This blog is a departure from the theme of the other blogs. Instead of using a book or movie for inspiration, I’ll reference an app and a website. The books I’ve read about sleep are textbooks or journal articles, so they aren’t the most thrilling reads to recommend. And besides rock-a-bye baby, I’m at a loss for songs about sleep; I do recommend soothing music of your choice to facilitate sleep—just type “spa music” or “music for relaxation” into your platform’s search bar and try some out. Nature sounds are great to listen to as well, but that is also a personal preference. With that clarification out of the way, let’s dive into information about sleep disturbances and how to fix them.

Is your bed the place where you sleep peacefully and soundly or is it the place you dread because all you do is toss, turn, and watch the minutes turn into hours? A poor night’s sleep can not only leave you feeling drained and sluggish, but it can also impact your mental clarity, attention, and mood. Sleep disturbances can be a one-off type of problem where you have a poor night’s sleep very rarely; in those cases, you are unlikely notice the disturbance impacting your life. Yet in other cases, sleep disturbances can be very problematic impacting work performance, interpersonal relationships, and overall quality of life. Poor sleep can be isolated to times of high stress or can be an indicator of depression and anxiety. Sleep disturbances can be disorder unto themselves, such as Insomnia Disorder or Circadian rhythm sleep-wake disorders. It’s important to identify what type of sleep problem to know the best course of treatment. With some sleep disorders, the sooner you apply the appropriate strategy, the better the prognosis.

sleep PROBLEMs

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Clarifying the exact nature of your sleep problem is a job best left to experts like (insert shameless plug) your friendly neighborhood telepsychologist. You can also speak with your primary care physician. Understanding the onset, symptoms, and context is important in making a proper diagnosis, and this is more than Dr. Google can offer you. You cannot go wrong by beginning with an assessment by a professional; in the meantime, here is some basic information for your understanding.

For some, sleep disturbances are brought on by conditions like a new puppy, a new baby, or shift work. These circumstances can of course impede our sleep patterns with shift work being most problematic overtime given some have shift work jobs for years on end whereas puppies and babies sleep through the night in time. Other factors that can impede sleep include conditions in your home, room or bed like a noisy neighbor, a snoring bed partner, or little ones (pups or tikes) taking up room. As much as is possible, it is important to minimize these impacts by maintaining good boundaries (crating dogs and sleep training kids) and taking actions where you can (talking with neighbors, using ear plugs). It’s also important to create and environment that is conducive to sleep--more about solutions to follow.

Sleep disturbances can also be brought on by conditions we would classify as stressful. You may have an important project deadline looming, concerns about an upcoming medical test or procedure, concerns for a problem a loved one is facing, or an unexpected financial strain. In cases like these, the situations may be time-limited, and this may disrupt sleep for a few nights or weeks. In these situations, once the stress passes, it’s likely that you will fall back into the restful sleep patterns you enjoyed prior to the situation. In these cases, the sleep disturbances may be eliminated by simple stress management strategies (e.g., increasing time practicing yoga, increased physical activity, talking things over with loved ones).

In more concerning situations, sleep disturbance may accompany depression or anxiety. Sleep disturbance is listed as one of the symptoms of Major Depressive Disorder (depression) and Generalized Anxiety Disorder (anxiety or worry about a range of topics). Sleep disturbance can accompany these disorders for several reasons. For instance, both anxiety and depression can be the result of serotonin imbalances; serotonin imbalances also impact sleep cycles. Sleep disturbances can also be due to worry or rumination and negative thinking; instead of a bed being a place of rest to a place to lay and think about all that is terrible in life. The goal would be to try to break this behavior so that sleep can once again be associated with the coziness of your mattress.

There are also several sleep disorders like sleep apnea or circadian rhythm sleep-wake disorders that are either organic or occurring from circumstances like shift work. One of the most common sleep disorders is Insomnia Disorder. Again, insomnia can be diagnosed by a healthcare or mental healthcare provider. It should be noted that an insomnia diagnosis is based completely on a person’s subjective experience of sleep; no labs are needed. However, some tests like bloodwork or a sleep study may be ordered in some cases to rule out any other conditions that could be masquerading as insomnia.

Some key aspects of insomnia include the following:

Dissatisfaction with the quality and quantity of your sleep
Trouble falling asleep, staying asleep, and/or waking up too early
Having trouble sleeping 3+ nights/ week for 3+ months consecutively
Being unable to sleep despite ample opportunity for sleep

SLEEP EDUCATION

Educating yourself about sleep problems and solutions is a great first step towards turning the problem around. This is absolutely something you can work on with your healthcare and mental health care providers. You can also access tools for further education. I know I just took a dig at Google for diagnostic purposes, but I will say Google can be helpful for resources. You can check out reputable sites like sleep.org for great information about sleep disorders, tips, and treatments. There is quite a bit to understand about sleep and sleep cycles. For one, we have natural cycles of alertness and exhaustion that cycle through a 24-hour period with the help of various chemicals in the body. Most humans have greater energy in the mornings with energy levels decreasing as the day passes, leading us to feel sleepy at night. It should be no surprise that this is how most humans are wired given we are diurnal creatures (verses nocturnal). The other cycles that impact our sleep are the cycles of the sun and moon, or rather day and night. This is why people struggle with daylight savings time changes or waking/sleeping in places like Alaska. As humans we are very much in sync with the daylight and darkness. Please know this is a review of the biology of sleep in the most basic sense; there are books and articles that go into much greater depth you can access at a library or on-line. There is also good information in apps like iSleep easy which combines basic education and tips with strategies for a better night’s sleep. Let’s turn to those strategies now.

