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World Sleep Day, Friday, 18th March 2022

Having originally trained in counselling over twenty years ago, Mike Ellerker worked as a despatch and warehouse manager for 14 years.

He studied with The Quest Institute, and after graduating in 2016, built a part-time therapy practice, before leaving full-time employment and pursuing therapy full-time.

Because of his own sleep problems and having lived with anxiety and depression, Mike developed a keen interest in the subject of sleep and its effect on mental health.

Mike specialises in helping people to manage the effects of stress, anxiety, depression, low self esteem, and to sleep better.

More recently he trained with Dr David Lee, a Biopsychologist at the forefront of sleep treatment.

Dr Lee is the author of ‘Teaching the World to Sleep’, the pioneer of the R.E.S.T. ProgrammeTM and founder and Clinical director of Sleep Unlimited Ltd.

Sleep

Introduction

It’s 3:00 am, and I swear that I have seen every hour pass on the clock next to my bed. Sleep should come easily because I’m exhausted, yet every night for as long as I can remember I have lain wide awake in bed willing sleep to come, but it doesn’t, and so I just keep waiting and waiting.

Even on the rare occasion when I have managed to fall asleep, I wake up shortly after, and in the early hours find myself staring at the ceiling. Eventually, the dawn chorus of birds outside begins as the sun rises.

 It’s pointless to stay in bed any longer so I get up and resign myself to the fact that today will be like all of the others, I’ll stagger through it blindly, relying on coffee to get me through, and when night-time comes around again, I’ll be waiting in the dark for something that will never happen.

Telling your friends that you are so tired that you’d accidentally tried cleaning your teeth with shaving gel is always good for a laugh, but persistent lack of sleep and the detrimental effects that it has on concentration, mood, and health are no joke.

I know because this is how things used to be for me. My sleep was poor. Even when I slept I’d wake up repeatedly through the night. I also suffered from frequent episodes of sleep paralysis, which began to make me fear the thought of sleep.

Things started to change when I began to study for my Diploma in Cognitive Hypnotherapy with The Quest Institute. As a result of what I learned from my mentor and friend Trevor Silvester, I started to enjoy being me, and both my sleep and mental health began to improve.

I learned to relax and manage the anxiety that I had suffered with for years, and my worries continued to fall away as I learned how to control my negative thoughts, and I haven’t looked back since.

Since graduating from Quest in 2016 and setting up my therapy practice, my interest in sleep and related problems deepened. I knew I could learn more and improve my sleep further.

I was also finding that many of my clients had sleep problems of their own, and I knew I could do more to help. So it was, that after lots of searching I discovered Sleep Unlimited ltd.

They are “A one stop shop for all things sleep”, they provide sleep assessment and sleep treatment. They also train individuals and organisations in the use of the R.E.S.T. Programme TM (which utilises CBTi) the NICE recommended treatment for sleep disorders, having a measurable effectiveness of 70 %.

Thanks to what I learned on the R.E.S.T Programme TM,, combined with the approaches from Cognitive Hypnotherapy,  the sleep problems which plagued me for thirty years, are now a thing of the past.

If you have sleep problems, I can guarantee you that you are not alone in your suffering. Research suggests that around one third of adults in the UK suffer from insomnia, although it is believed that the actual figure may be much higher. It’s not surprising then, that sleep researchers and clinicians believe that sleep problems pose as great a health concern as obesity, diabetes and cancer.

Left unchecked, when sleep problems become chronic they can cause serious problems and begin to negatively affect both physical and mental health.  For this reason, sleep is the foundation on which everything else relating to physical and mental health and wellness stand, and it needs to be taken more seriously.

It is estimated that insomnia and related sleep issues cost the UK economy around £40 billion every year owing to lost workdays, domestic, road and industrial accidents.  That’s a staggering amount of lost money, and of course, missed sleep.

And so, on World Sleep Day, I want to share some ideas and information with you which should help you sleep better and be happier as a result.

Part One: The Science of Sleep         

Blue light, Light Pressure and Melatonin Production

You were probably told as a child: “You’ll sleep well tonight after all that fresh air outside!”

Well, feeling tired after a day outside has nothing to do with fresh air, It’s all about daylight, specifically ‘Blue Light’ ,‘light Pressure’ and ‘Sleep Pressure.’

When you are exposed to natural daylight from the sun, ‘Blue Light’ passes through your eyes and into the brain along a pathway known as the Retinohypothalamic Tract (R.H.T).

This action converts the blue spectrum light into a substance called ‘Melatonin’ (our naturally produced sleep promoter.) The melatonin is stored in the brain in the ‘Pineal Gland’ (so called because it looks like a pinecone,) at night when it is naturally darker and the light around you has changed from blue to the red end of the colour spectrum, this signals to the Pineal Gland to release the melatonin that has been produced and stored during the day. This has the effect of helping you get to sleep, so if you want to get the best exposure to blue light, get outdoors in the morning, as this is when the blue light is strongest, which means that the amount of melatonin  produced and released later on at night will be increased. You can see the process of blue light converted into melatonin in the diagram below:

Artificial Blue Light

Of course, you’ll have heard about blue light boxes and bulbs which emit artificial blue light to give you a dose without getting outside.  Honestly, don’t bother with them because the dose you’ll receive from them is negligible compared to naturally occurring daylight which won’t cost you a penny!  So, get outdoors and save yourself some cash and remember, more light pressure (daylight into the eyes) means more Pineal Gland activity which equals more melatonin which means sleep.

