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 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 this 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

Two 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.

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

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. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Can’t sleep? Is it Insomnia Disorder?

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

Insomnia.
Photo courtesy of Pixabay.com

Frequently poor sleep might be Insomnia Disorder.

Most people have an occasional night with poor sleep. That does not rise to the level of being a diagnosable illness. But if you have those nights often, you just might be having Insomnia Disorder. There are many connections between your physical health, mental health, and biological functions. Sleep is a very important one of these connections.

Poor sleep can be a symptom of a mental or emotional disorder.

Poor sleep often accompanies Major Depressive Disorder. People who are depressed either sleep way too much or they find it hard to sleep at all. High levels of anxiety, any of the anxiety disorders, may interfere with your ability to sleep. Low need for sleep can be a part of bipolar disorders. Lack of sleep now can also be a warning sign that an emotional problem is just around the next bend in the road of life.

Poor sleep can be a primary disorder all by itself.

Poor sleep, if it gets to be a big enough problem, needs to be treated before it disrupts the rest of your life. Treating poor sleep is often a problematic issue. Medical doctors may treat it with medication which is a temporary solution but long-term you need to look at the connection between your sleep disorder and your mental and emotional health.

Counselors often see the connection between your sleep and your anxiety, depression or other mental illness but what may be missing is counseling about how to reduce the impact of your Insomnia or other sleep disorder on your life. Treating both problems at the same time is the recommended approach most of the time.

Mental Health practitioners use the DSM-5 as their guide to diagnosing and treating mental, emotional and behavioral disorders. (DSM is a registered trademark of the APA.)

For a full description of the way Insomnia Disorder gets diagnosed you should look at the DSM-5 but below is my plain language explanation of some of the things that would make a professional think that your sleep problems might justify a separate diagnosis of insomnia disorder.

Can’t fall asleep?

Most people experience occasional times when they have difficulty falling asleep. But if this happens to you a lot you should start looking at why. For many people, this is simply a lack of good sleep skills sometimes referred to as poor sleep hygiene.

Sleep hygiene involves things like having a regular bedtime, avoiding caffeine and other drugs that interfere with sleep close to bedtime, not watching an exciting sports event and then rushing to bed while still all wound up and so on.

Many people can cure their insomnia issues by practicing good sleep skills. Watch for an upcoming post on how you could do this.

If you have an anxiety, Major Depressive Disorder, or another mental illness, getting that emotional issue treated can improve your sleep. Nightmares, Bad dreams, and Sleep Terrors also need treatment. The nightmares that accompany Posttraumatic Stress Disorder (PTSD) especially need treatment. You can treat those nightmares without having to relive all those traumatic life events. More on that also in an upcoming post.

A rough rule of thumb is, if it routinely takes more than a half hour to get to sleep, you need to take a look at why.

Can’t stay asleep, could be Insomnia Disorder.

People with Insomnia Disorder wake up a lot throughout the night. This frequent wakening reduces the quality of their sleep. Awakenings also reduce the total amount of sleep. Get poor quality sleep or too little sleep and you will be tired all day. These sleep deficits pile up over time. Sleeping in on the weekend may feel like it helps a little but just like overdrawing your bank account cost you fees, overdrawing your sleep accounts all week comes with costs that can’t be made up with a few extra minutes on the week-end.

People with Insomnia Disorder will find that even when they stay in bed extra time they can’t sleep anyway.

Is your poor sleep or lack of sleep a problem?

If you find that your concentration is off all day that may be because of sleep issues. Do you find yourself getting sleepy or dozing off during the day? Look at your nighttime sleep. If you are one of those people who can get by on less sleep and still feel fine then you probably will not get a sleep disorder diagnosis. If the number of hours of sleep gets too low and you think you are fine but others tell us you are off the hook we may start looking at a bipolar disorder as a possibility.

Take a hard look at your daytime problems and consider if many of your emotional problems may be connected to your insomnia or other sleep problem.

Insomnia disorder can look like ADHD.

Poor sleep can also impair your attention. Lots of client’s referred for ADHD treatment turn out to have insomnia disorder or another sleep-related problem. I have lost track of the number of people who came in for an assessment, especially teens, and it turned out they were staying up all night on social media, texting or the internet. That is a lack of sleep skills, not ADHD.

Drugs, medications, and foods can keep you from sleeping.

Most people know that street drugs, methamphetamine, and cocaine, will keep you from sleeping. When you are high you don’t sleep. Then when you come down you crash and sleep for a very long time trying to make up for the awake run.

Caffeine from many sources can interfere with sleep. We miss how high the doses of caffeine little children are getting. Most sodas are loaded with caffeine. More and more people are drinking energy drinks and those beverages can also keep you awake long after you wish the effects had worn off.

There are lots of other medications that can mess up your sleep-wake cycle. If you are experiencing insomnia or another sleep problem talk with your doctor about the possibility that something you are talking is causing that. Do not forget to mention over the counter and herbal products also. Remember those over the counter headache pills you take? Some of them are high in caffeine also.

You can’t sleep if you do not go to bed.

Lots of people who complain about insomnia, poor sleep quality, and bad dreams are chronically sleep deprived. They are stressed or anxious about their awake life. Do not expect to fall asleep the second your head hits the pillow. Budget enough hours of your life to getting sleep if you want to have a happy, productive life.

Sleep times and cycles change as we age.

Sorry folks all of us are getting older. When we are young most of us want to stay up all night despite needing more than average sleep. Young kids need more sleep. If they do not get it they get grouchy, irritable and can’t concentrate.

Seniors and the elderly may need less sleep, they may also develop more sleep disorder problems.

What should you do if you have Insomnia Disorder?

