Managing Sleep

This topic appears in my main How to …. page, but the topic has been raised with me and I think a single and focused page on the topic might help. Tell me if it does (or does not!)

In general, when an event disrupts our sleep, it is possible for things to return to close-to-normal after a few weeks. If this does not happen, and your ‘old normal’ sleep pattern does not return, then the design of a safe experiment might help.

Limitation warning: No safe experiment works for all and every-one, every time. This especially applies to sleep management. It is management that is involved – not a ‘cure’. I think it best to build your own ‘tool box’; one that can help you feel more confident about having enough sleep, most of the time.

Here is the sleep cycle. It is hard-wired into our bodies. It is not an optional extra. Our neural networks sustain these cycles even though those same networks can disrupt them.

Note that each cycle last between 90 – 120 minutes; you might be a 90 minuter and I might be a 120 minuter. Half of that cycle is spent sliding down into a more relaxed state. In the second half we become increasingly alert.

Over time we develop a routine that suits us but it is not difficult for it to be thrown out of kilter.

Note, also, that there are two cycles of ‘deeper’ sleep, marked 2,3, and 4. The brain is reasonably inactive at these time. Instead there is a great deal of bodily activity as body tissue is repaired after the wear and tear of the previous day. This is the physical recovery housekeeping stage!

Later in the night there are more ‘shallow’ cycles. The yellow band shows when rapid eye movement (REM) sleep can occur. REM sleep comes and goes throughout the night. During REM sleep, the brain is particularly active and the body is stilled.

When we come close to that ALERT line it is possible to become awake, maybe aware of a dream. That is one reason why many of us report waking around 1 a.m. or 3 a.m. (assuming we retire around 11 p.m). At that point it is possible to become pre-occupied with that dream, or some other immediate thought. Our return back into sleep, via that half-cycle of relaxation can be impeded.

There is a lot of difference between individuals.

How are these cycles disrupted?

Among other things, by sudden changes to our routines; by destabilisation of our current normal (say, by moving home, job changes, death and separations) and by high emotion. Sleep is not an optional extra. After several sleepless nights, we find ourselves dropping off during the day. We may find it more difficult to make decisions and our mood may be affected.

Some safe experiments

What follows are prescriptions. This goes against my best judgment and the intended ethos of this web site. Therefore, please bear in mind that any direction can be effective only if adapted to your present lifestyle and routines. Some things in the lists to come may make immediate sense; focus on them and meet the others, bit by bit.

  • Change routines and practise alternative habits: sleep disruption might be sorted out without going to see a doctor (that’s not a recommendation to avoid the doctor, but rather to prepare for your appointment!).
  • A start can be to wake at the same time every morning, relatively early, with the help of an alarm, no matter what time you have fallen asleep the previous night. You should retire at the same time of the night without naps during the day time or evening (NB I take a siesta after lunch quite often – a civilised continental routine well suited to the life stage of us oldies). Siestas at tea-time, and after, are not recommended.
  • Eating habits may make it difficult to get off to sleep. Eating too little may promote early waking. What is your ‘present normal’ here and what small routine might be altered?
  • Smoking, alcohol and drinks containing caffeine, such as tea or coffee, can disturb sleep. I’m not asking you to give it all up but rather to just notice your routines and their impact on you, if it is evident.
  • The same applies to any drug – legal or illegal. All drugs have side effects and some may appear to help us manage our sleep. Others positively add to our problems. Any artificial aids need to be TEMPORARY and cautiously managed anchors.
  • We sleep badly when we are in pain or running a high temperature. That seems beyond our control, but what steps might be taken to reduce the time we are in pain or running a temperature? How do we go about eleviating these experiences?
  • Can others be helpful to us – for the sake of asking for things from them?

Even so, when a lack of sleep continues, everyday life can become trying. Anxiety can build up and we may find it very difficult to get off to sleep. In a depressed state I am more likely to wake early, or in the middle of the night. At this time we may well need to consult our family doctor. In the 21st century there are tablets available to help us with discomfort and unsettled sleep. That’s the first aid.