Unfortunately for Humans, smart phones, tablets, I-pads, laptops, TVs, etc (which we all love and can’t live without), emit artificial blue light. When you use these devices at night, the artificial blue light from these devices travels into your brain through your eyes just as natural blue light does. This stops the Pineal Gland from releasing the Melatonin as it is basically tricked into thinking it’s still daytime as no red light is being detected.

Reducing your exposure to artificial blue light from screens in the evening, particularly in the two hours before bed, will help you sleep better. So, make winding down from work and screen time part of your night-time routine.

Glasses with a blue light filter on the lens are available to buy and some devices have blue light filters which can be enabled as part of a night-time routine. But whilst they may prevent some blue light, they won’t block it completely, and more importantly they won’t prevent emotional arousal if you are reading upsetting news articles or getting wound up seeing social media posts that trigger a stress response.  Put simply, there is not enough scientific evidence that blue light glasses reliably help with sleep.

Light Pressure

The daylight that enters your brain through your eyes is known as ‘Light Pressure’ and it is measured in units called ‘Lux’. Even on a dull overcast day when you don’t see much of the sun in the sky you will still get the benefit of 10% more light pressure than you would if you stayed indoors.

The table below shows how light pressure doses vary across different environments:

Environment:

Light Pressure in Lux:

Domestic lighting

Around 50  –  300 Lux

Commercial offices

Around 500 – 800 Lux

Outdoors when cloudy/overcast

Around 1000 Lux

Outdoors with fairly clear skies

Around 10,000 – 25,000 Lux

Outdoors in direct sunlight

Around 50,000 Lux

Sleep Pressure

The longer you are awake the sleepier you will be as a result, as you are literally building up ‘Sleep Pressure’ which is simply pressure on you to sleep. You can think of this as the weight of tiredness.

When you sleep, your sleep pressure decreases and resets to zero, as you have relieved it by sleeping. Then when you wake up and remain awake the following day, sleep pressure begins to build again.

You can see this in action on the graph below:

Ultradian Rhythms

‘Ultradian Rhythms’ are our internal clocks, and they are responsible for regulating hormone production, the need to drink and eat, toilet trips and of course they reliably control our sleep/wake cycle.

Adults have a regular Ultradian Rhythm that lasts around 90 minutes. Babies have a cycle of about 45 minutes from being born and on into their first year.

As they grow into toddlers, the cycle increases to around one hour, and  into adolescence it increases to 90 minutes, where it remains for life.                                                                                  

When your Ultradian Rhythm ‘Peaks’ you have reached a peak in your alertness, and when it ‘Dips’ you have reached a dip in your alertness.  Your ability to concentrate literally ‘Dips out’ as cognitive function dips, and returns again as you are peaking.  You’ll probably be familiar with being unable to remember something or to think straight about a problem, then around 45 mins later the answer just seems to come to you as your concentration and focus return.

Each of the 8 segments on the clock face below represents an Ultradian Rhythm cycle that lasts for 90 mins:

So, in a 12-hour period there are 8 x 90 minutes, meaning that every 12 hours we will go though 8 Ultradian Rhythm cycles that each last for 90 minutes.

In a 24-hour period there are 16 x 90 minutes, meaning that every 24 hours we will go through 16 Ultradian Rhythm cycles that each last for 90 minutes.

It takes around 45 minutes in the cycle from peak to dip, and so from dip to dip it takes ninety minutes. To stand the best chance of falling asleep you need to be in a dip (you don’t need to be alert when you are trying to fall asleep,) likewise you will find it easier to wake up in a peak as you will be more alert.

The diagram above shows the peaks and dips of your Ultradian Rhythm cycle.

A quite accurate indicator of being in a dip is when we are yawning.  We yawn when we are tired, so knowing when you are in a dip is a really useful way of setting a bedtime. If you are trying to get off to sleep but can’t manage to, you are probably trying to go to sleep at a peak in your alertness when you need to be in a dip.

You’ll probably be familiar with being tired at some point in the evening and then your alertness increases and you don’t feel tired anymore.

Think of dips as sleep buses, a yawn is your indicator that the bus is near, your bed is the bus stop, and the destination is sleep. If you miss one sleep bus, you’ll have to wait 90 minutes to catch the next one.

Keep a yawn diary and note down when you are yawning in the evening.

If for example, you catch yourself yawning at 19:30 (7:30) but think this is too early for bed, just move your bedtime on by 90 minutes so that you can catch your next dip at 21:00 (9:00) or the next at 22:30 (10:30).  You need to be ready in bed to catch your dip when it comes, so aim to get ready for bed by 20:45 so you only have 15 minutes to wait.

