Just how important is good sleep?

Sleep is associated with a whole range of benefits: it is healing and allows the body to repair, such as after surgery or an illness. It boosts our immune system, can help regulate certain hormones and a lack of sleep has been linked to certain types of cancer.

If sleep was a drug, it would be amazing to prescribe!

However, there are times in our lives when we just won’t experience great sleep, whether that is due to highly stressful life situations or illnesses, the menopause or a new baby.

In these situations it can be helpful to accept and acknowledge that good sleep is just not attainable during this period, and we should aim not to dwell on our lack of sleep as the anxiety can become a vicious circle.

What is 'good sleep'?

Generally speaking, a working age adult needs between 7-9 hours and for those over 65 it is 7-8 hours.

However, that is very general and we are all different shapes, heights and sizes. So we say somewhere near this range is likely to be sufficient and it is actually more important that the sleep you get is regular.

Getting these amounts of sleep regularly is much better for you than a feast and famine approach of 3 or 4 nights of ‘great sleep’ followed by 2 or 3 very poor or short nights of sleep. It isn’t really possible to fully ‘top up’ or catch up on sleep

How about those who seem to wake frequently - is this avoidable?

Approximately every 1 ½ hours we go through a full sleep cycle: light sleep to deep sleep, back to light sleep again and then REM (rapid eye movement) sleep. Between each full sleep cycle we will briefly wake before going back to sleep again. Most of the times, these awakenings are so brief that we don’t remember waking up at all. So everyone’s sleep is “broken” at times, the important thing is that we go back to sleep again quickly.

As long as you are getting a few good blocks of sleep, the quality of your sleep is just the same as ‘sleeping through the night’.

Sleep does not need to be fully unbroken to be of good quality.

How does anxiety impact sleep?

Anxiety can cause us to become more aware of the fact we are waking up in between sleep cycles, and it can lead to being unable to fall back to sleep due to this heightened awareness.

When we are anxious, we feel a threat to ourselves as a result of adrenaline and cortisol running through our bodies. Our brain responds in the same way as when experiencing a response to a threat - superalert, ready to react. So it becomes a vicious circle: worrying about not going to sleep makes the brain even less likely to fall asleep.

How should people prepare for bed?

There are two aspects to winding down before bed and they are quite different: Physiological – calming your body down The mind – calming and slowing your mind

Physiological wind-down:

It is important to do something that will calm and relax you before going to bed. Everyone is different, so it must be something that YOU find relaxing, but could be:

• Yoga. Meditation. A long relaxing bath. Sex. Reading a book. Watching a film.

Slow and deep breathing techniques can help to calm the body. I use 4-7-8 where you breathe in through the nose quietly for 4 seconds, hold for 7 seconds then breathe out through your mouth with a ‘whoosh’ sound for 8 seconds. Repeat this 4-8 times..

Light levels:

The bright light emitted from phones and devices is not helpful to prepare the body for sleep as the brain thinks it’s daytime, stops producing melatonin and wakes us up. Enabling ‘Night Mode’ on your device is an improvement as the light is not quite as bright. Often people feel that bedtime is the only time they can really have to scroll through social media or check messages. However, it would be much better for your sleep if you actively make time earlier in the day to do this so you do not feel that pressure to grab some ‘me time’ after you’ve gone to bed.

Calming the mind:

Sometimes the big issues of the day are thought of at night when we stop and lie down. There are techniques to try and block the timing of these thoughts including:

• Take time during the day for moments of self-care to help reduce anxiety; to remove the anxiety from coming to mind just before bedtime.

• Brain dumping: write down all of the things that are troubling you a couple of hours before bed, so the thoughts aren’t fresh in your mind when you try to sleep.

• Create dedicated ‘worry time’: set a time during the daytime for 15 minutes to write down the worrying things and deal with these so they don’t take up all of your time and absorb you. Early evening can be an ideal time to do this so the mind is clear at bed time. You may also find distraction techniques helpful, including:

• Imagery: replace your anxious thoughts with an image of something positive. Maybe somewhere beautiful you have been or somewhere imaginary, then lie down and think about that image. When you are calm you are more likely to fall asleep.

• List your top 10: of anything! Start thinking about your top 10 films or restaurants, dates you’ve been on or holidays. It must be something positive in which your mind becomes engaged, your body is calmer and again you are more likely to fall asleep.

Dayime tiredness:

Sometimes medication, therapies and illness can make you drowsy during the day and at such times, it’s important to accept this.

If you are poorly or recovering from an illness and are spending a lot of time sleeping, try to get out of bed during the day, relax on the sofa instead. Keep bed for sleep at night if possible.

If you are sleeping a lot during the day and unable to fall asleep at night, you need to try and reduce the amount of daytime sleep.

Light exposure during the day is good for our bodies and reminds our brain it is daytime, so get outside if you can. If you are unable to go outside, try to sit by a window or you may wish to talk to your doctor about a Seasonal Affective Disorder (SAD) light box.

What if you have tried everything and still can't get to sleep?

If you have tried everything and you just can’t get to sleep, try getting up out of bed. Lying there and trying to force sleep can make you more anxious and frustrated, and your body becomes even more awake.

You will often find you are able to sleep upon your return to bed after a reset.

If you are unable to get out of bed, try sitting up with dim light, read for a while. No devices. Then try again.

Do you have any specific sleeping advice for people living with a stoma?

Explore different sleeping positions and the use of pillows to help you get comfortable and to support the body. Be more aware of what you eat later in the day as this may affect the stoma’s function during the night and therefore could disturb your sleep.

All of the techniques to reduce anxiety can be used to reduce any anxiety surrounding whether the bag will leak – and remember it’s quite unlikely to happen.


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