There are lots of questions about sleep that we do not know the answers to. However, we all know how important sleep is because the effects of not sleeping are very difficult to cope with. The good news is that we are developing a better understanding of what helps us sleep when the pattern goes awry. Some of these are not what you expect.
We are animals used to routine and cycles of daily life that follow patterns dictated by sunlight. We have a great ability to train our bodies to respond to certain stimuli in a programmed way. When I was at medical school I took part in research projects that firmly established neural connections within the brain that promoted and engrained reward related behaviours. Sleep is one of these behaviours and the rituals of going to bed train the brain to switch to this ‘downtime’ operational mode. If sleep becomes difficult, sticking to these routines, or re-establishing them, is the first and most important step. Evening exercise helps, especially if followed by a hot bath before bedtime. This has recently been shown to increase the speed of ‘dropping off’ by 36%. This is due to increase blood flow to the arms and legs causing the body’s core temperature to drop; a very old evolutionary trigger for sleep. Getting up at the same time each morning, whether you have slept or not, is also of vital importance. It is the brain’s exposure to morning sunlight that turns off the production of melatonin (our sleep neurotransmitter) but at the same time it resets the clock for it to switch on again 12 hours later ie when you need it again. Distraction techniques to help you drift off are not as good as concentrating on your breathing. Emptying your mind by thinking about your respiratory rate, following a pattern of counting to 4 while breathing in, holding for a count of 2, and then another 1 to 4 whilst breathing out is a very effective technique. Lastly to help sleep at night, a quick nap in the afternoon has enormous benefits, especially as you get older.
Troublesome sleep is aften a sign of low mood or anxiety and we would advise you to make an appointment with a GP if it is associated with other symptoms such as loss of motivation, tearfulness or weight loss. However, more often our patterns are disrupted temporarily and a reset will work. Wyndham House patients can access an on-line self-referral support service for free www.sleepstation.org.uk which has a 75+% rate for helping patients improve their sleep.
So, if you are experiencing sleep difficulties short or long term it is worth trying some of the above. Diligently follow the same night time routine. Do some exercise to relax your muscles. Have a hot bath to help your body ‘cool’ down. Don’t lie in but get up early. Concentrate on your breathing to help you drift off. Most importantly do not allow your brain to associate lying quietly in bed as anything other than a direction to turn off. If you cannot get to sleep then get up, leave the bedroom, read, watch TV, do a puzzle and then start again.
Anthony O’Brien
Wyndham House Surgery