Sleep Skills – Sleep hygiene

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

sleep

Child sleeping.
Photo courtesy of Pixabay.com

Do you have good sleep skills?

How did you learn to get a good night’s sleep? If you are like many of us, the sleep skills you learned taught you how to have insomnia, bad dreams, and a host of other sleep issues.

When you are young you do not want to go to sleep. Many children resist sleep and bedtimes with a vengeance. What you may have been taught, by example if not by words, was that sleeping was a punishment, and staying awake as long as possible was some sort of reward for becoming that mythical creature we all aspire to become “an adult.”

Sleep, too many of us, appears to be the result of doing and going until you wear yourself out and then you drop into an exhausted state of unconsciousness that passes for sleep. What gets missed in this equation are the many benefits of getting a good night’s sleep and how you develop the skills to have that restful sleep. One name for sleep skills is sleep hygiene.

The benefits of being a good sleeper.

Lots of good things happen to you when you sleep. Memories get consolidated and stored. Poor sleep reduces your ability to remember things and make sense of the world around you. A well-rested person is more alert and finds it far easier to “pay attention.”

During the day your brain does a lot of work. Even if you are engaged in a physically demanding endeavor you mind still consumes a lot of calories thinking about and directing all the other things you do. Your brain consumes somewhere between 20% and 25% of all the calories you use every day. Burning all those calories creates a lot of waste.

Most people understand that more exercise means more waste products. You eliminate the waste and you feel better. Exercise more and if calories taken in stay constant, you can expect to lose some weight. Wastes accumulated in your brain get cleared out at night while you sleep.

Poor sleep and you end up with a “trashy” mind which has difficulty with focus, concentration, and creativity.

Sleep skills can be learned.

Being a good sleeper is a matter of choices you make. There are secrets to most things in life. A good teacher or coach can show you how to improve your game. You can learn how to be a better, more rested sleeper by learning and then practicing a few basic sleep skills. Here are a few of the basic sleep skills.

To sleep, you need a cool-down period.

Between running around and falling asleep give yourself some time to decompress. Most people go and go and then leap into bed expecting to fall right to sleep. You need some cooldown time. Stop activities thirty to sixty minutes before bedtime. If you do any exercise do the slow mindful type not the strenuous kind in those last few minutes.

Unplug from electronics. Those bright lights hitting your eye condition you for more awake time. Reduce the light. Relax and get yourself in the state to sleep.

Avoid stimulants at bedtime.

Do not drink coffee, tea, energy drinks, or other stimulant beverages in the afternoon. Pay attention to the last one you had and see how this impacts your sleep. Some people can drink coffee late in the day and still sleep, others are more sensitive and even coffee at lunch will impact their sleep.

Train your brain to expect to sleep in bed.

Our brains quickly associate places with the thing you do there. Do not abuse the bed. Lounging around in bed reduces the sleep-bed connection. Use the bed only for sleep and sex. Your brain can connect sex with lots of locations but it won’t connect sleep with standing up. Do not confuse the default setting in your brain by expecting it to stay awake and social media surf one time while another time you ask it to sleep in bed.

Clear your mind of worries before going to bed.

Use whatever practice works best for you to clear out the problems and worries from the day before trying to sleep. Pray and turn the worries over to your higher power, journal out those thoughts. You may be able to call someone and talk about your concerns before bedtime.

Empty your head of things you need to remember to do in the future. Writing this down can help get them off your mind.

Have a set bedtime and a time to get up.

It can be hard to adjust to changes. Sleep is no exception to that rule. If every night you hit the sack at a different time your brain does not know when to let you get sleepy. Set a constant time and do your best to stick to it. People who stick to a wake-up time even on the days off find that their body adjusts and lets them know when it is time to sleep.

If you have different times for getting up and going to bed on the weekend it makes it more difficult to switch back and forth. The result may be waking up at the right time despite staying up late. Many people create a sleep deficit over the weekend.

Avoid daytime naps.

Taking daytime naps results in not being able to sleep when bedtime comes. Staying up till your tired can leave you exhausted the next day. Over time these daytime naps shift your schedule and can make it harder to switch back when you have to stay awake for the full day.

Develop a bedtime routine.

Running around frantically at bedtime wakes you up. You need a routine to let you wind down and get ready to sleep. Having a pre-bed routine reduces those last-minute things that need to be done and keep you up late.

Create a comfortable sleep place.

Dark sleep places help you sleep. Look for ways to reduce stray light. Turn off the electronics. Screen light tricks your brain into thinking you need to stay up a bit longer.

Do you sleep better when it is quiet? Do your best to curtail ambient noise. Earplugs work for some. If you prefer noise to drown out other sounds around you look for something that will not be diverting your attention. Background music may be helpful in managing the sound environment.

Cool temperatures help get the body ready for sleep. In hot climates or in the summer mouths coolness may be at a premium. If you don’t have or can’t afford air conditioning opt for a fan or fans that move the air over you. Feeling cooler at night than you did while awake will increase the chances of a restful night’s sleep.

Weed out life factors – shift work or recent stressful events.

Shift work can alter your sleep cycle. Some people can adjust while others never seem to. If you work when others sleep and sleep when others are up you will need to look for ways to accommodate that schedule. Some of these will be environmental things like darkness and consistency.

If you find that stress, anxiety, or trauma is impacting your ability to sleep, consider counseling or other help in reducing that stress. Mindfulness or meditation training can help.

Those are some thoughts on developing good sleep skills. Have you found any other things that improve your ability to sleep?

You might want to take a look at other posts on:

Sleep

Dreams and Nightmares 

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Some family secrets can be deadly.

What if your family secrets put you in danger?

Letters from the Dead The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead?

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive?