If, for example, you find yourself waking up during the night at 3:00 am (remember waking up normally happens at a peak,) then you can work backwards to plot a good bedtime. So 3:00 am is a peak, and so are 1:30, and 12:00.  If you add or take away 45 minutes from these times you can then identify your dips and plot a good bedtime.

If you do wake up in the night (at a peak), then you’ll have to wait 45 minutes for your next dip to come along.  As mentioned earlier, get up and do something non-stimulating until you are yawning again (entering a dip.)

Stages and Cycles of Sleep

Typically, when we go to bed and have lain awake for about ten to twenty minutes, as we fall asleep our brains move into N-REM (Non-Rapid Eye Movement) sleep. There are three stages to N-REM sleep, (N-REM 1, N-REM 2, and N-REM 3) each subsequent stage being deeper than the last.

Next, we move into REM (Rapid Eye Movement) sleep, where our brain waves and electrical activity resemble those associated with drowsy and wakeful states, this stage of sleep is most commonly associated with dreaming.

One complete sleep cycle (from lying awake and resting, then through N-REM1 to N-REM3,) and then into REM, usually lasts for approximately one and a half hours.  A typical night’s sleep will usually contain six or five separate sleep cycles.

Does your brain have too many tabs open?
Well, it’s a busy office!

We are all familiar with the concept of memory, but ‘fogettery’ is equally important. We make around 32,000 decisions a day, and each thought produces one page of data. That’s a lot of information to process, thankfully most of it happens outside of ‘conscious awareness.’

During N REM (Non-REM Sleep) ‘the busy office’ is tidied, and the ‘paperwork’ is processed. Anything with relevant value is stored in memory and anything that isn’t important is forgotten about – you really don’t need to remember that crisp packet blowing towards you in the wind from earlier on in the day!

How much sleep do we really need?

As we are all individuals, the amount of sleep we actually need depends on our age, and sex, so it varies from person to person.

People aged 19 – 45 years need around 7-7 3/4 hours sleep.

People aged 46 years and over need around 5 – 7 hours sleep.

Most adults tend to sleep anywhere from 6 – 9 hours per night, but it’s helpful to know if you are:

A: a short sleeper (6 – 7 hours per/night) B: a long sleeper (8 – 9 hours per/night)

The table below compares typical sleep lengths across different ages:

Age:

Approximate sleep duration in Hours:

Teenagers

Around 9 +

5 – 10 Years

Around 9.5 – 11

3 – 5   Years

Around12 – 13

Infants (3 – 11 months)

Around 15

Newborn babies

Around 18

Younger people spend more time in REM sleep, and the NREM sleep they experience is likely to be deeper.  Scientists believe that these two forms of sleep aid the development and growth of younger people’s brains.

Older children and teenagers appear to need more sleep than adults – they tend to go to bed later and sleep in longer. This could have led to the view that they are ‘lazy’, but the fact is they need this amount of sleep to aid the brain in ‘re-wiring’ itself as it develops while they are learning.

The older we get, the less time in REM sleep and deep sleep we spend, so unlike older children and teenagers this could by why learning new things becomes harder the older we get.

So now we’ve looked at some sleep science, I’ll introduce you to:

Part Two: The R.E.S.T. Programme TM

The R.E.S.T. Programme TM developed by Dr David Lee is exclusive to his organisation Sleep Unlimited ltd. It is a fantastically useful stepped care approach to treat those who are suffering the effects of Insomnia and poor sleep. It is currently the NICE treatment of choice for sleep disorders. It utilises CBTi which has a measured effectiveness of 70% in the treatment of sleep disorders.  It consists of four main elements, namely:

Routine, Environment, Stimulus Control, Thinking

Depending on the complexity of your sleep problem, you may not need access to all of the elements of the R.E.S.T. Programme TM, you may simply need help relating to just one specific area, whilst others will need more help with different aspects of their sleep problem.

Most sleep problems can be relatively easy to sort out, but occasionally I refer clients with more complex issues to Sleep Unlimited Ltd.

1. Routine – Good sleep requires a consistent routine.

Generally speaking, good sleepers have good regular bedtime/sleep routines, and poor sleepers have bad routines.

Sleep Chronotypes

‘Chronotypes’ describe a person’s sleep preferences; these preferences relate to when someone prefers to go to bed and when they get up.  When addressing your sleep routine, it’s important to identify your ‘Chronotype’:

Morning Larks:  Typically, these are people who like to go to bed early and get up early.

Night Owls:  Typically, these are people who like to go to bed late and get up late.

Abivalents:   Typically, these people fall somewhere in between the first two Chronotypes; they are neither really one nor the other.

Once you’ve Identified your Chronotype and ideal sleep length, it is easier to set up a sleep routine that will work effectively for you.

When it comes to sleep length you are your own expert, so ask yourself: How long would you like to sleep for?   Remember it’s very important that you are getting the right amount of sleep that’s realistic for your age.  So, when setting up a sleep routine make absolutely sure to give yourself enough time in bed.

