Sleep is a very important part of our daily routine and self-care plan. Quality sleep is as essential to our survival as food and water. Sleep affects nearly every type of tissue and system in the body from the brain, heart, lungs, immune system, mood and resistance to disease. Sleep is a dynamic and complex process that affects how we function. It is important to a number of brain functions, including how nerve cells communicate with each other.
The hypothalamus, a peanut-sized structure deep inside the brain contains groups of nerve cells that act as a control centre affecting sleep and arousal. The brain stem, at the base of the brain, communicates with the hypothalamus to control the transitions between wake and sleep. Sleep promoting cells within the hypothalamus and the brain stem produce a brain chemical called GABA which acts to reduce the activity of arousal centres in the hypothalamus and the brain stem. The brain stem also plays a role in REM sleep by sending signals to relax muscles essential for body posture and limb movements. Disturbed sleep is an extremely common feature of generalised anxiety. This is distressing and debilitating enough but it also plays a big part in the feelings of depression that often go with anxiety.
Every night we need two basic types of sleep. Rapid eye movement (REM) sleep, called so because our eyes dart around behind closed eyelids.
REM sleep first occurs about 90 minutes after falling asleep. Mixed frequency brain wave activity becomes closer to that seen in wakefulness. Your breathing becomes faster and irregular and your heart rate and blood pressure increase to near waking levels. Most of your dreaming occurs during REM sleep. This is the stage when our brain services our emotional intelligence system. Dreaming is an inbuilt stress-control mechanism. The amygdala, an almond-shaped structure in our brain that is involved in processing emotions becomes increasingly active during dream (REM) sleep. It is our alarm system and it sets off the signal whilst dreaming, alerting us to the fact that there are undischarged emotional arousals which need de-arousing in our dreams. This signal goes off at an alarming rate in people who worry constantly increasing the amount of REM sleep and decreasing the amount of slow-wave sleep. When sleep patterns are out of balance and the dreaming brain is in overdrive with REM sleep trying to discharge all the arousal caused by worrying, we awake feeling unrefreshed, exhausted and like we haven’t slept.
The ‘normal’ sleep pattern is to start the night with slow-wave body repair sleep, followed by our first period of REM sleep, which lasts approx. 10 minutes. As the night goes on, we gradually have less slow wave sleep and more REM sleep, culminating in about half an hour of REM sleep just before awakening in the morning (which is why we often remember the last dream we have had). Depressed people who worry a lot tend to have more and longer periods of REM sleep and more intense dreams until the brain is in overload and they wake up more exhausted than when they went to sleep.
The role of dreaming is to deactivate the emotional expectations that we get worked up about during the day which are still taking up space in our brains when we fall asleep. The arousals that are not expressed or acted out in our waking day produce our dreams. These arousals are there all day but below consciousness, waiting to be dealt with when we fall asleep. We dream out emotionally arousing expectations that we generate which our emotional brain unconsciously was expecting to have happened. Every day we generate many emotional arousals, positive or negative that don’t work out. Getting enough sleep of the right kind is vital for both our physical and mental health. We need enough slow-wave sleep to restore our bodies and renew our energy and we need dream sleep to discharge our unexpressed emotions form the day, so that we can start the next day rested, restored and ready to go.
HOW MUCH SLEEP IS ENOUGH?
Worrying about not getting enough sleep can actually be a cause of insomnia. The view from sleep experts is that most adults don’t actually need more than seven hours per night, but if you awake refreshed and energised and ready to start the day, you are getting enough sleep, however many hours you have had. It is well known that insomniacs sleep more than they think, however, if instead of waking up feeling refreshed, you feel as though you are in a bit of a daze, can’t concentrate and are forgetful, then you are not getting enough sleep. The most common cause of finding it difficult to fall asleep, stay asleep and not wake too early is stress.
TIPS FOR GETTING A GOOD NIGHTS SLEEP.
- Set a schedule – go to bed and get up at the same time each day.
- Avoid drinking tea or coffee late in the evening
- Avoid drinking too much alcohol. Having several drinks may initially get you off to sleep but, in the middle of the night, once the alcohol has been metabolised, your body goes into withdrawal and that wakes you up.
- Don’t take exercise within two hours of bedtime ( the hormones adrenaline and endorphins released can keep you awake) – but do exercise earlier in the day or evening.
- Relax before bed – try a warm bath ( you could add lavender oil drops), reading, meditation or visualisation.
- Have a hot milky drink or camomile tea before bedtime.
- Ensure you have a comfortable mattress.
- Put up blackout curtains or blinds to keep the light from waking you.
- Use the bedroom primarily for sleep – avoid bright lights and loud sounds – don’t watch TV or have a computer or mobile phone in your bedroom (the blue light will stimulate your brain).
- Try doing some yoga.
- Try spraying some lavender around the bed or use a lavender pillow.
- Preferably do not nap at lunchtime or mid afternoon.
- Try not to worry about whether you are sleeping or not!!
Sleeping through the night is a conditioned behaviour. Our sleep habits are learned so we can learn bad ones as well as good ones. It is important not to reward the brain for staying awake – don’t get up and watch T.V or decide to cook a meal. The brain needs to become bored, not stimulated - try doing a very boring task but as soon as you are really tired, return to bed. If you are still awake after 30 minutes get up and continue with the same boring task or pick another one. Try counting in your head something dull and repetitive or drawing 50 lines on a piece of blank paper. The brain stem is primitive but not totally stupid – it will quickly learn to let you sleep if it’s not getting rewarded during the night.