Self-Care: Good sleep as part of mental health recovery
By: Peter Walsh
Updated: 09 February 2021
By Peter Walsh
We all know that good sleep is beneficial. Yet, many of us still underestimate the costs of sleep deprivation and the enormous benefits that we can gain from something as simple and natural as sleeping. Lack of sleep has been associated not only with many psychological disorders, but has also been shown to be a risk factor for heart disease, diabetes, obesity and substance abuse.
Our waking lives and the time we spend in bed seem like completely different realities. We spend the days engrossed in the activities of our lives – the dramas, the worries, the relationships. And, then we climb into bed and “switch off”. If we drop off quickly, remain unconscious until morning and wake up feeling rested, we say that we had a “good night’s sleep”.
But, the time we spend in bed is not really a time of inactivity or switching off. On the contrary, it is a time of extraordinary activity. During the various cycles of sleep, the body undergoes repair, the batteries of the brain (glia cells) are recharged with nutritional “fuel” and experiences of the previous day are processed and integrated through the processes of dreaming.
It is often only when there is a disruption to the sleep cycle that we notice how important it is to our physical, psychological and emotional wellbeing. Even a single night of poor sleep can have a noticeable impact. Chronic sleep problems have the power to cause major issues in many different areas of our lives. Foggy thinking, inattention, moodiness, irritability, isolation, impulsivity and addictive behaviours often result from inadequate sleep. When tired, we are more likely to engage in other unhealthy habits in order to compensate for lack of energy and low mood.
The good news is that getting sufficient good quality sleep allows clearer thinking, sharpens concentration, raises and stabilises mood, promotes sociability, improves relationships and boosts creativity. And, yet for many of us, getting the extraordinary benefits of better sleep can seem like a struggle.
So, why do we struggle to achieve something that should be second nature?
Sometimes, our modern lifestyles work against the natural rhythms of the body. The internal clock that governs the phases of waking and sleep takes its cues from light and temperature. The shift in the hue of natural light as the sun goes down tells the body to prepare for sleep. At dawn, the light and warmth of the sun reverses the process. But, living in a modern world flooded with artificial light, central heating and endless sources of stimulating entertainment combine to disrupt our circadian rhythms.
Another major cause of sleep difficulties can be traced back to stress and rumination. Rumination (thinking and worrying about problems) creates a state of tension in the body that is exhausting and disrupts the ability to fall and remain asleep. When we ruminate excessively, we tend to dream more as our minds continue to chew over problems. This limits the opportunity of the body to repair itself and to recharge the glia cells in the brain. As a result, we often wake up feeling drained, depressed and unmotivated.
A final cause of sleep problems can be found in trauma. Part of the role of the dreaming process is to integrate experiences of our everyday lives. Emotionally traumatic memories have been shown to cause changes in the cycles of deep sleep and REM sleep. Sufferers of post-traumatic stress frequently report sleep disruption and nightmares as chronic problems until the sources of the trauma are treated.
Fortunately, there are some proven ways of re-establishing healthy sleeping patterns.
We can begin to improve the quality of sleep by putting in place practices that support the natural sleep cycle and reduce some of the harmful effects of our modern lifestyles. The following are just a few factors that we can change to improve the length and quality of sleep:
We can help to regulate our body’s natural sleep cycle by controlling exposure to light. The electric lightbulb makes it possible to extend the day well into the hours of darkness. But, bright lights and glowing screens prevent the release of melatonin, the chemical that regulates the sleep cycle. Melatonin normally begins to increase 2 hours prior to sleep and peaks around 5 hours later.
Limiting exposure to bright lights and switching off electronic devices during the last hour or two before bed, allows the melatonin to flow. It is equally important to ensure that we get outside during the daylight hours. Staying inside makes it more difficult to fully wake up and further disrupts the development of a healthy sleep cycle.
Melatonin levels decrease as we age and some people find it useful to take melatonin supplements to compensate for these losses. Compared to other sleep medications, melatonin supplements have been shown to be well tolerated and with relatively few side effects. It is advised to consult your GP before beginning to take melatonin supplements or other sleep remedies. But, in many cases, melatonin levels can be increased just by using the natural methods described above.
For many of us, the bedroom serves multiple functions. It may double up as a home-office, an entertainment room or a storage space for our possessions. It can be tempting to sit up late into the night answering email, messaging friends or binge watching the latest drama series, all from the comfort of your duvet.
But, good sleep can be enhanced by creating a space that is optimised for the purposes of rest. Limiting other activities in that room can strengthen the association between bed and sleep. Switching off the phone and the laptop can be an excellent first step. Ensure that the temperature is comfortable. If necessary, invest in blinds to limit the amount of light entering the room. Create an oasis of calm.
One of the simplest and most effective ways of re-establishing a healthy sleep routine is to maintain regular sleeping and wake-up times. It is tempting to sleep late at weekends or to take naps during the day to compensate for lost sleep. But, this often serves to prevent the creation of a regular routine.
We tend to get better at the things we practice. Lying awake twisting and turning is a skill that some of us learn to master through years of diligent practice. Some sleep experts recommend breaking the pattern by not lying awake for more than 20 minutes at a time. Instead of lying awake, get up and do something else. Recommended tasks would include anything that fatigues the brain and lulls the mind into a state of sleepiness. One famous psychiatrist was known to recommend waxing floors to his patients. But, reading 19th century novels can be just as effective. When sleepiness returns, it is time to get back into bed.
Where stress and rumination are the cause of disrupted sleep patterns, talking to a counsellor may provide a means of breaking the cycle of worry. By talking through problems, we can begin to recognise and change our self-defeating thought patterns, turn worry into positive action and discover healthier ways of dealing with the sources of stress.
Therapy can also help to uncover and heal traumatic memories which may lie at the root of our sleep difficulties.
Of the self-care actions that we can take to reclaim psychological, emotional and physical wellbeing, improving sleep is among the most effective. Even if you have struggled with sleep difficulties for many years, implementation of a few simple changes can bring remarkable and long-lasting benefits.
Note: If sleeping difficulties are severe or continue to persist over a longer period of time, it is advisable to consult your GP to better understand any underlying causes or concerns.
Frank, M.G., 2018. The role of glia in sleep regulation and function. In Sleep-Wake Neurobiology and Pharmacology (pp. 83-96). Springer, Cham.
Pillai, V. and Drake, C.L., 2015. Sleep and repetitive thought: the role of rumination and worry in sleep disturbance. Sleep and affect, pp.201-225.
Touitou, Y., Reinberg, A. and Touitou, D., 2017. Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: Health impacts and mechanisms of circadian disruption. Life sciences, 173, pp.94-106.
Zizhen Xie, Fei Chen, William A. Li, Xiaokun Geng, Changhong Li, Xiaomei Meng, Yan Feng, Wei Liu & Fengchun Yu (2017) A review of sleep disorders and melatonin, Neurological Research, 39:6, 559-565, DOI: 10.1080/01616412.2017.1315864
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