The importance of a good night’s sleep and ways you might achieve it

Dr Mike Scanlan, a retired therapist and lecturer in mental health at the University of Northampton and De Montfort University, provides some background into sleep and offers tips that could help you achieve a restorative night of rest.

What is a good night’s sleep?

During a night of sleep, people go through sleep stages: one such stage is of rapid eye movement (REM) sleep which is where you dream and process the stuff of the day, and stages of non-rapid eye movement (NREM) sleep. Each stage is associated with certain changes in activity in the brain and body. REM sleep is often associated with the mind and cognitive functions, while deep sleep is about physical restoration and health. Both are essential for wellbeing, and getting a balanced cycle of REM and deep sleep is important to feeling refreshed and restored.

What are the benefits?

There are many benefits to good, reliable sleep. Our bodies work better when they’ve had a good night’s sleep, and we can think more clearly. The restorative effect includes immune functions, so can improve wound healing for example. If you get enough sleep, you wake in the morning feeling restored. But that isn’t the case for many people. So, it is important to take steps to get the best possible sleep, but bear in mind that we all need different amounts of sleep to function well. For reassurance, the deficits of sleep where we haven’t slept well need to be really significant for it to have a detrimental effect on our overall health. People worry that if they don’t sleep well, they will struggle and this, in turn, can make it more difficult to get to sleep. This is known as the paradoxical sleep effect. Around two-thirds of people who are struggling with anxiety and depression don’t get proper restorative sleep because they spend too much time in REM sleep. That’s probably because their brain is trying to process a lot of stuff. This is why a problem shared and even dealt with aids our sleep.

Why can’t I sleep?

People are vulnerable when they are asleep. When you sleep you aren’t able to defend yourself because you are in a state of unconsciousness. So neurologically speaking, if your mind feels you are susceptible to threat it won’t allow you to rest. So make sure you are settled and you’re feeling at ease with yourself and the people around you (the old adage of not going to bed on an argument is true), otherwise your brain doesn’t like it.

Do you start worrying about things just as you’re dropping off to sleep?

You’re not alone if you do. What we often fail to do properly is put our worries to bed, literally, before we go to bed. Just as you’re planning to drop off, doubts, worries and concerns pop into our mind. And that’s because we haven’t actually dealt with them in the day. So structured worrying is really, simple.

Steps for structured worrying

• Choose a time of the day - early evening is good - and allocate time to write down all the things you’re worrying about today.
• Once you’ve written down all those things, look at your list and draw a line through any that aren’t your worry, like something in the news or climate change.
• Now choose one and decide how you are going to have an impact on it. Don’t think you are going to solve the problem as this isn’t problem solving but do one thing to impact it. For example if you are worried about money, make a plan to speak to somebody at Money Advice – and do it the next day. Then you’ve done one thing and your structured worry time is finished.
• Do the same thing the next day and if you do it for two or three days your brain will start to think that you are in control of your worries. Neurologically speaking, the brain then feels safer.
• If we worry but don’t do anything about our worries, the brain doesn’t like that at all. So this simple process can have an impact.
• You can take your list or a notepad to bed in case you want to add something to the list or remind yourself of something. Questions or worries can go round and round in your head as your brain is worried it will forget something, which means you can’t rest. Authors and writers take notepads to bed in case a really good idea comes to mind.

Getting back to sleep if you wake in the night

As we get older it is common to need to get up in the night for the loo, and there are tips on getting back to sleep quite quickly. Although we may not realise it, we often take steps that wake us up. For example switching on the light, putting on slippers, checking your phone. By doing this, you’ve completely disrupted your pattern. By switching on the light, it affects your melatonin level, which is the sleep hormone. So the first tip is don’t switch on bright lights. Glide yourself to the loo safely but without the bright lights if possible and smile. Smiling tells your brain that you are safe.

When you settle back into bed try cognitive shuffling.

What is cognitive shuffling?

