How did you sleep last night?

 

 

How did you sleep last night?

 

                Think about your sleep over the past week. Did you wake up feeling refreshed, without the use of an alarm clock, and not requiring caffeine? If you answered “no,” welcome to the club. According the World Health Organization, two-thirds of adults in ALL developed nations fail to obtain the recommended 8 hours of nightly sleep.

                While this statistic rarely surprises people, the long-term negative health impact of impaired or reduced sleep usually does. For starters, a lack of sleep demolishes our immune system, increasing the risk of cancer; it also increases our risk of infection to any number of viruses (cold, flu and COVID-19). Reducing sleep by only a few hours per night also increases the risk of developing a laundry list of other issues including dementia/Alzheimer’s, cardiovascular diseases (stroke and heart attack), diabetes, obesity, and reproductive issues. Indeed, it is almost impossible to find a system in your body that is not negatively impacted by poor sleep.

                In my work as a psychologist, I am keenly aware of the impact of poor sleep on our psychological health as well. Sleep reduction and loss has also been linked to many psychiatric illnesses including depression, anxiety, schizophrenia, and suicidality. During this difficult time in our world, sleep may be the most important tool that we have to combat all of the aforementioned maladies and yet, it seems to be getting more elusive for a greater number of people.

                In my own life, I am truly fortunate to say that sleep has rarely been an ongoing an issue for me. I joke with my family that the ability to fall asleep easily and nap without lingering effect is my superpower. I am embarrassed to say that I once fell asleep (mid-sentence) during a conversation with my wife; while this may sound disconcerting, I have been assessed for sleep issues in the past with the tests coming back normal. I feel fortunate to have been blessed and to have inherited this ability in the genetic lottery; unfortunately, many (almost all actually) of the patients that I see in clinic are not so fortunate. Those suffering from chronic illnesses and pain, for example, are at particularly high risk for sleep associated problems. For those of you that are having difficulty, fear not, there are a great many things that we can do to improve the overall quality of our sleep.

 

Sleeping pills – a word of caution

                Many people, when they start to have trouble with sleep, visit their family doctors and are prescribed sleeping pills. Research has repeatedly shown that far from improving the quality of sleep, these pills do the opposite and limit the amount of natural deep sleep that we obtain. This, as it turns out, is disastrous for our ability to cement new memories (as anyone with chronic pain will know). These pills have also been linked to an increase in early death (4.6 times greater) and increased risk of developing cancer, dying from heart disease/stroke, being involved in a fatal car crash, and falling at night among the elderly. Their name is a bit of a misnomer, in that they do not actually induce natural sleep, they sedate your brain in much the same way that alcohol does. Incidentally, alcohol also negatively impacts deep sleep and should also be avoided before bedtime.  Please understand that I am not advocating that you immediately stop taking these medications if you are currently on them; I am simply educating you as to the risks associated. If you are interested in removing them, please talk with your prescribing doctor before making this change.

 

 

So, if not pills, what else?

                As it turns out, there is an effective non-pharmacological method for improving sleep. This method is called Cognitive Behavior Therapy for Insomnia (CBT-I) and it is being embraced by the medical community as the first-line treatment of choice for insomnia. Without getting too much into what CBT-I is (I will address this further in my next blog post), it normally involves working with a therapist for several weeks to identify maladaptive (unhelpful) sleeping patterns; Both behavioral and cognitive strategies are then applied in order to improve sleep over time. Research has consistently shown that CBT-I helps people to consistently fall asleep faster, sleep longer and obtain superior quality sleep by reducing time spent awake at night. Importantly, these changes last even after the person stops seeing the therapist; contrast this with sleeping pills that often have the nasty side-effect of total insomnia when you attempt to come off from them. In 2016 the American College of Physicians even provided CBT-I with its stamp of approval and recommended the use of CBT-I for all individuals with insomnia as the first line of treatment (and not sleeping pills).

                Wouldn’t it be nice to get a little more good quality sleep at night? What if the potential treatment did not have to cost hundreds of dollars in therapist bills or potentially injure our health in the way that sleeping pills can? If you are interested in learning more about CBT-I and all things psychology related, consider subscribing to our email list. When new content becomes available, it will be automatically forwarded to your inbox so that you can read it whenever it is most convenient for you.

 

 

If you are interested in learning about some of the behavioral changes that you can start to make right now, we wrote a blog about this last year; click here to read:

 https://www.elevationprocess.com/sleep-experts-recommend-we-do-these-to-improve-sleep/

 

Stay tuned for more information about CBT-I and thanks very much for reading. Have a wonderful day.

 

 

Brandon