A Sleep Anxiety Wake Up Call

A tall elderly man, shrouded in a pale blue cotton blanket is being wheeled to a nearby ambulance. Squinting through the evening’s gloom, I stop to watch as he is gently manoeuvred in to the back of the ambulance and driven away.

Relieved and moist eyed I trudge up the hill to retrieve my car. I have just watched my Dad leaving hospital following five days of treatment for pneumonia. He is on his way home despite not being well enough to sit up in a wheelchair. I tried to persuade the doctor to keep him until morning – when he’d have more energy for the journey – they were sympathetic but resolute; they needed the bed.

Four nights before, Dad had arrived in Accident & Emergency with breathing difficulties, the lack of nursing staff and five-hour wait to see a doctor were clues that he wouldn’t be transferred to a ward any time soon.

I stayed up all night with Dad and caught three hours sleep in the middle of the next day before going straight back to the hospital. I’m not complaining, I was happy to do it and the staff did their best – they seemed overwhelmed by the number of patients, many of whom were elderly. It’s that time of year. But let’s not get distracted; this blog is about sleep anxiety.

I overheard one of the nurses telling a colleague she only gets one or two hours sleep at a time. It reminded me I would normally be worrying by now about how I would cope the next day; thinking I’d probably succumb to a cold and so forth.

Why then had my normal panic about missing a few hours sleep, never mind a whole night, not surfaced? I put this change down to the simple exercise I recently picked up in a self-help book Say Good Night Insomnia by Dr Gregg D. Jacobs.

A few weeks back, I followed the advice to make a note of the following

  1. the time I got in to bed
  2. went to sleep
  3. length of periods of wakefulness in the night
  4. time I woke up
  5. how many hours I allotted for sleep.

It only took me a few minutes each morning to complete the grid and tot up my total hours of sleep.

After a week I could see I was having at least six hours sleep – granted its not the longed for eight hours I’ve always believed I need. However, realising my overall average over the week, was seven hours plus a night, really surprised me. For the first time I felt less anxious about how much sleep I am actually getting. Perhaps you know that feeling … It bubbles up at you whenever you can’t get straight off, wake in the night or wake too early?

Noticing the thoughts occupying my mind, such as ruminating over lack of sleep; negative thinking how will I cope if I’m tired sometimes made me fearful before I even got in to bed. What hope was there of sleeping! The diary of sleep hours was a wake up call, excuse the pun, because feeling reassured I am getting enough sleep has stopped me waking up in the night! And staying up all night with my father really brought that home to me.

Yes, I have looked tired this week, not surprising given the worry over my dear dad. As far as the missed night is concerned though, I’m not panicking, I know I can go to bed a little earlier over the next few evenings and my body will take what it needs. After all, I’m not a teenager – I’m not growing!

Writing this also prompted me to re read a blog I wrote back in November 2103 Sleep Solutions and reminded me of some of my own advice. Oops, bad habits can creep up on us …

Here are those sleep tips with a few new ones added. I hope you find them useful. Please share any you may to have to add in the comments box:

  • Take advantage of your natural body clock – the circadian rhythm, and if possible reinforce it by keeping to a regular sleep pattern, even at weekends.
  • Thinking; are you leaving all your thinking time until you are lying in bed? Try giving yourself some space to back track over the day and process your thoughts before you need to go to sleep. A good way of letting go is to work through your day, what you remember and how you felt until bedtime.
  • Ruminating and worrying; if you’ve got something gnawing away at you, try talking it through with someone or keep a journal and write down how you feel. This should give you a sense of having shifted the problem and provide perspective. Night time waking can be linked to people having ‘a lot on their mind’, as the body’s subconscious uses the sleep phase, typically between 2:00 and 4:00 am, to process problems. Studies have shown that people who talk about their problems are less likely to wake up regularly in the night.
  • If issues are beyond your immediate control or influence, focus on why it matters to you to shift resentment and angry feelings.
  • Most people find they sleep better on days when they are physically active. We know that exercising releases feel good hormones that help relieve stress, so this in turn will help you sleep.
  • Depression; if you are suffering from emotional difficulties and they have lasted more than a few weeks, you may be depressed. This is something I have experienced and wrote about in my memoir An Inconvenient Posting. The book includes a Do’s and Don’ts of Depression section. It is recommended you consult your doctor if you suspect you are depressed.

