The Importance of Sleep
Matthew Walker tells us "sleep is not an optional luxury - it is mother nature's life support system!"
The quality of sleep has a significant impact on our general wellbeing. Sleep deprivation can affect concentration, mood and memory the next day. It can give us cravings for sugary foods. In the long term, these are thought to contribute to the development of different mental and physical health diagnoses e.g. depression, anxiety, dementia, metabolic syndrome.
During sleep the immune cell function is improved, which helps our bodies to fight infection (including COVID-19) and kill possible cancer cells. Sleep can upregulate genes to promote the immune system, where as limited sleep is associated with upregulation of genes that are associated with promotion of tumours, inflammation and cardiovascular disease.
There are some medical conditions that can contribute to altered sleep patterns and behaviour. If you are really struggling to sleep, despite trying some things discussed here, it can be helpful to discuss this with your GP.
The Sleepstation resource discusses the different states of sleep
Insomnia is difficulty falling asleep, staying asleep, waking up too early or needing a medication to sleep. Insomnia tends to be given as a diagnosis when it is interfering with your ability to function. However, we all have good and bad days of sleep and no matter where you sit on that sliding scale, things could perhaps always improve!
Dr Spielman talks about factors as:
Predisposing: Genetics or life experiences affecting circadian rhythm or hormones
Precipitating: A positive or negative event that triggers difficulty sleeping
Perpetuating: Examples include napping in the day to catch up, staying time in bed awake, irregular sleep patterns/shift work, using substances or sleeping tablets
Top Tips To Improve Sleep
Medications (hypnotics) are sometimes prescribed for just 2-4 weeks if insomnia is severe, disabling or causing extreme distress. There is limited evidence for the effectiveness of long term medications in the treatment of insomnia and there are concerns about their safety including drowsiness. They can lead to tolerence, dependence, rebound insomnia and increased risks in older people such as cognitive impairment and falls. CBTi, on the other hand, is a well validated, effective and safe method of treating insomnia.
Sleepstation is a clinically validated sleep improvement 6 week programme that can help you sleep better. Designed by experts and backed by science, the online sleep service is proven to combat even the most severe insomnia. The team of coaches, doctors and sleep experts can help you identify the underlying causes of your sleep problem and provide the personal support needed to improve your sleep.
Sleep problems can get worse the longer you leave them. if they are affecting your daily life, and if they have been occuring longer than 4 weeks, it's time to do something about it.
Unfortunately NHS referral is no longer available locally.
CBTi (Cognitive Behavioural Therapy Insomnia)
This is a powerful tool designed to be used by anyone needing help with poor sleep. You are likely to have had difficulties sleeping for some time and this isn't a quick fix. It may take some time and effort to re-train your brain. CBTi is designed to take at least 6-8 weeks.
Stimulus control rules (Dr Bootzin) for Insomnia:
1. Lie down intending to go to sleep ONLY when you are sleepy.
2. Do NOT read or watch television in the bedroom.
3. If you find yourself unable to fall asleep GET UP and go into another room. Stay up as long as you wish and then return to the bedroom to sleep.
4. If you still cannot fall asleep, repeat Step 3. Do this as often as is necessary throughout the night.
Resources: Apps and Books
Free CBTI (FreeCBTi.com)
Matthew Walker: Why we sleep