Round 1: Sleep
There are many ways to wellbeing. And sleep is one of them.
Here’s eleven research-based ideas on how to improve yours. References and educational resources are at the bottom.
Sleep. Something so mundane that it’s so often overlooked. This week sleep is the topic of our discussion.
Below, I’ll try to make clear what the links are between sound sleep and good mental health are. I’ll also share eleven simple sleep strategies that will likely contribute to a better night’s rest.
Sleep itself cannot be understood without reference to it’s opposite, the waking state. That we will also discuss, since a good night’s sleep is intimately related to what we do when we’re awake.
The Night Shift
Start with some basic questions. What is sleep? And how important is it? Sleep, without question, is a physiological need, a fundamental one at that. In its absence, humans cannot function well. Which is why sleep deprivation has sometimes been used as a torture tactic. Too many days and nights without sleep and you should expect to experience delusions, memory loss, delirium, even psychosis.
When we are asleep, however, our brains are doing anything but switching off. Strange as it may sound, our brains are metabolically more active during sleep than when we’re awake and solving some difficult task, like a stressful work situation. Although we personally have the feeling of being asleep, our brains are very much at work. They are working on processing emotions, deep cleaning, and growing our neural connections. Neuroplasticity, the brains ability to create new neural pathways, happens not as we’d expect. Because it happens when the brain has some downtime, such as when we sleep, walk the dog, or do the washing up.
So although at night we have the feeling of being switched off like a light, our brains are very much still switched on. Sleep can thus be considered an altered state of consciousness, one in which, for most people, brain regions associated with movement are switched off. That is why people do not physically act out their dreams. On dreams, and according to science, the precise nature of them remains unclear. However, dreams are probably part of that overall clean-up, maintenance, and repair operation. And since the content of our dreams often relates to our inner worlds, dreams are probably serving some kind of emotional processing role.
During the waking state, we have experiences, say and feel things. When we’re asleep, this is perhaps the ideal time for our brain to truly make sense of all these experiences, thoughts, sensations, and emotions. From this perspective, sleep is part of what keeps us sane, emotionally stable, and fundamentally in touch with reality. Sleep, in other words, is the foundation for sound mental health.
The good news is that for people who struggle with sleep, there are many cost-effective methods to experiment with and to try out. Hopefully they will improve your sleep.
What follows are eleven tips on how to improve sleep:
Don't oversleep.
Recall that the brain expends more energy when sleeping than when awake. If you sleep for 11 hours, that’s a lot of work for your brain. Instead of waking up feeling refreshed, you’ll likely be far more tired than if you’d only slept for 8 hours. More than 8 hours isn't necessary. Less than 5 is probably too little, especially in the long-term of a life.
Don’t snooze.
Instead, wake up when your alarm goes off, and try to get out of bed. Snoozing confuses your brain. Because when you fall back asleep, your brain begins to re-enter a sleep cycle, which tend to last around 90 minutes. By snoozing, you are effectively encouraging your brain to re-enter a long sleep cycle, even if you only want to snooze for another 10 minutes. Many people report the experience that they only wanted to snooze “for a few minutes”, but find that they snoozed for much longer than they wanted. Sleep cycles explain why.
Get up at the same time everyday regardless of how much sleep you’ve had or what day it is.
The human brain is a machine that is constantly predicting the future based on past data. If you wake up at 7am one day, 10am the next, and then 1pm the next, you confuse your internal biological clock - what is called your circadian rhythm. A confused internal clock cannot accurately predict the future; which means that inconsistency has the perverse effect of making it much more difficult to get a good nights sleep. In general, sleeping in is to be avoided, at least most of the time. This effect is so powerful that the treatment of bipolar disorder, a complex psychiatric condition characterised by extreme moods, almost always includes using this practice of waking up at the same time. In other words, routinising your sleep and wake-up times has an important role to play in how stable your moods will be. Which is a nice bonus.
Get outside soon after waking.
I do this even if its cloudy and grey, which it probably will be (Alas, English weather). Exposure to sunlight is the idea. Why? Photons, tiny physical particles that are made from electromagnetic radiation - what is normally called light - are outside and ubiquitous, even on cloudy days. Getting outside for at least two minutes helps to wake us up in the morning. In essence, morning light sends a powerful signal to the deep and ancient brain, saying: it’s time to wake up! Doing this also helps to calibrate our internal clock, which also helps us get back to sleep at night.
