Problems in nodding off
Although there are many different sleep problems, insomnia is by far the most common. Insomnia is characterised by problems in falling asleep, waking during the night or early in the morning. Most of us will at some time during our lives suffer from insomnia to some degree. Most insomnia will cure itself, however sometimes it can persist for long periods, or become so bad that the person can feel like they’re not sleeping at all. First it’s important to understand about sleep itself.
The different types
Sleep is not one uniform phenomenon. It comes in different ‘flavours’, if you like.
Firstly, we have slow wave sleep (SWS) which is divided into stages 1, 2, 3 and 4; stage 4 sleep being known as deep sleep. The best-known aspect is of course dreaming which occurs mostly in Rapid Eye Movement sleep, or REM. This state is unlike other sleep stages as the brain is very active, so much so that it has been called ‘paradoxical sleep’.
Interestingly, psychiatrist Thomas Wehr ran an experiment back in the 1990s in which people were thrust into darkness for 14 hours every day for a month. When their sleep regulated, a strange pattern emerged. They slept first for four hours, and then woke for one or two hours before drifting off again into a second four-hour sleep.
In 2001, Roger Ekirch published a ground breaking paper, based on 16 years of research, revealed something quite amazing: humans did not evolve to sleep through the night in one solid chunk. Until very recently, they slept in two stages.
In his book At Day’s Close: Night in Times Past, Ekrich presents over 500 references to these two distinct sleep periods, known as the “first sleep” and the “second sleep,” culled from diaries, court records, medical manuals, anthropological studies, and literature, including The Odyssey. Like an astrolabe pointing to some forgotten star, these accounts referenced a first sleep that began two hours after dusk, followed by waking period of one or two hours and then a second sleep.
This waking period, known in some cultures as the “watch,” was filled with everything from bringing in the animals to prayer. Some folks visited neighbours. Others smoked a pipe or analysed their dreams. Often they lounged in bed to read, chat with bedfellows, or have much more refreshing sex than we modern humans have at bedtime. A 16th-century doctor’s manual prescribed sex after the first sleep as the most enjoyable variety.
However, these two sleeps and their magical interim were swept away so completely that by the 20th century, they were all but forgotten.
Historian Craig Koslofsky delves into the causes of this massive shift in human behaviour in his new book, Evening’s Empire. He points out that before the 17th century, you would have to be a fool to go wandering around at night, where ‘Ne’er-do-wells and cutthroats lurked on pitch-black streets’. Only the wealthy had candles, and even they had little need or desire to venture from home at night. Street lighting and other trends gradually changed this, and eventually night time became fashionable and hanging out in bed a mark of indolence. The industrial revolution put the exclamation point on this sentence of wakefulness. By the 19th century, health pundits argued in favour of a single, uninterrupted sleep.
We have been told repeatedly that the eight-hour sleep is ideal. However, in many cases, our bodies have been telling us something else. Since our collective memory has been erased, anxiety about night time wakefulness has kept us up even longer, and our eight-hour sleep mandate may have made us more prone to stress. The long period of relaxation we used to get after a hard day’s work may have been better for our peace of mind than we realised!
The need for sleep
Although we are not yet sure of all the benefits sleep brings, several points are clear.
- REM sleep is essential for emotional health. Dreaming has the function of ridding the emotional centres of the brain of unfulfilled emotional arousal from the previous day, thus leaving us more able to cope well with the next day’s emotionally arousing incidents (bucket emptying).
- When we don’t get enough REM, we can often feel a bit ‘hyperactive’. REM is suppressed by alcohol – you may have noticed the effect of being a bit ‘wound up’ the day after a heavy night’s drinking. This is due, in part at least, to the fact that you have not dreamt enough. You can imagine what happens if we constantly under-dream.
- Slow wave sleep is essential for rejuvenation of physical processes. The exact ways in which this happens are as yet unclear, but we do know that the immune system benefits from a good night’s sleep. A reduction in sleep of 2 hours per night has been shown to reduce the number of natural killer cells (disease fighters) by as much as 20%.
- Extreme sleep deprivation can cause highly unpleasant and bizarre effects such as loss of balance, memory and even hallucinations. So we can see that a good night’s sleep is not a luxury; it is an absolute necessity. We need six to six and a half hours minimum each night in order to function the next day and ideally a regular eight to nine hours. Younger people, up to their early 20’s can need as much as 12 hours a night as their brains and bodies are still growing.
