Dominic O’Ryan – Sleeping Well

Hello. My name is Dominic O’Ryan and I am the Lead Psychologist in Substance Misuse and the CBT Training Lead for Camden and Islington NHS Foundation Trust and I’m going to talk to you for a few minutes about sleeping well; in particular about sleeping well during these strange times.

I think it’s best to avoid all the literature that tells you about how bad it is to sleep badly. You don’t need any more information then how you feel. Sleeping well is also by definition good for you. Getting a good night’s sleep helps us feel refreshed and is very important for our physical and mental health.

However, heightened levels of arousal due to constant work and social stress, broken and shifting routines, home working, difficulties switching off and broken boundaries between work space and home space and sleep space, are amongst the kind of pressures that people are under at the moment and they can have an enormous impact on our wellbeing, and our sleep in particular.

We can find ourselves struggling to get off to sleep, we can experience broken sleep and nightmares, and we can experience general fatigue on waking, wondering if we’ve got any sleep at all.

So I’m just going to say a few things about what’s going on during sleep because I think it is helpful to remember that sleep has a natural structure and its own way of managing itself.

Firstly, sleep is driven by the earth’s own day-night cycle. This circadian rhythm is as in-built and important as any other biological or physical process. If we are working shifts, or not getting natural light in the day or we’re exposed to high levels of light at night, sleep will be broken. So the first step is to check on our own day-night cycle and to take steps as far as possible to retain or reset that soon and often.

Secondly, and paradoxically, sleep is designed to be broken. Sleep has distinct phases of light sleep, deep sleep and rapid eye movement or REM sleep. Dreaming happens in all phases but is mostly associated with REM sleep. These phases together last for an hour and a half or maybe 2 hours at a time. Even though we might think we should be sleeping for longer, we naturally come back to the surface of wakefulness after this time, then generally speaking we drift back to sleep without paying much attention.

But something that happens to all of us sometimes, and to more and more of us at these times, is we noticed that we’re awake and then we can become quite agitated about this, which in itself gets in the way of the natural process of falling back to sleep. And so accepting that waking up in the night is actually a part of sleeping well is a key step in returning to sleep.

Thirdly, humans are natural problem solvers. And we can easily fall into the trap of trying to use day-time active, conscious problem solving at night. We try to solve the problems of the day and we try to solve the problem of why we’re not asleep by actively thinking about them. This kind of problem solving is for day time only.

Instead, that’s something that’s sleep is designed to do on its own. The phases of sleep all have problem-solving components built in. They are there to help us consolidate memories, make sense of things, practice our emotional responses, and anything that we do that interferes with the natural process of sleep just makes the natural process unworkable.

If sleep is proving to be elusive just let sleep look after itself. If you’re not getting to sleep then look for a tendency to problem-solve and just allow yourself to gently stretch and let your mind wander off and do something else. The more we try and bring it back to problem solving of getting back to sleep, the more we’re getting trapped in active problem-solving mode when the problem really is something that can solve itself.

Paul Gilbert’s model of threat mind, drive mind and compassionate mind is very helpful here. We can experience poor sleep as a threat, so we get more aroused. We respond by using our drive systems to try to fix it. In reality the best thing to do is just to be gentle, kind, open and let the compassionate mind look after itself.

This part of ourselves can sometimes be tricky to activate and a simple soothing rhythm breathing practice for a few minutes, a few times during the day, can make it easier to bring on line at night.

And so, if you’re lying still in bed with your eyes closed in the dark, breathing gently, who is to say that you aren’t actually already asleep and you just think you’re awake.

Overall, allow your mind and body to look after you, by being kind to yourself during day and particularly at night.