During an initial session with a new client, one of the areas we often explore is their quality of sleep, as I know the impact that poor quality sleep can have on our mental health. Getting a good night’s sleep is key to being able to regulate our emotions, maintain our window of tolerance, and keep our mental, emotional and physical health in good condition.
“Given that a single sleepless night can make you irritable and moody the following day, it’s not surprising that chronic sleep debt may lead to long-term mood disorders like clinical depression and generalised anxiety disorder in adults.”
Sleep, alongside food, water, air, is an essential requirement for human beings. It is a basic biological need. But in addition, good quality sleep is necessary for our mental health. We know that good sleep is vital for our cognitive performance: our own experiences can tell us that when we are tired, haven’t slept well or for long enough, that we are less able to maintain focus and concentration, that we make mistakes, become distracted or cannot retain information. We cannot process information as quickly, our executive functioning is poorer. This in turn can impact on our mental health: we may see ourselves in a negative light, being critical of ourselves, losing self-confidence or self-esteem.
Poor quality sleep can impact on us physically: increasing appetite, feeling lethargic, for example. According to The World Sleep Society, lack of sleep has also been linked to significant health problems such as diabetes, high blood pressure, weakened immune systems, and heart problems. And the result can be that we feel unmotivated, lose confidence, feel unattractive, become anxious about our health. If we are not achieving, not feeling satisfied or worthy, feeling physically unwell, our mental health is at significant risk. Mental health conditions that can be linked to lack of sleep, or poor quality sleep, are depression, anxiety, having intrusive thoughts, psychosis.
“Most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help.”
So what makes for a “good night’s sleep”?
The World Sleep Society suggest three main elements:
Duration: sleeping long enough for you to feel “rested and alert” the next day;
Continuity: periods of sleep are ideally unbroken or disturbed;
Depth: sleep should be deep enough to be restorative.
TOP TIPS FOR A GOOD NIGHT’s Sleep
To optimise your sleep, it can be helpful to create a sleep routine. No, bedtime routines are not just for babies and toddlers! Having a regular sleep-wake cycle (going to bed and getting up at routine times) can make a considerable difference to the quality of your sleep. Paying attention to the environmental factors, your mindset and activities can all contribute to getting that much-desired “good night’s sleep”. Often people tell me that they find it hard to get to sleep because they are feeling anxious, on edge or cannot switch off. The tendency is to try and relax once we get into bed. However, by this time, if we’re feeling stressed, it can often be too late. Ideally, it’s preferable to try and regulate before getting into bed, so that the brain associates bed with a sense of calm, relaxation and sleep.
Create the right conditions
Try avoiding all sources of caffeine a few hours before bed. Remember caffeine isn’t just in coffee; it’s also in things like tea, chocolate, and fizzy drinks. Sugar, alcohol and nicotine should also be avoided if possible.
Keep your bedroom for sleeping: checking emails, social media or making lists in bed may stop your brain associating the bedroom as a place of quiet rest and, instead, the bedroom becomes associated as a place of cognitive activity. If you are tempted to check your phone last thing at night, try switching it off, or leaving it in another room. If you need an alarm, perhaps swap your phone for a clock: there are some great non-ticking clocks out there!
Circadian rhythms (our 24 hour body clock) are influenced by light and temperature. Ensuring you are not too cold or hot can make a big difference to your sleep. Similarly, think about the light levels in your room. Some people sleep better in total darkness, whereas others may benefit from a night light to help them feel more safe and secure (yes, even adults!).
Consider your activities: doing exercise is a great way to relax, however, the endorphins released from exercise can also impact on sleep, so try to avoid exercising within two hours of bedtime. Perhaps try a lavender bath, reading a relaxing book, or listening to soothing music.
Eating melatonin-rich food can be helpful (melatonin is the hormone that helps us feel sleepy), such as bananas, blueberries, cherries, pistachios, wholemeal toast, a glass of warm milk.
Meditation and breathing exercises can also help: controlling your breathing, exhaling in a slow, steady way, sends a message to the brain to slow the heart rate. It activates the parasympathetic response, which helps us feel calmer, more relaxed, reducing the flow of cortisol (the stress hormone). Gentle yoga poses, such as Child’s Pose, can also help trigger our body’s calming response. Listen to a guided relaxation or peaceful music. Headspace and Calm are both good apps to try.
Progressive muscle relation (tensing and relaxing different muscles) can reduce stress, by decreasing the heart rate and decreasing the flow of cortisol (the stress hormone). It can create a deep sense of relaxation.
Waking in the night
If you wake in the night, and don’t fall back to sleep quickly, it’s generally better to get out of bed than to lie there tossing and turning. If possible, move to another part of the house, listen to something soothing, practice some relaxation techniques and return to bed when you are feeling sleepy. Try and ignore the clock: I’m sure that at some point we’ve all done some clock watching, lying there calculating how many hours’ sleep we can have if we go to sleep now, but this often causes us to feel more distressed about losing sleep. Ultimately, sleep can’t be forced, so try and turn the clock away from you, and close your eyes, focus on your breathing, or a calming image, and allow sleep to come naturally.
Still Struggling?
If you have made sustained changes to your sleep routine and find that you continue to have disturbed sleep, or insomnia, it may be advisable to speak to your GP. You can find more advice about sleep issues from the NHS Every Mind Matters site.
If you are struggling with your mental health, please do speak out: you could talk to your GP, a friend, family member or colleague, or book an appointment with a counsellor.
Aislinn Marek is a qualified person-centred counsellor, registered with the BACP. She has worked within the NHS, education and private practice for many years, and is passionate about supporting people with their mental health.
Aislinn is also the author of The Sleep Book: Helping Busy Brains Settle For Sleep, a book for children and their parents/carers.