Stress & Sleep
Stress and sleep problems go hand in hand... Stressful situations, whether they are major problems/losses or minor daily hassle, often keep us awake at night as we constantly ruminate over them. Conversely, lack of sleep or an irregular sleep pattern (e.g. having a baby or working night shifts) can make us stressed and more prone to negative mood during the day. Very often, having a chronic sleep problem works as a self-fulfilling prophecy: people go to bed stressing about the night ahead and, not surprisingly... the problem recurs!
Stress can affect sleep in different ways. Most commonly people complain of insomnia - difficulty falling asleep or maintaining sleep (frequent awakening). On the opposite end of the spectrum are people who react to stress by feeling fatigued and sleepy throughout the day, in most extreme cases suffering from narcolepsy: a condition where people simply fall asleep any time and anywhere, often right in the middle of a stressful situation. Other sleep problems include the so-called parasomnias: abnormal movements or behaviour during sleep, such as sleep walking/talking, sleep terrors and nightmares, sleep paralysis, tooth grinding (bruxism) and bed-wetting, all of which can be worsened by stress.
There is a close biological link between stress hormone cortisol, mood and the sleep/awake cycle regulation. Cortisol levels normally fluctuate during the day, being at their peak when we wake up and then declining throughout the day in preparation for bedtime. If we encounter a stressful situation, our cortisol levels will temporarily increase but after the stressful situation has ended, the levels will go back to normal and continue declining for the rest of the day.
Chronic stress, however, disrupts this daily cortisol rhythm which results in sleep problems as well as mood disturbance such as depression and anxiety. And it becomes a vicious circle as disrupted sleep further disrupts the cortisol production. In fact, very often sleep problems, particularly the early morning awakening, are the first sign of depression and should be taken very seriously.
Managing Chronic Sleep Problems
There are a many ways to deal with sleep difficulties: from having a relaxing bath (perhaps with some essential oils - lavander in particular) and a cup of hot cocoa at bedtime to the more pharmacological solutions, such as prescription or over-the-counter sleeping pills. Some people even resort to self-medicating with alcohol which is a bad idea, particularly in the long run, as it not only reduces the quality of sleep but can result in alcohol dependence.
One of the more effective tools to try out is switching off any hand held devices a couple of hours before sleep, as bright light significantly disrupts the release of sleep hormone melatonin. Another thing that many people report to be extremely helpful in treating insomnia and particularly the problem of waking up in the middle of the night, is doing a mindful body scan - there are many excellent body scan audios you can use, just make sure you can access them in the middle of the night without having to use your smart phone (perhaps have them on an ipod/CD?).
While many of these strategies and tools might work, often they're not enough and it's important to tackle the stress/sleep issue at a much deeper level. A number of non-pharmacological approaches work well with sleep problems, including psychotherapy, coaching, behavioural modification, healthy diet and lifestyle, etc. Eliminating stressors or reducing our reaction to them is an essential component of any effective treatment for sleep problems.
Stress-Busting Techniques for Sleep Management: