• Reflective Resources

S is for sleep

Early to bed and early to rise makes a man healthy, wealthy, and wise.” Benjamin Franklin


I’m sure many people have heard the above rhyme and there is a lot of truth in it. Decent sleep is vital to optimal health and for various aspects of brain function; it can improve your focus, concentration, productivity, and performance.


“Sleep is an investment in the energy you need to be effective tomorrow.

Tom Roth


A decent night’s sleep can make a positive impact on your entire day and is an essential part of self-care. You cannot live an optimal life and flourish without proper sleep. Unfortunately, despite knowing this, we now sleep less than we did in the past, and the quality of sleep has diminished too because modern life and technology have interfered with our sleeping patterns and this is having an impact on our general health and well-being.


Sleep is the golden chain that ties health and our bodies together.

Thomas Dekker


Melatonin is the "chemical expression of darkness" and inhibited by light. Melatonin, the "light of night" is involved in sleep regulation, as well as in a number of other cyclical bodily activities and our circadian rhythm (24-hour internal clock)


“Melatonin is exclusively involved in signalling the 'time of day' and 'time of year' (hence considered to help both clock and calendar functions) to all tissues and is thus considered to be the body's chronological pacemaker or 'Zeitgeber'." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855314/


Melatonin is a hormone that is produced mainly in the pineal gland (and a small portion in the retina) as a response to darkness. The synthesis and release of melatonin are stimulated by darkness, Environmental lighting does not cause the rhythm but entrains it (alters its timing)


“Light has two effects on melatonin: day-night light cycles modify the rhythm of its secretion, and brief pulses of light of sufficient intensity and duration abruptly suppress its production .In humans melatonin has diurnal variations. The hormone secretion increases soon after the onset of darkness, peaks in the middle of the night, between 2 and 4 a.m., and gradually falls during the second half of the night”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855314/


It is possible to take melatonin as an additional supplement. Ingestion of melatonin affects sleep propensity (the speed of falling asleep), as well as the duration and quality of sleep.


“Even a soul submerged in sleep is hard at work and helps make something of the world.” Heraclitus  


Sleep is essential to function properly. It is not something we can skimp on thinking what we are doing is more important. When we are sleeping appropriately, we are not wasting time, we are creating a better quality of life, thereby helping ourselves and helping others.


Kairos is concerned with the notion of seizing the appropriate time to do something which will affect our future; there is a time for work and play and there is a time for sleep.


Insomnia


It is estimated that around 1 in 3 people have some form of insomnia which can present as:


trouble getting to sleep initially,

trouble remaining asleep or

trouble getting back to sleep.


Most people have experience insomnia symptoms at some time of their lives.


As we get older and our health naturally declines there is a higher risk of experiencing insomnia unless we proactively and intentionally work to avoid it. Women and shift workers have higher rates of insomnia compared to men. The circadian rhythm for the release of melatonin from the pineal gland is closely synchronized with sleep habits and changes in sleep patterns because of shift working with its unusual working hours or time differences e.g. when travelling across time zones are correlated with sleep disturbances.


Insomnia causes


Insomnia can be caused by a variety of things:


It can be health related i.e. connected with medication taken or pain experienced or physical deformity of e.g. nasal passages

Caused by stress experienced at work or in your personal life particularly with unresolved issues

Scenarios connected with your mental health eg anxiety, depression, grief

or unresolved trauma.

Extraneous sounds/disturbances – noisy neighbourhood, partner snoring/partner’s use of CPAP machine

Eating or drinking too much before bedtime


Sometimes there is no clear cause for insomnia, in which case it is called primary insomnia.


How does insomnia affect people?


When we don’t have sufficient sleep, it can be harder to focus and remember things. Our concentration is reduced and risks of accident can increase because our reactions are not as fast. In addition we are likely to be more emotional, think irrationally and a lack of sleep can cause us to experience a depressed mood and it may have a knock on effect on relationships.


When we sleep as well as giving our body a chance to repair, we give our subconscious a chance to untangle all the experiences of the day and simplify our problems.


“It is a common experience that a problem difficult at night is resolved in the morning after the committee of sleep has worked on it.” John Steinbeck


So how can I create healthy sleep habits?


Create a conducive environment


Simplify your sleeping environment. It is harder to sleep when the environment that you are in is full of clutter and not relaxing or there are different lights, sounds etc either in the room itself or outside. As far as possible, declutter the excess and try to make your bedroom a place of calm.


Temperature is important too; the ideal room temperature for optimal sleep is between 60 and 67 degrees.


Make sure that your bed is comfortable. The bed/mattress/pillows you are using can affect the quality of your sleep and how long you stay asleep. Sometimes, poor sleep quality or sleep deprivation is connected to your sleeping position.


If you sleep on your back, health experts suggest placing a small pillow under the backs of your knees, which may relieve stress on your spine. For side-sleepers, place a pillow between your knees and if you sleep on your stomach, you try putting a firm flat pillow under your pelvis to reduce stress on your lower back.


Some people find a weighted blanket helps them to relax more easily, fall asleep faster and stay asleep longer.   Studies show that firm but gentle pressure lowers the physiological symptoms of stress by slowing the heart rate and regulating pulse oximetry.


Create a regular, relaxing bedtime routine


Bedtime routines are useful regardless of age because by following the same routine every night before bed it sends a message to our brain that it’s time to sleep. The body has an internal clock and hormones that control sleepiness and wakefulness. This clock works best if we go to bed at the same time each night as our body likes habits.

The National Sleep Foundation (NSF) recommends creating a sleep schedule and then consistently sticking to it over the long-term i.e. going to bed at the same time each night (including weekends) and waking up at the same time every morning.  


