Sleep – for something pretty straight forward, it can become quite the thorn in your side when you’re not getting enough of it. 

It likely isn’t without your best efforts. Maybe you start by hastily wrapping up your tasks for the evening and try to go to bed a bit earlier than usual. You’ve brushed your teeth and washed your face, taken a melatonin supplement, and turned all the lights out. With the added help of blackout curtains and a white noise machine, you spend the last several minutes before the anticipated end of your night scrolling through social media before a much-needed sleep.

After lights out and pillows positioned just the way you like, you close your eyes and try to go to sleep.

Then it begins…

Perhaps this sort of scenario has resonated with you. After a long and stressful day, you looked forward to getting to sleep early and let your body recuperate only to spend a good chunk of that desired sleep time awake. You’re not alone: 1 in 3 Canadians have trouble falling asleep or staying asleep, while 1 in 4 do not get the recommended 7 to 9 hours of good quality sleep (Wang et al., 2022).

It is reasonable to want to increase your chances of getting a long and restful night sleep by quickly wrapping up your evening tasks, winding down by scrolling through social media, and trying to sleep. These habits and behaviours are intended for you to reach a goal of getting to sleep earlier. Unfortunately, some of these behaviours promote wakefulness rather than sleep. For instance, rushing through last minute tasks before sleep stresses your body and thus telling it that it is not prepared for rest. The light from your smartphone as you are scrolling through social media, or any screentime for that matter, actually inhibits the release of the sleep hormone melatonin in your brain’s circadian clock, suprachiasmatic nucleus of the hypothalamus. Lastly, laying in bed awake while reviewing the stressors of your day not only stresses your body out further, but also tells your body that your bed is not a place just for sleep. Fortunately, simple changes to your routine, particularly at night, can help improve your chances of getting to sleep. 

Sleep Hygiene

You may have heard the term ‘sleep hygiene’ before – it encompasses a few behaviours and habits changes that promote sleep (Bennett, 2020; Edinger, et al., 2021). Some examples include:

• Consistent wake-up time: Set alarm and wake up at the same time every day. This helps program your circadian clock to know when to wake up every morning. 
• Go to sleep when sleepy, not tired: Only go to sleep when you feel a heaviness in your eyes and could fall asleep at any moment. If you’re able to watch a TV show, scroll through your phone, do some light cleaning, or eat – you may be tired, but not ready for sleep.
• Limit your bedroom to sleep and sex: This is pretty straight forward – other than ‘doing the deed’ or to sleep, do not use your bed for any other activity. See Part II of blog post for more information.
• A nighttime routine for relaxation: Having a routine before bed helps signal to your body (and mind) it is readying for bed. Relaxing habits like brushing skin care, stretching, or simply closing the curtains and turning off lights around your home are great ways to signal to yourself that sleep is fast approaching. Having a book with just enough warm light to read is an excellent way to prepare yourself for sleep. 

With these habits and behaviours in mind, think about how you might want to improve your sleep hygiene. Is there one that you think is pretty easy to change? Sometimes a small change is all that is necessary to ensure sleep serves its intended purpose, to recover and prepare you for the next day ahead. 

Dr. Robbie Woods (C. Psych.) is a clinical psychologist at the Centre for Interpersonal Relationships (CFIR). He provides psychological services to adults who are seeking assessments and treatments for a variety of conditions including anxiety (e.g., generalized, social, health, panic), obsessive-compulsive (e.g., body dysmorphia, skin-picking), and depressive disorders (e.g., major depressive, persistent depressive). Moreover, Dr. Woods has a keen interest in treating sleep difficulties, namely insomnia, using a combination of evidence-based cognitive and behavioural interventions as recommended by the Canadian Sleep Society and the American Academy of Sleep Medicine.

References:

Bennett, D. (2020). Cognitive-Behavioral Therapy for Insomnia (CBT-I). Sleep Medicine and    Mental Health: A Guide for Psychiatrists and Other Healthcare Professionals, 47-66.

Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., …   & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia      disorder in adults: an American Academy of Sleep Medicine systematic review,                   meta-analysis, and GRADE assessment. Journal of Clinical Sleep Medicine, 17(2),       263-298.

Wang, C., Colley, R. C., Roberts, K. C., Chaput, J. P., & Thompson, W. (2022). Sleep      behaviours among Canadian adults: Findings from the 2020 Canadian Community          Health Survey healthy living rapid response module. Health reports, 33(3), 3-14.

It’s the week after the “spring forward” time change for daylight saving time (DST). How are you feeling? Many people feel slight groggy the first Monday after DST starts, due to losing an hour of sleep, but the adverse effects can linger for days or even weeks! Circadian rhythms can affect sleep. Are you looking for proof? One sobering statistic shares that fatal car accidents increase by 6% the week after DST begins.

