Poor sleepers will be only too aware of the impending dread of another night’s sleep. The anxiety builds as the clock slowly ticks towards our bedtime. As you prepare yourself for bed, the feelings of frustration start to kick in significantly affecting our Physiology of sleep combined with habitual negative self-talk pitching in, and you have now created the perfect sleepless storm.
The modern world is contributing significantly to the underlying decline of our quality of life with sleep deprivation contributing considerably to the problem.
There are many variables as to why people do not attain good sleep, whether it be long term or short term issue. You can have 2 people present with the same problems, age, duration, attend the same therapy, and yet get very different results. Ah, the power of the mind and the individual’s character.
Assisting countless patients with their sleep over the years, I found the more common issues fell into 6 main categories.
Genetics
- Genetic tendencies
- Family dynamics
Relationships:
- Family
- Marriage / partner relationship
- Our Children
- Childhood issues/grudges with old friends or siblings
- Work colleagues or managers
Career:
- Career Advancement
- Schedules and project deadlines. Usually short term
- Managers and colleagues impacting us
Financial:
- Meeting our financial commitments or just paying the bills
- Investments
- Loans
- helping out children financially
- The wedding
- College
Trauma or guilt:
- Post-traumatic stress disorder
- Deception or keeping a secret. I had to remind people many times, I was not a priest.
Life questions:
- Beliefs? Not speaking of religion but more along the lines of childhood beliefs or life experience beliefs.
- What do I want?
- What am I doing with my life?
- Where am I at?
- Why aren’t I happy, lucky, married, satisfied?
I have expanded on these below:
Genetics
Family history of poor sleepers can be in our genetic makeup although the jury appears to be still out on this. There does seem to be a genetic factor that determines our preference for morning or evening, better known as the lark or owl syndrome.
What researchers do seem to agree on is that it could be environmentally passed down through the ages. I cannot tell you how many patients I have seen over the years that told me they come from a long line of poor sleepers so they believed it was a lost cause trying to change it.
If a person has experienced difficulty sleeping in their life and their child displays similar behavior, then this can be ingrained through language as they grow up. Phrases such as “what do you expect, you’re a poor sleeper just like your mother or grandmother or grandfather” will have an impact on your psyche as you grow older. Hearing repeated phrases throughout our lifetime develops into acceptance of this “truth.” It is worthwhile looking at the sleep strategies page to learn more.
Power of the individual’s mind – Monkey mind
Busy mind syndrome is a BIG one. Next, to our heart, the mind is one of the most powerful tools we possess. It can talk us in or out of anything. A busy mind can be short term or long term, but if you are a chronic worrier, then this will become your habit. I have heard partners often say that “she or he is not happy unless they have something to worry about and if they don’t have anything to worry about, they will find something. Sadly for some, this is true and can reflect on their waking life
Some of the invasive thoughts that fit most categories above are;
- Worrying about something that may never happen, the “what if” scenarios.
- Worrying about an event or situation that you hae decided will be a bad outcome.
- Rehearsing a conversation in your head over and over. Whether it is a difficult conversation that is coming up or a conversation that has already taken place. “I should have said” scenario
- The “To do” list
- Clock watching. Looking at the clock and calculating how many more hours of sleep you have left before it starts all over again. Chastising yourself for not going to bed earlier. Yep been there!!!
All of these examples cause a reactive sensation within your body, pushing up your cortisol levels (fight or flight hormone) and affecting the release of melatonin, our sleep hormone. The more anxious you become over your impending lack of sleep, the less likely you are to fall asleep. Over time your body becomes conditioned to this, and so the habit is formed. What the mind dictates the body will always follow.
Check out strategy solutions page ( sleep strategies)
Negative self-talk becomes a habit of thinking before getting into bed, resulting in dreading the night ahead. Where the mind goes, the body will follow.
Despite resolving an issue, depending on the length of time it took to reconcile, it can take a few days to change the learned response created with this stress, but also your systems will be flooded with higher than healthy stress levels which may take some time to dissipate
Personal circumstances
- Past trauma: War veterans, accidents, natural disasters, childhood upbringing, school/workplace bullying, chronic stress, domestic violence, a victim of crime, witnessing a traumatic event and the list goes on.