Being awake in bed and waiting too long for sleep to come along (‘Sleep latency’) can create worries about your ability to sleep. This can then lead to you becoming frustrated, which begins to impact negatively on your sleep.  Similarly, remaining in bed in the morning after you’ve woken up can begin to build the association of being in bed and not sleeping, so try to get up straight away and don’t linger under the covers.

Once you have identified your ideal bedtimes and rise times (by examining if you are a long or short sleeper) start to implement them into your sleep routine. Remember that it’s important to stick to these times, so make sure that you are going to bed every night at the same time and getting up every morning at the same time. Consistency is key, stick to the same times every day and night of the week, including weekends.

Once you start to deviate from your routine it becomes easier for you to fall back into old ways, but remember the old saying: “If you keep doing what you’ve always done (your old sleep habits,) you’ll end up with the same old result you used to have” (poor unsatisfying sleep). So be consistent!

Once you are in bed, if you can’t get to sleep in around 15-20 minutes, (or if you’ve managed to get off to sleep and have woken up through the night, and can’t get back to sleep again for 15-20 minutes). Leave the bedroom! Find something to do which is non stimulating.

At this stage don’t do any of the following things as they all negatively impact your sleep!

Don’t:

  • Exercise
  • Drink too much fluid
  • Drink milky drinks
  • Drink alcohol
  • Drink coffee/tea or anything caffeinated
  • Smoke/vape or chew nicotine gum
  • Eat anything, particularly chocolate, sugary foods, or foods that contain carbs
  • Watch T.V, use your mobile, tablet, laptop, PC (avoid blue light emitted by these devices.)

 It is very important that you only return to bed when you are feeling sleepy again. This should take around 45 minutes when you start to enter a dip in alertness on your ‘Ultradian Rhythm.’  Remember that yawning is a good indicator of when you are entering an ‘Ultradian Dip.’

To begin with making your sleep time shorter may make you feel more tired, but it should mean you’ll sleep better the next night as you will have built up ‘Sleep Pressure.’

2. Environment: Good sleep requires an optimised sleep environment.

If you want to increase your chances of having a good night’s sleep, then you need to make sure that you have a good sleeping environment.

Sometimes people overlook obvious things like the condition/age of their beds, mattresses and pillows. If these things aren’t comfortable then they aren’t going to help you sleep.

Put simply, you need:

  • A comfortable pillow.  A saggy flat, or lumpy old pillow won’t help.  Does your pillow pass the hold and flop test?  Hold your pillow out at arms length, if it folds easily and flops down droopily you really need to invest in a new one as your old pillow is unlikely to offer any support in bed.  Remember to fluff up your pillows to make them more comfy.
  • Seasonally appropriate bedding.  The ‘Goldilocks rule’ applies here. Ideally having the right bedding means that you shouldn’t be too cold in winter and too warm in summer.

 Maintaining a fairly constant and reasonable temperature in the bedroom is a good idea.  Your body naturally begins to cool down to allow you to get to sleep, this happens when you are entering a dip in alertness on your ‘Ultradian Rhythm.’ By contrast your body temperature naturally raises as your alertness increases and you begin to peak.  It’s the reason why you feel warmer in bed around the time you wake up.

I’ve spoken to many people who report feeling warmer and more alert when trying to get to sleep, so experiment with your central heating programme and bedroom temperature and see what works best for you.  And remember, it could mean you are trying to go to sleep at a peak and not a dip.

  • Ventilate your bedroom.  Remember to open your windows in the morning to ventilate your room and let some fresh air in (nothing pollutes a room like stale garlic breath from last nights pizza). Seriously, stale air doesn’t help, and trapped moisture and condensation from our breath can cause mould to grow in poorly ventilated rooms. 
  • Thick curtains. Skimpy, wafer-thin curtains won’t help. Darkness is one of the things that sleep likes, so you need to reduce as much light as you possibly can from interfering with your sleep.  Invest in a blackout blind or some heavy curtains made of thick material, or alternatively you can use a black out sleep eye mask. If you are going to use a mask, make sure that the elastic isn’t too loose or too tight.
  • A comfortable bed and a comfortable mattress. A creaky, sagging old bed and a worn-out old mattress with springs sticking out won’t help.

If you’re in need of a new a bed/mattress/duvet/pillows etc, remember Google is your friend. There are many rival companies selling different mattresses and beds and many of these vendors allow you to try out a mattress free for a set amount of time to see if you like it. Alternatively visit a bed showroom and try a few different mattresses to see which best suits your needs. Lots of companies that sell mattresses tend to make bold claims about how well you will sleep on their respective products versus other brands.

Bed industry research shows that there is no single type of mattress that has been reliably proven to positively impact on sleep more than another.  So, whether you’re looking at a memory foam, wool, or pocket-sprung mattress the rule is simple:

It needs to be comfortable for you so, make sure it isn’t too soft with too much give or too firm and unyielding. Some people prefer a soft surface, whilst others prefer a medium or firm surface.  Imagine a scale ranging from quicksand to bricks, and again consider the Goldilocks rule, make sure it’s just right for you. The same applies to bedding and pillows, just keep it comfy.