The hour or so before you go to bed is important so be consistent and intentional about creating a conducive routine and creating the right atmosphere,


A routine will vary from person to person, but could include:


Having a small snack at bedtime e.g. 2 x kiwis


"Kiwis naturally contain serotonin, a neurotransmitter that, when levels are low, may negatively affect quality sleep. In one study, people who ate two kiwi fruits one hour before bed for four weeks experienced increased total sleep time and sleep efficiency," Lauren Manaker

https://pubmed.ncbi.nlm.nih.gov/21669584/


Taking a warm bath A study found that taking a hot bath about 90 minutes before bed could help people fall asleep more quickly. The hot water actually helps change your body's core temperature so that you go to bed with a lower temperature. A drop in temperature helps signal to the body that it's time for bed.


Reading, journaling...


Meditation, breathing, listening to a sleep app


Having a warm (non caffeinated) drink


Use essential oils Studies show that the fragrance from lavender plant oils can be therapeutic and help aid sleep


Reducing the lighting


It is also recommended to turn off all screens (e.g., computers, smartphones) 1-2 hours prior to bed, and if possible, not have them in the bedroom. Harvard research shows that blue light suppresses melatonin, the neurotransmitter responsible for regulating the body’s sleep cycle.

Being in a brightly lit environment or the blue light of the computer can reduce evening levels of the a sleep-promoting hormone, melatonin


How much sleep do we need?


Most adults need between seven and eight hours sleep each day It can be helpful to limit the time you actually spend in bed to around 8 hours too so your body gets used to the idea that if it wants to sleep it does so in the time you allocate. Experiment with the time you go to bed/wake up with gradual changes until you find a routine/time slot that works for you then stick to it


Things that are detrimental to sleep that you should avoid include:


Caffeine – it should not be consumed in the early evening and some people say to refrain from consuming coffee after midday


Cigarettes before going to bed or during the night.


Alcohol aggravates problems like snoring and sleep apnea. Although it might help you get to sleep, it will make it harder to stay asleep.


Stimulating activities should be avoided in the hour before bed; including moderate exercise, computer games/social media or texts, emails communications etc, television,/movies, having important discussions, or working on a specific problem etc


Falling asleep on the sofa during the evening as it will reduce your sleep pressure and make it harder to fall asleep later when you go to bed.


It is important to not be hungry at bedtime but having a full stomach makes it difficult to sleep. The evening meal should be at least 2 hours before bedtime.


How can I help myself during the day to sleep well at night?


If you use your bedroom for other activities during the day e.g. as a living room or study this can make it harder for the brain to link it to sleep.

Exercise in the morning or before the evening meal is good for sleep, but not just before going to bed.


Being out in the natural daylight especially during the morning will improve sleep at night. This will help with your body clock and the melatonin levels in the body


What should I do if I can't get to sleep?


Sleep is not something that you can force to happen. If you have difficulty falling asleep and still not asleep within 20 to 30 minutes of going to bed one suggestion is that you get up and go into another darkened room and sit quietly until you feel tired and sleepy again. It is important not to switch on your phone or start to do a job but just relax and rest until you start to feel sleepy again. This helps your mind link bed with sleep – not with being frustrated and not sleeping.


Sometimes this simply doesn’t work and you find yourself feeling increasingly awake then an alternative approach is suggested by Dale Carnegie


"If you can't sleep, then get up and do something instead of lying there worrying. It's the worry that gets you, not the lack of sleep".


The most important thing is not to start fixating on your lack of ability to sleep.


“True silence is the rest of the mind, and is to the spirit what sleep is to the body, nourishment and refreshment.” William Penn


If you are having trouble with shutting off your mind, as soon as your head hits the pillow, try listening to quiet music, a sleep app or practise meditation or breathing We can never shut off our mind and our thoughts so all we can do is try and make them calmer thoughts or distract ourselves but if this fails as before don’t stress about it just get up and sit quietly until you feel sleepy. Sometimes, despite your best efforts, you may not feel sleepy and end up feeling awake and get very little sleep but it is important not to worry about it and just try again the next night checking that you are doing everything you can do yourself to create the right conditions for a good night’s sleep.


Naps


“There is more refreshment and stimulation in a nap, even of the briefest, than in all the alcohol ever distilled.” Edward Lucas


The average adult sleeps for between seven and eight hours a day. Short naps of around 30 minutes will not be a problem during the early part of the day but evening naps or dozing in front of the tv can make it harder to get to sleep at night later on.


Medication


Medication is designed for short term or intermittent use only, and always under the supervision of your medical doctor but it is only a short term fix.


This post is just a collation of everything I found in the time I allotted this week. I can see it is definitely going to be a work in progress and hopefully a useful point of reference and discussion. I welcome any personal contributions, links to research etc etc


Finally, it is often said if you can’t sleep to ‘count sheep’ but a more constructive way that will redirect your thoughts is to count your blessings


“End the day with gratitude. There is someone, somewhere that has less than you.” Zig Ziglar


Some questions to think about/or discuss below:


How do you sleep?


Have you got a regular sleep routine?


What have you found that helps you sleep better or affects your quality of sleep?


If you want to reflect more on this subject, here are some links to get you started:


https://pubmed.ncbi.nlm.nih.gov/21669584/


https://www.sleephealthfoundation.org.au/caffeine-and-sleep.html


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855314/


http://www.sleephealthfoundation.org.au/pdfs/facts/Common%20Sleep%20Disorders.pdf

https://www.reflectiveresources.com/post/sleep-scientist-matt-walker-explains

Reiter RJ. The pineal gland and melatonin in relation to aging: a summary of the theories and of the data. Exp Gerontol. 1995;30:192–212. doi: 10.1016/0531-5565(94)00045-5. [PubMed] [CrossRef] [Google Scholar]







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