- Childhood – Lack of structure throughout childhood. Things like regular bedtimes, meal times, discipline or even getting to school on time can result in ingrained habits that can be fixed but require commitment and discipline (link to course here)
- Situational conditions. These tend to be acute and tend to fall into what I call a chapter, although if not addressed or resolved, can continue for quite a while. Situations like moving house, living conditions, flatmates, separation from a close relationship, job stress, children making poor life choices, unforeseen financial stress or health crisis
Parenting
Worry goes hand in hand with parenting both from the raising of children and secondly the personal impact on our identity. Concerns about how our children develop into adulthood, friend choices, education choices, career choices, our relationship with them as adults, and the list continues.
Secondly, however, once the kids become more independent and start to venture out on their own, as a parent, we can find ourselves a little lost. I have found this in a higher percentage of stay at home parents rather than career parents, but can still occur none the less. The loss is not coming from a regret perceptive but more from the “now what?” perspective. To go from never having enough time to go to the toilet in peace to suddenly having time to read a full magazine article can take some getting used too. This feeling of identity loss can result in an existential crisis manifesting symptoms of depression thus impacting the sleep.
Career circumstances – corporate, travel, shift-workers, self-employed
Our career choice can have a significant impact on our quality of life and stress management resulting in sleep deprivation and physiological changes with our bodies. Some of these are
- Corporate – deadlines, travel, long hours and time away from family
- Shift workers – Results in circadian changes and affects performance, cognitive alertness, and both physical and mental health
- Tradesmen – Early rise times affect the sleep stages usually resulting in less restorative sleep and sleep quality
- Job security – changes at work or replacement of management can cause insecurity about our jobs not only from the employment concern but also changes to our roles
- Extreme High Achievers. Pushing themselves to achieve levels of success by a timeline in their lives can set them up for personal collapse. The short term and long term planners will push themselves beyond their own limitations most times and do not take rejection well. They find out in the actual world they are competing with their peers with the same aspirations and goals. They do not stand out amongst this group. Unfortunately this can tend to have a negative impact in their life where they crash and burn with slow recovery or completing drop away from their goals to pursue a simpler life.
Health history
How our bodies cope both physically and mentally from ongoing health issues will affect our sleep. This is a double edged sword as poor sleep may lead to disease states.
- Heart disease & stroke can cause an underlying mortality shock that can play on a person mind.
- Diabetes, uncontrolled, can affect sleep patterns and blood sugar levels, which, in turn, affect your Sleep level and quality.
- Chronic fatigue can be a result of sleep deprivation both from a fatigue factor and also our internal systems not functioning as they should.
- Immune function is affected due to our bodies not producing proteins called cytokines and a reduction in disease-fighting antibodies.
Pain
Musculoskeletal diseases such as arthritis and osteoporosis, fibromyalgia, neuropathy and degenerative conditions all cause pain resulting in restlessness and fragmented sleep. If the pain is severe enough, it will impact the depth and quality of sleep despite pain killers. The pain usually disturbs in the later part of the night after 2am and can affect the depth and quality of sleep.
Ref: https://www.sleepfoundation.org/articles/pain-and-sleep
Medication history
Sleeping tablets, antihistamines, asthma, anti-depressants, Anti-arrhythmic medication, Beta blockers, diuretics and blood pressure medication can have a residual fatigue effect on the body or some patients may have an underlying hypersensitivity resulting in disrupted sleep. If you have found a correlation between your medication and your sleep, it is best to speak to your doctor before you make any changes.
Attitude to sleep
Many people do not take sleep serious nor give it the level of importance it deserves. Many people wear it as a badge of honor bragging how well they survive on minimal sleep. Quite often, our tiredness will be related to what is happening in our life rather than connecting it back to the core of the problem, sleep deprivation. For example, we may be going through a relationship breakdown and although emotionally spent, our sleep is hugely impacted by the stress associated with this. During these periods, we need to sleep more than ever to ensure our coping mechanism remain intact and yet it is usually our sleep that we sacrifice first. The first thing to go is our coping mechanism when we are sleep deprived, very closely followed by cognitive processing and perception.
I have also seen many times over the years, people’s perception of their sleep. This is very high in sleep apnoea sufferers as they quite often report they sleep fine regardless of getting constantly interupted from deep level sleep to maintain breathing. When a person is using an automatic CPAP, a therapist can decipher a reasonable level of sleep indicated by the pressure. It is not unusual to download CPAP data and see data use for an entire night but the patient will insist that they were awake @ 3am and removed their mask at that time. As a therapist performing sleep studies, a patient will be asked to describe their sleep during the investigation and many will report that they barely closed their eyes all night. A sleep study shows EEG (brain activity), which indicates the stages of sleep so you can view when sleep commenced and the depth of sleep obtained. Despite the reported minimal sleep, the study often shows over 70% of the night was spent in some level of sleep phase and even a reasonable level of deep sleep.