Why are sleep problems so common?
Disruptive sleep happens easily for many of us as it requires progressive relaxation in order to take place. Therefore anything that raises our adrenaline levels, or causes us to worry, can interfere with the natural process of sleep. Some people seem to be able to ‘switch off’ the day’s worries and can sleep in any environment. For others, sleep seems to be much more delicate.
Sleeping pills – a real ‘insomnia cure’?
When you haven’t slept for days, the thought of ‘sweet oblivion’ is extremely attractive, and who can blame those of us who choose a fail-safe option like a sleeping pill? In the long run however, they can lead to more problems. Sleeping pills impair quality of sleep and often have other side-effects such as anxiety and disorientation.
So what can be done about insomnia in the long term?
When a person has chronic insomnia it is almost as if they have ‘forgotten’ how to sleep properly, or that they have become conditioned to responding to the situation (i.e. bedtime) with anxiety or irritation instead of relaxation. What often needs to happen in these circumstances is a ‘re-training’ of the mind and body in achieving the state necessary for sleep to occur.
The difficulty with sleep is that the harder you try, the less likely it is to happen. This means we need to approach it in a different way. Rather than going directly for the goal, we need to ‘set the scene’ so that natural processes can take place by themselves.
If you think about the days before the electric light bulb, when it was dark, everyone had to rest and relax as there was no light to continue working or ‘surfing’. So bear this in mind and be aware that the ‘blue’ light of a computer activates the brain cells just as they have a need to relax prior to bedtime. Television can have a similar effect on the brain and of course, watching a fast-paced thriller or disturbing news programmes are more likely to stimulate adrenaline than calm and relax you.
- Soft lighting, what is it about some bedrooms that make them so calming? One answer is the absence of clutter. Learn from this – always try to put things away, no matter how late you get home as it will help clear your subconscious and you will sleep more soundly.
- Your bedroom windows should block out light – street lights, dawn. We produce the hormone known as melatonin in order to drift into sleep and stay asleep. We naturally wake up as it gets lighter, so invest in a good set of dark curtains, or a ‘black out’ blind. Darkness encourages melatonin which promotes sleep. If you get up in the night, don’t switch bright lights on as they will encourage your brain to respond as if the sun were coming up.
- Establish a regular bedtime routine. This can be brushing your teeth, washing your face, or reading for a few minutes. Meditating or praying is a great bedtime ritual and of course, a really good Relaxation CD like mine. Try to avoid heavy conversations and emotional activities before bed. Make it a rule not to bring your problems to bed with you. You need a calm brain for quality sleep.
- To help you drop off, a few drops of lavender oil on your pillows, nightwear and pulse points – put a sprinkling into your washing machine when you wash your bed linen and nightwear. Essential oil-scented candles burning in the evening will encourage relaxation at the end of your day.
- The best beds have great linen and lots of marshmallow-soft pillows – they cocoon and comfort your body. If you suffer from poor circulation, put a pillow under your knees and feet, or use them to raise your head and upper back to help you breathe more easily.
- Avoid alcohol just before you retire. Whilst it may help you to nod off it will also wake you up later in the night, about 4hrs later, as your liver processes it. While alcohol can speed up the onset of sleep, it disrupts it later as the body begins to metabolise the alcohol, causing arousal. Your quality of sleep will be less good if you use alcohol.
- Use your bedroom only for sleep, relaxation or sex. Doing work accounts or watching stimulating TV will create an association of alertness with your sleeping area. Your bedroom needs to be a place to shut out the concerns of the day and really wind down and relax.
- Avoid any stimulants such as tea; coffee, alcohol or even hot chocolate too close to bedtime and if possible not after 6 pm because you need to have a gradual wind down period before retiring to bed. Even if you can fall asleep with a caffeine buzz, caffeine disrupts the sleep cycle and reduces the quality of your sleep. And remember, chocolate and many other foods have caffeine.
- Exercise early and often. Physical activity can help by synchronising circadian rhythms, reducing stress, decreasing REM sleep, and causing many favourable neuro-chemical changes in your brain. However, exercising too close to bedtime can rev you up and keep you awake. Vigorous exercise is best in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed without problem.
- Any vigorous exercise you do, such as aerobics, needs to be done at least three hours before going to bed to give your body the chance to return to normal – so that you can begin the wind down and start to relax prior to your sleep period.
