Resetting the Clock
As we have seen the body-clock is affected by light, it is also strongly impacted on by daily routine and habits. Supporting the function of the hypothalamus and creating the best conditions possible for a good nights sleep, can be broken down into the following steps.
Identifying the issues-what are your current habits Restoring a routine-regularity helps reset our biorhythms, sometimes these cues are called ZIETGEBERS ...a German word for ‘time-givers’ Practical issues- what do you eat before bed, what is the ambiance of your bedroom, is your mattress supportive? Exercise-releasing tension, as well as endorphins through exercise, is a helpful way to relax. IDENTIFYING YOUR SLEEP ISSUES The first step in creating the conditions for good quality sleep is to become aware of your current habits, and begin to notice behaviours which may be unhelpful. You might notice that you make little time to relax during the day or notice things which ‘wind you up’ before bed. You can use the sleep diary to get an idea of what actually happens each night if you are having difficulty sleeping. RESTORING A DAILY ROUTINE Finding a balanced and paced daily routine, sends powerful sub conscious messages to the hypothalamus, helping it to regulate. IN THE MORNING - Decide when you will get up, the night before. Be realistic. If you currently get up at 11 am, you will not easily manage to rise at 7! Drop your rising time back by half an hour every week or so until you find a reasonable time, which works for you. Try to keep it regular, to reset your body clock. Use an alarm, and do your best to get up when it rings! Be gently persistent! - When you get up, open the curtains, stand by the window and really widen your eyes. Let as much light in as you can! You could use this time to gently begin to move and stretch, turning your neck from side to side, and using the other stretches from the ‘Moving Well’ section. Some people like to stretch in the shower or as the kettle boils for your morning cuppa. - Breathe! Perhaps use some relaxed breathing to slow your mind if you are already creating a list of jobs in your head. If you are using the activity diary, you may already have an idea of the priorities for the day. Hold steady! - Have something to eat before you take any medication you need. DURING THE DAY - Structure your day. You may have already read the finding balance section. Much of the guidance there is relevant here! Being aware of how you are, and what you are carrying emotionally as well as mentally and physically, will help you prioritise plan and pace your day. You can keep moving at the appropriate tempo, building breaks and rests before you get wound up and exhausted. - Daytime naps - it may be that you need a nap to make it to the end of the day. The secret here is to be regular with your nap-time, and skillful about the minimum time needed to recharge you. Give yourself permission to have a sleep, and enjoy it, but try not to over do it ! Erratic naps here and there, or extended sleeping one day and then not the next, creates a confusing message for the hypothalamus, and knocks its mechanisms out of kilter. If you are sleeping in the daytime, you will be reducing the amount of light you experience, as well as reinforcing the problems associated with inactivity. Use an alarm. Nap early in the afternoon, so as to create as little disruption to your bedtime and night time sleep quality as possible. If you currently sleep for 2 hours, try knocking ten minutes off each day until you reach a point where you know you are getting just enough to see you through. At first this may feel difficult, so use a phone call to a friend, an easy job, or one of your exercise sessions to distract you and help you feel more awake! Regularity and not over-resting are the key issues. LATER IN THE DAY Perhaps at a point just before or after your evening meal, take some time to stop for a few moments and check in with yourself. How are you in your physical body...are there troubled areas needing your attention, where are your thoughts...busy, worrying, what is the tone of your emotional state....angry, sad, lonely? Can you release some physical tension, acknowledge how you are feeling, just as it is, and notice what is on your mind. Maybe making a list of the things that will worry you and the next step towards dealing with those issues would help. You could jot down WHEN you will take some action. Often writing things down allows the mind to let go a bit and stop going around in circles. If the mind is more at ease , your physical body can also begin to unwind. NIGHT TIME ROUTINE The body clock responds to regular cues, and so the pre-bedtime routine is an important signal to the body that it is time to wind down. Those of us who are parents know the importance of a bedtime routine. The progression through tea time, playtime, bath time, and story time, are all ‘environmental signal’ to help the child prepare physiologically as well as psychologically, for the end of another day. In theory! The same is true of our adult body chemistry. Try to avoid mental and physical stimulants in the later part of the evening. TV programme that increase our tension levels will not be helpful if we already have trouble sleeping. Dealing with controversial issues in the family may be unavoidable, but will certainly be unsettling. Avoid coffee, and perhaps reduce your fluid intake generally after about 8 pm. Alcohol may make you sleepy initially but can disrupt your sleep cycle. Computers and back lit screens will make you feel wakeful. Having a bath can be relaxing. Allow yourself some time to cool down before getting into bed, since it is this cooling process which increases sleepiness. Eating foods rich in tryptophans can help you to sleep better. Foods that are high in calcium, like milk and dairy products can be helpful, as can some carbohydrates. Here is some advice on the best sleep inducing bedtime snacks! http://fooddemocracy.wordpress.com/2008/01/28/sweet-dreams-the-right-foods-for-a-good-nights-sleep/ Decide on a regular bedtime which makes sense to you, aim to be in bed at the same time each night. For most people around 1O.3O pm is a reasonable time, aiming to be turning lights out at around 11 pm. This is obviously variable from person to person. However, as adults we generally need somewhere between 7 and 9 hours of sleep each night. DURING THE NIGHT Bed is for sleeping not for worrying. It is important to break the psychological links between bed and worry or agitation. For this reason it is a good idea to get out of bed after 1O or 15 minutes, if you are restless. Try to identify why you are not sleeping. Is it worry? Could you look at your planning list, and add to it or remind yourself that there IS a plan? Are you in discomfort, do you need to review when you take pain medication in the evening to get the best and most lengthy night time effect. Are you just alert? Could you keep the lights dim, but have just enough to do a little reading, to unwind and begin to feel sleepy? Notice if you tend to catastrophise about not sleeping. This will only wind you up further! It IS difficult not to sleep well...but worse things could happen. Notice your ‘middle of the night stress’, and help yourself with some 4x4 breathing or a mindfulness or relaxation practice. PRACTICAL ISSUES Think about:- NOISE - would ear plugs help? LIGHT - would blackout blinds, or an eye mask help? YOUR BED - are your mattress and pillows right for you, giving support where you need it? Have a look at the posture section in the Moving Well page TELEVISION - Is there a TV in your bedroom do you watch it right up until you need to sleep. Back lit screens will inhibit melatonin production and increase your alertness. Kindles are fine, since they are not lit from behind. YOUR BEDROOM - it may help to take some time to make your bedroom a relaxing place to be. Reminders of things you need to do, like lots of laundry or piles of unpaid bill sitting beside the bed, will not create a calming environment! Your bed should be kept for ‘sleep or sex’! EXERCISE If you can manage to increase your levels of daily exercise you will begin to produce more cortisol, a hormone produced by the adrenal glands, and part of the HPA axis. Cortisol helps you to cope with stress, and is a complex body chemical. The levels of cortisol in the blood stream need to be balanced, too little is not helpful, too much leads to adrenal burn out. However, research shows that people suffering fatigue states, and CFS/ME, show low levels of blood cortisol. Moderate exercise acts as a physical stressor prompting cortisol production. You can find out more about Adrenal Fatigue in this book by James Wilson. Adrenal Fatigue: The 21st Century Street Syndrome USEFUL WEBSITES http://www.helpguide.org/life/sleep_tips.htm http://www.papworthrssc.nhs.uk/sleep-services-hygiene.php |