Sleep and insomnia

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In this article we explore sleep and insomnia. Sleeping problems and insomnia can affect people’s wellbeing. Keep reading to learn more strategies to improve your sleep and overall wellbeing.

Do you find that you?

Can’t switch off?
Feel drowsy, lethargic or even fall asleep during the day?
Often feel agitated or irritable?
Feel tired, or get told that you look tired?
Have trouble controlling your emotions?

Why is sleep important?

Sleep is an essential active and involuntary process. You will fall asleep at some stage, whether you want to or not, simply because your body needs it. It’s fundamental to your wellbeing.

While you sleep your brain is actually very busy. It organises and processes memories, information, feelings and events. It picks up, filters and files them away. This is not only important for things like consolidating memories, but also connecting new insights and creative ideas. Hence, sleep is essential to our resilience and our capacity to recover and carry on.

Sleep has been likened to a dishwasher for the brain, sweeping away toxins in the night. Lack of sleep can lead to poor health, both mental and physical. When our physical or mental health is affected, this can in turn lead to further lack of capacity to sleep. It can become a vicious cycle.

It’s important not to compromise. Our sleep provides us with the ability to function effectively and to control mood, performance and relationships.

How much sleep should we have?

All animals have sleep patterns. Some sleep most of the time, others very little of the time.

Humans have become used to sleeping at night. Essentially, we are daylight creatures. This is why shift work can cause stress for some people.

The actual time of sleep needed, each day, varies for everyone. There is no hard and fast answer. Some people need just 5 hours a night, others need 10.

Research has found, that on average, an adult human being needs between 7-8 hours of sleep each night. Older adults need between 6-7 hours of sleep a night, and children need at least 9 hours. This can be shortened if it’s replaced by short naps during the day.

How do I know if I’m sleeping enough?

You may not be getting enough sleep if:

You feel irritable or agitated most days.
You find yourself drinking or needing more coffee/caffeine.
You have difficulty staying awake when you sit still, watch television or read.
You have difficulty concentrating of focusing your attention.
You have lapses in memory, or find yourself learning things slower than usual.
You seem to react more slowly.
You have trouble controlling emotional outbursts.
You find yourself becoming angry, upset, teary or anxious more easily.

Any of these symptoms could be an indication that you’re not getting enough sleep.

What are some common problems?

Having a problem sleeping for one or two consecutive nights is not usually a major issue. The body is likely to catch up on sleep the next time around.

However, if your difficulty sleeping continues, the problem may be insomnia. Depression and anxiety can be common causes of insomnia. Typically, it’s thought that difficulty falling asleep is linked to anxiety or stress. However, difficulty staying asleep (e.g. waking in the early hours of the morning) is related to depression. If you are experiencing stress in your life, in a significant way, this can certainly lead to insomnia, and the vicious cycle that was described above. You can find out more about helping with depression, stress and anxiety on this website.

Oversleeping can also occur as a result of depression. You may find that you have no incentive to actually get up at a reasonable time in the morning. The problem is, oversleeping can be just as unhealthy for you as under-sleeping, and has been linked to physical health problems such as diabetes and cardiovascular disease.

Nightmares can occur, usually in the early morning. They are probably linked to frightening or difficult experiences during the day and may also be linked to past trauma or ongoing problems. Hence there can be a link between nightmares and anxiety when these are recurring phenomena.

There are other disorders such as sleep apnoea. This is a disorder in which your breathing temporarily stops during sleep due to a blockage of the upper airways. This can be a dangerous physical problem and does need to be addressed with your GP.

Most people know when they are ‘not sleeping well’ and if this problem persists then it’s time to try something new, or even seek help.

What can I do?

There are numerous things that you can do to adjust the way you live and the way you sleep.

Significant consumption of caffeine, alcohol and nicotine all impair your capacity to sleep. If you’re experiencing difficulty sleeping, try cutting these back or (if you can) avoiding them entirely.

Caffeine, for instance, takes a long time to break down in the body. If you drink coffee before attempting to sleep, you’ll struggle to sleep. It might be an idea to try cutting off your caffeine intake at about 2pm, to see if this has any effect on your ability to sleep. Try this technique for two weeks and see how you go.