- Get more natural light. Getting out in the sunshine during your day will boost serotonin, a neuro-chemical, which improves melatonin release, allowing your brain to shut down. Avoid bright lights and electronic screens after the sun goes down.
- Stop watching TV, replying to Emails or surfing the net for at least an hour before bedtime, ideally at least 2hrs before bedtime and at least 90mins before bedtime, as the blue light of these screens stimulate your brain.
- Make a list of the things that you are thinking about, such as jobs that you need to do. Once you have written these things down the brain acknowledges that you have written them down. It knows that it can tackle the jobs when you wake up. You will not spend your night trying to remember everything you need to do.
- Ensure that your bedroom is cooler than the rest of the house, but not cold. The body cools as we drift off. Go to bed when you feel sleepy or tired and work towards getting a regular bedtime and a regular waking up time. Remember that like our caveman ancestors, we tend to wake earlier in the summer than in the winter months with the lighter mornings. If your bedroom is cold, or you have poor circulation, your feet will get cold and cause sleeplessness. To avoid the problem, wear a pair of warm socks in bed. Similarly, if your bedroom is too cold this will keep you awake.
- If you have an alarm clock, especially digital display, put it somewhere so that you cannot directly see it from your sleep position. If you are awake and can easily see the time this tends to accentuate being awake.
- Avoid irregular shift work if at all possible. When we work shifts our body clock goes out of sync. Our sleep cycle does require a consistent pattern.
- Limit food and drink before bedtime. Stay away from large meals close to bedtime as digestion can interfere with sleep. Also, dietary changes can cause problems. If you are struggling with a sleep issue, it’s probably not a good time to start experimenting with spicy dishes.
- Try having a small carbohydrate snack before you go to bed. Having a mug of warm milk with no sugar encourages the release of serotonin which encourages slow wave deep sleep. Research has also shown that you should eat a banana before you head to bed because they are rich in carbohydrates, which helps relax your body and brain. Similarly, eating two Kiwi fruits, about an hour before bedtime, is beneficial as they give you Tryptophan (an amino acid) which will help you make Serotonin which in turn helps you make the sleep hormone Melatonin. You will also get your daily requirement for Vitamin C!
- Take a hot bath in subdued lighting, with lavender scented bath essence. This helps because in order to go into sleep your body needs to cool. After a bath the cooling will encourage sleepiness. Likewise, ensure your bedroom is comfortably cool.
- And an important point is – don’t sleep in during the day. Sleep is a beautiful beast that needs to be tame. It needs to be exclusive to night times. Sleeping during the day will drive out night time sleep!!
- Get into a regular routine of getting up and going to bed at the same time every day of the week in order to reset your rhythm.
- Engage the power of association and use my relaxation CD. Let it quietly play each time you go to bed and again if you wake up in the early hours. Allow yourself to fall asleep by drifting down into trance and slipping sideways into trance and get your best bucket emptying sleep – let your secretary empty your bucket and help the boss stop thinking about the problems, that only the secretary can sort!
Getting back off when your eyes are wide awake.
This happens to everyone! If it is an occasional occurrence, do not concern yourself about it, it is quite normal. When it happens regularly then review your dietary indiscretions, your alcohol intake, your bedroom’s sound proofing or your partner’s snoring to see whether you can figure out what is waking you up.
If anxious thoughts are keeping you awake, write them down. Keep a journal of your thoughts to unload them; you don’t need to show anyone your journal. Move those anxious thoughts from your mind to the journal and leave them there. Get in the habit of wrapping up your day by making a list of any concerns or tasks, things you need to remember and how you plan to deal with them into your journal and then it is ready for the next day and you are not having to ‘carry’ the thoughts.
Remember – you cannot fix things in the middle of the night!
There is nothing you can do about a problem in the middle of the night, remind yourself that you tackle the concern in the morning, when you are fresh, after a night’s sleep. Let your “Secretary” get on with the work and let your “Boss” get back to snoozing. Do not try to sleep, enjoy relaxing the mind and body, it will still leave you feeling refreshed come morning time.
If you really cannot sleep, get up and do something really boring… do a jigsaw: If you lie awake for more than 20 minutes, and it is making you more anxious, get up and do something non-stimulating for a few minutes, such as working on a jigsaw. NO surfing the web, no TV! If you feel that you have to read, then read something boring, the most boring page of the newspaper or one that you would never normally read under normal circumstances. Keep the lights as low as possible.
