Relax ... and banish those sleepless nights

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There are few things worse than feeling bone tired, yet not being able to sleep. It is enough, almost literally, to drive us crazy - not least because we know the importance of sleep to our wellbeing. We know this not just from the 'latest research' in papers, linking poor sleep to everything from obesity to learning difficulties to marriage problems. We know it from our own experience. In the words of JoJo Jensen, author of Dirt Farmer Wisdom: "Without enough sleep, we all become tall two-year-olds.”

Sleep is necessary for physical rest and recuperation, and also for emotional and psychological health. Poor-quality sleep impacts on physical health (lowering immunity for example) and psychological health (reducing our capacity to cope with every day stressors).

There are many reasons why someone might not be getting the sleep they need - stress, anxiety or depression are very common factors. Stress and anxiety commonly cause restless sleep and/or difficulty falling asleep while depression or low mood often results in early waking (that is waking for no apparent reason at about 3-4am).

Of course, lack of (or poor-quality) sleep actually makes stress, anxiety or depression worse over time, as it impacts on our ability to concentrate, make decisions and general ability to cope with day-to-day tasks. From a psychologist's point of view, sleep needs to be the first thing dealt with in any treatment program for anxiety, depression or stress.

I usually start with basic sleep tips:

  • Make sure that you get up at the same time every morning, even if you had a late night or poor sleep the night before. Set your alarm.
  • Routine is very important for good sleep, so having regular times for meals and other activities also helps.
  • Even if you are tired during the day, don’t have a day sleep. Trying to catch up on missed sleep during the day may seem sensible, but it actually just confuses your body clock.
  • Regular exercise can help sleep patterns, especially if you exercise outside during the daylight hours.
  • Limit your intake of coffee or other caffeinated drinks (like tea and soft drinks) to two a day, and don’t have any of these after about 3-4pm.
  • Have a bedtime routine. Adults as well as children benefit from following a bedtime routine, such as a warm shower, reading and perhaps doing a relaxation exercise (see below for a simple relaxation technique).
  • Massage can be useful for relieving the muscle tension associated with stress or anxiety.
  • Warm milk or camomile tea can be a useful part of a bedtime routine.
  • Make sure that your bedroom is dark, and as quiet as possible. If noise is a problem where you are trying to sleep, get some ear plugs or try some background noise like a fan or relaxing music played quietly.
  • Set aside some time for problem-solving and thinking during the day so that you can allow your mind to relax when it is time for sleep (this takes some practice, but remember you can choosewhat you think about and you don’t have to be at the mercy of your thoughts.
  • Talk to someone (friend, family or professional) about whatever it is that is going around and around your mind. If this is not possible, try a 'free writing' exercise. Free writing is writing for a set amount of time (at least 20 mins is recommended) without taking pen off of paper. This sort of writing is not done with the intention of you 'solving' your problem, just downloading your thoughts from brain to paper.

Very often a period of poor sleep resolves with the regular use of some or all of the techniques above. Occasionally, a temporary sleep disturbance will develop into insomnia, which is persistent sleeplessness with accompanying worry or anxiety about getting enough sleep.

If your sleep is seriously disrupted for at least three nights a week for more than two weeks, and you are worrying or 'obsessing' about how little sleep you have been getting, you may be suffering from insomnia. If you do suspect insomnia is your problem, it is important to be checked out by your GP initially. There are some medical conditions that may cause or contribute to sleep disturbance and it's best to either rule these out straight away or deal with them.

Another good reason to see your doctor is to discuss whether or not your sleeplessness may be caused by depression. Early waking, when caused by depression, is often successfully treated with an anti-depressant medication. Ask your doctor to help you develop a plan for getting your sleep back on track that suits you and your circumstances. [Please note that this plan should not involve the use of sleeping tablets (these are different to antidepressant tablets) for more than 3-5 nights].

Relaxation:

One of the simplest relaxation exercises to do is called Progressive Muscle Relaxation. It involves consciously tensing and then relaxing different muscle groups throughout the body.

This exercise can be done in bed as you are getting ready to fall asleep and is great for relieving muscle tension and giving your mind something to think about other than your worries.

  1. Make sure you are warm and comfortable.
  2. Close your eyes and take 5 deep breaths.
  3. Starting at your feet, curl your toes over and tense your feet as hard as you can for the count of 5-10 seconds. Then relax them completely for the count of 20-30 seconds. Notice the difference in bodily sensations between the tension and the relaxation.
  4. Next move to your calf muscles and tense these for 5-10 seconds. Then relax them completely for 20-30 seconds.
  5. Next stop is your thighs and buttocks. Tense, hold for 5-10 and then relax for 20-30.
  6. Move up to your tummy, and lower back. Arch your back and tense your pelvic floor and tummy muscles all at once. Tense. Relax.
  7. Next your upper body and arms. Clench your fists as tight as you can and, while clenched, push your fists together to increase the tension across your chest and upper back. Hold for 5-10 seconds and then release the tension. Relax for 20-30 seconds.
  8. Finally, tense your face and jaw as tight as you can and hold the tension for 5-10 seconds before releasing. Feel the muscles relax in your face.
  9. Take another 5 deep breaths. Repeat the progression through your body once more if you would like.


Previous columns by psychologist Angie Willcocks

Please click here to ask Angie a question, or to offer any comments or ideas for topics that you think might benefit mining families.

To talk with a trained volunteer telephone counsellor at any time of the day or night, call Lifeline on 13 11 14. To contact the info line at beyondblue: national depression initiative, phone 1300 22 4636.