Sleep Management

Sleep has important physical, mental and regenerative purposes. However, many people experience problems getting to sleep, waking in the middle of the night, or waking early and not being able to get back to sleep. The sleep cycle We move in and out of between 4 and 5 cycles of specific sleep stages each night. Movement through each cycle takes approximately 90 minutes. Each stage in the sleep cycle regenerates specific systems of the body and mind. Sleep cycle stages Non-REM (Rapid Eye Movement) Sleep: Stage 1 - During this stage you become drowsy, your thoughts become incoherent and you may feel like your are floating or falling. Stage 2 - This is a stage of quiet readiness. In this stage you can wake up quite easily and will be awoken by soft noises or movement. Stage 3 - The brain and body are beginning to relax and you settle into a deeper sleep Stage 4 - A sound sleep. 40% of the usual blood flow to the brain is diverted to the muscles to restore energy. This is when you are most difficult to wake up. REM Sleep: This occurs about 90 minutes after Stage 1 of Non-REM Sleep and reoccurs every 90 minutes. The brain is highly active at this time, but the muscles are relaxed to almost paralysis. During REM sleep we go through a process of mental and emotional regeneration. It is a time of integration and consolidation of our daily experiences. As you progress through cycles of NON-REM and REM sleep, deep sleep becomes increasingly shorter and REM sleep becomes increasingly longer (it is longest after 12pm), which is why you can often recall dreams just after waking. Overall 25% of our night-time sleeping is spent in REM sleep. Substances that impede sleep

  1. Caffeine (includes coffee, coke and chocolate)

  2. Nicotine, like caffeine, is a stimulant and can prevent good sleep

  3. Alcohol. It initially acts as a sedative, but then acts as a stimulant during later stages of the night.

  4. Some tranquilizers can be detrimental to achieving REM sleep.

  5. Eating before sleeping. Digestion can make it difficult to relax. If you are hungry, try drinking warm milk or eating carbohydrates instead of proteins.

10 helpful strategies

1.Develop a routine of going to sleep and waking up the same time every day.

2. Try not to take day-time naps. If you are very tired during the day, set a timer so that you do not sleep more than 30 minutes. Do not sleep after 3pm.

3. Sleeplessness can be "learned" through certain associations that you may develop consciously or unconsciously. It is important that you associate your bed primarily with sleep. So don't read, watch TV, study or have deep discussions while in bed, as this makes it difficult for your body and mind to associate bed with rest and sleep, which will then make it difficult for you to get to sleep.

4. Develop environmental cues to help you associate bed-time and your bed with sleep, for example:

•Do not use your bed as an activity centre

•Go to bed only when you are sleepy

•If you don't fall asleep within 10 - 15 minutes, get out of bed and go into another room. Do a non-arousing activity until you feel sleepy. When you feel drowsy, go back to bed.

•If you are still awake after 15 -20 minutes, get up and repeat your non-arousing activity or another one. Do not return to bed until you are sleepy

•Repeat as often as necessary until you fall asleep within 15 - 20 minutes

•Get up the same time each morning, regardless of how little sleep you had. A consistent wake-up time will help your body develop a regular sleep pattern

•Do not nap. Your goal is to establish consistent sleep cues at regular times., napping can disrupt those cues. Studies have shown that napping cannot substitute for a solid night of good sleep.

•Ensure that your bedroom environment is conducive to sleep. Make sure that you have a comfortable mattress, a good pillow, limited light, and limited noise. Our body has built in systems to make us feel sleepy at night and awake during the day. For example, our temperature drops during the night and rises when it is time to wake. We also release melatonin (natural sedative) when it is dark. It is important to therefore ensure that your sleep environment allows these body systems to function properly, for example sleeping in a dark environment.

•Establish a regular bed-time routine so that your body knows that you are going to sleep. For example, having a shower, brushing your teeth, reading quietly, turning off the lights and then going to sleep. This routine should start the same time every night.

•Avoid using bedtime as thinking time. If your mind is overactive, it may be helpful to write what is concerning you down and setting a specific time during the day to attend to or 'worry' about it.

•Use relaxation techniques.

5. Use a torch or night light for trips to the toilet. Do not switch on room lights as this will wake you up. Keep warm clothing beside your bed if you have to get up during the night.

6. Have water at the bedside so you don't have to got to the kitchen if you get thirsty during the night.

7. Exercise during the day, but do not exercise vigorously within 3 hours of bedtime. Your body will not be ready for a long sleep if you have been resting all day.

8. Don't regard it as serious or dangerous if you cannot get to sleep at night. Worry and anxiety will reduce your ability to sleep even more. Usually, the harder you try, the worse it will be. Remember humans can function quite well without a nights sleep, although you may be a little more irritable and tired than usual. Remember that you will probably catch up on lost sleep the following night and that you will eventually get to sleep, as humans cannot go without sleep for more than 72 hours.

9. As in all behaviour change, these strategies require persistent and consistent practice to be effective. In some cases it may take between 4 to 6 weeks of applying these strategies for benefits to be noticeable.

10. Ask yourself, "How would your life be different if you could get a good night's sleep every night?"

If you would like to discuss concerns about Sleep Management with a Psychologist, please phone Regional & Rural Mental Health Services on (07) 4637 9989, or contact us via our Contact Form to arrange an appointment to see a member of our team.

Dr Pamela Seaton