The underlying issues of sleep problems

Most of us have gone through a stint where we’ve been unable to drift off, woken up earlier than we planned or found it hard to get up in the mornings.  

Because sleep problems are quite common, they’re often brushed off or just accepted as part of life. However, while a few sleepless nights are usually nothing to worry about, a frequent lack of sleep can have a serious impact on our health.

Sleep problems have been linked to irregularities in blood pressure and metabolism and weight, all of which can increase a person’s risk of heart disease. They can also take a toll on our mental health.  

Sleep helps us to regulate our emotions and stabilize our mood. When we don’t get enough sleep we can feel irritable (who hasn’t eye rolled a few too many times when tired?), stressed or generally low. A lack of sleep can even lead to mental health issues like anxiety or depression, and vice versa.  

Why am I struggling with sleep?

There are many possible reasons why someone might be struggling with their sleep, for instance:

• Feeling stressed

• Working patterns (for instance, if you work changing shifts)

• Side effects of certain medications

• A mental health condition, like anxiety or depression

• Certain illnesses, like heart disease, asthma or a pain or nerve condition

• Internal body clock (circadian rhythm sleep-wake disorders)

• Eating or drinking too much late at night

Types of sleep disorders

A sleep disorder can impact the quality of your sleep, the time when you can sleep and the quantity of sleep that you get. Some of the most common sleep disorders include:

• Insomnia or chronic insomnia: You have difficulty falling or staying asleep

• Restless leg syndrome: You have an uncontrollable urge to move your legs

• Shift work sleep disorder: You struggle to fall asleep or you are tired when you want to feel awake

• Delayed sleep phase syndrome: You fall asleep at least two hours after your desired time

• REM sleep behaviour disorder: You act out your dreams during REM sleep

• Obstructive sleep apnea: Your breathing stops and starts while you sleep

• Narcolepsy: You can’t control your ability to stay awake or fall asleep

Lauren’s* story

Lauren* was going through a stressful time at work when she began having trouble with her sleep. She was under a lot of pressure and felt as though she was being micromanaged, which led her to questioning whether she was good enough.

‍I felt anxious and uneasy all the time. I had physical tummy butterflies driving into work and during any meetings. My self-esteem hit rock bottom.”

Lauren had no trouble drifting off to sleep, which she puts down to emotional exhaustion, but she struggled to stay asleep and found herself repeatedly waking up in the early hours of the morning. At that point, her mind would start whirring with thoughts about work and she’d replay all of the conversations she’d had the day before.

She started to keep a notebook next to her bed so that when she woke up she could make notes about work. She believed that this would help her to feel more prepared the next day, but ultimately it made her more stressed and delayed her sleep further.  

When Lauren’s mind was busy, she tried to distract herself by going on social media, but this would make her feel even more overwhelmed. Conscious that she didn’t want to wake her husband with her phone light or by tossing and turning, she’d sometimes go downstairs to sleep on the sofa, but always ended up turning the TV on.  

“I would doze at around 5am and my alarm would go off at 6am, so I felt exhausted, low and empty dragging myself back upstairs to get ready for the day, already dreading it.”

Lauren’s sleep problems began to take a toll on her relationships with her family. She was very irritable with her husband and struggled to be present around her son, who was two years old at the time. This led to her feeling guilty and even worse about herself.  

Aware that something needed to change, Lauren started to think about how she could improve her sleep, and by extension, her wellbeing. She thought about going to her GP but she wasn’t sure what to say, so she decided to crack down on her evening routine by making it more relaxing and less stressful.

“I started to practice mindfulness by putting my phone away at night and drawing when I felt like distracting myself. I thought about how all of this could affect my son, so I made sure that I focused on his nighttime routine, which relaxed me.”‍

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How to manage sleep problems

Dan, a therapist at ieso says…

“Often people can lie in bed for hours on end, thinking or worrying which causes them to feel anxious or low. After time this begins to build a negative association with bed. To build a positive association with bed we recommend the 20-minute rule.

This involves – If we are in bed for around 20-30 minutes (try not to clock watch) and have not fallen asleep, we recommend getting up out of bed and completing a relaxing activity such as reading (Try not to use a screen with a blue light), then return to bed when you have the desire to sleep.”

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If you’re struggling with your sleep, here are some things that might help…

• Improve your sleep hygiene. Make sure that your bedroom is sleep-friendly. The temperature shouldn’t be too hot or too cold and your bed should be comfortable. If there’s any light or noise that bothers you, you could try wearing earplugs and a sleep mask.

• Go to bed and wake up at the same time - even on the weekends. Routine can help our brains know what to expect, when.

• Don’t work or watch TV in bed, so that your mind associates your bed with the place that you switch off and go to sleep.  

• Turn off your phone and the TV an hour before bed. Screens can stimulate your brain and keep you awake. Instead, try reading, listening to calming music or an audiobook.

• Leave the day behind. If something is worrying you, try talking to someone you trust or writing it in a notebook. This can help you to let go of the thought.

• Don’t force sleep. If you haven’t dropped off after 30 minutes then get up, do something else relaxing until you feel sleepy, then try going back to bed.

• Seek support if you need it. If you’ve tried all of these things and you’re still unable to get a restful sleep, speak to a healthcare professional to get help with identifying the issue and for information about how to treat it.  

Cognitive behavioural therapy (CBT) can help with sleep problems - find out about how it works as a treatment here. If you’d like to refer yourself for online CBT with ieso, you can get started by registering here.