Insomnia

Struggling with Insomnia?

Resources (apps, books, podcasts and website links)

Check If You Have Insomnia:

Do you feel tired after waking up?

Do you experience anxiety over not getting enough sleep? 

Have you been struggling to sleep for a while? 

 Do you feel tired and sleepy during the day? 

 Do you go to bed at night fearing that you will not be able to sleep? 

 Do you wake up through the night and have problems falling asleep? 

If you’ve answered yes to any of the above, then continue below…

Test your knowledge

1.	Tiredness during the day is a sure sign I am not getting enough sleep.	TRUE	FALSE
2.	Sleeping tablets or “sleepers” are safe to take for insomnia.	TRUE	FALSE
3.	If I had a bad night and didn’t sleep enough, it is best to sleep-in or take naps to catch up on lost sleep.	TRUE	FALSE
4.	It is difficult to train your brain to sleep naturally without sleeping tablets.	TRUE	FALSE

Answers

1. Tiredness during the day is a sure sign I am not getting enough sleep. TRUE 

Sleep restores our bodies. While you sleep, your body rebuilds muscles that have been worn-down during the day. Your brain also processes the day’s memories. Without enough sleep, your mind struggles to focus and think clearly. If you have enough sleep you should feel rested and ready for the day after you wake. Teenagers need about 8-10 hours of sleep a night, and adults require 7-9 hours. Poor sleep will cause you to feel sleepy during the day; you may nod off sitting in a comfortable chair after lunch or watching TV in the early evening. However, sleeping during the day after a bad night will only worsen insomnia.

2. Sleeping tablets or “sleepers” are safe to take for insomnia.  FALSE 

These medications are also known as ‘sedative-hypnotics.’ They work by reducing brain activity to induce sleep. They are no longer recommended as a first line treatment for insomnia as they cause several serious side effects, such as…

• Loss of memory
• Poor concentration 
• Tiredness during the day 
• Falls with the potential for serious fractures 
• Driving accidents 
• Accidents while operating machinery 
• Rebound anxiety the next day and difficulty sleeping the next night
• Addiction with drug seeking behaviour 

3. If I had a bad night and didn’t sleep enough, it is best to sleep-in or take naps to catch up on lost sleep.  FALSE 

It is best to stick to a regular sleep schedule, even if you had difficulty sleeping the night before. If you had a bad night, following a routine of staying awake until your normal bedtime helps to build pressure for sleep. Your brain will feel tired, thus it will be easier to sleep the following night. Sleep is an essential brain function. You will sleep better after you have been sleep deprived. 

4. It is difficult to train your brain to sleep naturally without sleeping tablets.  FALSE 

Learning to sleep naturally is possible and can be done by anyone. Many sufferers of insomnia have learned to sleep well by following healthy sleep habits, also known as sleep hygiene. Everyone will have the odd night of insomnia, but it is important not to allow these nights to be the cause of bad sleep habits. 

Did you know?

The world record for staying awake was set by Randy Gardner in 1964. He was only 17 years old when he set the record and he stayed awake for 11 days! He was kept awake by his friends and his health was monitored by specialists. Towards the end of his attempt, he was noted to have concentration and memory problems, paranoia, and hallucinations. The Guinness World Records for sleep deprivation are not being kept anymore for fear that participants will suffer ill health. At least we know now what the maximum awake time is for insomnia sufferers!

Sleep specialists say that sleep is an essential brain function, like breathing. You do not have to think about every breath that you take, it happens automatically. In fact, if you think about your breathing and try to regulate it intentionally then your breathing becomes irregular. Sleep is similar, trust your body and brain to do its job and let sleep happen naturally with its own rhythm.

How to convince your brain to sleep

Train your brain to associate your bed with sleep. People tend to toss-and-turn in bed when they are struggling to sleep. This causes your brain to learn that tossing-and-turning is what we do when we are in bed. Stop this by getting out of bed after tossing-and-turning for about 20 minutes. Don’t look at the clock, just estimate 20 minutes and get out of bed if you can’t sleep. Do this with a smile; you are not letting your brain learn bad habits! Go and do something boring in a darkish setting until you feel tired and are sure that you will fall asleep when you return to bed. Go back to your bed and try to sleep. If you toss-and-turn again, get up after about 20 minutes and repeat your boring activity until you feel tired. Your brain will quickly learn that if we don’t sleep when we are in bed then we are going to get up! 

Practice good sleep rhythms and habits. Only go to bed at night if you are tired and ready to sleep. Getting up at the same time every morning will help to ensure that you are tired at the same time every night when you want to sleep. Make sure that your bedroom is comfortable, quiet, and dark throughout the night. Use ear plugs if it is noisy and a mask for your eyes if it is light (especially in the morning during summer). Follow the same routine towards bedtime to train your brain when it is time to sleep.

