I have had sleep issues as long as I have been battling mental health issues, which is coming down to a rough total of ten years. However, it had somehow never occurred to me to seek out help for this specific problem.
Finally, this year, I was offered the chance to partake in sleep therapy as a way to keep me occupied while on the wait-list for treatment. For six consecutive weeks I would be learning all about sleep health, and how lifestyle and mentality can affect your rhythm. In this post I’ve summarised for you how the sleep therapy treatment has effectively changed my routine.
Routine before therapy
As this is an issue I have been battling for a while, I had done research on the matter before. Based on information I found online and suggestions I got from Twitter friends, I developed my own effective sleep routine before bed. This routine helped me fall asleep faster and easier.
Here’s what it looked like:
- No screens 30 minutes before bed. Instead, I would read a book and write in my diary.
- After brushing my teeth I would start one of my favourite albums on the stereo and get into bed.
- I would then read children’s stories for a while (Calvin and Hobbes comics, Winnie the Pooh collection, Alice in Wonderland).
- After that: lights out. Usually, I would fall asleep in no less than 15 minutes.
As you can see, this routine worked pretty well for me. My remaining issues, however, involved tantalising nightmares, waking up several times at night, not being able to go back to sleep, and waking up in the hour before my alarm went off. During these times when I lay awake, I often would ruminate and dwell on anxious thoughts.
Most of my nights, even if I wasn’t haunted by nightmares, were very restless. It would feel like I’d just come back from a long day full of new impressions rather than a good eight hours in bed. The impact this had on my day-to-day life was huge. As you can probably imagine, I simply didn’t have the energy to deal with things. Most days I was fighting off horrendous headaches from lack of sleep, and there really wasn’t much I could do about it.
I was hoping sleep therapy would offer some solutions and bring improvements to my routine. Most times I have found that educational groups like these are well worth your time, as there is often at least one new thing you can take away from it.
The group therapy was pretty intense and there were a lot of challenging tasks we had to do. The therapy cycle was also interrupted by the Corona measures taken in my country, which meant one day we couldn’t get together as a group all of a sudden, and appointments had to continue individually over the phone.
Here’s roughly what I had to do:
- Keep a sleep diary for six weeks.
- Attend weekly meetings (1.5 hr a week).
- Take on new assignments given out during those meetings. (building up from 6-11 assignments a week)
Sleep therapy wasn’t just about adjusting your lifestyle for better sleep, but also challenging any mental issues concerning sleep with Cognitive Behavioural Therapy (CBT).
Only a part of the assignments I performed for sleep therapy.
In terms of lifestyle changes, we weren given quite a few useful tools. Most of all, we worked on finding a balance between exercising effort and finding relaxation throughout the day. We learned to take more breaks in order to find rest and practised some relaxation exercises. We got to discuss our personal issues with the group and were given personal advice.
One of the major highlights for me was when one of the therapists suggested I take my shower later in the evening so I don’t struggle staying awake on the sofa afterwards. Such a simple solution, but absolutely mind-blowing to me at the time!
Stimuli control and sleep restriction
Two of the hardest lifestyle changes we were asked to execute, were the methods of stimuli control and/or sleep restriction. The former meant only going to bed when you felt sleepy and solely spending your time in bed asleep. The latter was about cutting down your hours so much that you were only using your time in bed for sleep.
I chose to try sleep restriction and started cutting my nights short by 15 minutes every day or so, until I got to a point where I woke up fresh at 6AM every day. The time I saved in the mornings by getting up so early, I used for relaxing activities such as reading.
Cognitive Behavioural Therapy (CBT)
In terms of psychotherapy, I was surprised to find a good number of irrational thoughts concerning sleep roaming around in my head. It got weirdly deep and very much confronting when I saw that a lot of my core insecurities were affecting the way I dealt with sleep as well: how I felt I wasn’t good enough and I had to try harder, I didn’t feel normal, everyone else was better than me, I would always be the troubled girl with mental health problems, etc.
I had tried CBT before, but it wasn’t helpful at the time because my issues had been purely circumstantial. Now, with a pure focus on sleep, I found it very interesting and helpful. Most of all, digging up the underlying roots of my thoughts and speaking them out loud made me realise how silly my attitude towards sleep could be. Fortunately I’m a fairly rational person, so I could argue against these irrational thoughts quite easily.
Final changes to my routine
The sleep therapy treatment offered lots of different methods and tips to change your ways, but in the end it was up to you to try them out and find what works best for you.
My routine underwent the following changes:
- Showers later in the evening, usually between 9.30-10PM so I’d feel nicely rested for bedtime.
- Then read and continue my evening routine as usual.
- Bedtime between 10.30/11PM.
- Wake-up time at 6AM.
- Read for 30 minutes/an hour and slowly commence my day.
- Two relaxation exercises throughout the day, usually one in the morning and one in the afternoon after work.
- A break somewhere in between where I did absolutely nothing for 5-10 minutes.
Occasionally I also tried writing down some of my most frustrating dreams in the morning, just to get them out of my head.
I started setting my alarm for 6AM, working back from 7AM for 15 minutes every day.
The trial period
After our six sessions came to an end, we entered something like a trial period. We got to try out our new routines for a month before a final come-back session, where we would reflect again upon the new changes and our current schedules.
During this time I seemed to be doing okay, except that quarantine had put a different spin on my life. Also, the clocks changed for summertime, which messed up my body clock quite a bit. On top of that, the whole isolation period has been affecting my mood, and now depression has caused me to sleep more and feel less motivated to do things during the day.
So overall, I’d say it is still a struggle, but at the same time I certainly feel I have improved as well. My biggest win is that I no longer spend hours lying awake in anxiety anymore.
Best tips for sleep
These are my best sleep tips summed up:
- No screens before bed for at least 30 minutes.
- Take plenty of breaks during the day.
- Find bedtimes that work for you and keep to them throughout the week. Don’t stray more than 1.5 hour from them when, for example, you want to sleep in for a day.
- Find activities that help you relax and practise them twice a day (i.e. relaxation exercises).
- Keep a diary to empty out your brain before bed.
- Try a sleep diary where you track your nights, perhaps you’ll find certain patterns.
- Don’t snack before bedtime (from approx. 1 hour in advance or so).
- Write out your dreams in the morning if they’re bothering you.
- Keep a notebook beside your bed to write down any ruminating thoughts that keep you up at night.
- Get up and go do something else if you’re lying awake for longer periods of time.
- If possible: follow your body clock and get up without an alarm for a while, to see what bedtimes suit your natural rhythm.
- Avoid doing any activities other than sleeping (or sexual stuff) in bed. Your brain needs to be able to connect this place to sleep, and sleep only.