Take some long, slow deep breaths. Inhale to the count of five, hold and breathe out. Do this 10 or 12 times and do not be concerned if you fall asleep before completing this exercise.
Drink some warm milk or camomile tea. Have a banana.
Beginning at your feet and working up to your head, tense, hold, and then release all the muscles of your body. Listen to my relaxation CD, get those headphones back on!
Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism’s environment. They are found in most living things, including animals, plants and many tiny microbes. Our biological clocks drive our circadian rhythms.
The “master clock” that controls circadian rhythms consists of a group of nerve cells in the brain called the suprachiasmatic nucleus, or SCN. The SCN contains about 20,000 nerve cells and is located in the hypothalamus, an area of the brain just above where the optic nerves from the eyes cross. Circadian rhythms are produced by natural factors within the body, such as the amount of serotonin we have made during the daytime, but they are also affected by signals from the environment. Light is the main cue influencing circadian rhythms, turning on or turning off genes that control an organism’s internal clocks. The circadian rhythm can change sleep-wake cycles, hormone release, body temperature and other important bodily functions.
Circadian rhythms are important in determining sleep patterns. The body’s master clock, or SCN, controls the production of melatonin, a hormone that makes you sleepy. Since it is located just above the optic nerves, which relay information from the eyes to the brain, the SCN receives information about incoming light. When there is less light—like at night—the SCN tells the brain to make more melatonin so you get drowsy.
Circadian rhythm disorders can be caused by many factors, including:
Time zone changes
Changes in routine
And most of all, remember:-
Whatever we think in our left pre-frontal cortex (the Boss), our Secretary thinks is actually happening and gets our mind and body to behave in this way.
As I mention on my CD about how our Brain works
“I’m going to be late”… and you are conditioning yourself to be late. If we say “I can’t sleep” or “I have insomnia” or “I can’t get a good night’s sleep” then we do not get a good night’s rest as we have told ourselves to sleep badly, if at all.
So, begin telling yourself how well you do sleep, how you manage a straight eight hours (or however long you need), tell yourself how you get enough sleep each night and wake refreshed and ready to begin your day and you’ll surprise yourself just how quickly you do begin to sleep like a baby.
Establishing fixed times for going to bed and waking up (avoid sleeping in after a poor night’s sleep)
Try to relax before going to bed
Maintaining a comfortable sleeping environment (not too hot, cold, noisy or bright)
1) Napping during the day
2) Caffeine, nicotine and alcohol within six hours of going to bed
3) Exercise within four hours of bedtime, although exercise in the middle of the day is beneficial
4) Eating a heavy meal late at night
5) Watching or checking the clock throughout the night
6) Anything mentally challenging up to 90mins prior to bedtime
7) Watching or checking the clock throughout the night
Only use the bedroom for sleep and sex
Establish fixed times for going to bed and waking up (avoid sleeping in after a poor night’s sleep)
Maintain a comfortable sleeping environment (not too hot, cold, noisy or bright)
Do something every day to give your body the exercise it needs to make it want to rest. Do something each day that stimulates your mind – a crossword for example, and take time to calm your mind for the last few hours before bedtime. These things will help you to build up your Serotonin, which will in turn help you to create your sleep hormone, Melatonin. We make both of these from the same amino acid – tryptophan. Being unable to nod off or waking regularly and staying awake demonstrates a deficiency in these essential brain chemicals.
To help, ensure your diet is rich in chicken, cheese, tuna, tofu, eggs, nuts, seeds and milk as they are all high in tryptophan. Lettuce and oats also help us sleep. A high potency multi-vitamin may help you to convert the tryptophan in your diet into Serotonin and Melatonin.
Do not leave it too late in the evening to eat, as this will keep you awake. A small carbohydrate snack can be beneficial to help you sleep as it creates a need for insulin, which carries the tryptophan into the brain!
Extra little things that you can do to help are to avoid all stimulants such as sugar and caffeine in the evenings, choose calming herb teas, lemon balm, camomile, St. John’s Wort and listening to soothing music.
Calming the body, relaxing the nerves and the muscles will help tremendously – some gentle yoga perhaps. Too much stress, too many stimulants, especially sugar, or if your magnesium levels are too low you may be experiencing restless legs or cramps that keep you awake.