In light of our current global pandemic, socio-economic issues and general mountains of stress, sleep does not always come easy.
Mopani Pharmacy talked to Clinical Psychologist, Nicola Munro, regarding sleep, and how to get optimum rest.
It’s a vicious cycle of not getting enough sleep, feeling tired all day, not coping with everything due to fatigue and at the end of the day, feeling stressed and worried – again, not getting enough sleep!
“Sleep deprivation is both a cause and a consequence of poor mental health,” said Nicola.
We see this across industries – as businesses are struggling to meet their targets, “How do I convince people to spend their last R100 with us?”
And we see it in our personal lives, “I only have R100, which essential do I spend it on?”
Lying awake at night, you think about when last you have seen your family members or friends, how you will manage working in new circumstances and getting your children through their academic year.
Our new “normal”, is somehow much harder than it was ever before – and getting enough sleep appears to be the last priority, even though it should be one of the firsts.
At what point does “trouble sleeping” become “insomnia”?
“If your sleep issues interfere with your ability to function at work or school, then it is often classified as insomnia or insomnia disorder”, said Nicola.
You may feel chronic fatigue, depressed or anxious. In severe cases, if you have a mental health condition, you may experience psychosis, paranoia or mania. You may even feel lonely or isolated, yet not feel like you have the energy to see anyone.
Feeling forgetful or fuzzy like your brain has been coated with fog with mood-swings are also common.
What keeps you up at night?
Identifying exactly what causes your mind to refuse to switch off, is helpful. Yes, life is happening right now. How does it affect you per se?
It could be sleep disturbances like anxiety, nightmares or psychosis.
You could even be getting enough hours of sleep but remain unrested, not getting good enough quality sleep or giving up your sleep to do other things.
The subject of these worries could be about money, work or family issues – or something as simple as not having a comfortable place to sleep undisturbed. You may even be a parent or a caregiver that needs to adapt to someone else’s sleep schedule. Medications, alcohol or drugs, could influence your sleep.
It is up to you to find out what is hindering your sleep, and why – before you can do anything about it.
“It can be useful to use smart technology like fit bits or smartphone apps, to informally record and analyse data about ones sleeping patterns”, said Nicola.
According to the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) the diagnostic criteria for insomnia disorder include;
- A predominant complaint of dissatisfaction with sleep quantity or quality
- The sleep disturbance causes clinically significant distress or impairment of functioning
- The sleep difficulty occurs at least three nights per week, for at least three months, despite adequate opportunity for rest
- Your insomnia is not better explained by any other sleeping disorder or as a side effect of a substance
- When coexisting mental disorders or conditions cannot be explained as the cause of your insomnia
Types of sleep
There are two types of sleep, rapid eye movement (REM) sleep and non-REM sleep, which consists of three stages. “We cycle through all stages of non-REM and REM sleep several times throughout the night, with increasingly longer, deeper REM periods taking place toward morning,” Nicola explained.
Most of our dreaming occurs in REM sleep. Stage one and two of non-REM sleep are lighter levels of sleep, while stage three of non-REM sleep is our deep sleep.
“Although all levels of sleep are important, during our deep sleep, various critical functions take place in the brain which supports short-term and long-term memory as well as learning”, said Nicola.
Deep sleep promotes many bodily functions such as rejuvenation of cells, hormone production and boosting the immune system.
What techniques would you recommend to help someone get to sleep?
Nicola recommends practicing good sleep hygiene. Sleep hygiene consists of the habits and conditions that contribute to falling and staying asleep and train our brains into a healthy pattern. These include:
- Moderate exercise of 20 to 30 minutes, earlier during the day
- Reduce sugar and caffeine intake, particularly in the afternoons, the last meal of the day should be high in healthy fat and protein
- Magnesium and potassium, either in your diet or as a supplement to assist with sleep
- Stop screen time two hours before bed or use an app that blocks the blue light on your devices
- Control environmental elements like light, temperature and sound levels at bedtime – it should be dark, cool and quiet; white noise like a fan might be helpful
- Use a wind down ritual, as you would with a child, like a series of habits in the same order to teach your brain that it is time to sleep; have a warm bath, rub lotion or essential oils into your skin, do some stretching, read or listen to relaxing music
- Try to go to bed at the same time and wake up at the same time every day, even on weekends
“Once you are in bed use the 20-minute rule. This means that if you have not fallen asleep within 20 minutes of trying to fall asleep, you should get up and do something that makes you feel drowsy, like reading, listening to a calming app or a relaxation exercise. Once you are drowsy, return to bed. If you cannot fall asleep within 20 minutes repeat the process”, said Nicola, explaining, “This is actually quite difficult in practice, but it teaches your brain to associate your bed with sleep, instead of tossing and turning”.
Once we get into bed, we start overthinking about everything that happened that day, “We wonder what people really meant, start to worry about tomorrow and imagine worst case scenarios”, Nicola explained.
“This is actually the worst time to do this as we are entering a pre-hypnotic state. This means that our unconscious mind becomes highly suggestible to any information we are thinking in our conscious mind. Therefore, we want to make sure that any information in our mind at that time is positive, life affirming and good”, she continued.
“Right before bed time, is the best time to speak positive affirmations to your child or partner, and the worst time of day to be critical with them”, said Nicola.
She explained that, if your mind becomes too active in bed, it is useful to employ of the following methods:
- Do some constructive planning and problem solving for 10 to 20 minutes, rather than worrying. This may involve reflecting on the day, identifying any potential problems or concerns, asking yourself which parts of those concerns you can control or influence and writing down possible solutions to implement the following day
- Remind yourself that you have done your problem solving and further planning will be shelved for now. Then try to rather deliberately push out those thoughts with very intentional thoughts and mental activity. This can include mentally listing all of the things you are grateful for in detail, mentally listing positive affirmations or rehearsing positive experiences for the following day (e.g. being confident in a meeting)
At what point should someone reach out to a doctor to help them sleep?
If your inability to sleep is interfering with your ability to live your life effectively, it would be wise to see out a medical practitioner.
“I would suggest a doctor who is willing to investigate the cause of the insomnia, rather than only alleviating the symptom, and to address the cause first before prescribing sleeping pills, if it is not an emergency or critical situation”, said Nicola
To book a consultation with Nicola, you can book an appointment with her on 072 268 3743. You can find her practice on 31 Melkweg Road, Nelspruit.
Read more: ADHD – what you need to know
Mopani Pharmacy has a variety of supplements that may aid in helping you sleep better and getting better quality sleep. Ask our knowledgeable pharmacists to assist you in choosing the correct product for you needs.
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