Check out sleep.org for more info!

SLEEP SOLUTIONS

Practicing good sleep hygiene is almost always the first recommended step towards improving sleep. I know the term “sleep hygiene” sounds a bit strange, as if it implies we need to combine cleanliness with sleep, but this term is about practicing good sleep behaviors--ones that will facilitate restful sleep. Here are some tips to get you started:

1. DEVELOP A BEDTIME ROUTINE.

Did you think bedtime routines were only for kids? Although they are great for kids, they are also great for us at any age. Bedtime routines signal to us that it is time to wind down, put the day away, relax, prepare for slumber, and sleep. This is a way we can condition the body and mind (think Pavlov’s dog) to prepare slumber. Try a routine like dimming the lights, changing into comfy pajamas, and turning off electronics in the hour before bed.

2. TEMPERATURE CHECK.

Temperature plays a role with sleep. It’s important that you feel cool as you are falling asleep. A cool temperature cues the body for slumber. Be sure to set the thermostat to cool or turn on a fan. You might take a hot shower or bath before bed as part of your routine because when you get out of that hot water, your body will immediately cool when it hits the air. This drop in temperature will help you feel sleepy plus the hot water probably helped you relax your muscles.

3. CREATE A COMFORTABLE BEDROOM ENVIRONMENT.

Be sure your bedroom is your sleeping sanctuary. You want a dark environment so consider black out curtains if needed. Have dim lighting at night. Be sure you have the right mattress for you, and if it’s old or seen better days, you may want to replace it. The right fitting pillow for your body is also important. All natural materials like cotton breathe better than synthetics so you may want to keep this in mind as you shop for sheets and comforters. Electronics are great but they are not great in the bedroom. TVs are very problematic for sleep; if you want to have one in your bedroom, try putting it in a cabinet or armoire that has doors so the TV can be shut away at night.

4. BEDS ARE FOR SEX AND SLEEP.

Many people engage in activities in bed that have nothing to do with the two main activities beds and bedrooms are for. Reading, watching TV, and surfing phones are activities many people do in bed but really ought to avoid. Why? Back to what was said earlier about classical conditioning—by engaging in non-sex or non-sleep activities in bed, you are associating your bed with those activities. You are training your brain to pair alertness with bed instead of the relaxation that follows sex and the rest you get with sleep with your bed.

5. STOP WORRYING IN BED.

Piggybacking on the last point, beds are for sex and sleep only. However, many people under stress or struggling with anxiety or depression allow their minds to wander to worry and negative thinking once in bed. If you do this, you are basically training your brain to start worrying as soon as your head hits the pillow. You need to break this association. If you find yourself worrying, try using calming guided meditations for sleep from a favorite app instead. Learn to compartmentalize your worry with a strategy like journaling. Give yourself a dedicated time to worry maybe after dinner or some other time not associated with bed. Write about your worries for 20 minutes or so and then stop when time is up. When you catch yourself trying to worry in bed, redirect yourself and say something like, “No, not now. I’ll save it for my worry time tomorrow.” If you need to do something more, try getting up out of bed and engaging in some simple activity like putting dishes away, folding laundry, sweeping the floor or anything else that’s brainless until you feel sleepy, and then try laying down again.

These were some constructive tips to get you started. There are more sleep hygiene strategies you could apply to build on these. If you’re still struggling after some of these changes, it may be time for the next step: Brief Behavioral Therapy (BBTI) for Insomnia or Cognitive Behavioral Therapy for Insomnia (CBTI). These strategies are the most effective strategies for insomnia per clinical studies. They are more powerful than any sleep medication. They are safe, easy, and non-habit forming. BBTI can be accomplished in 5-6 sessions and CBTI in about 12. Working with a provider who is trained in these strategies (another shameless plug!), can get you the relief you seek. This program combines education with sleep hygiene and specific sleep recommendations tailored just for you. The most effortful part on your end will be keeping sleep logs and sticking with the recommendations—seems worth it to me to get relief from insomnia and back to an energized life. There is no reason to suffer when solutions are available.

BENEFITS OF ONLINE COUNSELING

Online counseling saves you time and energy as you access mental health care from your home or office without having to take time out to commute to and from the appointment. Relax in the comfort of your own space as you devote one hour to self-care. Secure platforms are used to protect your privacy. Research shows online therapy and in-person sessions are equally effective. So why not choose the more convenient option? Save time, gas, and minimize stress so that a one-hour appointment takes only one hour and not 3 with traffic.

BEGIN COUNSELING WITH AN ONLINE THERAPIST IN COLORADO, FLORIDA, MARYLAND, AND PENNSYLVANIA

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Sleep Disturbance Solutions

sleep PROBLEMs

SLEEP EDUCATION