Below is a list of ideas to help you get your sleep back on track:

• Get up at the same time every morning and go to bed at the same time every evening, even on weekends. This can help you fall asleep faster since your brain will understand the habit you have set.
• Don’t watch TV in your bed. Make your bed a trigger for sleep so when you fall into it at the end of the day, your brain will recognise your fluffy duma and soft pillow as a place for rest.
• After dinner put your devices, such as your computer or mobile phone, on a yellow light or warmer display setting to avoid blue light. Blue light promotes wakefulness, thus try to avoid looking at a blue light screen before you go to bed.  
• Don’t use your mobile phone just before you try to sleep. You may read something upsetting that can keep you awake. Also, avoid playing video games or participating in an engaging activity right before bedtime. These will cause your brain to be active when it should be winding down.
• Exercise during the day or early evening. This will tire your body out, leaving you more prone to sleep.
• Avoid caffeine after 2pm. Caffeine is a stimulant and will keep you awake. Alcohol too should be avoided as it may lead to rebound brain activity, causing you to wake in the middle of the night. 
• Ensure that your bedroom is comfortable. Eliminate noise and light to create a cozy, sleeping environment.
• If you wake up during the night, avoid using your mobile phone. If you must look at it then search the internet for “sleep hygiene”. Read up on it and try to follow the advice.
• Don’t sleep-in or nap during the day if you had a bad night. Some people call this daytime sleep a “nanna nap”. Cut out daytime napping altogether until your sleep pattern is healthy. Once your sleep patterns are back to normal then you can carefully add a short daytime nap if you want (less than 30 minutes and also known as a “power nap”). 
• Your thoughts are crucial when trying to fall asleep. Try not to worry, rather write your worries down for the next day. Try picturing something calming to encourage sleep. Some people think of black velvet or blackness to promote sleep. Others imagine something pleasant like walking on a tropical beach on a beautiful day. Some people replay in their mind good memories from the past. It is good practice to have the same thoughts or memories in your mind that enable you to feel calm, so that you may fall asleep easier. It is also good to have the same sleep promoting thoughts or images every night when you go to bed.

The Story of Mr Black

“I am 45 years old and have been struggling with insomnia for years. I have been nervous before going to bed; I was scared I would not be able to sleep again. I have felt tired and grumpy during the day. My relationships have suffered, and I have struggled with life at home and at work. I even thought of leaving my work because I could not cope. My depression and anxiety were just going downhill. 

I spoke to my nurse and realised that I was making things worse out of habit. Because I was so tired, I would often nap during the day, especially after dinner while watching TV. I would also watch TV in bed and scroll through Facebook posts. It often upset me and I would struggle to fall asleep. I would wake up through the night. I even took some sleeping tablets, but it made me feel like a zombie the next day, so I stopped it. 

My nurse helped me to chart my sleep habits and I started to learn a lot about sleep hygiene. I started getting up at the same time every morning, even after a bad night. I forced myself to stay awake during the day and became so tired towards the evening that I fell asleep without difficulty. I removed the TV from the bedroom and it helped me to associate the bed with sleep. 

I did not wake up as often through the night and when I did, I was ready for it. I got up after about 20 minutes of tossing-and-turning. I would then have half a glass of warm milk and sit in the lounge reading old magazines. I would go back to bed when I felt tired and would usually fall asleep without any problems. If I had a bad night then I would tell myself, “I will get through the day without napping to sleep better the following night”. 

I also learned that I could fall asleep easier by thinking about my favourite rugby game. I thought about the two tries that my team scored, replayed them in my mind, and sleep would follow. 

I feel so much better and intend to stick with healthy sleeping habits.”

How to track your sleep and why you should

Sleep monitoring helps you get a better understanding of your sleep patterns, which can be helpful to determine the cause or solution to your problem. Monitor your sleep with devices such as Beddit Sleep Monitor or the Withings Sleep Tracking Mat. Smart watches and fitness trackers can also be helpful to measure your sleep.

Use a sleep dairy

Use this diary to monitor your sleep. Complete it in the morning. Do not worry about exact answers, just guess if you are unsure. You can show this diary to your nurse or doctor, it will equip them with more information so that they can better help you.

Enter start date:_______	Day 1	Day 2	Day 3	Day 4	Day 5	Day 6	Day 7
At what time did you go to bed last night?
How long did it take you to fall asleep?
How many times did you wake up through the night?
In total, for how long were you awake during the night?
At what time did you get up to start your day?
In total, how many hours were you able to sleep last night?
Rate your sleep quality from last night from 0-10: 0 is extremely poor, and 10 is excellent.

Resources

Apps

CBT-i Coach: An app for people struggling with insomnia. This app will guide you through ways to improve your sleep habits by developing positive routines and tracking your sleep. Click here to find out more.

Books

Say Good Night to Insomnia by G. Jacobs: This book teaches powerful relaxation techniques to take control of your mind and body. Helpful exercises and tips are provided along the way to help you better manage your sleep.

End the Insomnia Struggle by C. Ehrnstrom: Provides an easy, all-inclusive program to help treat insomnia. You are taught how insomnia goes from a few nights of poor sleep to a chronic problem, how sleep actually works and tactics to overcome sleeplessness.

Depression and Bipolar Workbook by C. Aiken: Shares “30 ways to lift your mood and strengthen your brain.” This book is designed to help you cope with depression, hypomania and anxiety.

Podcasts

CBT-Insomnia, A Patient Guide: This short, 20 minute podcast explains how Cognitive Behavioural Therapy (CBT) can treat insomnia and improve depression. Click here for more.