The Struggle with Sleep 24 Jun 2018

Why sleeping well helps

Lack of sleep puts a stress on body.

We know that the way we live our lives impacts on quality of sleep. So if we eat better, move better, get more light in day, then we would have much better quality sleep... so we would be more attentive, more focussed, and a better mood the next day. It's a cycle.

We also know that mental health difficulties are currently at a peak in the UK- and mental health and sleep are closely related.

Sleep deprivation can start having an impact on attention, memory recall, work, relationships and then thoughts and feelings and mood. Things can escalate quickly and so managing sleep well and making it a priority can help to head off these conditions.

Normal Sleep

This may seem a bit weird but we don't actually just go to sleep and then wake up in the morning! we do have moments of wakefulness normally throughout the night.

We actually sleep in cycles of about 1 to 1.5 hours long.

Why? Well we have this prehistoric part of our brain (the amygdala) that is wired to protect. Worry and checking is an important part of our brains function, it serves a good purpose - it keeps us out of danger. In sleep we've been programmed that every hour and half we wake to 'check for danger'. We don't need to check for danger now of course but in the prehistoric times waking regularly helped us not get eaten by predators! This sleep cycle, called the circadian rhythm is still wired into our brain.

So we shouldn't be striving for 6-8 hrs total sleep. It's completely NORMAL to wake up a few times throughout the night. Our brains are designed to do this, to 'check' and keep us out of danger. In these normal 'momentary gaps of wakefulness' (every hour and a half), we will usually change position and then get back into the next sleep cycle.

How it can become difficult

It can become hard to tie these 1.5 hour 'sleep cycles' together! Particularly the bits between wakefulness and sleep.

The important thing is what we do in those regular wakeful times; but of course the first thing people will do is 'get busy'! It is these 'behavioural actions' that push us further away from sleep.

Here's an example... We check our phones, make a witty facebook post. This creates light stimulation - inhibits our sleep hormone (melatonin), we activate cortisol the "get ready for the day" stress hormone, and as far as the bodies concerned the days begun! (Smart phones in the bedroom can be a real problem.)

We can also start to 'think' things. If you're already a little stressed this can lead to racing thoughts, anxiety during that wakefulness moment and suddenly the cortisol arrives in plentiful supply!

So you can see how a 'normal' sleeper can have a night of poor sleep due to life stresses, work, relationships. This sows seeds of doubt in their trust of their ability to sleep... ("that wasn't nice, I hope that doesn't happen tonight"). This increases the 'threat detection' part of brain (the prehistoric amygdala), which kicks in... so their relationship with sleep changes. They can be feeling sleepy downstairs but, instead of their normal sleep cues, as they go to the bedroom their heart pounds, their mind begins to race, the brain asks "where's the danger? where's the tiger?" Wham! Night time arousal has occurred and they're wide awake!!

We are creatures of habit!

This quickly becomes a habit. For chronic insomniacs this becomes a learnt condition - the way in which people relate to night time changes. People become good at not sleeping!

Here's an example - I've given you a big, juicy pear - you salivate, feel hungry, you've had good pears in the past and you're looking forward to this one... but just as you're about to bite maggot appears... Suddenly the function of pear has changed... and if it was bad enough for you (you eat the maggot) it might change quickly! ("I'm never going to eat a pear again."). I'm sure you recognise that vomiting after a nice meal can create the same feelings even weeks after the event. Just thinking of that food makes you feel a little sick!

Then you can be too focussed on sleep! It becomes a fight, you want to fix it, but the harder you try the bigger the problem seems to become.

Sleep hygiene is important... as we've discussed already, habit is helpful, so healthy, repetitive habits will help!

I'm sure you know these techniques well, but they include exercise, natural light in the day, a comfortable mattress, a dark bedroom at the right temperature, diet, avoiding caffeine and alcohol, building a regular sleep routine.

If you want to learn more here's a good PDF:

SleepHygiene    

Drop the struggle ("Drop the rope!")

If you're really struggling with sleep, it may feel like a tug of war you're losing and sleep hygiene may not be enough on its own...

This is where ACT (acceptance and commitment therapy) comes in.

ACT teaches people to lean towards the discomfort, be curious with the thoughts and feelings that arise, accept them and then let them go. To stop struggling.

You see, the thoughts and feelings aren't the problem; it's our relationship with them that is. When we struggle with our sleep, this causes distress and suffering. We try hard to get rid of the problem, fix it, our internal self-talk then kicks in, we start predicting, catastrophizing, "Oh no not again", "what if...?" and it becomes a vicious cycle. The distress increases and the sleep does not improve.

Your energy has been given into trying to stop what you don't want (the distressing effects of not sleeping) rather than what you do want (to sleep) and the more you struggle the bigger the hole seems to get. But you daren't "drop the rope".

If you ask a normal sleeper how they sleep they will probably answer "I don't do anything I just go to sleep". There's no fight, no special techniques. They're not struggling!

"Dropping the rope" doesn't mean to give up, it means actively choosing to accept the distress, stop fighting it, stop 'trying' to sleep, go with it. That's tricky because sleep does cause distress... so you naturally want to pull on it, fight it! (But fighting it hasn't worked)

As you drop the struggle you can become more mindful with the distressing thoughts and feelings, observe and accept them without judging them, become playful with them rather than picking up the rope again.

This allows space for flexibility.... take a step back, let go of the struggle, accept you have difficulty sleeping right now and all that brings to you, calm your amygdala and start to plan...

That's just the beginning... But for more information www.thesleepschool.org is a great resource and its ACT based!

Bowen Therapy for Sleep

I have worked with many clients who have reported that their sleep has improved subsequent to Bowen Therapy.

We know that Bowen Therapy enables a deep state of relaxation and in addition affects the Central Nervous System, allowing the body to switch from its high arousal state into rest, relax and restore mode.

Bowen Therapy also targets muscle tension and discomfort. There is no forced manipulation or hard tissue adjustment and so the body is given no threatening signals.  Clients often report of a reduction in pain and stress levels as well as improved function - all of which help give a good night's sleep.