Attitude to life
Depending on the circumstances of a persons life experience and the environment they were raised in, this can leave a lasting impression on their approach to life. Some people can be a product of their childhood. For example, if they have grown up in low socio-economic living, had a bully or submissive parent or poor schooling, these can result in negative behavior and develop their self image. Without the right guidance or a mentor, it is difficult to change the way they think because they don’t know any different. Living with negative talk or negative expectation becomes their world. It takes a strong personality to recognize and then change their own path and quite often will meet resistance from those around them. It is easier to blame the way we were raised and involves less energy to fight back. Some lack the skills or resources to improve their outcome. Depression, lack of motivation, laziness, victim mentality, or lack of personal responsibility are all outcomes from this learned behavior. These emotions, such as depression and victim mentality, will impact sleep as there is underlying stress associated with the thoughts created.
Undiagnosed sleep disorders
Many people are walking around with undiagnosed sleep disorders such as restless legs, REM behavior disorder, parasomnias, insomnia or sleep apnoea to identify the main culprits. Many people with sleep apnoea are unaware they have it, especially if they live alone or despite their partner or friend telling them they stop breathing in their sleep. Ignorance is bliss. Insomnia is more commonly known, and most people who suffer it will be only too aware. I have put links in the resources pages to help you identify these disorders. I have been working in the field of sleep medicine and have specialized in the education of sleep apnoea and CPAP therapy.
http://sleepdisorders.sleepfoundation.org/contents
Menopause
Before (peri), during or after menopause, is a recognized stage in a women’s life where sleep may be strongly affected. Hot flushes, mood variations which can be a combination of sleep deprivation and hormone fluctuations, night sweats and sleep-disordered breathing become more evident during this period. If it causes considerable sleep disruption, it can lead to sleep state changes, particularly from deep to light level and waking more frequently.
A quick fix if you feel the onset of a hot flush with that slight anxiety followed by the rise in temperature, quickly drink an icy glass of water. It usually stops the agitation or at the very least , passes quickly.
Undiagnosed allergies
Lack of awareness of existing allergies can significantly affect sleep quality. Nasal obstruction, irritated skin, asthma and food sensitivities to name a few. Some are seasonal like allergic rhinitis, while others are perennial. These symptoms can disrupt sleep resulting in sleep deprivation and mood variations.
Clock watching
Most sleep experts will tell you to remove the clock from the bedroom, particularly if you get anxious about your rise time. This is common amongst early starters such as tradesmen, commuters and travelers. If you require an alarm, set the alarm and move the clock facing away from your view across the other side of the room. This will give you peace of mind. Refer to the steps in this site to learn about natural waking and your personal sleep requirement ( Setting your body clock )
Perception of time is very limited during the night and it is difficult to assess how long we have been asleep unless we look at a clock. If you “convince yourself ” it is still early in the night and you have several hours left, you will fall back to sleep much easier. Anticipation of how many hours you have left in bed is a real concern to many and will increase the cortisol levels preventing sleep onset. Phones should not be in the bedroom as it is to easy too reach for them and scroll through the news feeds on social media if we are having difficulty getting back to sleep.The irony is by jumping on social media you are giving your body permission to be awake and developing a bad habit. Habits are learned very quickly. If you are setting an alarm, choose a gentle tone that slowly increases in sound level rather than a blasting alarm. It is kinder to wake up to nature sounds rather than a blasting noise. If you are into phone apps, there are quite a few that monitor your sleep staging and gently wake you from a light sleep rather than a deep sleep. ( Setting your body clock )
Life questions
Although I have seen this appearing in my younger staff in recent years, “life questions” appears to be more age-related and possibly stronger in females than males. More commonly starting in the late ’30s to early ’40s, our stages of life and circumstances begin to change. The kids are getting older, more independent and you may find you have a bit more space to breathe and take stock of where you are in life. This is a time where people do life reviews and start to ask the big questions of themselves. It is not uncommon to see a family member, friend or work colleague completely reinvent themselves, taking on a university course to upskill or become self-employed, completely changing their career paths. These probing questions will certainly cause stress and lead to sleep deprivation until resolved.