Sleep is undeniably one of the most valued parts of our lives – it has persisted through natural selection processes despite its counterintuitive role in keeping us (as animals) safe from predators, hunting, eating, and reproducing. With this in mind, understanding the importance of sleep on wellbeing is necessary in learning to mitigate or intervene on illness or diseases that affect our capacity to function effectively. There are typically two types of sleep that occur in a pattern of 3-5 cycles per evening, (1) Rapid Eye Movement: when dreaming occurs, (2) Non-Rapid Eye Movement: has 3 phases, including deepest sleep.
Though it is not the only form of rest, sleep is the most effective form of restoration we can offer our brains and bodies each day. Our sleep wake cycles are largely determined by build-up of sleep pressure that can be mediated by factors such as caffein and melatonin. These factors are also influential in the architecture of sleep and the different stages of the sleep cycle. NREM sleep serves to reflect and process information experienced during our wake states – it facilitates integration of information received/experienced with the purpose of forming a more accurate view of the world. The varying levels of caffein, melatonin or other mood-altering chemicals/substances and affect the quality of this integration or effective/restful sleep is for us. Further, these factors also influence our access to NREM sleep which is crucial to the restoring not only the body but also the mind.
The important link between sleep and health is evident through associations between sleep quality as a mediator between other wellbeing indicators such as improved memory, motor skills, learning, concentration, recovery from physical activity and creativity. Some of the neurological and psychiatric illnesses associated with poor sleep include anxiety, depression, bipolar disorder, stroke, and chronic pain. Other associations also involve our physical health such as diabetes, heart attacks, infertility weight gain, obesity, inflammations, and immune deficiency. It goes without saying there is a clear link between chronic poor sleep and lifespan. Specifically important to the Therapy space is the role of Sleep in influencing and being influenced by psychiatric illness. The crucial role of sleep in rewiring our emotional circuitry, directly implicates this mental health and our capacity for internal regulation and regulation in the presence of others (a side note: REM sleep has been described as “what stands between rationality and insanity”). There are lifestyle factors that can be addressed such as previously mentioned caffeine, alcohol (one of the most powerful suppressors of REM sleep) intake, as well as forms of restorative practices as well as sleep hygiene (discussed below), that can improve and return sleep to regularity.
Sleep disorders or sleep-wake disorders involve persistent problems with quality, timing and amount of sleep which results in daytime distress and impaired capacity for functioning. Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition)
There are currently several diagnoses under the umbrella term of sleep wake disorders and of which Insomnia Disorder is one of the most common. In the treatment of clinical populations, evidence suggests that Cognitive Behavioural Therapy modified for Insomnia (CBT-I), Mindfulness and Yoga as being effective forms of treatment (Taylor and Pruiksma, 2014; Koffel, Koffel, & Gehrman 2015). The basic features of a cognitive behavioural treatments involve a three-pronged approach of (1) Restricting time in bed to increase sleep drive, (2) Restricting behaviours that occur in bed/bedroom to sleep – to promote strong association with sleep and (3) reframing unhelpful beliefs/thoughts associated with sleep. Holding in mind that there are effective and accessible interventions for both sleep disorders and disturbances – making regular and routine sleep a priority can have far reaching impacts on both individual and collective wellbeing.
Tips for Healthy Sleep
- Stick to a sleep schedule
- Exercise is great, but not too late in the day. Try to exercise at least thirty minutes on most days but not later than two to three hours before your bedtime.
- Avoid caffeine and nicotine.
- Avoid alcoholic drinks before bed.
- Avoid large meals and beverages late at night.
- If possible, avoid medicines that delay or disrupt your sleep.
- Don’t take naps after 3 p.m.
- Relax before bed. Don’t overschedule your day so that no time is left for unwinding. A relaxing activity, such as reading or listening to music, should be part of your bedtime ritual.
- Take a hot bath before bed.
- Dark bedroom, cool bedroom, gadget-free bedroom.
- Have the right sunlight exposure. Daylight is key to regulating daily sleep patterns. Try to get outside in natural sunlight for at least thirty minutes each day. If possible, wake up with the sun or use very bright lights in the morning.
- Don’t lie in bed awake
Citations:
Why we Sleep by Matthew Walker
Zeichner, S. B., Zeichner, R. L., Gogineni, K., Shatil, S., & Ioachimescu, O. (2017). Cognitive behavioral therapy for insomnia, mindfulness, and yoga in patients with breast cancer with sleep disturbance: a literature review. Breast cancer: basic and clinical research, 11, 1178223417745564.
Chokroverty, S. (2010). Overview of sleep & sleep disorders. Indian J Med Res, 131(2), 126-140.
Taylor, D. J., & Pruiksma, K. E. (2014). Cognitive and behavioural therapy for insomnia (CBT-I) in psychiatric populations: a systematic review. International review of psychiatry, 26(2), 205-213.
Koffel, E. A., Koffel, J. B., & Gehrman, P. R. (2015). A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep medicine reviews, 19, 6-16.