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders, see my Facebook author’s page, davidjoelmillerwriter.

Getting rid of Nightmares that maintain Depression and PTSD

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Nightmares maintain depression and PTSD.
Photo courtesy of Pixabay

Then Come Nightmares.

Frequent nightmares play a major role in maintaining depression, PTSD, and other mental health problems. It is common for people to think that they need to cure the PTSD or Depression and then the nightmares will go away.  The opposite approach is more likely to be productive.

Most treatments for PTSD do not target the nightmares. There are treatments for nightmares available, some as brief as three sessions. These have been shown to help reduce nightmares and promote recovery from other problems.

Treatment for nightmares has been shown to reduce symptoms of PTSD and depression.

Children also suffer from nightmare related problems. Children who are fearful because of a family problem, moves, divorces or separation develop symptoms of mental illness. “Bad dreams” are the result of the child’s out of control fear and are at the root of many childhood attention or conduct disturbances. When the child gets a good nights sleep they behave, when they don’t sleep they don’t pay attention, and they don’t mind.

Nightmares are associated with high levels of anxiety. They are fear based.

Most people who have PTSD, depression, bipolar disorder or any other diagnosis also have a co-occurring anxiety problem. Now sometimes anxiety is good, it protects you from danger. But when the anxiety circuits do not turn off the anxiety gets to be the problem rather than the solution.

We also see lots of disturbing dreams in clients recovering from substance abuse problems. Substance abuse counselors report clients sharing about drug using dreams. We have some simple interventions around those issues, but not much research has been done in this area because substance abusers, people with Bipolar Disorder and people with psychosis are routinely excluded from research studies. I believe that the treatment for nightmares will work for anyone.

The solution is to tone down that fear circuit.

Before I describe a treatment method for reducing nightmares – a word of caution, working on nightmares, especially those that maintain PTSD, can be a painful process. It is best to work with a therapist or other professional person, and you need to make sure you have a strong support system in place in case you have difficulty coping.  For more on support systems see “How to develop a support system” or “How supportive is your support system?”

Taming nightmares involves three steps.

1. Learn relaxation methods.

Nightmares are fear based, and the fear persists after you awake. Sitting thinking about the scary part of the dream might reinforce the nightmare and result in memorizing your nightmare. Fear and relaxations are not compatible. The more you relax, the less fear you will have. As you get better at relaxing your fear shrinks and your dreams become less traumatic.

2. Learn sleep hygiene

Keeping regular bedtimes, reducing or eliminating caffeine especially in the hours before bedtime and other efforts to improve sleep naturally are helpful. It is important to allow plenty of time for sleep.

People who stay up late and get up early gradually become sleep deprived. Lack of sleep aggravates all sorts of mental health issues. Insufficient sleep increases the possibilities that you will be suddenly awakened and will remember the “bad dreams.”

During sleep the brain keeps working on our issues, memories are consolidated and thoughts organized. We only call dreams “nightmares” if we awake during the dream and have memories of it. Better sleep can result in fewer nightmares.

3. Begin treatment of the nightmares once you are relaxed and well rested.

The process of “reframing” nightmares makes them less scary and more manageable. Reframing or reprocessing is helpful for intrusive daytime thoughts as well as for nightmares.  The application of this to reducing or eliminating nightmares was described by Rhudy et al. in their 2010 article on CBT treatment for nightmares in trauma-exposed people, where they called it “ERRT” therapy.  Ben Furman has also described a similar approach for use with children.

Disclaimer- Rhudy et al.’s study, like most research in the mental health area, excluded substance abusers, people with mania or psychosis and probably screened out all people with Bipolar Disorders. The sample size was also low with about twenty people per group. There is so much overlap between substance abuse, bipolar disorder and PTSD in the clients I see these studies leave out exactly the people who most need new effective treatments. That said – the ideas appear to be fully appropriate for clients with co-occurring disorders.

Here is how it works:

To reprocess or reframe nightmares do the following things:

A. Write out as full a description of the nightmare as possible.

Getting it down on paper tames the story and makes it manageable. It also allows you to go back over it and add missing details. In step C you will be rewriting it with added insight.

Remember that it is a normal process for your brain to use your dreams to make sense of your experiences. In dreams, your brain will turn the experience around and examine it from all sides. Your brain may also play out multiple alternative endings for the event. It is not the dream that is the problem; it is the connection between the dream and fear that makes this a nightmare.

If you have several versions of the dream try to write them all down.

B. Read the nightmare story aloud.

Listen for the themes in the story. What are the fear messages? I think it is helpful to be able to read this to a therapist or other support person who can keep you from being overwhelmed and can provide some insight into things you may not immediately see. Just don’t make someone listen to your nightmare that is not emotionally able to hear the story.

C. Re-script the nightmare.

What is the expected ending? What is an alternative ending? Write out the story this time with a new less scary ending. Read the new version out loud. Has seeing a new possible ending tamed the fear?

Furman described a story, not sure where it originated, in which a grandmother applied the sort of approach to her grandson’s nightmare.

The child came to grandmother scared because of a nightmare.

“Grandma, ” he said, “I had a nightmare.”

“There are no such things as nightmares,” The grandmother said “Only goodmares. All dreams should have happy endings. The problem is you keep waking up before the end. What is a good ending that could have happened?”

In this story, the child then works with his grandmother to find new happy endings for these scary dreams. The result – fewer scary dreams and less fear when bad dreams occurred.

Warring – in people with PTSD who were treated with re-scripting the fear declined first, anger later and the frequency and length of nightmares were the last things to decline.

Talk to your care provider about this process. If you try this process, see if it works. Learn to relax more. Tame your sleep. Then tame your nightmares. If you have had success in changing your nightmares ending please share your success with the rest of us.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.