Routinise sleepy time.
Just as getting up at the same time each morning helps to set the internal clock, so does going to sleep at the same time each night. Sleep hygiene is the term often used for creating a positive ritual around sleep. Having a good hygiene means performing and avoiding certain actions most nights that encourage a better night’s sleep. Avoid things that stimulate and excite you: caffeine, sugar, exciting books, videos, and so on. Try to do things that relax you: hot showers, sex, reading a story, watching a documentary, listening to a hypnotherapy or calming track, deep breathing, journaling, and the like. Whatever the routine and whatever works for you, consistency helps.
Make your bedroom slightly cold, not hot. Because it is easier to fall asleep in a cold rather than in a hot room. In order to achieve sleep, our core body temperature drops by 1-3 degrees Celsius each night. Sleeping in a slightly colder room can thus help this biological process along.
Know the true effects of alcohol on sleep. Alcohol, that much loved substance the world over, reduces anxiety. People love it because it relieves stress, makes us feel chilled, and can help us get to sleep. Indeed, alcohol does have these effects, at least on the surface. Alcohol, however, just like caffeine, disrupts sleep. And it disrupts sleep consistently. While it may be easier to fall asleep after a few drinks - alcohol is after all a sedative - the quality of sleep achieved is poor. After some alcohol, our brain cannot complete the emotional processing, and the clean-up operations effectively. Moreover, alcohol prevents us truly entering deeper sleep cycles. Yes, we sleep - but only lightly. It should be no surprise that this surface level sleep is not refreshing nor is it good for our brains, moods, or mental health, especially in the long term. Now, this isn’t rocket science: the more alcohol you’ve consumed, the more disrupted your sleep will be. It’s also worth knowing that even though alcohol reduces anxiety in the short term, the longer term is effect is to increase anxiety. Which means if you drink 3 beers tonight, you’ll probably feel relaxed. But the day after, your biological systems release excess cortisol, a stress hormone, and you end up more anxious because of the beer. Avoiding or minimising alcohol intake is thus one way to improve sleep, brain function, and anxiety levels.
Drink caffeine carefully.
Much research suggests that caffeine has many positive effects for humans, like improved focus, memory recall, and mood. It’s therefore popular. When consumed in traditional ways, like in a cup of tea or coffee, caffeine truly has few downsides. Yes, too much caffeine makes people feel anxious and too alert. But that can easily be remedied in the future by knowing what your personal limits are. The more sinister aspect to caffeine is akin to alcohol: sleep disruption. Biochemically, caffeine essentially blocks action in our brains adenosine receptors. Throughout the day, our adenosine system increase in activity. The more it increases, the sleeper we feel, eventually causing us to sleep at night. That’s good and normal. The main effect of caffeine is this: it blocks and slows down adenosine activity. Which is why drinking caffeine helps to wake us up and helps us to focus. However, it’s easy to see that if caffeine’s effect is to slow down our sleepy system, then this could disrupt our ability to get to sleep. To have better sleep, we don’t have to abandon caffeine. But we do have to get more careful about caffeine consumption. Roughly, caffeine sticks around in our brain for about 12 hours. For most people, it thus makes sense to stop drinking caffeine after a certain time, like 11am or midday. Having a cut-off time for caffeine consumption helps it’s effect on the adenosine system to wear off, and helps to promote good sleep. For people who can drink caffeine at 7pm and fall asleep as normal, it’s worth pointing out that the effect is similar to alcohol. Although it may feel that you can get to sleep easily, the true effect is that your sleep quality will be much reduced, since your brain is not being permitted to have real downtime, real rest. Sure, you might feel asleep, and indeed you might be asleep, but your brain is still active, and is being active in a more alert rather than a more restful way.
(This isn’t necessary, but for anyone interested in self-experimentation: try and go a month without drinking alcohol and caffeine. Probably, you’ll discover that you’re sleeping much better and more deeply. And probably your dreams will be richer, more vivid, and more common, reflecting the better quality of sleep.)
Do some exercise.
Humans were made to move. If we spend the day sat down and moving little, we are not getting ourselves physically tired. And if we’re not physically tired, there is less real need for sleep. Getting physically tired can be as simple as getting outside for a walk, doing press-ups at home, going for a run, or to the gym.