When going to bed:

  • Turn off blue light emitting devices such as TVs, tablets and Smartphones, which cause the brain to be alert. Kindles and some e-readers do not emit blue light.
  • Avoid reading or watching anything upsetting or unsettling on the run up to bedtime.
  • Over stimulation from caffeine is a reality. If you are particularly sensitive to its affects watch out for chocolate as well because of the caffeine in cocoa beans.
  • Exercising is good but not after 8:00 pm when it may rev up your system.
  • Eating heavy or sweet food near bedtime will also hamper your levels of comfort and over stimulate your body.
  • Distractions; got a noise you can’t block out? Invest in some good earplugs. I have friends who swear by them.
  • Be comfortable; cool, dark and quiet. Have anything you need close at hand; water, eye shades etc. If something is not right (itchy clothing for example) sort out the problem straight away.
  • Do not dwell on getting to sleep; focusing on the fear of not being able to sleep is the trademark of the insomniac. Negative thoughts and self-talk are guaranteed to keep you awake. Try techniques below.
  • Imagine you are a night watchman and you are not allowed to go to sleep! Use the power of the paradox…

You might like to try some relaxation techniques:

  • Just breathe… gently in through your nose and out through your mouth. Focus on your natural, deep breaths low down in your abdomen. This will help your mind step away from thinking and as you become the observer, switch off. If you find your mind keeps skipping on to other thoughts just notice this and gently come back to focusing on your breathing.
  • Relaxation CDs and downloads; there are many different ones to choose from; some include guided relaxations which will help relieve tension in your muscles.
  • Sleep aid CDs and downloads; many work on a similar principle to the relaxation aids, some include hypnotic, positive messages to help improve how you think and feel about sleep.  Most also aim to benefit those who wake in the night and would like something to help them get back to sleep if they do. I tried Paul McKenna’s I can Make You Sleep which comes with a book, DVD and CD and found it helpful.
  • Herbal Remedies and Bach’s Sleep Remedy; some people find Valerian is helpful for sleep disturbances and Bach’s remedies for balancing the body’s resources. You will need to mention any herbal remedy you are taking to your doctor if you are taking prescribed drugs.

Sleep Solutions

We all need enough sleep each night to nourish our brain and body ensuring we can feel at our best the following day. Isn’t it amazing that while we are not even aware of it our mind, body and spirit are fusing together, healing and restoring us. Neuroscience is still battling with understanding the human experience of sleep or put another way…

There are more things in heaven and earth, Horatio

Than are dreamt of in your philosophy

Hamlet

William Shakespeare

I used to be able to ensure a good night’s sleep by loosing myself in the pages of a book, now it’s not always that simple. So what’s gone wrong? Like many others, my life has got busier and busier over the years – a backdrop of work, domestic responsibilities, occasionally punctuated by more stressful events – nothing out of the ordinary (except perhaps moving countries several times as an expat).

When did you last sleep really well? I’ve asked myself. As a child growing up in Newcastle, I was always in bed before my older brothers (something I mildly resented from underneath the quilt in my little mustard bedroom). I remember mid summer’s fading light cast a glow through my calico curtains; backlit bunches of raspberry hued flowers seared a lasting image on my memory. With the memory is a sense of waiting for sleep to come, tiredness shunning my young bones in the wake of a school holiday induced high perhaps. Eventually a spiral of hymns and songs arranged and replayed in my mind, would comfort and lull me to slumber. Sleeping was never a problem, not then.

Have you noticed that people who sleep well don’t have to try? It just happens.girl asleep Hmm. Somewhere between the it just happens place of childhood and the I desperately need a good night’s sleep of mid-life motherhood, things deteriorated.  When one of our children was still a pre school-er it was easy to blame bouts of insomnia on being ever alert. Hard wired and hyper vigilant to night time noises, I persevered like so many other parents, through a disrupted sleep pattern of bleary interruptions and early morning demands for attention. Nowadays, nights are rarely broken by small people crying out for me and so I’ve finally realised it’s time to consider what’s going on?

