Are you sleeping well?
If the answer to this is no you’re in good company. A recent UK study show that more than half of us are struggling to sleep*.
Disruption to sleep is always debilitating, but given the current concerns over Covid-19, lack of sleep could carry even greater risks. Scientists believe that there could be a knock-on effect on our day-to-day resilience, and perhaps even an increased likelihood of catching the virus or experiencing worse symptoms as the immune system is compromised**.
The reasons for an increase in sleep issues may be obvious, with heightened anxiety and disruption to routines the cause of many a sleepless night. Even when events seem to be out of our control there are still things we can do to help ourselves.
Here are my 10 top tips to sleeping well.
- Is it really a problem?
All humans work to a natural rhythm of life – something called the circadian rhythm – which is a roughly 24 hour cycle. The length of this natural cycle can vary a little between people, but the average seems to be around 24 hours and 15 minutes. We actually use natural daylight each day to sort of recalibrate ourselves into the 24 hour cycle as that’s what works for us.
The Circadian Rhythm is responsible for activating brain and body mechanisms designed to keep us awake and alert, and then reducing this alerting influence at night time ready for sleep. The peak and trough points for wakefulness and sleep can vary greatly from person to person. You may have heard the terms Night Owls and Morning Larks used to describe people, and these patterns are often strongly determined by genetics.
Culturally night owls are usually at a bit of a disadvantage as the accepted work patterns of industrialised nations don’t suit these people – they can find themselves forced into an unnatural sleep/wake rhythm. However given the current disruption to work life and routines it’s possible that with no imperative to conform to a rigid start time, night owls are experiencing an irresistible urge to “reset” to natural patterns
TIP 1 – Consider – is it actually a sleep problem, or is it a problem with the sleep patterns you have previously been forced to adopt? Are you simply fighting a natural “reset” to your body’s preferred settings?
- Manage light levels
Our bodies rely on a chemical called Melatonin as the biological command for the timing of sleep. Melatonin begins to rise in response to light reduction, and it gives a very clear and loud message to the brain that night time is approaching. During the night, as light increases, melatonin levels gradually decrease, and the absence then of circulating melatonin tell the brain that wakefulness can return.
The availability of constant light, whether from old fashioned yellow light bulbs or the blue LED light of our many entertainment devices, plays a very significant role in confusing our melatonin signal and messing with the planet’s natural 24 hour cycle.
Artificial light in the evening can make us believe that we are suffering from sleep onset insomnia (trouble going to sleep), where in fact what is happening is we are simply delaying our release of melatonin by perhaps 2-3 hours by switching on the light or playing with our tablets.
The overhead light bulb (yellow light) has some effect, however blue LED light is worse as the light receptors in the eye are more sensitive to blue light meaning that exposure to blue light has twice the impact on suppression of melatonin. Lockdown probably means we’ve had more time on our hands, and turn naturally to electronic devices to occupy that time.
Blue light is also particularly to be avoided as it also affects the quality of our sleep, meaning that the brain doesn’t get the chance to carry out the repair work it usually does while we’re asleep. That has a knock on effect and might even make it harder to sleep the next night….and the next….
TIP 2 – Dim the lights and limit your screen time in the run up to bed-time.
- Don’t nap
As soon as we are awake a chemical called Adenosine starts building up in our brain. Every moment that we are awake the concentration of this chemical increases and the longer we are awake the more is accumulated. As adenosine is created in the brain, it binds to adenosine receptors. This binding causes drowsiness by slowing down nerve cell activity.
Increasing adenosine means an increasing desire to sleep, and when concentrations peak we feel an irresistible desire to sleep. This usually happens after around 12 to 16 hours of being awake.
Adenosine levels decrease during sleep – even a short nap may cause enough reduction to impact sleep at a normal bedtime. More sedentary time and boredom under lockdown creates greater opportunity for nodding off when we perhaps didn’t mean to.
TIP 3 – Avoid napping during the day, and certainly after 4pm. Find something active to do to stave off sleepiness and boredom during the day.
- Control caffeine intake
This won’t be a surprise – we all know don’t we that caffeine is a stimulant and that drinking an expresso just before bed is probably not a great idea. But let’s have a closer look.
Remember our sleep pressure chemical, adenosine? Caffeine actually mutes the sleep signal of adenosine. It does this by latching on to the very same receptors that adenosine uses to slow down our nerve cell activity. Caffeine effectively blocks these receptors so that the sleep signal simply can’t get through – a bit like putting your fingers in your ears to block out noise.
It therefore tricks you into feeling alert and awake.
I’m sure you’re familiar with this effect, however you may not realise just how persistent caffeine is in the system. On average it will take your body 5 to 7 hours to metabolise HALF of the caffeine from a cup of coffee. There is still enough strength in the remaining half, even though considerably diluted, to continue to disrupt sleep for several hours more.
Caffeine is metabolised by an enzyme in the liver, but the effectiveness of this enzyme varies considerably from person to person based on genetics, age, other medications and even the quality and quantity of prior sleep. Sensitivity to caffeine therefore varies widely between people, and even for the same person at different time.
There’s another effect to bear in mind here too – that of the caffeine crash. Caffeine blocks the sleep message of adenosine, but it does not destroy the adenosine itself. In the absence of sleep the level of this chemical in your system will keep right on building up. When the caffeine does lose its effect you will immediately get an overwhelming dose of sleep pressure and energy levels will plummet rapidly. If this is at an inappropriate time the temptation will be to reach again for the artificial stimulant just to keep going.
Finally, be aware that while we mainly associate caffeine with coffee, it is also present in tea, dark chocolate, pain relievers and some other surprising places….and decaff doesn’t generally mean no-caff!