Circadian Rhythms 

The term circadian means ‘about a day.’ The circadian clock, located deep in the brain in the suprachiasmatic nucleus (SCN), coordinates systems throughout the body, including sleep and hormones. Exposure to light keeps our circadian rhythm tightly linked to the local 24-hour environment. 

Circadian Influence on Sleep 

In normal sleep, two processes interact to keep people awake for approximately 16 hours and asleep for around eight hours. One process keeps track of the need to sleep, while the other method (controlled by the circadian clock), provides strong signals favoring sleep or waking at specific times. 

Sleep disorders can be caused by a mismatch between sleep needs and the timing of the signals from the circadian clock. The result can be fatigue, poor work performance, and sleep disturbances, particularly difficulty falling asleep or waking up at desired times. 

Night shift work 

People who work at night often experience reduced alertness and job performance during their shift, as well as inadequate daytime sleep ( one to three hours less) when they return home. They may also have trouble staying awake while driving home. 

Advanced Sleep Phase Syndrome (ASPS) 

ASPS folks are “early birds” with bedtimes around 6:00- 9:00 pm, and early morning awakening around 1:00- 3:00 am. Sleep quality is generally normal if they can go to bed early, but poor if trying to stay up late. 

Delayed Sleep Phase Syndrome (DSPS) 

DSPS people are extreme “night owls,” with bedtimes around 3:00-6:00 am and wake times around 12:00-3:00 pm. Sleep quality and duration are normal when they are allowed to sleep at their preferred biological times, but DSPS symptoms appear when trying to sleep earlier because of work or school demands. 

Conclusion 

Conflicts between the circadian clock and work/social demands can lead to poor sleep. Careful control of exposure to light and sleep timing can help people adjust their clocks to the requirements of their jobs and social lives. 

Suggested readings 

Boivin, D.B. & Boudreau, P. (2013). Circadian rhythms and insomnia: Approaching the time barrier.  Insomnia Rounds, 2(4), 1-8. https://css-scs.ca/files/resources/insomnia-rounds/150-010_Eng.pdf

Fritz, J., Vopham, T., Wright, K., Vetter, C., & Fritz, J. (2020). A chronobiological evaluation of the acute effects of Daylight Saving Time on traffic accident risk. Current Biology, 30(4), 729–735.e2. https://doi.org/10.1016/j.cub.2019.12.045

Walker, M. (2018).  Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner. 

Elaine Waddington Lamont, Ph.D., M.S.W., R.S.W. is a clinician at CFIR (Ottawa) with experience in helping people to rediscover and harness their inner resources. Elaine has spent the past 15 years doing neuroscience research aimed at better understanding how the environment influences biological rhythms like sleep, hormones, and metabolism, which, in turn, affects our mental health. 

by: Dr. Karine Côté, D.Psy., C.Psych. 

Do you have a hard time falling asleep? Do you wake up frequently during the night? Do you tend to wake up too early? Do you feel like your sleep is never really restful? You are definitely not alone! According to the American Academy of Sleep Medicine, about 30% of adults experience occasional insomnia, and 10% of the population suffers from chronic insomnia. 

The impacts of sleep difficulties on our psychological and physical functioning are diverse. They can include mood fluctuations, increased stress and irritability, problems with concentration and motivation, low energy and fatigue, an upset stomach, and muscle tension and headaches. Fortunately, there are strategies that can help improve your sleep quality. 

1. Practice sleep hygiene

Limit coffee, tea, and sugar intake after 3 PM. Eat your dinner and exercise at least two hours before your bedtime. Your bedroom should be comfortable and quiet, and try to limit looking at electronics, screens, and alarm clocks while in bed.

2. Implement a sleep routine

Maintaining a consistent routine throughout the week is vital. Ideally, your bedtime and wake-up time should be the same every day, even on weekends! 

3. Limit time spent in bed to sleeping

Time spent in bed should be reserved for sleeping (and romantic activities) only. Activities such as watching TV or reading in bed can contribute to your sleep difficulties. It is, therefore, more beneficial to engage in these activities in a comfortable space outside of your room and go to bed only when feeling sleepy. 

4. No napping

It is often tough to resist napping when we feel tired. However, to give you the best chance of sleeping during the night, eliminating any length of napping is essential.

5. Regulate your anxiety

Our sleep difficulties are often related to anxious thoughts that are hard to control. Writing them down before bedtime can help release anxious feelings, while also being reassured that your thoughts are not forgotten in the morning!

Consistently practicing these strategies will give you the best chance to overcome your sleep difficulties. However, if these tips do not work and insomnia persists, don’t be discouraged! Cognitive-behavioral therapy (CBT) offered in psychotherapy can help you regulate your sleep and provide beneficial effects that last well beyond the end of treatment. Don’t hesitate to reach out to Centre for Interpersonal Relationships for support – it is time to prioritize your sleep and regain restful nights! 

Dr. Karine Côté, D.Psy., C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Côté provides psychological services to individual adults and couples experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. She works from a humanistic approach and integrates therapeutic techniques from gestalt and object relations psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT).