Ask the Therapist

For several months, I’ve been struggling to fall asleep at night. More recently, I’ve been waking up during the night and can’t get back to sleep for an hour or so. It’s starting to affect my mood as well as my job performance. What suggestions do you have for how to get a good night’s sleep?

Healthy sleep habits, also referred to as sleep hygiene, are critical for maintaining mental, physical, and emotional health. According to the National Institute of Health (NIH), 2011, “chronic sleep loss or sleep disorders may affect as many as 70 million Americans, and have been linked to problems with mood, increased risk of obesity, diabetes, cardiovascular disease, and infections”. 

There are a number of benefits to getting good sleep that are associated with improvements in learning, memory, and mood. In an NIH publication on healthy sleep, studies show improvement in one’s ability to learn tasks and remember what they have learned when they are feeling well rested. They go on to say that healthy sleep habits enhance “creative problem-solving, simplifying tasks, and improving performance”. On the other hand, sleep deprivation is known to contribute to difficulties in processing information, focusing and attention, confusion, and decision making. 

Chronic sleep deprivation is said to be connected to depression. Dr. Nereida Gonzalez-Berrios, 2021, stated that “people suffering from depression and mood disorders would find it difficult to either fall asleep or maintain a good night’s sleep.” She goes on to say that, “someone not sleeping well through the night or not even getting enough rest in the morning will show signs of mood swings, irritability, sadness, or a dampened mood.” 

Maintaining heart health is yet another reason to practice good sleep hygiene. “Sleep gives your heart and vascular system a much-needed rest,” NIH, 2011. Throughout the night, one’s heart rate, blood pressure, and breathing rates fluctuate. These fluctuations are said to lead to a healthy cardiovascular system. 

There are hormones released during sleep that contribute to, “boosts in muscle mass, repair of cells, and tissues in children, and fighting various infections,” NIH, 2011. Obesity and diabetes have been associated with a lack of sleep as sleep helps to regulate appetite, energy use, and weight control. 

There are a variety of factors that determine the amount of sleep one needs to maintain overall health. Although sleep needs vary from one person to the next, Dr. Eric Olson, 2021, recommends eight to ten hours per 24 hours for 13–18 year-olds and seven or more hours a night for adults. In addition to age, Dr. Olson shared the following factors that also affect the amount of sleep needed: frequent sleep interruptions, previous sleep deprivation, hormonal changes,  physical discomfort with pregnancy, and changes in sleep patterns associated with aging.

There are several factors that can disrupt one’s sleep. Stimulants such as caffeine and nicotine can cause one to struggle with falling asleep as the body doesn’t feel tired. Although alcohol is a sedative, it prevents the stages of sleep that are considered to be restorative. Particular medications, both prescribed and over the counter, can make it difficult to fall asleep. These include those that contain caffeine, decongestants, and steroids, as well as certain blood pressure and heart medications. 

Psychological disorders, such as depression, can contribute to sleep disruptions. People who experience high levels of stress often have difficulty falling or staying asleep. Sleep disruption in menstruating women is linked to the change in hormone levels at different times during their cycle. Menopausal women can experience sleep disruption due to hormonal changes causing insomnia, night sweats, and hot flashes.

In an article written by Erica Hersh, 2020, she outlined ten Healthy Sleep Hygiene Habits:

  • Keep a consistent sleep schedule, including weekend days. 
  • Create a relaxing bedtime routine, 30-60 minutes before bedtime, to help unwind and prepare for sleep (e.g. warm bath or shower, gentle stretches, meditation, listen to soothing music or a sleep story, read a book).
  • Turn off electronic devices before going to sleep as blue light reduces melatonin levels in the body.
  • Exercise regularly but avoid doing so 1-2 hours before bedtime.
  • Limit caffeine intake.
  • Make your sleep environment work for you (e.g. cool, dark and quiet bedroom, comfortable mattress, pillows and bed linen, etc.).
  • Use bed only for sleep (and sex) as it strengthens the brains association with sleep.
  • Go to bed when tired. If you don’t fall asleep after 20 minutes, get out of bed and do something to unwind.
  • Limit or avoid napping when possible. If you do nap, do so for 30 minutes or less and avoid napping later in the afternoon.
  • Manage stress before going to bed (e.g. write down your to- do list and prioritize it, write down worries to get them out of your head, use a weighted blanket to help ease feelings of anxiety, meditate, etc.).

If after consistently practicing healthy sleep hygiene habits you continue to struggle to get good sleep, I would suggest that you consult with your medical provider.  

“True silence is the rest of the mind; it is to the spirit what sleep is to the body, nourishment and refreshment,” William Penn.

By Gladys Smith, Licensed Independent Social Worker & Co-founder of Soul Creek Nature Therapy. 

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