Monday 18 June 2018

A three-step approach to good sleep

 

Photo posed
Photo posed

The ideal conditions for great sleep usually involve three elements. Good sleep hygiene, de-stressing activities, and a healthy dose of 'positive thinking'. With this in mind, Sasha Stephens has come up with a set of 10 easy pointers.

Follow these suggestions and you'll get your sleeping conditions near-perfect. You'll be sleeping better in no time.

STEP ONE

Implement good sleep hygiene - This is a set of 'going-to-bed habits' designed to lay a perfect foundation for sleep.

1 Good sleep loves routine. So start getting up at the same time every day, resisting the temptation to 'catch up' on sleep on your days off.

 2 Bizarrely, spending slightly less time in bed often has a fantastic effect on sleep quality and the time it takes to drop off. If you're spending eight hours in bed, but only sleeping for five, cut your time in bed down by 30 minutes to an hour.

3 If you wake in the night, don't look at the clock. Waking once or twice in the night is perfectly normal. But concrete knowledge of the exact time will often cause anxiety, making it harder to get back to sleep. This is particularly important if you have 'sleep maintenance insomnia' (falling asleep easily but waking early).

4 Do nothing in bed but sleep or have sex. This means no TV, no working, no late-night Facebooking, and no lying in bed in a stressed state. If you're wide awake and sleep seems miles away, it is usually better to get up rather than stay lying around in bed. Stay up for at least 20-30 minutes. Then go back to bed and start the falling-asleep process all over again.

5 Don't 'try hard to sleep'. Sleep is not something you do, it is more like something you do not do. In fact, one of the very best 'techniques' to use in bed is to lie down and do absolutely nothing.

6 Don't nap. Napping in the day is often at the expense of a proper full night's sleep. So If you're having trouble sleeping, avoid snoozing on the sofa in front of the TV. How do such simple things make a difference? If you currently have a poor sleep routine of napping, lying in at weekends, or if you use your bed to read, watch TV, work, and chat on your phone, it's no wonder you don't sleep well. With no routine, your body has had no idea when it's supposed to be sleeping. And by lying in bed not sleeping, or by using your bed for activities other than sleep, you start to associate going to bed with being awake. So your body lies there awake because that's what you've taught it to do.

Follow these steps and you may find everything is magically transformed. Because good sleep hygiene teaches your body a different association: that bed is all about sleep and sleep is all about bed. Eventually, you'll make this association so strongly that just the thought of your lovely, warm, soft bed will be enough to make you feel sleepy. You'll find you fall asleep as soon as your head hits the pillow.

STEP TWO

7 Deal with any underlying tension or anxiety by introducing a regular de-stressing activity into your day. We usually assume relaxation techniques are something to be done at bedtime. But it's far more effective to reduce your general background stress during the day. In this way, there's no need for bedtime techniques and nothing left for you to 'do' once in bed.

This makes the whole 'going to bed' process more natural and like that of a normal good sleeper. With nothing to do in bed, tension will be lower, thoughts will be dreamier and sleep will come so much more easily. The easiest, healthiest and best way to de-stress is simply to increase your exercise levels. And if you don't currently get any exercise, don't be surprised that your sleep isn't great. Check with your doctor first, but hard cardio such as circuits or boxing can work wonders for insomnia, particularly if you are someone who spends all day sitting in front of a computer screen or at a desk.

The result is a body that is deliciously worn out and naturally relaxed falling gratefully to sleep at bedtime. If you're not used to exercise at all, just a daily walk will usually do. Buy a pedometer and keep a count of your daily steps. Could you manage 10,000 steps every day outdoors? What a double-whammy that would be - an hour's exercise and a big dose of sunshine vitamin D.

All you have to do is get off your chair and walk. It will boost your mood, immunity and your sleep. But if you already work on your feet all day, or you already get a lot of exercise, you might want to pick a more sedate relaxation activity.