  • Stick to sleeping in your bed and not anywhere else in the house. This helps to build the positive association between your bed and sleep, but sleeping elsewhere begins to undermine this, so make sure your bed is the only place that you sleep.
  • Napping. Whilst some people feel as though they need to nap during the day because of poor sleep on the previous night, napping is not advisable in the case of healthy adults. Remember that ‘sleep pressure’ increases with being awake, so napping reduces ‘sleep pressure,’ which will prevent you from getting to sleep later on at bedtime.  If you feel that you need to nap throughout the day, then sorting your sleep routine out should eliminate dependency on napping. However, in the case of older people with dementia, napping during the day for up to, but not over, one hour, can help to reduce the rate of cognitive decline. Just remember to restrict napping to the bedroom.
  • Seek to eliminate or reduce noise.  If you can reduce noise in your sleep environment, you will sleep better as a result.  Over time, some poor sleepers can become sensitive to even the most benign of night-time noises which include;

Ticking clocks, the hum of an electric alarm clock, the noise of boilers, radiators, central heating etc…, persistent rain or whistling wind in winter. This can be particularly true of those who are struggling just to get off to sleep. Whilst a ticking clock can become irritating as you are trying to get to sleep, it is unlikely to wake you from sleep, unless it’s a Cuckoo clock or has a chime to match the bass notes of Big Ben.

So, look for ways in which you can remove or reduce noise in your bedroom. If you are lucky enough to have more than one bedroom, try moving your bed to another room in the house to escape the noise.

Excessive noise from inconsiderate neighbours isn’t always easy to address, but most noises can be dealt with by investing in a pair of ear plugs.  There are hundreds currently on the market, made from a range of different materials, some are soft foam plugs, whilst others are a hard plastic coated in soft foam or rubber. All of these ear plugs range in price from around £1 upwards.  Some are noise cancelling. Just remember that different noises have different frequencies, so whilst one set of ear plugs might reduce high pitched noises, they won’t block out the noise of a snoring family member.  Buying a set of earplugs is a relatively easy and low-cost way of reducing noise. Try buying a few different types and trying them out to see which work best and which are most comfortable for you to use.

  • Keep your bedroom free from unnecessary clutter and distractions.  Having a sleep environment conducive to good sleep means a bedroom free from clutter and distractions. Keep it tidy and sleep friendly.

It’s quite a common occurrence for poor sleepers to have lots of things in their bedroom to occupy them whilst they are awake and unable to sleep.  As a result, they begin to create and reinforce a negative link between their sleep environment (bedroom) and the activities that they are engaging in (not sleeping, doing other things whilst awake.)  This is a problem because it becomes a ‘self-fulfilling prophecy,’  it sets the expectation that they won’t sleep and leads to negative beliefs about their ability to sleep. I regularly hear things like: “I take lots of stuff into the bedroom to keep me busy because I know I won’t be able to sleep.”

 Things poor sleepers tend to do in bed: 

  • Watch TV
  • Smoke
  • Drink alcohol
  • Work on laptops/send emails
  • Play on computers, phones, tablets, I-pads
  • Surf the internet and social media channels

Good sleepers who sleep well don’t do these things in the bedroom, they do them outside of their sleep environment.                                       

So, when it comes to creating a good sleep environment, remove all unnecessary clutter and work-related items, and remember that the bedroom should only be used for sleeping and love-making.

3. Stimulus Control: Identifying and controlling behaviours that prevent sleep.

It’s very common for people to engage in behaviours that prevent them from sleeping well or prevent them from sleeping at all, such as: 

  • Drinking too much fluid in an evening before bed.  This is a very common cause of sleep disruption, it can prevent you from getting to sleep in the first place, and it makes it more likely that you will wake up in the night and will need to use the bathroom.  Limiting the amount of fluid that you drink in the 2- 4 hours in an evening before going to bed will vastly increase your chances of sleeping well right through the night until morning.

I regularly come across people who drink too much fluid and end up paying regular nocturnal visits to the bathroom.  It was certainly a factor in my own sleep problems.  So how many litres of fluid should you drink a day?

The answer is different for everyone, and contrary to popular belief it’s not 2 litres a day, despite what many people believe.  As a rule, just drink enough to quench your thirst, if you aren’t thirsty and de hydrated, don’t drink too much.  Drinking too much fluid throughout the day can be the main reason for disrupted sleep.  As we age, we naturally lose tone in our pelvic muscles, so help your bladder by not drinking too much.

