a therapist and the latest research. Where possible I hope to invite other professionals to weigh in on the subject being discussed. I hope that this will give you the confidence that the material you are reading is sound and reliable. I’ll include the sources that I use so you can verify for yourself the substance of the articles.
At the conclusion of each blog will be a quick tips section – so if you want to skip the theory and discussion part and skip right to the fix just scroll to the bottom of the post.
Why start off with sleep you might ask – of all the possible topics??? Sleep is one of the most fundamental building blocks for both mental health and physical health. Aches and pains, stress, depression, anxiety – all of these things are made all the worse by poor sleep habits. Things hurt more and depression and anxiety are worse when we don’t get the sleep we need. There is no question that our bodies and minds are an integrated system and when one isn’t working well the other is also impacted. Today, more and more doctors are looking at sleep patterns for patients who have had a heart event such as a heart attack! The poor sleep habits may not contribute directly to the heart attack but poor sleep may impact the recovery of the patient.
Factors that impact sleep are individualistic and multi-varied. That means there are so many things that get in the way of a good nights sleep. If you are struggling with your sleep you might feel like there is nothing you can do to change it, but I assure you that with some effort and willingness to do things differently and taking the issue seriously you can train your body to get the sleep you need.
I want you to hear that again – it will take something on your part to make the changes you need – but if you are struggling with depression and/or anxiety this should be your first line of defense. Your body and your mind need sleep in order to function at its highest level.
Two Sleep Rhythms – the 24-hour clock and the 8 hour Sleep
Humans and the world we live in follow a consistent 24 hour pattern – 1 day; for your sleep pattern this is known as the circadian rhythm. There is daylight and night. Humans are not typically meant to be nocturnal (awake during the night). If we shift our pattern of sleep to become night owls, either for work or for pleasure, we can start to feel the impact.
“Once our body clocks, or circadian pacemakers, start “telling the wrong time,” we feel it in lethargy, fatigue, and a sleep cycle gone haywire. The clock says one thing and your body says another, very similar to jet lag. Synchronizing these two clocks (internal and external) come with hitting the “re-set” button every 24 hours. We can do this by exposure to morning light and by activity. For example, when you want to be alert and awake but your body doesn’t want to follow, you can stimulate your body to re-set itself just by going outside into the sunlight for 10 or 15 minutes or engaging in some physical activity, preferably outside in the bright light.”
You should be aiming for 8 hours of sleep per day. And that too has a pattern. In the most basic of terms your body goes through 4 non REM (Rapid Eye Movement) stages of sleep – each one taking your deeper into sleep – before reaching the REM stage. Each of these stages is unique, but REM seems to be the stage that is associated with dreams and the consolidation of learning and memory. According to Medical News Today A lack of REM sleep has been linked to: reduced coping skills migraine headaches and weight gain.
Shift Work can be one of those things that really impacts the sleep rhythm and sleep quality. The effects of shift work can include sleep deprivation (leading people to think and move more slowly, make more mistakes, and become more forgetful), it can cause irritability, impatience, anxiety, depression and lowered productivity. Shift workers are also more likely to experience stomach problems, menstrual irregularities, illness, weight gain, heart problems, high blood pressure, and a higher risk for diabetes than day workers.
Well that’s great, you say, but I have to earn a living and my job requires that I work shifts that have me working some days and some nights or all through the night – so now what?!?
There is more to sleep than just getting 8 hours a day. The kind of sleep we get and when we sleep matters a lot. Sleep isn’t just about the time we are in bed; it starts long before that. A good sleep that leads to feeling rested and ready to take on your day means that you are getting enough sunlight and physical activity during the day. Sunlight and physical activity translate into a healthy sleep and a healthy mind and a healthy body. So if you do shift work it’s important that you are still finding time to take care of your body and getting sunlight! Your circadian rhythm – that internal clock that allows you to sleep – depends on some input from Mother Nature. The sun offers a whole host of health benefits, but it is certainly linked to our ability to sleep. Creating a schedule, not over sleeping, not trying to “catch up” on your sleep on the weekends and trying not to nap during the day are all useful tips to getting the deep rest your body needs. I hear you screaming at me now, ‘But I need sleep, I’m tired’. Instead, shake off that ill-timed tiredness with a walk – even in the rain. Even through the rain and the cloud you’ll get those much needed rays, a bit of exercise, and a feeling of being refreshed that will sustain you until when you reach that scheduled time for rest.