Have downtime before sleep.
It is a weird fact that our brains are more active in sleep than when awake and at work. Weirder still, our brains are similarly more active when we’re sat on the sofa doing nothing than when we’re at work solving a complex task. But a fact it is, one that was established some eighty years ago. One thing this means is that humans need downtime - a period of nothingness - for the brain to process the events of the day, to think our thoughts. This downtime is not wasted but is a kind of work for the brain. So if we live very busy lives and don’t give ourselves downtime throughout the day, we get to bed at night, and find that as we’re trying to drift off to sleep our brains are perversely very active. Annoying. But for those who live busy lives and don’t have downtime, it’s likely that leaving this downtime until right at the end of the day is contributing to a bad night’s sleep. An easy fix is therefore to create small breaks throughout the day where your goal is for your brain to have downtime, to think about nothing in particular, to do nothing in particular, other than simply to process. This might look like sitting there and doing nothing, getting outside on a walk without headphones, or just being inside your own thoughts with no disruptions. Doing the washing up is my favourite for this. Our brains need downtime, and this shouldn’t be left until we’re winding down for a night’s sleep.
If you consistently struggle with sleep and have tried the above steps, consider addressing psychological causes.
While there are many practices to improve a night’s sleep - like avoiding alcohol and caffeine, or waking up at the same time each day and getting outside - sometimes there are psychological reasons that we cannot sleep. Things are on our mind. And human beings are masters at self-deception. We lie to ourselves and rationalise about all sorts. But while we can temporarily hide from ourselves in the busyness of a day, this cannot last forever. Sleep is that one time of day where we are forcibly slowed down. We have to sit with ourselves and our thoughts. Bedtime is thus a classic time for psychological contradictions to make themselves known. Perhaps you are avoiding something on purpose, or you are ashamed of some action you’ve taken. Or it might be that something terrible has happened to you and you don’t want to think about it. You can push these thoughts and emotions aside during the busyness of a typical day. That is healthy and normal. All adults must to some extent learn to find the correct time to address things, which sometimes means pushing things away for a later time. But this is a poor strategy when pursued over the long-term. At night, we get tired, and our psychological defences become weaker. As we’re trying to get to sleep, we find that our minds are active with this and with that. If you feel like you’re avoiding some past of yourself or some bad event that happened in your past, then a great way to address this is with pen and paper. Write down what is going on internally and start addressing it. Writing can be effective since you can explore yourself at your own pace and in your own words. Working alongside a competent therapist can also facilitate this process, since therapists may be able to see things that you cannot. In short, addressing that which we’re avoiding or is painful to us is an effective way to improve our ability both to get to sleep and to have a restful night.
References and further education for a better nights sleep
Many commentators cite sleep information from Matthew Walkers book Why We Sleep. I got my information from his Ted Talk accessed at https://www.youtube.com/watch?v=5MuIMqhT8DM&t=1039s&ab_channel=TED But also, sleep is often a theme discussed in various episodes of the Huberman Lab Podcast.
Circadian rhythms and bipolar is discussed here https://www.youtube.com/watch?v=uLEjoMykwh4&ab_channel=CRESTBipolarDisorderNetwork
A physiological fact is that alcohol disrupts sleep. One can measure this if you have a smartwatch. My source for this was the episode on alcohol of the Huberman Lab Podcast, accessed at https://www.youtube.com/watch?v=DkS1pkKpILY&ab_channel=AndrewHuberman
Light in the morning is helpful for waking and avoiding bright light at night is helpful for sleeping. A topic discussed by Huberman, accessed at https://www.youtube.com/watch?v=ZpUe3eWKeS4&ab_channel=TimFerriss
Effects on caffeine in the brain, reviewed at https://pubmed.ncbi.nlm.nih.gov/26677204/#:~:text=In%20addition%2C%20caffeine%20has%20many,subset%20of%20particularly%20sensitive%20people. Another review here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202818/
Exercise is good for the brain, accessed at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770965/
The benefits of writing to oneself are summarised in this PDF document. It is associated with the website https://www.selfauthoring.com/ which facilitates a structured and research-based way to begin. I personally have used the structure on this site and would recommend it. But also picking up a pen and writing down one's emotions, struggles, goals, and intentions is something I find frequently helpful and at times invaluable.