Having set out to find out what I might do to help myself sleep better, I’m now two months into what I’ve come to think of as my ‘sleep improvement plan’ (sounds grand I know).  I thought I’d share some of the ideas that are helping me move me towards my goal of becoming a consistently good sleeper.  I’ve discovered that it really is all about being able to switch off (no surprises there) and learning not to worry about getting to sleep or anything else. Easier said than done you might think. Then read my top sleep tips, I’ve been pleasantly surprised how much a holistic approach to sleep disturbances can help.

  1. Thinking; notice your own behaviour; are you leaving all your thinking time until you are lying in the dark tossing and turning? Try giving yourself some space to back track over the day and process your thoughts before you need to go to sleep. Start from the time you woke and work through what you remember and how you felt until bedtime. This can be a good way of letting everything go and feeling becalmed.
  2. Ruminating and worrying; if you’ve got something gnawing away at you, try and talk it through with someone to gain perspective or keep a journal and write down how you feel. This should give you a sense of having shifted the problem a little, even if matters are beyond your immediate control or influence. You can control how you react and feel about problems and decide not to give them any more energy at this time (when sleep should take precedence). Imagine filing problems away for safe keeping until there is a more appropriate time to think about them.
  3. Depression; if you are suffering from emotional difficulties and they have lasted more than a few weeks or you are unable to lift you mood, you may be depressed. This is something I have experienced and written about in my memoir An Inconvenient Posting. The book includes a Do’s and Don’ts of Depression section. It is recommended that you consult your doctor if you suspect you are depressed.
  4. Night time waking can be linked to people having ‘a lot on their mind’, as the body’s subconscious uses the sleep phase, typically between 2:00 and 4:00 am, to process problems. Studies have shown that people who talk about their problems are less likely to wake up regularly in the night.
  5. Exercise. Most people find they sleep better on days when they are physically active. We know that exercising releases feel good hormones that help relieve stress, so this in turn will help you sleep.

When going to bed:

  1. Light emitting devices such as TVs and Smartphones cause the brain to be alert, so watching programmes in bed and checking Facebook or emails before trying to sleep is not helpful, however tempting. Twitter is a hungry bird and I’m guilty of this one!
  2. Over stimulation from caffeine is a reality. If you are particularly sensitive to its affects watch out for chocolate as well because of the caffeine in cocoa beans.
  3. Exercising is good but not after 8:00 pm when it will probably make you revved up and possibly too hot to sleep.
  4. Eating heavy or sweet food near bedtime will also hamper your levels of comfort and over stimulate your body.
  5. Distractions; Got a noise you can’t block out? Invest in some good ear plugs.
  6. Be comfortable; have anything you need such as eye shades, water and tissues close at hand. If something is not right (itchy clothing for example) it might be better to get out of bed and sort out the problem straight away, rather than battle on against discomfort. It will help you to feel confident that all is well and drift into sleep more easily if you are comfortable from the outset.
  7. Do not allow yourself to dwell on getting to sleep; focusing on the fear of not being able to sleep is an insomniac’s worst nightmare (sorry). Negative thoughts and self talk “I know I’m not going to get to sleep” are guaranteed to make things worse. Instead imagine you are a night watchman and you are not allowed to go to sleep! Use the power of the paradox…

You might like to try some relaxation techniques:

  1. Just breathe… gently in through your nose and out through your mouth. Focus on your natural, deep breaths and keep at it, this will help you step away from your thinking process and switch off. If you find your mind keeps skipping on to other thoughts just notice this and gently come back to focusing on your breathing.
  2. Relaxation CDs and downloads; there are many different ones to choose from; some include guided relaxations which will help relieve tension in your muscles.
  3. Sleep aid CDs and downloads; many work on a similar principle to the relaxation aids, some include hypnotic, positive messages to help improve how you think and feel about sleep.  Most also aim to benefit those who wake in the night and would like something to help them get back to sleep if they do. I tried Paul McKenna’s I can Make You Sleep which comes with a book, DVD and CD and found it helpful.
  4. Herbal Remedies and Bach’s Sleep Remedy; some people find Valerian is helpful for sleep disturbances and Bach’s remedies for balancing the body’s resources. You will need to mention any herbal remedy your are taking to your doctor if you are taking prescribed drugs.