The role of sleep and one’s mental health

In Guest Blog by Fiona

Derek Fisher has been working in the care industry for over 17 years in various forms and is currently a house manager for a charity who have sheltered accommodation for disabled people.

“I have a keen interest in dementia and I am an admin for Dementiahelpuk. I have been involved in dementia for over 15 years. My ambition is to see a national 24/7 dementia helpline.
I live in Essex and work mainly in NE and NW London and Hertfordshire. I am a keen football fan and I love cricket. I also enjoy gardening.”

Dr. Nicola L. Wheeler is a Clinical Psychologist and Systemic Practitioner working in the NHS with older people. Her work is very focused on the recovery model’s ‘CHIME’ principles – connectedness, hope and optimism, identity, meaning, and empowerment.

“I work collaboratively with my clients to support and empower them to have more insight into, and understanding of, mental well-being, and identify triggers that might lead to ill-being. By working together to share knowledge and learn and practise skills, I hope clients will move along their recovery journeys and develop strategies and routines to help them manage ill-being and enhance their well-being.”

Derek and Nicola discuss the impact of sleep on mental health, and share strategies to help improve your sleep and wellbeing.

The role of sleep and one’s mental health

A goodnight’s sleep enables processing and consolidation of information from your day, and provides your body with time to rest and recuperate, so is vital for physical and mental well-being.

Worries/anxieties e.g. about health, money, family or work, may impact the quality and restfulness of sleep. Sleep can also be disrupted in a number of mental health problems including low mood/depression, psychosis, bipolar disorder, and in the context of dementia and head injury. Problems sleeping may be a sign of increased vulnerability to poor mental health.

On going to bed, lying in the quiet and darkness, trying to get to sleep, you may find your mind starts racing with thoughts and you are unable to switch off – every possible action and consequence is reviewed, along with the ‘what if …?s”. The perceived worry/problem is going round and round your head like a ball bouncing off a wall, and just won’t stop or go away.

When it’s time to get up, you feel unrefreshed and unrested because the problem is still there, and you may find yourself approaching the day in a negative mindset. This negative mindset may further impact your mood and energy levels. Grumpiness and lethargy are common, and possibly accompanied with muscle ache/weakness and stomach pains. The problem/worry is still consuming your thoughts, most likely escalating in severity, as you are constantly focusing on it – but perhaps you are building a mountain out of a molehill as the worry/problem weighs heavier on your mind.

Strategies to help improve your sleep and enhance your wellbeing:

1. Develop a good sleep hygiene routine – have a set bed time and a time to get up, and try to stick with this

2. Try to limit the time you focus on the problem/worries to a set amount of time each day – maximum of 1 hour e.g. 7-8p.m. at the start of your bed time routine. During this time, make sure you write down your worries/problems exactly as you are experiencing them. Then try to generate some potential solutions or alternatives which are kinder and more compassionate to you.

If you are finding solution-focused thinking challenging or your thoughts are very distressing, perhaps think what a friend might say to you if you shared these thoughts/worries with him/her, or alternatively what you might say to a friend in the same position

3. If you have thoughts or worries entering your mind outside of your worry time, notice these thoughts, so you are acknowledging them, but remind yourself that you have a set worry time each day to think about these worries/problems and that you will give them time then. This will help you get some control over the amount of time you spend worrying so reducing the ‘all consuming’ impact of the worry/problem

4. Once you have had your worry time, in the lead up to bed time, try to give yourself some time to wind down and relax – have a warm bath with soothing/relaxing bath foam to help your muscles ease, and then practice a mindful breathing exercise. Self care is really important and should not be underestimated.

Try to avoid watching television on the run up to bed. Instead, you might try listening to some calming/soothing music or an audio book (not on a distressing topic), or doing some mindful colouring (colouring mandalas with their logical colouring instructions i.e. working in circles to colour in the pattern from outside to inwards, can be particularly helpful if you are becoming anxious)

5. Try talking to someone close about the problem – it’s an old cliché but ‘a problem shared is a problem halved’ and the other person may be able to support in generating solutions, or help in thinking about things in a more compassionate way. You may also consider accessing professional support through Citizen’s Advice, or talking therapy through your G.P., or other charitable support

6. Try to tackle the problem in its early stages to reduce the possibility that it might get out of hand – write information down so you have a record of your thoughts and possible solutions. Writing things down will save you constantly trying to remember it and trying to make sense of it in your head – remember things can be clearer on paper. You should always tick off when you have done things so that you can recognise your achievements and your progress along your recovery journey

7. Breaking challenges/tasks/problems down into smaller steps can make them more manageable and not seem so onerous – remember to celebrate each small step as recovery is a journey!

8. Try to avoid taking sleeping pills as these, as attractive as they may seem, can be addictive and you become reliant on them if you take them regularly. Try having a warm milky drink e.g. Horlicks or hot chocolate made from milk, or a tea made with a sleep-easy teabag as part of your bedtime routine.

Snacks like banana, oat biscuits or a turkey or peanut butter sandwich are rich in the natural chemical which induces sleep so are good if you are feeling a little hungry – it’s not good to go to bed hungry as you will focus on this and it will keep you awake

9. When in bed, try to close your eyes and think of outer space and nothing but stillness and peace, stars shining in the dark. This can be very calming. This technique takes a while to master so don’t give up.

Alternatively, you could do a progressive muscular relaxation exercise (i.e. working progressively up your body from your toes and relaxing each muscle group in turn) or a guided relaxation exercise (e.g. in a forest or on a beach) – there are lots of tracks readily accessible via YouTube that you could listen to

10. Don’t drink caffeine before trying to sleep. Give yourself at least 2 hours before going to bed after a caffeinated drink. Alcohol should also be avoided as part of your bedtime routine

11. Avoid exercise at least 2-3 hours before bed, but you might benefit from a short mindful stroll (10-20 minutes) after your worry time and before your relaxing bath

12. Try to ensure that your bedroom is not too hot or too cold, but around 18oC, and that your bedroom is a calming environment so a soothing colour

All the above might help, but the real help is self-help and there are a number of apps which can be downloaded on a range of devices which you might find helpful e.g. Breathe2relax, Headspace, Relax Melodies, Sleep Diary, Calm, Sleep Better.

Mindfulness is a good skill to practice daily and several times a day. There is also a cognitive behavioural therapy app for people who experience insomnia called CBT-i. Seek medical advice if sleep deprivation is affecting your general health.

Remember, if you are stuck in a cycle of poor sleep then you need to do something different to create a change. Try to use the above strategies to develop your own sleep hygiene routine which fits with your personal timings.

Continued little or very disrupted sleep can lead to increased mental health difficulties. You may get short tempered and explode at the smallest thing, become agitated or nervous, and this may also impact your relationships with others e.g. you become withdrawn and insular, or you get easily annoyed by others and their actions. Owing to your tiredness, you may also stop engaging in hobbies or interests and this also has negative consequences for your well-being; remember being active (physical and mental) during the day will also help sleep.

Napoleon said that a man can survive on just a few hours’ sleep, but experts have found this is not the case. The average person needs about 7-8 hours sleep each night – this will depend on your health, age and how active a lifestyle you lead. Everyone is individual so the amount of sleep each person needs varies. You may use apps like sleep cycle to find out if you are getting sufficient, and good quality sleep.

We hope you find this information helpful for achieving a more restful and recuperating night’s sleep – remember sleep tight and don’t let the bed bugs bite!

“My grace is sufficient for thee; my strength is made perfect in weakness”

“My grace is sufficient for thee; my strength is made perfect in weakness”