How to cope with sleep problems

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How to cope with sleep problems

There's a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health.

sleep image

Poor sleep leads to worrying. Worrying leads to poor sleep. Worrying about sleep is like your mind trying to fight itself. That's a horrible place to be.

What are sleep problems?

If poor sleep is having a significant impact on your daily life, it is likely you will be considered to have a sleep problem. The Royal College of Psychiatrists and The Mental Health Foundation provide information about different types of sleep problems.

You may find a sleep problem can lead you to:

  • have negative thoughts, feel depressed or anxious – if you have little sleep you may feel less able to rationalise worries or irrational thoughts
  • feel lonely or isolated – if you feel tired you may not want to be sociable or see friends
  • experience psychotic episodes – if you have a psychotic disorder or bipolar disorder, a lack of sleep may trigger mania, psychosis or paranoia, or make existing symptoms worse

For me sleep problems are a tell-tale sign of declining mental health. The worse I sleep, the less I feel able to cope during the day. The less I am coping, the worse I seem to sleep.

How can my mental health problem affect my sleep?

There are number of ways a mental health problem can affect your sleep. For example:

  • Anxiety can cause thoughts to race through your mind, making it difficult to sleep.
  • Depression and seasonal affective disorder (SAD) can lead to oversleeping – either sleeping late in the morning or sleeping a lot during the day. If you experience difficult or troubling thoughts as part of depression, this can also cause insomnia.
  • Post-traumatic stress disorder (PTSD) can cause nightmares and night terrors, disturbing your sleep. This can mean you feel anxious about falling asleep, which could lead to insomnia.
  • Paranoia and psychosis may make it difficult for you to sleep. You may hear voices or see things that you find frightening, or experience disturbing thoughts, which make it hard to fall asleep.
  • Mania often causes feelings of energy and elation, so you might not feel tired or want to sleep. Racing thoughts caused by mania can make it hard to fall asleep and may cause insomnia.
  • Psychiatric medication can cause side effects including insomnia, disturbed sleep or oversleeping. You may also experience sleep problems after you stop taking psychiatric drugs.

This page covers some tips and ideas to help you get good sleep. Remember, you might need to try a few different things before you find what works for you:

Sometimes the methods that I've used before to help me sleep won't work as well, and that's OK, things change. You just need to try different things until you find what works again.

Watch Jonny Benjamin talk about how his mental health affects his sleep, and how he has learned to manage it.


Establish a routine

Try to establish a regular sleeping pattern by going to bed and waking up at roughly the same time every day. Go to bed only when you feel tired enough to sleep. Then get up at your usual time. This may mean you will spend less time actually in bed, but more of the time in bed asleep.

Routine, routine, routine. Preparing your brain and body for sleep, letting yourself know that it's time to wind down. Then in the morning set a time to get up and stick to it no matter what.

Relax before you go to bed

You may find a relaxation routine can help you prepare for sleep. There are several things you can try:

  • do something calming – such as listening to relaxing music, or having a bath
  • breathing exercises – in a comfortable position, try this: breathe into your belly (not your chest) then out through your nose, making your out-breath longer than your in-breath; repeat until you feel relaxed
  • muscle relaxation – consciously tense and relax your muscles, one after the other, starting with your toes and working up your body until you reach the top of your head; Progressive Muscle Relaxation is a technique some people find useful – this NHS guide has further details
  • visualisation – picture a scene or landscape that has pleasant memories for you
  • meditation – you can learn meditation techniques at a class or from self-help guides; many people also find mindfulness helpful

 

 

Read Annie's blog about not being able to switch off and sleep, and how she copes with anxiety.

Make sure where you sleep is comfortable

You may want to experiment with the temperature, light and noise levels to work out what works best for you. On the whole, dark, quiet and cool environments generally make it easier to sleep, but this will vary from person to person.

Keep a sleep diary

You may find it difficult to work out what's affecting your sleep. A sleep diary involves recording information about your sleep habits to help you understand your sleep problem and what's affecting it. If you want to, you can show it to professionals you're working with, so you can work together to understand the problem you're having.

A sleep diary could include information about:

  • what time you go to bed and what time you get up
  • total number of hours of sleep
  • overall quality of sleep, ranked 1–5
  • how many times you wake up in the night, how long you are awake and what you do while you are awake
  • whether you have nightmares, night terrors or sleep paralysis, or have sleepwalked during the night
  • whether you sleep during the day, and for how long
  • any medication you're taking, including dose and what time you take it
  • the amount of caffeine, alcohol or nicotine you have
  • the amount of physical activity you do
  • what you eat and drink
  • your general feelings and moods, including any anxious and repetitive thoughts.

You can create your own diary using an online template – there's an example on the NHS Choices Live Well website.

Try to resolve stresses and worries

Try to identify anything in your life that's causing you stress or worry that might be affecting your sleep. You may find it helpful to talk to a friend about the thoughts and feelings that affect your sleep, or write them down.

I found meditation and writing down my feelings in a little notebook before I settled down for bed really helped.

Once you've identified what's causing your sleep problem, there may be practical measures you can take to address the problem – such as finding ways to manage anxiety or talking to your employer about reducing your workload.

Give yourself some tech-free time

Use of bright screens on laptops and phones in the evening has been shown to negatively affect sleep.

Try to give yourself some tech-free time an hour or so before bed, to help yourself prepare for sleep.

I avoid my phone or TV – instead I listen to a meditation podcast or read a book.

Check for a physical cause

  • pain, illness or other unknown physical problems can disturb your sleep
  • visit your GP to investigate potential causes and get help with treating them
  • talk to your partner: snoring, preferred side of the bed and other common issues can often disturb sleep and can be resolved; The British Snoring and Sleep Apnea Association has more information on its website and a helpline

Food, drink and exercise

Caffeine, alcohol and sugary foods may give short-term help but they can all disturb your sleep patterns. For details see our information on food and mood.

Doing regular physical activity can also help you sleep, as it makes you more physically tired – particularly if you exercise outdoors. This doesn’t have to be strenuous exercise – any activity, for example housework, gardening or going for a walk, can help. See our information on physical activity, sport and mental health.

When I'm suffering from sleeping problems it's usually the result of not getting enough physical exercise and staying in bed.

Medication

Many drugs, particularly common ones for mental health problems, can affect your sleep. If this is the case, talk to your GP to discuss alternatives. See our pages on seeking help for advice on speaking to your doctor.

Ask about treatment options

You don't have to do it all by yourself. You might want to talk to your doctor or a mental health professional about what you're experiencing and the treatment options available, such as:

  • Talking treatments. For example, Cognitive Behavioural Therapy for insomnia (CBT-I) is a type of CBT that can help you recognise and change unhelpful thought patterns and habits around sleep.
  • Medication such as sleeping pills and SSRI antidepressants can be helpful in dealing with short periods of severe insomnia, as they can help you break a cycle of not sleeping and help you return to a more regular sleep pattern.

Losing sleep is extremely frustrating but I sleep much better now since going to the GP and being prescribed medication.

  • Sleep clinics are used to assess sleep problems. You'll need a referral from your GP to access a sleep clinic on the NHS.

See our pages on seeking help for more on how to speak to your doctor and having your say in your treatment.

Read others' stories

Read other people's tips about how to cope when you're having sleep problems.

 

Want to add your story? Find out more about blogging for us.


This information was published in November 2016. We will revise it in 2019.


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