In these busy and stressful times that we live, feeling rested and getting a good night's sleep can feel like a difficult task. This in turn can be frustrating, as sleep is such a crucial part to maintaining our wellbeing and mental health balance.
Dr Natalie Bodart, founder of The Bodart Practice, chatted with Dr Stuart Sadler, a Clinical Psychologist and Sleep Specialist, who has a clinic based in Newcastle Upon Tyne to talk about all things sleep.; myths and tips! Here are five sleep myths and five top tips that can help you to get a better night's sleep.
Sleep myths
Myth #1: Everyone needs 8 1/2 hours of sleep a night.
We hear a lot about the importance of getting over 8 hours of sleep a night, but is this true for everyone? When it comes to sleep, although duration is important, it is more about the quality of sleep than the number of hours that you get. For example, it is better to get 6 hours of consolidated sleep than to have 8 hours of poor quality, broken sleep. Evidence suggests that people need between 6-9 hours of sleep, but this is very dependent on the individual's needs. It is important to recognise what works for you, because sleeping for longer than this can actually have a detrimental effect and leave us feeling groggy and moody.
Myth #2: If you are not sleeping you should just nap during the day to make up for it.
If you are sleep deprived, then something called ‘sleep pressure’ builds up, leading to you feeling sleepier the next day or night. Therefore, having a few nights of inconsistent sleep may actually help with better sleep for another night, especially for those with insomnia. However, after this ‘sleep pressure’ dissipates, it’s gone. So whilst napping in the daytime might seem like a good idea it can take away from your ‘sleep pressure’ and lead to a lower quality of sleep that night. This is known as social jet lag (Banks, Van Dongen, Maislin & Dinges, 2010). We can liken this to feeling hungry; if you know you have a meal that night but are feeling hungry and snack during the day, you are less likely to eat all of your dinner that night. As hard as it might feel to resist a nap, if you have had a bad night's sleep you are better to try and stay awake to get back into a normal sleep routine.
Myth #3: I’ll get dementia if I don’t sleep.
Although there are studies that have highlighted that people with dementia have poor quality sleep, they do not identify cause and effect (that classic age old question, what came first, the chicken or the egg?). What research does highlight is that lack of sleep can lead to increased blood pressure, which can increase cardiovascular risk and other health problems. Lack of sleep can also increase the risk of mental health difficulties, such as depression and anxiety. The important thing to remember is that this is not going to happen after a couple of weeks of poor sleep. A famous study in sleep deprivation was carried out on an individual called Randy Gardener, who remained awake for 11 days and 25 minutes. While there was a reported deterioration in his concentration, increase in moodiness and problems with short term memory he was still able to function to a degree and beat the researcher at a game of Pinball.
Myth #4: If I have a few drinks I will sleep better.
It may be true that alcohol helps you to fall asleep initially, but it has a big impact on the quality of sleep that you get. Alcohol knocks off the stage of sleep where you dream and in which mental recovery occurs. This stage of sleep is where memories of the day are sorted and filed away in your brain and is called the ‘REM’ (rapid eye movement) stage of sleep. After drinking and going to bed, the first two stages of NREM sleep (N1 and N2) and REM sleep increase, leading to waking up multiple times at night and decreased sleep quality (He, Hasler & Chakravorty, 2019). This contributes to the grogginess felt when hungover the next day due to the lack of ‘REM’ sleep. Therefore having a few drinks in order to sleep better actually has the opposite effect and contributes to a more mentally disruptive hangover.
Myth #5: I shouldn’t wake up during the night.
It is actually very normal to wake up during the night. Even very good sleepers wake up on average around 4-5 times, it just tends to be for a couple of seconds. You have a mechanism called sleep inertia, which means that you forget the few seconds or minutes before you fall asleep. If you wake for a few seconds, say you roll over or cough, that tends to be around the time that we finish a sleep cycle and wake up before going into the next cycle. You only remember these events if someone keeps you awake or we are awake for longer. The things that can wake us in the night can be similar to those that prevent you from falling asleep in the first place, i.e. not feeling calm, safe, relaxed etc.
Sleep tips
Tip #1: If you wake up in the night with a busy head, write down your thoughts.
Worry tree from getselfhelp.co.uk
During the night and while you are in the darkness, your frontal lobe is less effective and less able to regulate your emotions. Your frontal lobe is the part of the brain responsible for your decision making and judgement. If you wake up during the night feeling stressed because you cannot sleep or you have thoughts racing around your mind, writing these down in a journal is a good way to take these things off your mind, allowing for calmer thoughts. Writing thoughts down also allows you to take the opportunity to reflect on these thoughts the following day with a clearer head. In many cases these thoughts can be quite catastrophic such as ‘I’m still awake, this is going to ruin my day’ or ‘I’m worried I will not be able to fall asleep at all.’ Writing down these thoughts can be a cathartic way of processing them and allowing ourselves the chance to rationalise them. The next day you can sort the thoughts into those you can do something about, and those that are worries and can be let go. The worry tree can be a helpful flow chart when considering how to deal with different thoughts.
