Sleeping wellSleeping well

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by psychologist Sivert Straumepresented at RCNUWC

Flekke, Sunnfjord, Norway 01.11.2010

The presenterThe presenterSivert Straume

Psychologist

Sleep research

Clinical work, Aleris medical centre, Bergen

Aleris

Biggest private health and care enterprice in Scandinavia

Sleep school

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Sleep. ConclusionSleep. ConclusionSleep is important

Follow some sleep advices

Don´t worry about your sleep

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SleepSleep

muscle relaxation

altered physiological processes

ignoring the surrounding environment

altered brain activity

an altered state of consciousness

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Normal sleepNormal sleep

6-9 hours a night?

Well-being, good mood, adequate alertness, good health

A natural process

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InsomniaInsomnia

«A condition of unsatisfactory quantity and/or quality of sleep, which persists for a considerable period of time, including difficulty falling asleep, difficulty staying asleep, or early final wakening»

(Nonorganic Insomnia in ICD-10)

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Causes of insomniaCauses of insomnia

Depression

Anxiety

Somatic disorders and pain

Environmental factors

Vicious circles of behaviour and cognition

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Sleep apneaSleep apneaDuring sleep:

Snoring

Choking or gasping

Long pauses in breathing

Daytime sleepiness

Waking up with a dry mouth or sore throat

Morning headaches

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Behaviourally induced Behaviourally induced insufficient sleep insufficient sleep

syndromesyndrome

exessive daytime sleepiness

short sleep duration

considurably longer sleeping in weekends

voluntary, but unintentional

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Pseudo-insomniaPseudo-insomnia

Worrying about sleeping to little, while actually sleeping sufficiently.

Exaggerated beliefs about sleep need

Sleep-state misinterpretation

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Environmental sleep Environmental sleep disorderdisorder

Lying awake due to the bad sleeping environment

Typically sleeping partner´s snoring

«Noice in the room, outside the building and in the room next door»

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Poor sleep, Poor sleep, consequencesconsequences

Short-term

Sleepiness

Fatigue

Reduced alertness

Bad mood

Reduced learning

Long-term

Depression

Anxiety

Weight gain

High blood pressure

Disability

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Sleep. ConclusionSleep. ConclusionSleep is important

Follow some sleep advices

Don´t worry about your sleep

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Sleep - a natural Sleep - a natural processprocess

Sleepiness factors:

Sleep drive

Internal clock

Wakefulness factors

Physiological

Emotional

Cognitive

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«Calculating» «Calculating» sleepinesssleepinessSleep drive

+Internal clock

- Physiological arousal

- Emotional arousal

- Cognitive arousal

= Sleepiness

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Insomnia, vicious Insomnia, vicious circlescircles

negative emotions associated with bed and bedtime

exaggerated beliefs about the negative consequences of sleep loss

dysfunctional compensatory strategies

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Advices for good Advices for good sleepingsleeping

Sleep hygiene

Stimulus control

Sleep restriction

Cognitive therapy

Relaxation techniques

http://www.medicinenet.com/insomnia/page5.htm#stimulushttp://www.lommelegen.no/sovn/1

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Sleep hygieneSleep hygieneSleep as much as possible to feel rested, then get out of bed (do not over-sleep).

Maintain a regular sleep schedule.

Do not force yourself to sleep.

Do not drink caffeinated beverages in the afternoon or evening.

Do not drink alcohol prior to going to bed.

Do not smoke, especially in the evening.

Adjust the bedroom environment to induce sleep.

Do not go to bed hungry.

Resolve stress and anxiety before going to bed.

Exercise regularly, but not 4-5 hours prior to bed time.

http://www.medicinenet.com/insomnia/page4.htm#sleep20

Stimulus controlStimulus controlUse the bed only for having sex and sleeping, not working, reading, watching TV, eating, or other mentally stimulating activities.

Go to bed only when you feel ready to sleep.

Turn off the lights and all the noise in and around the bedroom.

Get up at the same time every morning to avoid over-sleeping.

If you do not fall asleep longer than 20 minutes after going to bed, get up and try some relaxation techniques until you are ready to sleep again.

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http://www.medicinenet.com/insomnia/page5.htm#stimulus

Sleep restrictionSleep restrictionCareful assesment of sleep pattern with a sleep diary

Calculating and planning a new sleep schedule with less time in bed

Adjusting sleep schedule to allow gradually more bed-time as sleep efficiency improve

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Cognitive therapyCognitive therapyUnrealistic conceptions about sleep

Erroneous conceptions of the sleep problem

Erroneous beliefs about the consequences of sleep-loss

Misinterpretation of day-time functioning, for instance by interpreting all negative incidences as caused by the sleep-loss.

Erroneus beliefs about the causes of sleeplessness

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Sleep. ConclusionSleep. ConclusionSleep is important

Follow some sleep advices

Don´t worry about your sleep

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Reasons not to worryReasons not to worry

Biology is on your side.

Sleep is important, not crucial.

Our body compensates for lost sleep

Trancient insomnia is normal.

Treatment is available

Worrying will not help you

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How to deal with How to deal with worryingworrying

Distraction (pleasant thought)

Mindfulness

Constructive problem solving

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Sleep. ConclusionSleep. ConclusionSleep is important

Follow some sleep advices

Don´t worry about your sleep

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Seasonal Seasonal affective affective disorderdisorder✴Depressive symptoms

✴Controversial diagnosis

✴Light therapy

Useful links:About SAD•(in Norwegian): http://www.sv.uit.no/seksjon/psyk/LYSBEHANDLING.htm•(in English) http://depression.about.com/od/sad/a/besttreatment.htmSelf-help organization: http://www.sada.org.uk/Light therapy lamps:•http://www.pixmania.com/no/no/1786636/art/lanaform/genial-light-67220.html•http://www.anxiety-depression-solutions.co.uk/Golite_Blu_BEST_FOR_CHRONIC_FATIGUE_PRICE_DROP_CHEAPEST_ONLINE_STOCK/71.htm?jssCart=236de6168d2795c8e8aaaacd67e0f9d2

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