TIP 4 – find all the sources of caffeine that creep into your daily routine and plan alternatives. If you really can’t do without coffee, try limiting it to early morning only.
- Avoid alcohol
With UK alcohol sales up 22% in March it seems likely that one or two of us are enjoying a drink or several more than we might usually have. And many people believe that a drink helps us fall asleep, and can help us sleep more soundly.
However, alcohol is misunderstood.
Alcohol is actually a sedative that works by binding to the receptors in the brain and preventing neurons from firing electric impulses – the things that control most of our bodily functions.
As the brain is thus sedated it becomes easier for you to let go of consciousness.
However sedation is not a natural sleep, and there are two main issues that arise from this.
Firstly alcohol induced sleep is not a continuous sleep, and is therefore not restorative. You make well not remember the numerous small awakenings, but they are nevertheless disruptive and have a significant impact on how you feel and function the next day.
Secondly alcohol also affects the quality of our sleep in the same way as blue light, meaning that the brain isn’t doing the necessary processing while we’re asleep, again with that knock on effect lasting several days.
TIP 5 – Enjoy an occasional drink but avoid drinking heavily and try not to regard it as something to help you to relax or to sleep.
- Manage temperature
Ambient room temperature along with bedding and clothing determine your bodies core temperature. And ambient temperature is a major culprit in affecting our sleep in our centrally heated and thermostatically regulated homes.
Remember melatonin? That chemical which informs our bodies that night time and therefore the time to sleep is approaching based on the onset of darkness. The body also relies on a drop in temperature (as in the setting of the sun) as a cue for it to initiate the evening surge of melatonin.
In fact our core temperature needs to drop by 2-3 degrees F, or around 1 degree C to successfully initiate sleep.
This means a bedroom temperature of around 65 degrees F or 18 degrees C is ideal, assuming standard bedding and night clothes. In reality this feels just a little too cold for comfort when you’re out of bed.
TIP 6 – Confusingly, considering that we’re trying to lower the core body temperature to initiate sleep, a hot bath just before bed can actually help. The heat of the water dilates the blood vessels near the surface of the skin and helps to draw out inner heat, so our core temperature reduces. For the same reason warming your hands and feet at bedtime also seems to help as it draws warm blood to the extremities and away from the core.
- Allow enough time
It might sound obvious, but under lockdown our usual daily routines are out of the window and with no imperative to stick to our usual bedtime there may be a temptation to stay up just a little bit later…..and then later still…but lighter mornings, kids, pets etc may still demand that wake at our normal time. Studies show that we need 7 to 8 hours to operate effectively, both mentally and physically. The last 1 to 2 hours are particularly important, so you are really missing out if you are getting less than 6 hours and again the knock-on effects may be felt in disrupted sleep patterns further down the line too .
TIP 7: Keep to routines as much as possible and allow for 7 to 8 hours in bed each night.
- Create a decompression zone
With the constant media focus on worrying reports of the pandemic , available 24/7 via our televisions, phones, tablets and other devices, we can easily find ourselves still ‘wired’ at bedtime. Whether watching a news report or interacting on social media, these things stimulate the mind and generate anxiety at a time when you should be winding down.
TIP 8: Put the phone and laptop away at least an hour before bedtime and avoid any evening or late night news. Listen to music or watch something harmless on TV. Consider brushing your teeth an hour before bed, as this kind of activity can make you more alert.
- Focus on what you have achieved
With our usual work and social activities restricted and the challenge of adapting to the new norm, many are finding it difficult to find energy and motivation to complete what may seem like even basic tasks and projects. Going to bed with a mental ‘to do’ list, or beating yourself up for not getting enough done is not conducive to a good night’s sleep.
TIP 9 – when you get into bed, review the day and find 5 things you have achieved. They needn’t be big things, they could be things as simple as changing a light bulb, tidying a cupboard, going for a walk or contacting a friend.
- Use relaxation techniques or audio tracks.
There’s no doubt that anxiety can play a significant role, and is often at the root of sleep issues. Ironically it is also while we’re asleep that the brain has the greatest chance to process our anxieties, so it’s easy to see how a vicious circle of disrupted sleep – reduced anxiety processing – anxiety build-up leading to more disrupted sleep can be established.
TIP 10 – Learning relaxation techniques or listening to a relaxation audio track at bedtime can help with physical relaxation, and it’s when our bodies are relaxed that our minds can relax too. Sleep often follows.
Taking this a step further hypnotherapy, used alongside psychotherapy, offers a gentle and effective solution. By using deep relaxation in a guided way we can help the brain to process anxieties, reset thought patterns to break the vicious circle and develop longer term positive behaviours and mindsets. As part of this process sleep is generally much improved.
For more information, to book a free initial consultation or to request a downloadable relaxation track please email firstname.lastname@example.org or call 07761 533372.
*Research in May 2020 by 2,254 UK residents in the 16-75 age bracket. The study was carried out by market research company Ipsos MORI and King’s College London. https://www.kcl.ac.uk/news/how-the-uk-is-sleeping-under-lockdown
** While it’s too early for any studies to have been done on the effects of sleep on this particular coronavirus (Covid-19), in 2015 researchers in the US deliberately infected 164 volunteers with the rhinovirus (common cold). They found that the people who slept less than six hours a night were four times more likely to develop cold symptoms than the ones who slept for seven hours or more. Aric A. Prather, PhD, Denise Janicki-Deverts, PhD, Martica H. Hall, PhD, Sheldon Cohen, PhD, Behaviorally Assessed Sleep and Susceptibility to the Common Cold, Sleep, Volume 38, Issue 9, September 2015, Pages 1353–1359, https://doi.org/10.5665/sleep.4968