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.

Managing Uncertainty

In the kitchen, I am glowing in the humidity underneath a wash of pale spotlights. Outside in the dark yard, the cedillas emit their ceaseless din. Rubbing my strained eyes I wonder, with a heart pumping fast, could there be  someone out there looking in at me?

A toad releases an ungodly belch. Nothing feels normal. Moving through to the garage, I locate a familiar looking screwdriver, large and heavy in my hand. I know I need it, but can’t remember why. Turning to leave, I press the wrong switch and jump as the garage door clangs loudly and begins to rise up into the gloom. As it lifts up and out, a downpour of Hollywood proportions comes in to view.

The rain is making V shapes as it hammers on to the drive. I feel my senses ambushed and shiver perversely in the heat. I stab at the switch repeatedly and beat a hasty retreat.

My chest is tight and skin prickling inside swaddled sheets. Bound like an Egyptian mummy I try to free my heavy legs. Rain is lashing down on the bedroom roof.

Calm down, I tell myself. The positive self-talk begins to sink in as I realise TV footage from the previous evening has worked its affects on me. Images of Houston in Texas submerged again, have reconnected me to old experiences and fears. It’s a sense of being out of control, the not knowing how events will play out …Hurrican Ike storm gathering

I suspect most of us have memories of an extraordinary weather event and have felt the unstoppable powerful of nature at her worst. Hurricane Ike was special to Houston; the eye of the storm covered the width of the city. Houston took a direct hit.

It is perhaps a cliché to recount a dream sequence, but aren’t dreams fascinating? They inform us, provide a commentary from the unconscious. Watching news footage undoubtedly tapped into mine, giving me nightmares. Sensations that passed through my body five years ago, recalled in the here and now, while I slept.

Short scrappy scenes; waking in the stifling heat, striding forward, fumbling through a dark house, clammy and panicked, desperate to locate a cup of tea or some iced water. Only then to remember the power is out. There are no lights, or kettle to boil or iced water to pour from the fridge. The power outage went on for two very long weeks …

It wasn’t life threatening for us, although sadly approximately 200 people did die as a direct result. It was a slow trial; a test on the nerves. The aftermath was at best inconvenient. At first there was a sense of adventure, the ‘together in the trenches’ moments. In the photo you can see our children inspecting our neighbourhood the morning after Ike. houston 2009 139

The knowledge of the hurricane approaching and inherent uncertainty was more challenging. Growing up in England, I’d experienced storms, high winds and flooding before. I was in my early twenties and living alone when the 1986 ‘hurricane’ passed through Kent. Sevenoaks, where I now live, lost six of its seven oaks, planted in 1902. Although the oaks were replaced, it has been known as ‘One oak’ ever since …

In 1986 the Kent weather event caused significant damage and yet it wasn’t a true hurricane. Another crucial difference was it happened without warning. The BBC weatherman, Mr Fish, famously poo poo’d the idea of a hurricane coming when he read the weather forecast on the evening before. As a result the fear of what might play out was absent.

Back then; I woke at 2:00 am to a chorus of unfamiliar whistles and crashes. I was awestruck by the chaotic scene in the street below my flat. Trees bent double, trash-cans bounced down the street like discarded newspaper. Unable to make sense of the scene and alone in my little flat, I went straight back to bed and slept on. Oh to be young and carefree of life!

When you are an expat you take what the posting brings as part of the package. You expect the unexpected (some of it very positive) and you cope as best you can. The ten day build up as Hurricane Ike made it’s way across the Gulf of Mexico and subsequently the certainty of it’s impending arrival, were scary. And yet there was no time to deal with the anxiety, hurricane preparations – boarding windows, gathering essential supplies took over.

Dealing with the unknown, the unexpected and feeling out of control are some of our most stress inducing experiences. So how might we cope with uncertainty coupled with fear?

6 Tips for Managing Uncertainty

1) Thinking logically when you are feeling anxious is challenging, so a clear head will be help. I recommend you stop what you are doing and sit down, now tell yourself to relax. Easier said than done? Take a deep breath in through your nose to the count of ten and then breath out through your mouth, slowly to the count of ten. Relax your jaw and facial muscles. Do this seven times and you notice as you begin to feel calmer. Repeat this as many times as you need to.

2) Ask yourself, What is the worst that can happen? Consider what action you can take now to prepare or help ease your situation. If you are truly powerless over events (a rare occurrence) commit to staying calm, this will help maintain a sense of control.

3) Remind yourself ‘This too shall pass’.

4) Distracting ourselves can be a way of ‘avoiding’ particularly when we know we should be doing something we don’t want to! Conversely, at times of great stress, distraction or displacement activities can allow us the space to calm down. For example, studies have shown that doing something with your hands that doesn’t require much thought, such as knitting, will help. Moderate exercise is another good stress buster.

5) Remind yourself that although uncertainty is difficult to tolerate, it is not impossible to do so. Recall a time in your life when you coped with not knowing what was going to happen. With the benefit of hindsight, what have you learned from surviving that experience?

6) Mindfulness can help us to still the mind and stay focused. Do you have memories of unexpected events?

Would you would like to share your experience and possibly what you learned from them?

Watch ‘An Inconvenient Posting‘. Huge thanks to author Jack Scott  and Liam Brennan at Summertime Publishing for their work on my book trailer and new look blog. If you have a second to ‘like’ them I would very appreciate it 🙂