Alcohol, while people often say it helps them get to sleep, is linked to restless light sleep, and frequent waking. Further, alcohol is a diuretic and consuming it before going to sleep will probably result in waking during the night to use the toilet.

Medication

Medication can help on a short term basis and sleeping pills (even over the counter ones) are best used for a short time, only. Their use should be carefully monitored and only taken in consultation with your doctor. There can be a range of side effects to their use and their long term use is not recommended. They can be useful, however, to get your sleeping patterns back on track.

Psychological help

This revolves around reprogramming your thought processes. You can have unhelpful thought processes about sleep that leads to clock watching and a restless night.

For instance:

Unhelpful thought process		More helpful thought process
ugh, I’m not sleeping!		I am not sleeping at the moment.
I can’t ever seem to get to sleep. What’s wrong with me?		Most nights I can go to sleep, eventually, if I am patient.
I’m just no good at sleeping, others always seem to be able to sleep so easily.		What might help me right now? OK, I will get up have a drink of water, and perhaps read for a while because I usually feel sleepy after that.
Result – prolonged lack of sleep.		Result – sleep comes naturally and without being forced.

Sleep hygiene

Sleep hygiene is having a routine and practising behaviours that encourage sleep, and avoiding things that are likely to keep you awake.

For example, make the hour before bedtime a time for winding-down. Avoid anxiety provoking activities such as working or thinking about work, listening to or reading the news, or talking with someone who tends to stress you out. Try to end the day with relaxing thoughts and activities.

Don’t look at bright screens leading up to bedtime, as this can confuse your body clock. Keep the lights dim as bedtime approaches. If you do get up in the night, don’t switch on the overhead lights. Use a torch to go to the bathroom, or a table lamp to read.

Try to keep the bed just for sleeping and sex, i.e. not for watching TV or reading, so that your body associates bed with rest.

Keep your daytime naps to under half an hour, so you don’t throw out your next night’s sleep. A twenty minute nap can be very helpful, but any longer can throw you out of schedule.

Do your exercise in the morning, never before bed. Otherwise your increased heart rate and adrenaline will take a while to settled back down, and will definitely keep you up.

Finish eating or snacking a good few hours before you go to bed also, as your digestive system can also keep you awake.

Breathing exercises as insomnia strategies

Your breath is the key to relaxing so you can fall asleep.

Focus your attention on your breath, feel your breath as you breathe in and then as you exhale. Do not try to control your breathing. Just feel the air moving in and out and notice where you feel it. You may feel air moving in and out through your nostrils. Or you may be aware of the air filling your chest or your diaphragm or your stomach. Whatever you notice is completely acceptable. There’s no right or wrong way to do this exercise.

Continue to focus your attention on your breathing, until you fall asleep. You’ll have to continually bring your attention back to the breath when you become distracted by thoughts — because you will, perhaps as often as every single minute. This is normal, just keep refocusing on your breath, as many times as it takes.

Watching your breath serves two important purposes:

Focusing on your breathing is very relaxing. When nervous, many people hold their breath, or breathe shallowly. This habit creates additional tension. By observing your breath, you release the effort to control it. When you stop controlling your breath, your body takes over and your breathing naturally becomes deeper, fuller and more relaxed.
Your attention is on your breath. This activity occupies your mind and there is no room for worrisome thoughts. If these thoughts do intrude, acknowledge them, then let them pass. Don’t follow them, don’t get frustrated by them, just gently turn your attention back to your breathing.

Other insomnia strategies

Any mindfulness exercise can be an effective relaxation or insomnia strategy, although that isn’t necessarily the sole purpose of mindfulness. We have an example mindfulness activity available here: Mindfulness meditation: Who are you?

Where can I get help?

Visit a General Practitioner – they can help refer you to a specialist.
See a Psychologist – you can find these through your GP (and get a Medicare rebate) or the Australian Psychological Society (APS). The APS provides a referral service on 1800 333 497 or through their Find a Psychologist web listing.
See a Counsellor or Psychotherapist – Anglicare Southern Queensland offers counselling, so if you need any further assistance or support, please get in touch.