Tip #2: Only go to bed when you are about to fall asleep.
You may think it is helpful to go to bed early to try and force yourself to go to sleep, but this can actually have a detrimental effect on your sleep.
There is a difference between tiredness and sleepiness. Dr Sadler highlighted that tiredness relates to when you have done things in the day that have left you feeling a little exhausted, whereas sleepiness is the state where you are struggling to keep your eyes open (we have all had that moment sitting watching Netflix and your head starts to drop and you can't keep your eyes open). It is at that point of sleepiness that you should be taking yourself to bed. The less time spent in bed awake the better.
Tip #3: Address your daytime routine.
If you are struggling to sleep at night it can be helpful to take a look at what you are doing during the day. Are you doing enough during the day to leave you in a state of sleepiness? Are you doing any exercise, as exercise is a helpful thing to assist in managing our sleep cycle? Are you doing rigorous exercise too close to going to bed? Literature suggests that it is best to avoid exercise that increases the heart rate for around 2-3 hours prior to going to bed. Some exercise however, such as yoga nidra and gentle stretching, can be useful prior to going to bed, as it can help calm the nervous system and allow you to feel soothed and safe, prompting better sleep.
It is also important to make sure that you are getting enough daylight during the day to help with your sleep routine and to view sunlight as close to waking as possible. It is also important to ensure that your sleep environment is as calm, safe and comfortable as possible. A cooler room tends to be more beneficial to sleep. We love the Huberman Lab’s sleep toolkit for more info on this.
Tip #4: if you can’t sleep, move.
We have all been there, that moment when you are lying in bed wishing yourself to go to sleep and getting frustrated that it is just not happening. The longer you lay there the more frustrating it can feel, and very quickly the thoughts come racing in of what time you need to get up in the morning, how many hours you have until the alarm goes off, how tired you are going to feel tomorrow, and so on. One way to break this is to get out of bed and move. We are not encouraging you to engage in anything too stimulating, i.e. going on your phone, watching TV or exercise, but this movement can include getting out of bed, doing a few gentle stretches, progressive muscle relaxation, or yoga.
Aromatherapy is another way of inducing calming thoughts and environments before bed. This can be particularly helpful for those suffering from nightmares and post-traumatic stress disorder (PTSD). When inhaling essential oils such as lavender, the particles reach the limbic system to produce relaxant effects, influencing blood pressure, heart rate and brain activity. Much research conducted in this field has suggested aromatherapy has positive effects for depression, anxiety, and sleep amongst other things. Essential oils can be administered through inhalation, massage, or skin application.
Tip #5: Re-script your nightmares.
If you have a bad dream or a nightmare it can be helpful to write it down and then alter the ending slightly. Research has highlighted that we process humour more easily than many of our other emotions and part of the reason that we have recurring nightmares is because we have trouble processing the emotion connected to the memory. Writing it down allows you to externalise it and if you are able to modify the ending in some way it makes it more tolerable to the brain to reprocess it.
In the moment that you wake from the panic or fear of the dream or nightmare it is important to reorientate yourself to the present moment and ground yourself by looking around the room and reminding yourself that you are safe right now. Bring yourself into the present moment by asking yourself; what can I touch, smell, see, hear and taste?
If in doubt, seek help…
One of the important points to take away from this article is that sleep can be improved quickly, so if you are having prolonged difficulties with your sleep then talk to someone. Seek some support in helping you to figure out what is going on and how you can take steps to get your sleep back on track.
If you would like to talk to us about accessing therapy sessions for sleep then you can book a free call with us here.
Dr Stuart Sadler and his team can be reached via his website contact page
Resources & References
Overcoming Insomnia; a CBT self-help book
References:
Banks, S., Van Dongen, H. P., Maislin, G., & Dinges, D. F. (2010). Neurobehavioral dynamics following chronic sleep restriction: dose-response effects of one night for recovery. Sleep, 33(8),
1013-1026.
He, S., Hasler, B. P., & Chakravorty, S. (2019). Alcohol and sleep-related problems. Current opinion in psychology, 30, 117-122.
Written by Dr Hannah Green, clinical psychologist at The Bodart Practice and based on an interview between Dr Natalie Bodart & Dr Stuart Sadler