12 Sleep

  • Approximately one third of the population has sleeping difficulties at some point during the year. Such problems can include difficulties to fall asleep, or a tendency to waken early and/or several times during the night. 
  • Sleep is constructed of cycles of around 60–90 minutes, and each cycle contains all the various stages of sleep. At the beginning of the night deep sleep dominates the cycle, whereas at the end of the night dream sleep dominates. At the end of each cycle we come into a stage of consciousness, but we only remember this if we are awake for more than four minutes, or so.
  • When sleep comes, we are controlled by our circadian rhythm, and it can take some time to change this rhythm; it is usually possible with around 15–30 minutes per night.

Things that affect our sleep

  • Fear of being unable to fall asleep. Everyday anxiety and stress can affect sleep. When a worrying thought has burrowed its way in, it results in an “alarm” reaction in which the heart races, and the blood pressure and muscle tension increase. It usually takes about one hour before we feel calm again. Try to remember experiences of things going well the day after a night of bad sleep. To be a perfectionist on such a night and believe that your sleep will function as normal will only make things worse. Accept things as they are, i.e. when sleeping difficulties arise, it can actually be the fear of the effects of these difficulties that take over and become the focus for the fear instead. The initial problem may well be stress and anxiety for everyday worries, but the main obstacle then becomes the fear of how things will turn out if you do not sleep.
  • Circadian rhythm. When you experience sleeping difficulties, it is advisable to keep a similar rhythm of sleep and wakefulness every day.
  • Sleep hygiene. Reasonably regular habits for actually going to bed. Differentiate between activity at day and night in terms of sound and light.
  • Diet. No large meals before going to bed. A cup of warm milk with honey can be good. Coffee, Coca Cola and tea contain substances that stimulate wakefulness. Caffeine has a half-life of 3–7 hours. Alcohol can make falling asleep easier, but when its effects dissipate, the heart rate and blood pressure are activated with a feeling of increased anxiety and wakefulness.
  • Exercise is a way for the body to engage in an active and relaxed activity and can improve sleep, but should be carried out 2–3 hours before going to bed.
  • Our “feel-good” hormones, which are stimulated through touch, warm baths, laughter and happiness, for example, can make falling asleep easier.

Advice for better sleep

  •  If you wish to change the time you go to sleep, begin changing it by 15–30 minutes every three days.
  • Thoughts: What is it that keeps you awake? Around one and a half hours before you go to bed take a large piece of paper and write down your thoughts and worries. Identify worrisome thoughts and see if you can reformulate these as reasonable and calm thoughts, so that they will allow you to let go of the problem for the night. Try to let yourself leave the difficulties on the page for the night. Clean yourself out before going to bed. Tomorrow is another day!
    Body: Exercise for presence (recommended after the thought-flow exercise above) focussing on the body and breathing to break bad thoughts. Close your eyes and sit in a stable position on a chair with both feet on the floor. Focus on the different parts of the body, starting down at the soles of the feet moving up to the neck, taking one body part at a time, and simply observe how each part feels without making any judgement. Then focus on how you breathe in and out. If a thought comes, let it come but do not concentrate on it; should you lose your focus, go back and focus on your breathing again. Finish by taking a deep breath, and stretch your body. You can also try the next exercise.
    Relaxation exercise. This can be done in bed, when it is time to sleep.
    1. Relax the jaws and larynx. Close your eyes and take a deep breath – breathe in, breathe in, hold your breath, feel the tension and then breathe out.
    2. Open your eyes halfway and allow them to sink.
    Continue by repeating steps 1 and 2 for a while, and then simply continue breathing at your own speed. You can also strengthen the effect of breathing out by counting down from 400 every time you breathe out until you can no longer keep counting. Then you can use soothing images in your mind to help you feel calm and relaxed for a good night’s sleep
  • Feelings: Fill yourself with pleasant feelings – you are sure to already have plenty of pleasant emotional memories to use here
  • Distraction: When you have achieved balance between thoughts, body and feelings, it can be good to occupy your thoughts and feelings with something relaxing, such as reading an undemanding book or newspaper, or listening to soothing music, in order to maintain your good balance.

Late-night vigil: Get up out of bed if you realise that sleep is not coming. It is better to break bad thought patterns with something completely different for a while. In general, it can take one to one and a half hours before you will be able to sleep again.

Sleeping pills: If you need to use sleeping pills, try a short course (2–3 nights in a row) in order to establish better sleeping patterns, and to help change your day and night hormones. Sleeping pills diminish your deep sleep and dream sleep, but are a good replacement when nothing else is working. Lack of sleep wears down your resources and affects your tolerance of everyday concerns.

Doctor Karin Engquist
Secretary Susanne Jönsson