Other tips for staying awake when you need to train your body to wait until the right time for sleep include playing music, dancing, drinking water, exercise, games or conversation.
Sleep Disturbance and Depression seem to go hand in hand. The physical feelings of depression can include fatigue, insomnia and even nightmares. As the depression lingers persistent sadness and feelings of worthlessness can increase – tiredness seems to make the negative things we are telling ourselves all the more believable. We don’t have the energy to combat the negative thought patterns we fall into. A vicious cycle has begun
Medication is often used to combat depression, which can either be sedating or arousing. Unfortunately doctors often do this without an finding out about something a simple as sleep patterns. I’m NOT saying to stop your depression medication if you’ve been prescribed it – and certainly not without consulting your doctor first. But a conversation with your doctor on the potential side effects your experiencing to your sleep pattern or the side effects on sleep of your depression or anxiety medication may be worthwhile.
Depression medications all work on neurotransmitters chemically altering your brain. Serotonin, dopamine and norepinephrine are typical examples. Neurotransmitters all play a role in maintaining or initiating sleep or helping you feel awake. Selective serotonin reuptake inhibitors have a calming or sedating effect, while norepinephrine and dopamine reuptake inhibitors increase feelings of being energized – potentially leading to insomnia.
A conversation with a patient and compassionate doctor on the effects that your medication is having may make a great deal of difference. Getting the right dosage and the right fit for you is really important.
Work On Your Relationship to get a better night sleep. When we lie down each night next to a partner whom we love and respect and who loves us in return we get the added benefit of less stress and a release of oxytocin. So, yes, a good sex life is actually beneficial to good rest. In the latest edition of Reader’s Digest (April 2018, p.33) they state, “people tend to be more subjectively satisfied with their shut-eye when they cuddle up next to a loving partner – it releases oxytocin, a feel good hormone that reduces stress and promotes pair bonding.”
A lot goes into sleep. However, if you find that your sleep is out of whack and if you are serious about improving your overall health and wellbeing there are things that you can do – or at least try – before reaching for medication.
Follow these tips to establish healthy sleep habits:
- Keep a consistent sleep schedule. Get up at the same time every day, even on weekends
- and during vacations.
- Set a bedtime that is early enough for you to get at least 7 hours of sleep.
- Don’t over sleep thinking you’ll “catch up”
- If you don’t fall asleep after 20 minutes, get out of bed. (Don’t turn on music or the T.V.)
- Establish a relaxing bedtime routine.
- Take a warm shower or bath and brush teeth as part of your evening routine.
- Read a book or write in a journal.
- Use your bed only for sleep and sex.
- Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
- Limit exposure to bright light in the evenings. Turn off electronic devices at least 30 minutes before bedtime. Especially ones with blue and white light. No games!
- Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
- Exercise regularly and maintain a healthy diet.
- Avoid consuming caffeine in the late afternoon or evening. (Not past 3:00pm). This includes soda’s, chocolate and even decaf coffee which is rarely 100% free of the stimulant.
- Avoid consuming alcohol before bedtime.
- Reduce your fluid intake before bedtime.
- Turn the lights out at bedtime. If you need a night light have it out in the hall.
- We are dark deprived in urban areas. Try black out curtains for your room to shut out streetlights.
- Noise from the house or the street can be a factor; try earplugs.
- Don’t have music playing in the background. Though white noise may be worthwhile if noise in your home from the street or housemates is interfering with sleep.
- Banish pets from the bed.
- Make sure your mattress adequately accommodates both of you. Invest in a quality mattress.
Conclusion (with an extra bonus for making it all the way through the article!!!)
At the end of the day (did you catch my silly joke?) sleep is not just a natural event. Sleep is a discipline and something that we can train our bodies and our minds to do for optimum health.
If you are doing all of these things and find that you are still not getting the rest you need you may have another sleep impairment such as sleep apnea. A conversation with your doctor is recommended. But try some of these tips before reaching for a magic pill.
I’ve included a Sleep Log for you to start to track your actual sleep pattern. You can take it with you when you go to visit your health care professional or mental health care professional. It might give them some tangible insight into what you are experiencing and ways to further assist you in getting a much needed good nights rest.
Readers Digest, April 2018 “How to hack your sleep: Top secrets to superior slumber”.