Good treatment for most people with Insomnia Disorder involves three things. Talk with your medical doctor and see if there are underlying medical issues. Work on sleep skills, sleep hygiene, relaxation and other skills. Get your mental health issues treated. Nightmares, trauma, anxiety, and depression are all treatable and they all interact with sleep quality.

Thanks for reading all this way. Sleep well and live well.

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

Sleep

Dreams and Nightmares 

Staying connected with David Joel Miller

Two 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.

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

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. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Do you have Nightmare Disorder?

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

Nightmare

Nightmares maintain depression and PTSD.
Photo courtesy of Pixabay

Do you have bad dreams or is that a Nightmare Disorder?

We know there are connections between sleep, sleep disruptions and a number of mental illnesses. The connection between nightmares and Posttraumatic Stress Disorder (PTSD) is fairly well-recognized. Dreams related to your trauma is one of the symptoms of PTSD. What often goes unnoticed is just how connected poor sleep and having a mental or physical health issue can be.

Sleep disturbances can be both the result of and the cause of significant life problems. Many people ignore their bad dreams and nightmares. You shouldn’t. Disturbed sleep may be a warning that something much worse is on its way. Some of these issues can threaten your life and your sanity. Frequent nightmares increase the risk someone will attempt suicide. Drinking to shut off the nightmares increases the suicide risk even more.

Nightmare Disorder is included as a Mental Disorder in the DSM-5.

Nightmares fall along a continuum which runs from an occasional upsetting dream through frequent bad dreams that leave you feeling upset when you wake up, to those severe things like Nightmares and ends at the point of Sleep Terror Disorder where people wake up screaming. Sleep Terror Disorder along with Sleep Walking was combined in the DSM-5 getting the new name Non-Rapid Eye Movement Disorders, but that’s a topic that needs to wait for a future post.

Bad sleep is a symptom found in several other mental Illnesses so the sleep disorders get little attention from most Therapists. Given the human tendency to pretend there is nothing wrong with us until we hit the wall so to speak, it is not surprising a lot of sleep disorders go undiagnosed or get diagnosed as something else.

Nightmare Disorder is part of a group of conditions called Sleep-Wake Disorders.

Sleep-Wake disorders do not get diagnosed or treated by therapists of counselors all that often. Usually, sleep problems get one of two problematic treatments. They could be referred to a sleep disorder specialist who uses the International Classification of Sleep Disorders (ICSD-2) with its myriad subcategories. The other possibility is that sleep disorders are often taken as a symptom of a more common mental illness.

Poor sleep could be anxiety, depression or PTSD.

Nightmares or Bad Dreams can be a part of some anxiety disorders. Changes in sleep and appetite are key symptoms of depression. But just having bad dreams in and of itself does not automatically get you an anxiety or depression diagnosis.

Many nightmares are a part of Posttraumatic Stress Disorder (PTSD.)

Trauma- and Stressor-Related Disorders are such major factors in mental health that the Trauma- and Stressor-Related Disorders now have their own DSM chapter. Bad dreams and nightmares are one major factor in PTSD and other similar disorders that once you say you have bad dreams expect the professional to ask about any trauma history and any recent or current stressors.

If you have PTSD or another Trauma-Stress related issue nightmares are likely, but just because you have bad dreams does not mean you have PTSD. When I decide to write this post on Nightmare Disorder I looked up a hundred or so recent research articles on Nightmares and Bad Dreams. The largest part, a strong majority of those articles, were about Nightmares in people with PTSD. But there were a bunch of other mental health conditions that were connected to poor sleep also.

Nightmares and Bad dreams are connected to Borderline Personality Disorder, OCD, DID, GAD and aging.

That is only part of the list. OCD stands for Obsessive Compulsive Disorder, DID is Dissociative Identity Disorder and GAD is for Generalized Anxiety Disorder. Each of these diagnosis has related OCD like, Dissociative and Anxiety Disorders.

All these related disorders including bad dreams of one kind or another which makes me wonder if many people with one mental illness should also be getting a diagnosis of Nightmare Disorder. That and sleep disorders are one of the factors leading to the development of other mental health issues. In that vein, sleep disorders also greatly increase the risk of relapse in those with a substance use disorder.

What are the symptoms of Nightmare Disorder?

For the full text of the symptom see the official DSM-5 but here is my short, plain language version.

  1. Frequent, upsetting, bad dreams that really scare you.
  2. You can wake up quickly.
  3. These bad dreams are getting in the way of you living your life (family friends, job etc.)
  4. Drugs, alcohol or another mental illness are not the best explanation for why this is happening.

On top of these and a few other more specific criteria, Nightmare Disorder has a bunch of “specifiers” about when how often and how bad these dreams are.

A word of caution here. This is post is an effort to explain some kind-of complicated stuff. Diagnosis should not be a do-it-yourself project. There are a bunch of other Sleep-Wake Disorders that might also need to be ruled in or out. Some sleep problems are a sign of life-threatening physical conditions. You may also have some other mental issue or guess what?

Your bad dreams may be a normal reaction to some stress in your life right now.

Drinking alcohol to quiet bad dreams is a really bad idea. The amount it takes to knock you out is very close to the amount that will kill you. Especially do not mix alcohol with prescribed sleep or anxiety meds. You can work with your doctor on meds for bad dreams but when the meds wear off the dreams can get worse.

If you are having sleep disruption, bad dreams, nightmares, night terrors or related sleep problems, talk with your doctor or other professional and see if medication, therapy or some other treatment might be helpful to you. Don’t put it off. Even normal sleep issues if left untreated can eventually impair your physical or mental health.

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

Sleep

Dreams and Nightmares 

Stay tuned, more on sleep’s connections to mental health, wellness and recovery are coming.

Staying connected with David Joel Miller

Two 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.

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

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. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.