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Your field guide to insomnia

Getting a good night of sleep can seem like the most effortless and natural thing in the world, but when we can’t fall asleep it can quickly feel elusive and frustrating. There are a few techniques we can use to help us fall asleep, and some things we should always practise before we go to bed to give ourselves the best chance of being able to drop off easily.

Before you hit the sheets

Many major causes of not being able to drop off to sleep actually happen before bedtime. Caffeine, nicotine, alcohol and food can all stimulate our brains and keep us awake at night, so be sure to limit these activities to earlier in the day.

While alcohol may help you fall asleep, it’s also associated with more awakenings during the night which can leave you feeling more tired the next day.

Bright lights and screens just before bed can also keep us awake. And not just because the scary movie or heartbreaking drama arouse our emotions. What many don’t realise is the light these devices emit (particularly blue wavelengths) suppress melatonin, the hormone that encourages sleep, making it harder to fall asleep.

Never take these screens to bed. Bed should be for two activities: sleep and intimacy. This encourages your brain to think of your bed as a place of rest. You should also create a wind down routine and a calm environment. This might involve dimming the lights and taking a bath.

Your circadian rhythms, or “body clock”, sync many of your bodily functions, including hormone release. Keep a routine to keep your rhythms regular. Big shifts in your sleep timing are like being in a constant state of jetlag. If you have problems falling asleep, go to bed when you’re tired and make sure to get up at about the same time every day. Try to keep this routine on the weekend and even after a night of poor sleep.

Another good idea is to turn your clock away. Watching the minutes pass can contribute to worries.

What if I can’t fall asleep?

Sometimes thoughts or worries can keep us awake at night, contributing to a feeling of being “wired”, even though we’re tired. To make matters worse, poor sleep is linked with poor mood, which means you may feel more anxious and easily frustrated the next day.

Increases in the stress hormone cortisol make it harder to fall asleep. Relaxation techniques such as deep breathing and progressive muscle relaxation can help release tension and decrease stress that has built up during the day.

Mindfulness meditation techniques have been found to be effective in helping people drop off to sleep. These involve relaxation, meditation and awareness exercises that help focus your attention to be “in the moment”, acknowledge different sensations, and “let go”.

By learning how to manage your physical sensations, thoughts, and emotions in a non-critical way, you can move from a stressed to a calm state during the day and at night. Join a class or download a mindfulness app with guided meditation you can listen to at bedtime.

If you can’t fall asleep after about 30 minutes, don’t stay in bed. Lying in bed counting sheep doesn’t help. Get up, go to another room and do something quiet and restful in dim light like reading a book (preferably one that is not too thrilling!). Avoid your computer, mobile or TV, because the light they emit can stimulate your mind and keep you awake. When you start feeling tired, go back to bed. If you still can’t fall asleep, get up again. Don’t worry if you have to repeat this several times. Remember to get up at your regular wake time.

What if I find it hard to get up in the morning?

Our “body clock” is wired to sunlight. If you have trouble getting up in morning, try opening your blinds to let the sunlight in. The dawn light will help you wake up naturally.

Things to remember

The amount of sleep we need changes with age. Newborns need around 16 hours of sleep per day, adults about seven to eight hours, and older people generally sleep less. There are individual differences too – the main thing is that you feel refreshed the next day.

Our bodies cycle through different sleep stages every 90 minutes ending with a short period of wakefulness. Remember, short awakenings during the night are normal.

If you have a night of poor sleep, try not to put too much emphasis on it during the day. Know that breaking bad habits and creating good ones takes time. Don’t give up, stick to your healthy sleep routine.

If you continue to have problems or suspect you have an underlying sleep disorder, see your doctor or a sleep specialist. Sleep medications can help in some cases in the short term and should always be monitored by a medical practitioner.

Cognitive behavioural therapy for insomnia (CBT-I), which addresses thoughts and behaviours around sleep, has been proven to be effective in the long term. To access this treatment, ask your doctor to refer you to a sleep psychologist. There are also effective CBT-I programs online such as SHUTi that can be accessed from home.

 

BY JOANNA WALOSZEK, POSTDOCTORAL RESEARCH FELLOW IN PSYCHOLOGY, UNIVERSITY OF MELBOURNE