For my part, I will examine further the problem-solving safe experiments rather than the ‘first-aid’ route. further information from the NHS is available. Does it match what I am saying? It does not always work that way!

Furthe safe experiments – repetition deliberate!!

  • Consider how you might collect some information (safe experiments need results!). When you examine your sleep routine consider the specifics. WHEN, WHERE or WITH WHOM do you prepare for sleep and get ready for it? A diary covering the mid-evening and onward – kept for a given period of time, say, one month – can help to identify these things.
  • Take moderate amounts of exercise during the day-time, such as swimming or walking (not in the mid- to late evening).
  • Cut down or stop drinking tea or coffee in the evening. Try a milky drink before going to bed, if it helps.
  • Don’t drink a lot of alcohol. It may help you fall asleep, but will almost certainly make you wake up through the night.
  • Don’t eat or drink a lot late at night. Try to have your evening meal early rather than late.
  • Explore ways to relax before going to bed. Some people use relaxation systems. There are many to be found on the Web. However, beware under-estimating your own ability to create your own safe place in your own head. Have a go and roam around in it.
  • Make sure that your bed and bedroom are comfortable – not too hot, not too cold or too noisy.
  • Listening to quiet music might help as long as any switch off does not wake you again!
  • Don’t go without sleep for a long time. Establish a regular pattern of going to sleep and waking up at the same time every day.
  • If you’ve had a bad night, resist the temptation to sleep the next day – it will make it harder to go to sleep the following night.
  • If something is troubling you then write it down before you go to bed. If necessary, keep a note-pad next to your bed. This will provide a reminder or To Do list for tomorrow’s action. It is possible that some issues will appear less problematic in the cold light of day.
  • If you can’t sleep, say, after 20/30 minutes, then get up and do something you find relaxing. Reading and watching television might be tempting but it is easy to lose track of time here. Instead, can you find a boring routine task you have neglected for some time; clean out the sock drawer?
  • After a while, say, around 20/30 minutes you can go back to bed again – whether you feel tired or not. Note the length of a half-cycle in the diagram above is around 45 – 60 minutes so the 30 minutes, above, is not a random or magic figure; it is not quite a half-cycle. The key here is to see if your body can tell you whether you are at the bottom or top of a sleep cycle.
  • When you return to bed, and if sleep does not come quickly, use thinking-about-breathing I have mentioned before. Slow your breathing – in only through the nose – and countdown, one by one, from 1000 on the out-breath. You may find you forget the number – that is not important. Just keep counting down as best possible.
  • If the breathing and countdown is too much – requiring too much concentration – then, again, that is not crucial: just keep counting down slowly. This is one safe experiment that is intended to fail. If you are good with figures, and you want to make the experiment trickier, then do a countdown in threes; that is, 1000, 1997, 1994 etc.
  • Let me end with a cunning strategy. If you return to bed and find you do not sleep yet again. Use slowed breathing to go back into visualisation of a relaxing scene and then use the thought that says: “I am not going to sleep, I am not going to sleep etc”.
  • If your adaptations of these approaches seem not to help then talk over things with a very trusted friend or professional. Some people tell me that speaking things out seems to help devise further action required, if it is needed.

None of what I have to say here may help if you are a shift worker and you are required to sleep outside your own natural rhythm. It is possible that your work colleagues will be best equipped to identify some suitable safe experiments.

There are a number of additional complications that can disrupt our sleep routines. It is at that point that some professional help may be useful. However, if you want to research some specific and well-known disorders further, then look out for topics such as Sleep Apnoea, Sleepwalking, Night terrors, persistent Nightmares or Restless Legs

Useful reading

Get a Better Night Sleep Ian Oswald and Kirstine Adam, Optima

Why We Sleep James Home, Oxford University Press

Sleep like a Dream the Drug-Free Way Rosemary Nichol, Sheldon Press

Return to:

Welcome

How to give yourself a nudge

How to design safe experiments.