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Brent Scobie Brent Scobie
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What’s more important than a good night’s sleep?

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Have you experienced problems with sleep? The heavy eyelids in the mid-afternoon, forgetfulness, lack of energy, trouble concentrating, perhaps dozing off in the living room chair? If so, you are not alone.

According to the American Sleep Association, 30 percent of American adults report periodic issues with insomnia while 45 percent say that poor or insufficient sleep has impacted their daily functioning within the past week. Not only can lack of sleep be an indication of an existing mental health condition such as depression, poor sleep can also make mental health conditions more likely.

To be fair, everyone is likely to experience periodic difficulties with sleep. Our days are stressful after all. But there are some telltale signs that it might be more of a problem than you might be willing to acknowledge. Ask yourself these questions:

  •         Do you have trouble falling asleep or staying asleep three or more nights each week?
  •         Has your difficulty with sleep continued for longer than one month?
  •         Does your difficulty with sleep cause problems for you during the daytime such as excessive fatigue, reduced concentration, or productivity?
  •         Limit daytime napping. Staying awake during the day helps you to fall asleep at night.
  •         Avoid stimulants close to bedtime such as caffeine, nicotine and energy drinks. Caffeinated beverages and foods (coffee, tea, cola, chocolate,) can cause difficulty falling asleep, awakenings during the night, and shallow sleep. Even caffeine early in the day can disrupt nighttime sleep.
  •         Avoid alcohol in the evening. Although alcohol helps tense people fall asleep more easily, it causes awakenings later in the night and reduces the quality of sleep.
  •         Incorporate exercise into your weekly routine. Schedule exercise times so that they do not occur within three hours of when you intend to go to bed. Exercise makes it easier to initiate sleep and deepen sleep.
  •         Avoid heavy, rich, fatty foods before bed, but try not go to bed hungry. Hunger may disturb sleep. A light snack at bedtime (especially carbohydrates) may help sleep, but avoid greasy or “heavy” foods.
  •         Ensure your bedroom is a comfortable temperature with minimal light and noise. A comfortable, noise-free sleep environment will reduce the likelihood that you will wake up during the night. Noise that does not awaken you may also disturb the quality of your sleep. Carpeting, insulated curtains, and closing the door may help.
  •         Turn the alarm clock around so you cannot see the time. Clock watching may lead to frustration, anger, and worry which interfere with sleep.
  •         Sleep only enough so that you are rested in the daytime. Restricting your time in bed helps consolidate and deepen your sleep. Excessively long times in bed lead to fragmented and shallow sleep. Get up at your regular time the next day, no matter how little you slept.
  •         Avoid screen time before bed. Using electronic gadgets before bed can disrupt sleep because it sends alerting signals to the brain and slows the release of melatonin thus charging you up versus settling you down before bed.

If this is your experience, you might consider making some changes, even reaching out for some professional help.

Typically, the first step in correcting troubled sleep is to evaluate and adjust your sleep hygiene--a variety of different practices and habits that are necessary to achieve quality nighttime sleep. Try the following:

A second approach to tackling sleep difficulties involves the use of stimulus control strategies. The process of a bedtime ritual leading to the bedroom, the bed and eventually sleep creates a conditioning history for our bodies that we remember. It cues our bodies to sleep. The stimulus control strategies below are designed to help re-strengthen your body’s sleep response:

Establish a regular nighttime routine and consistent bedtime and wake time. This consistency in sleep habits leads to regular times of sleep onset and helps to set your “biological clock.”

Use your bed only for sleep or intimacy, not work, reading or playing video games. The learned sleep response that is triggered by our nighttime routine can be weakened when we incorporate other activities that require our attention.

Don’t try and force sleep. If you find yourself lying in bed and unable to sleep for longer than 30 minutes, get up and find an quiet activity outside the bedroom to engage in for another 30 minutes. Return to bed regardless of whether you feel tired and try to initiate sleep. If still unable, repeat the process.

On the surface, sleep hygiene and stimulus control strategies may seem too simple to be true. Give them a try. You may find that making some slight adjustments over a period of several weeks may have a helpful impact. If not, it may be helpful for you to consider speaking with a healthcare professional. In some cases, chronic sleep problems can be a sign of a more severe medical condition. In addition, there are some very effective cognitive behavioral treatments for insomnia.

(Brent Scobie, Ph.D., LCSW, is Acadia Hospital’s Vice President for Clinician Services and Quality and a therapist for Restorative Health.)


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