Think of a good word; I tend to use the word ‘breath’. Then take the letters of the word and, as you lie down in bed, you quietly say to yourself what is in your mind’s eye using reassuring, soothing, gentle sorts of images. For example, start with the letter ‘B’ and picture a balloon blowing near a brown dog and continue with images beginning with ‘B’. Then move on to the letter ‘R’ where you might picture a rabbit rummaging through radishes on a rainy day. This tricks your brain into thinking you are in the early stages of dream sleep because dreams are made up of abstract pictures, words and concepts.

Some people use the same word each time, others change them. It doesn’t matter what approach you take as it’s the abstract nature of it that works.

If you’re struggling with symptoms or side effects you may need to cool down

One thing that can help with symptoms or side effects is to check you are not too warm as this can irritate things like itching and sweats. Try cooling yourself down, particularly your feet, and you might find that helps. Some people get out of bed and lie on the floor for a while to cool down.

Find your sleep window

Importantly, go to bed when you are tired. People fall into the trap of missing their sleep window. Historically, before electricity, people would go to sleep around dusk as there wasn’t a lot that people could do once darkness had descended; it was a signal for sleep. They would then wake at dawn to fit everything into the day available. Human beings are designed to go to sleep a lot earlier than we do today. However, we have a number of sleep windows, so if you miss one, another will come along. But it can be helpful to work out when your sleep window is and stick with it, trying to go to sleep at the same time each day and waking at the same time. Preserve those natural rhythms because they serve us well. But don’t fall into the trap of thinking ‘I’ll go to sleep early tonight because I have a big day tomorrow’, because it rarely works.

Darkness

We are beginning to realise that darkness is important and glymphatic clearance is when we get into deep wave sleep and the brain does a sort of clear up. This means we wake up feeling a bit clearer. If your bedroom isn’t dark, or there is a glow, consider getting some blackout blinds.

Exercise during the day

Exercise during the first part of the day can help with sleep. It doesn’t have to be extreme; just something that leaves you breathing a bit heavier.

Drinking coffee or other stimulating drinks

Being stimulated by caffeinated drinks like coffee can impact your sleep. Try having your last caffeinated drink around midday and see if that helps. Experiment with decaffeinated drinks for two or three weeks and see if the quality of your sleep improves.

“Try drinking only decaffeinated drinks from midday to see if this helps you to sleep. And keeping your bedroom as dark as possible is also likely to help.

Napping and dropping off before bedtime

People who are struggling with side effects like cancer-related fatigue often question whether they should have a nap in the day. If you sleep well anyway, a nap may well be helpful. But if you struggle to sleep at night and you can do without a nap, try to. If you have a nap, consider setting an alarm so you don’t nap for more than 30 minutes.

It isn’t unusual to drop off in front of the TV. If you do this, then gently take yourself to bed as stealthily and calmly as you can. A bit like if you wake in the night. Smile to yourself, creep into bed. Consider listening to an audio book as they are great for sleep because the brain quite likes background noise.

A final tip - letting go with Leaves on a stream

An important thing is to practice the process of letting go. A valuable tool to do this is called Leaves on a stream. It works best for those people who are visualizers. This is particularly for getting off to sleep when you first get to bed.

• Lie in bed and you imagine that there’s a stream that’s just running from the top right hand corner of your consciousness somewhere up above your right eye. And it meanders its way down and disappears somewhere past your left shoulder.
• Imagine yourself sitting on a grassy bank and at the top of the stream, a leaf falls from a tree and it lands on the stream.
• Watch the leaf in your mind’s eye. And as it comes past where you are, just watch the leaf and let it go down to the sea.
• Watch another leaf, let it go down to the sea.
• On the third or fourth leaf, just as the leaf gets very close to where you are, put any thoughts that are in your head on that leaf.
• Let the leaf carry them down to the sea. Ask your brain for another thought that might be troubling you. And the leaf comes down. As it gets close, you pop that thought on the leaf. And the leaf carries it away.

This is a very well-established sleep meditation. It allows the brain to let go of stuff, and the images are not threatening. And that combination of letting go and feeling safe might help you to get off to sleep.

Listen to Dr Mike Scanlan

This article is based on a podcast with Dr Mike Scanlan.