Stress control for a good night’s sleep

One of the most common side-effects of stress, other than feelings of panic and irritation, is having trouble sleeping. In his book about stress control, Dr  Jim White analyses the factors that we need to consider in order to get a good night’s sleep and suggests a series of tricks we can use to ensure we’re getting the best sleep we can.

In our busy, fast-paced modern world we are all victims of stress and its many side-effects: statistics indicate that at any point 1 in 5 of us has a stress problem, a real problem that makes us miserable and badly affects our day-to-day lives (and maybe the lives of those close to us too). This makes stress one of the biggest problems we face today and is one of the most common problems dealt with by doctors.

So how can we control our stress levels and ensure we get a full night’s sleep? Dr White suggests a two-fold approach: analysing our personal circumstances (ages, lifestyle, medications) and then tweaking our environment and habits.

When thinking about what we need to do in order to get a good night’s sleep, there are several factors that we should consider:

Age. As we get older, we need less sleep (our bodies – and brains!– aren’t growing much now). Once we get into middle age we get less deep sleep and so can be woken more easily. Most middle-aged people don’t need as much sleep as they did when they were twenty. Are you perhaps trying to sleep too long for your needs? If so, try going to bed fifteen minutes later each week and see what amount of sleep works best for you.

Lifestyle. The amount of sleep you need also depends on your lifestyle. So someone with a hectic lifestyle who expends a lot of energy each day will probably need more sleep than someone with a more sedate lifestyle. This means having to balance age and lifestyle – a very active eighty-year-old may need more sleep than an eighteen-year old couch potato.

Pills. A quick word on sleeping tablets. Your GP will probably give you only a few (if any). This makes good sense as sleeping pills do not work in the long run (and often not at all). They change the type of sleep you get. Don’t depend on them; there are much better ways to get a good night’s sleep. Your GP may give you an anti-depressant to use over a longer period. But, again, unless your doctor feels it could help low mood, it is better to learn the skills that can teach you to improve your sleep.

Once we have established our personal circumstances, there are a few things we can do to adjust our surroundings and habits in order to guarantee a restful night.

Your bedroom

1. Get the room fresh. At some point in the day, open the windows to let in fresh air.
2. Get the room at the right temperature. This is the ‘Goldilocks Rule’: the room should not be too hot or too cold. Around 18°C is best. Too hot makes us more restless, gives us less REM sleep and tends to wake us up more. Too cold makes it harder to get to sleep and maybe leads to more nightmares.
3. Your bed. If your bed is past its best, and if you can afford it, think about a new one. Make sure your pillows are right for you. Don’t have a duvet that makes you too hot.
4. We are made to sleep in the dark. So make sure you have thick curtains or blackout blinds. An eye mask works fine. Try to avoid bright screens, e.g. on your tablet, while reading in bed. Due to the light it gives off, switch your phone off or leave it in another room during the night.
5. If you can’t stop the noise outside the house, use earplugs. You can also get an FM radio and tune it off the station so you get ‘white noise’. This is good for swallowing up other disturbing noises. Use ear plugs.

Calm your body

1. Exercise can be helpful, but don’t do this in the few hours before going to bed – early evening is perfect. A brisk thirty-minute walk is fine, or even two fifteen-minute walks.
2. Avoid big meals in the few hours before bedtime. Your digestive system wakes up and starts to work hard just when you want your body to be calming down. A slice of toast or a biscuit before bed should be fine (bread and pasta can be good for making us drowsy). Avoid fatty or spicy food. Avoid red wine, cheese, nuts and bacon as these tend to wake us up.
3. Try to reduce your liquid intake in the evening to reduce the likelihood of waking to go to the toilet.
4. This wakes up our bodies. So cut back on tea, coffee, energy and fizzy drinks, some painkillers and headache tablets. Try to cut it out as much as you can from late afternoon onwards.
5. Milky drinks. The old wives were right! Ovaltine, Horlicks or hot milk might help you get to sleep. Take these instead of tea or coffee at bedtime.
6. Like caffeine, nicotine wakes up the body and keeps us alert. Try not to smoke for at least ninety minutes before bed. Never smoke if you wake up during the night. If you are a heavy smoker, you would be best to give up anyway. Ask your doctor for advice on ways of stopping.
7. Never rely on alcohol to get to sleep. Although it can make you sleepy, it can also wake you up. It makes us snore more, affects our breathing and makes us more restless. It reduces deep sleep and REM sleep – the type of sleep we really want. It can add to our stress the next day. If you think alcohol is a problem, please see your GP for help.
8. Body temperature: Apply the ‘Goldilocks rule’ (see above)! Don’t have a hot bath or shower straight before bed. And try not to be too cold before jumping into bed.

Calm your mind

1. Worry time. It can help to set a time in the evening to do your worrying – say 8 pm. Do this well before your bedtime. So if you start to worry in the morning, stop yourself and ‘save’ the worry until your ‘worry time’. Come 8 pm, stop what you are doing and worry about all the things you have stored up over the day. Chances are you will have forgotten them. Even if you do try to worry, you’ll probably find it very hard to ‘feel’ the worry.
2. Try not to go to bed on an argument. So work hard to make up before you get into the bedroom.
3. Use one of your relaxation techniques before going to, or when you are in, bed. Once you get good at it, you should be able to run the exercise through your head without having to listen to the audio track.

Build up good habits

1. Bedtime routine. Do you have a bedtime routine? A transition between day and night? Give your body and mind a chance to build up a good routine. So go to bed at more or less the same time. Get up at the same time. Avoid long lie-ins. Build up a routine at night that slows you down and tells your body that you are getting ready for bed.
2. Relax before bed. Think of ways to slow yourself down in the hour before going to bed. Decide what you want to do – read? listen to music? chat? watch TV? And do it. If you have just come in from a night out or off a back shift or if you are studying, make sure you give yourself a space in which to switch off and relax.
3. Tech detox. See if you can avoid all technology in the hour before bed. Don’t check emails, texts and/or social media while in bed.
4. Your partner. If your partner snores or is restless, ask if he or she could move to another room. Your partner has to move –not you – as you have to learn to sleep well in your own bed. Once you are making progress, your partner can be invited back to sleep in the same bed.

Dr Jim White is a consultant clinical psychologist who has spent most of his career in the British National Health Service. He is the originator of the ‘Stress Control’ model, a large-class cognitive behavioural approach for common mental health problems that is extensively used in Britain and internationally.