I highly recommend any type of daily meditation. You could also do yoga, breathing exercises, dancing, tai chi, or a particular therapy or technique you enjoy that calms you down and makes you feel relaxed.

STEP THREE

You've tightened up your sleep hygiene and implemented some exercise or de-stressing activities to deal with tension and anxiety. For most people, these first two steps are all that is needed to begin sleeping well. If you still see no real improvement, there's usually just one more thing that needs looking at - your thinking about sleep. Fear, low expectation of sleeping, and obsessive or anxious thoughts, particularly about sleep, can keep you awake through almost anything.

So is this the time to reach for the sleeping pills, just to calm that anxious thinking? In short, no. I am resolutely opposed to the prescribing of sleeping pills, particularly for long-term insomnia. This is because beside the side effects, I believe pills often make insomnia worse, not better.

To understand this, consider the message implicit in the prescribing of a sleeping pill - this pill will make you sleep because, let's face it, you aren't capable of it on your own. This means every night that you fall asleep on medication your trust in yourself is diminished. Keep taking the pills and your expectation of ever being able to sleep on your own eventually disappears.

The self-belief you need to sleep naturally is robbed by sleeping pills. When the pills stop working (as is usually the case), you are then cast adrift and alone with no expectation of being able to sleep at all, with or without medication.

This is an extremely frightening place to find yourself. (Be warned: If you currently are taking sleep meds, you should never, ever stop taking them without consulting with your doctor. Sudden withdrawal can be positively dangerous, even fatal.) But if pills aren't the answer, how on earth do we go about changing negative thinking and poor expectation about sleep?

It was as a result of my 15 sleepless years that I became a bit of an expert in the psychology of insomnia - how it's made worse by certain ways of thinking and speaking, and improved by expectation, routine and habit. Finally, the scientific community is coming around to a similar way of thinking and is beginning to acknowledge the problems associated with sleep meds.

In 2016 the American College of Physicians suggested that Cognitive Behavioural Therapy for Insomnia (CBTI) must be used as the first line of treatment for chronic insomnia, not sleeping pills.

A good Cognitive Behavioural Therapy therapist will work wonders but as most of us don't have access to that, here are a few things you can try yourself. 8 If you are plagued by a busy mind or anxious thoughts at night, keep a notepad and pen next to the bed. If a thought won't leave you alone, get up, turn on the light and write a note to yourself to deal with the issue in the morning. Then let go of the thought and go back to sleep.

9 Stop all complaining about sleep. Don't ever refer to yourself as an 'insomniac' and banish the word 'insomnia' from your life. One of my favourite little mottos is: 'The story you tell about your sleep will come true.' Remember that.

If you're telling a constant story of poor sleep, that story is going to keep coming true. So start talking up the good nights and downplaying the bad ones. And try and tell yourself it's no big deal if you don't sleep well. Because, paradoxically, the less you care about missing sleep, the easier it often is to achieve. 10 Finally, get on with your life as normal. This is essential.

Don't ever allow a sleep problem to dictate the way you run your life, cancelling appointments or hiding away from the world. The more compromises you make for the sake of sleep, the more you draw attention to the problem, and the worse it gets. The more things you do to try and 'fix' your sleep, the worse it often becomes. This is because insomnia is an affliction made worse with attention.

Feed it with fear and attention and it just grows bigger. So, one of the very best things you can do after a bad night is totally ignore it.

Whether you're new to insomnia, you've got a long term-problem, or whether you're slap-bang in the middle of a really bad patch of sleep and are desperate to get things back to normal, my advice is always the same:

1. Keep the sleep hygiene good.

2. Get some exercise or de-stressing done.

3. Get on with your life, avoiding complaining about sleep and paying as little attention to the problem as possible. By following this three-part plan, you reduce the chances of sleepless nights. It's just not possible to have night after night of no sleep when these circumstances remain so right for so long. Sleep eventually becomes irresistible.

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