Lack of Sleep -- ENEMY #1 TO SANITY

I sometimes joke that, if everyone slept well and exercised regularly, I would need to find a different line of work. Trouble is, I believe this. On their first appointment, more than 70% of my clients report not sleeping well. This is about double or triple the national average. If you then add in the folks who don't exercise, the percentage would probably be above 95%.

Lack of sleep contributes to a long list of physical and psychological problems -- anxiety, depression, anger, high blood pressure, obesity, etc. It also elevates the risk of Alzheimer's disease. So sleep is really, really, really important.

No doubt, for many of my clients, there is a vicious circle: lack of sleep makes the problem (anxiety, depression, anger, whatever) worse. The more severe the problem, the harder it is to sleep.

I often coach clients on how to get more and better sleep, with five key strategies (which are outlined below). Sometimes (maybe 10-20 percent of the time), the client returns just two weeks later reporting that their sleep is better, and the reason for seeking counselling is also gone. No more anxiety! Not depressed anymore! Getting along with my spouse much better! For the majority of cases (maybe 50-60%), there is improvement in sleep, and there's definite but not complete improvement in the reason for seeking counselling. There's still more counselling work to do, but the task is considerably easier. Some clients don't do what I suggest, and not surprisingly, there's not much change in the sleep or the counselling issue. Finally, a small percentage of clients have a sleep disorder that requires consultation with an MD.

My experience is that doing all five of the following optimizes your chances for a better night's sleep.

1. Reduce or eliminate consumption of stimulants. Typically, we're talking about coffee, tea (black, green or white), chocolate, colas, yerba matte and nicotine. For all but nicotine, I recommend that clients move toward no consumption of stimulants after 12 noon (i.e. 10 hours before bedtime). For nicotine, I suggest backing up the last cigarette 15 minutes further away from bedtime, increasing that if one can.
2. Exercise. From a sleep and mental-health point of view, exercise means getting the heart rate up somewhat (like going for a walk) for a sustained period (30 minutes) at least four times a week, preferably every day. Some clients, used to intense workouts at the gym, may turn their nose up on such a mild workout, and they are more than welcome to do more. But if sneaking in a 30-minute walk is the only alternative to doing nothing, then it's time to get humble and do it. Note: walking small dogs doesn't count; they stop and sniff too often!
3. Reduce light exposure, especially from electronic devices, in the two hours before bedtime. In short, the blue light coming off TVs, laptops, pads and phones interferes with your hormonal chemistry designed to support sleep. You have three options: (1) don't use those devices for the two hours before bedtime, (2) for smaller devices, use or get a blue-light filter app that automatically filters out the blue light (so the brain thinks you're looking at a campfire, rather than daylight), or (3) get some glasses that are designed to filter out the blue light and use them.
4. Talk to a pharmacist about over the counter sleep aids, or to a doctor about prescription medications.  Your doctor has strong and highly effective medications when sleep is a serious issue. Your pharmacist can guide you in over-the-counter products, of which there is a big variety: herbs, magnesium, 5-HTP, synthetics from Benedryl or Nyquil, melatonin, etc. Be sure to bring with you a list of medications you are currently taking -- pharmacists are experts in the drug interactions that you don't want. 
5. ​If you still have trouble getting to sleep, or getting back to sleep, try one of these two techniques. Progressive muscle relaxation: starting with the feet, tense all the muscles for a slow count of five, then release for a count of five, feeling whatever sensations may be occurring in your feet. Then do the same for your calves. Then thighs, then buttocks and groin, then abdomen, then chest and back, then hands, then arms, then neck and then face. Finally, relax feeling the sensations in your entire body. Word Exercise: think of a word that has no repeating letters, so "abdomen" would work, "repeating" would not. So, with "abdomen", start by thinking of all the words you can that start with "a"; when you run out of steam of the a's, move on to words that start with "b", then "d", then "o", etc. Most times, I fall asleep before the fourth letter.

It is important to do all the solutions together. Many times clients have said to me, "I've tried melatonin, and it doesn't work for me." They may be right and they may be wrong. It may be that melatonin alone doesn't work, but maybe melatonin, exercise, cutting back on coffee and turning off the cellphone early does. Once your sleep gets better, you can experiment with not doing individual strategies to figure out if it's necessary or not.

If these strategies don't work, you can talk to your doctor, or find a therapist qualified to do Cognitive Behavioural Therapy for sleeplessness.

Sweet dreams. Let me know if you put this into practice, and what your results are!