  • Avoid drinking milky drinks just before bed, unless this is an already established habit.  You’ve probably heard that drinking a milky drink before bed can help you get off to sleep, but it is more likely that it will actually keep you awake. The proteins fats and sugars in milk aren’t quickly digested and processed, so as the sugars are released you will get an energy boost and your body temperature will be raised which will prevent you from getting off to sleep.  There is one caveat here, if drinking a milky drink before bed is something that you have done for years and it doesn’t prevent you from sleeping, that’s okay as your body has likely become used to it.  Just don’t start this thinking it will help, because the science says it won’t.
  • Drinking caffeinated drinks like coffee and tea before bed.  We are all aware that caffeine is a powerful stimulant, that’s why many of us enjoy using it to perk ourselves up in the morning, but it’s important to remember that caffeine has a long half life, so it can remain active in your body for a quite a long time.  Drinking coffee and strong tea in the morning is fine, but if you are struggling to get to sleep in an evening, avoid having drinks containing caffeine after lunch time.  If you do regularly drink coffee, tea, and fizzy drinks (which often contain a combination of caffeine and sugar), you need to limit them, so you are not consuming them in the hours (or longer if possible) before bedtime.

Caffeine also hides in other things too:

  • Hot Chocolate
  • Chocolate bars
  • Medications that state they are non-drowsy also contain caffeine as an active ingredient.
  • Energy drinks contain high levels of Caffeine, Taurine, Sugar, and a whole raft of artificial sweetners and E-numbers.

To put it bluntly, energy drinks are ‘Stress in a can’.  Drinking them can make you feel jittery, which is basically triggering the fight or flight response. You certainly shouldn’t drink them if you know that you have heart or other Cardiovascular problems, Epilepsy, or suffer with Migraines. In fact, it is a good idea to avoid them altogether.

  • Drinking Alcohol in the evening before bed.  Alcohol is a depressant, and it is the ‘No 1 self-prescribed hypnotic substance.’  Alcohol has a hugely negative impact on your sleep by stopping you getting the deep restorative sleep that your body needs. That, combined with the added negative effect of waking up with a headache and being dehydrated, is reason enough to drink sensibly.

Your alcohol intake should be limited to the recommended daily and weekly allowance of:  3-4 units a day for men, and 2-3 units a day for women.  The recommended weekly allowance of alcohol is 14 units.  Spread your drinking over a period of three days, and make sure that you have at least a minimum of two alcohol free days per week.

It’s also important to remember that the servings of drinks that you pour at home are likely to be more generous than drinks measured and served in pubs bars and restaurants.

So, if you drink alcohol, make sure that you drink earlier in the evening in moderation, making sure that you do not drink in the two hours before you go to bed.

  • Smoking, vaping, chewing nicotine gum. Nicotine is another well known and widely used stimulant. It raises your heart rate and elevates your blood pressure, making it difficult for you to get off to sleep and remain in deep restful sleep.

If possible, avoid smoking altogether, but you should at least try to not smoke in the two hours before you go to bed. You certainly should never smoke in bed due to the obvious risks involved.

Giving up smoking can be difficult and stressful in itself as your body craves nicotine.  Try and gradually step down the time that you would normally smoke in the evening, for example:

Day one: stop smoking in the two hours before bed

Day two: stop smoking in the two and a half hours before bed

Day three: stop smoking in the three hours before bed.

  • Exercising before bed.  Of course, it’s well known that daily exercise is a good thing for your all-round physical and mental health.  Daily exercise can help promote healthy sleep as it is a natural way to help you feel ready to rest, and make you tired enough for sleep.  Try to stick to exercising in the mornings, or at least in the early afternoon. If you can, exercise outdoors as exposure to natural light in the blue spectrum creates melatonin.

Don’t engage in any particularly heavy exercise in the evenings too near to your bedtime, as it raises your body temperature, blood pressure and  heart rate, all things which will not help you to get off to sleep.

Stick to exercising earlier on in the day, don’t exercise in the two hours before bed, and if you do still want to exercise in the evenings, keep it simple – try some gentle stretching exercises and/or some gentle breathing exercises. 

  • Eating too late the evening.  When it comes to evening meals try not to load your plate up and don’t overeat. Try to eat a balanced healthy diet.  It’s a good idea not to eat in the three hours before bedtime because as our bodies start to digest food our body temperature is raised, and the sugars contained in our food lead to an energy boost. This will prevent you from being able to sleep.
  • Avoid hot baths or showers in the two hours before bed.  We have already looked at body temperature and sleep, and how your body naturally begins to cool down to get you ready for sleep.

It used to be thought that having a hot bath before bed would help you get to sleep. Since then sleep scientists have found that it will actually prevent you from sleeping as it then takes your body longer to cool down again.  So have your bath or shower earlier in the evening, not in the two hours before bed.

  • Keep your bedroom as a sleep-only zone.  I have already said that you should keep your bedroom free from unnecessary clutter and distractions, but it’s an important point that bears repeating.

I’ll admit that my own bedroom was far from welcoming and conducive to a good night’s sleep. It was cluttered and full of distractions, but now it’s my ‘Sleep Haven’ and I look forward to sleeping there.  Good sleepers tend to have fairly tidy clutter free bedrooms, but poor sleepers and people with insomnia tend to take things into their bedrooms to occupy themselves with when they are awake and unable to sleep.

Whilst it may seem like a good idea to take things into your bedroom in order to relieve boredom and frustration, it will actually make your sleep problem worse.  Put simply, everything that you do in your bedroom that isn’t related to sleep can negatively reinforce the connection between not sleeping and your bed/bedroom.  Proactively work at preserving the bedroom as a sleep only environment, so when you enter your bedroom, you are primed for sleep. The only activities that you expect to engage in, in the bedroom are making love and sleeping.

Another point worth revisiting here, is if you can’t fall asleep within 20 mins of closing your eyes, get out of bed and leave the room. At this point you should do something non-stimulating and return to bed only when you are feeling sleepy.  The same goes for if you fall asleep and wake up but can’t get off to sleep again.  Remember yawning is a reasonably accurate indicator of when you are entering into a dip in alertness and you are ready for sleep.

  • Avoid sleep tracking gadgets.  Whilst it may seem like a good idea to use a sleep tracker and/or app to monitor your sleep, it can actually make your sleep worse. I’ve spoken to lots of people who have said things like “I didn’t think my sleep was too bad, but my sleep tracker is telling me otherwise!”

 If you went to a sleep clinic, they would fit you with an ‘Actigraphy Bracelet’ which would accurately measure and record your sleep data.  These are incredibly expensive items that are scientifically and clinically calibrated to collect sleep data with a high degree of accuracy.

Sleep tracker bracelets and apps that are available to buy ‘over the counter’ are simply not accurate enough to be of any real use.  So, if you have one, think twice about using it.  You could be sleeping quite well but then believe that your sleep isn’t as good as you thought.  Remember the saying, ‘If it’s not broke, don’t fix it!’

4. Thinking – Identifying and controlling negative emotions and thoughts.

It may seem like an obvious point to make, but people without sleep problems just go to bed and sleep, it’s not something they have to consciously think about, it’s just something they do. Whereas poor sleepers are all too focused on wanting to get to sleep, they believe that they are chasing a horse  they will never ride.  Remember that what is on the mind is brought to mind.

In this way, poor sleepers start to live up to the label they have given themselves. Worrying about sleep can lead to sleep performance anxiety around sleeping. That’s why thinking or saying, “I really need to get to sleep” will have the opposite effect, “I need sleep” becomes “I won’t sleep.”

Being consumed with thoughts of something that you believe you will never get only reinforces the problem, and it creates stress which only makes the issue worse.

People with insomnia don’t really have a sleep problem, the real problem is an issue with ‘Hyper-Arousal’ and it’s this that prevents them from being able to sleep.  If you are stressed then sleep is not going to happen. Being proactively involved in building new sleep habits and routines, learning to recognise and control negative feelings and thoughts, and learning to relax can help you to damp down the emotional and physical components of Hyper Arousal. Worrying and thinking negative thoughts can affect both your mood and your sleep, especially if you are dwelling on your inability to sleep, add to that another worry or two and it suddenly becomes easy to feel overwhelmed.

Worrying in the daytime often goes around in a full circle leading to you worrying at night, and then repeating throughout the following day.  If you are feeling anxious before bedtime and worrying about things in bed, this will prevent you from getting to sleep and is likely to spill over into anxiety-fuelled dreams.          

Unfortunately, we humans have an ‘in-built negative bias’. It means we prioritise bad news over good, which primes our inbuilt survival mechanism, the ‘Flight-Fight’ response.  All of this was good news for our ‘Caveman’ ancestors, keeping them safe and primed to look for possible dangers. Without it mankind wouldn’t have survived, but in our busy modern life it gets in the way.

We don’t face the same threats to our survival that our ancestors had to be wary of, nowadays Sabre-Toothed Tigers and Cave Bears have been replaced with money worries, arguments with loved ones, war, shady politics, trolling and abuse on social media, noisy neighbours, climate change and pandemics. Our stressors may have changed but the effect of stress on our nervous system remains the same.

Alleviating anxiety, worry and being more relaxed and having less frequent worrying thoughts throughout the day and the evening can help you feel calmer and improve your mood. This impacts positively on your sleep.

So here are a few tips to help break the cycle and ‘switch off’ for sleep:

  • Avoid night-time worrying in bed.  Purposefully set time aside during the daytime to write down a list of things that you need to do, or a list of worries and concerns that are bothering you.  By listing your worries and concerns you can make them more manageable by organising them and separating them out under the following three headings:
  1. Concerns/worries I can control (things that you can actually do something about like losing weight, eating healthier)
  1. Concerns/worries/ I can influence (finding out how to get help with a specific problem or problems, planning etc…)
  1. Concerns/worries I can’t control or influence (what other people think of me, the weather, fuel prices etc…)

When you have organised your list, you can begin to prioritise your concerns.

Start with 1. Concerns/worries I can control

These are the things that you will have the greatest success with and will make the biggest impact.

Next move onto 2. Concerns/worries/ I can influence

 That leaves: 3. Concerns/worries I can’t control or influence

Things beyond your influence or control have to be left alone. They are things that you can’t alter so its important to let them go, as no amount of worrying will change them.

I’ve included a Pdf worksheet version of this technique in the resources section.

If your problem is something that you can do something about but need another person’s advice, then make a plan to get the help or advice that you need. Don’t leave it, be proactive and do something about it.  If you find yourself constantly thinking about things that you have to do, create a to do list or action plan. Remember to set small goals that are easy to achieve.

The Sealed Envelope Technique

Psychologists discovered that people who wrote down their worries, put them in a sealed envelope and put them away, were much more likely to be able to put their worries aside, compared people who just wrote them down without sealing them away. This technique is something that I encourage my own clients to do to help put their worries outside of themselves.  So, get some envelopes, start writing, put them away in a tin or box and forget about them.  This is effective for adults and children alike.  Children can have great fun making and decorating a worry box (you’ll find lots of examples on Pintrest).

Guatemalan Worry People/Dolls

This is a practice not just confined to the people of Guatemala, it is something that is common to other countries of the world. It’s just a small cloth bag which contains a family of small fabric dolls, some children, some adults.  The idea is that you tell each doll a worry, then place them under your pillow and they keep your worry for you while you sleep.

 I still have a set of my own worry dolls; they don’t get a lot of use now but there was a time when I used them regularly and they worked for me.  Again, it’s something my clients can do if they want to, and those that do have reported that it works for them.

I’ve included a link to the dolls available on Amazon in the resources section.  If you or if someone you know is creative, get crafting or ask them nicely to make you some.

If your worry and stress is caused by your sleep problem, sorting out your sleep and making a few changes to (or implementing a new sleep routine) will help to ease your worries and put you back in control.

And remember, simple things like our connections to other people and nature can positively impact our mental health.  Getting in touch with someone you haven’t spoken to in a while could boost your mood, and you’ll pay that good feeling forward so others benefit too.

You could even try joining a group to pursue a new or existing interest or take up a hobby.  Try getting outdoors more, a short walk outside in the morning will help promote the production of melatonin, so look for opportunities to get yourself outdoors.  It doesn’t cost you anything and it’s the easiest routine adaptation to implement.

If going out for a walk isn’t possible, just having your morning cup of coffee or tea outside will help boost your mood, and of course as already mentioned, regular exposure to natural light will help to improve your sleep.

Actively telling yourself that you don’t need to worry as you have already dealt with the worry or have made an action plan can give you some ‘head space’ especially when you are preparing to go to sleep.

I learned first-hand the benefits of purposefully setting aside time to relax, it gave me space in my head and helped me to manage and control the flow of largely negative thoughts that rattled around my tired brain.

For that reason, I’ve included a 10-minute mini meditation which uses guided visualisation and breathing to help you relax. It’s a nice, quick exercise which means you should easily be able to slot it into a busy routine. Making it a part of your pre-bedtime routine could help you quiet unwanted thoughts and help you relax before bed. You’ll find it in the resources section below.

That’s all for now, thanks for reading my article.  I hope it provides information and help for you, a friend or loved one.

Resources

Worksheet version of Circle of Concern/Influence

The Worry Tree

Sea of Stillness Recording     

                        

External resources:

Link to worry Dollshttps://www.amazon.co.uk/Worry-Dolls-Guatemalan-People-Handmade/

www.mikeellerker.co.uk
mike@mikeellerker.co.uk

 QCHPA/Quest Institute:

https://www.qchpa.com/what-is-quest-cognitive-hypnotherapy/

https://www.qchpa.com/evidence-based-therapy/

Sign up to My Quest Hub to receive positive insights in your email inbox:

https://www.qchpa.com/quest-hub/

Sleep Unlimited:                                              

https://sleepunlimited.co.uk/contact/

https://sleepunlimited.co.uk/next-courses/

Dr Lee’s book:

https://sleepunlimited.co.uk/2017/07/18/teaching-the-world-to-sleep/

References and acknowledgements:

Book: ‘Teaching the World to Sleep’ by Lee, Dr David, R .
Published by Routledge books, 2017

Book: ‘The Circadian Code’ by Panda, Satchin, Dr
Published by Vermillion books, 2018

Book: ‘Why We Sleep’ by Walker, Mathew, Dr
Published by Penguin books 2018

Article: ‘The Human Circadian Rhythm’  by Lee, Dr, David, R.
published on: https://sleepunlimited.co.uk/2017/01/30/the-human-circadian-rhythm/

Article: ‘Sleep the origins and purposes of’, ‘Slumber Cycles’, ‘Sleep Patterns.’ by Dijk, Derk-Jan, Winsky-Sommerer, Raphaelle.
Published in: New Scientist, The Collection, Volume two/Issue Five, 2015                                 

With Special thanks to Sleep Unlimited ltd  and to Dr David Lee, for allowing kind permission of the creation of visual graphics and use of  the Term ‘R.E.S.T. Programme TM , and elements of his research and work within this article.