Sorting out sleep patterns

The body is built to function best on a consistent pattern of sleep and waking, rather than on pure numbers of hours of sleep. Depression often disrupts sleep, and sorting out sleep patterns can make a very big difference to how you feel.

Why does depression disrupt sleep?

It is not surprising that sleep deprivation or disruption is an effective method of torture. Sleep deprivation alone can bring about many of the symptoms of depression, in an experimental situation. But even too much sleep of the wrong kind can cause problems.

One theory* is that depression disrupts sleep because habits of depressed thinking during the day build up such high levels of stress and emotional arousal that when the brain tries to discharge the stress during periods of REM sleep it becomes exhausted rather than refreshed.

This would explain the common experiences in depression of waking feeling exhausted, waking early (protecting the brain from any further over-active REM sleep) and wanting to sleep all the time.

Sleep strategies

Try the following strategies for improving your sleep-related habits. Don’t get too focused on exactly how many hours of sleep you get and try not to worry too much about sleep disruption. Sleep patterns take a while to regulate themselves so it’s worth sticking with the strategies even if you don’t see quick results.

Work on your ‘sleep hygiene’

  • Make a realistic plan for a consistent sleep pattern. Get up at roughly the same time every day, including weekends, and go to bed only when tired.
  • Give yourself an hour to ‘wind down’ before bed – stop work, perhaps have a light snack, then do something relaxing like reading a book or chatting with a friend before you do your final pre-sleep rituals like brushing teeth etc.
  • Do what you can to ensure your bed is comfortable, and that you keep noise and light to a minimum. It is best to be neither too hot, nor too cold, and it is useful if you can circulate some fresh air in your room before bed time.
  • Only go to bed once you are sleepy. If you find yourself tossing and turning, get up and do something gentle in low light. Only go back to bed again when you are tired. Tossing and turning makes you associate going to bed with being awake.
  • Some people might benefit from a ‘siesta’ pattern, but make a set nap time and restrict it to no longer than 20 minutes. If you are having trouble with insomnia then try to avoid naps.
  • If you are over-sleeping, give yourself small realistic goals for getting up at a set time and staying up for a set period (eg. 10 minutes to start with) before going back to bed if you still wish to. Plan an activity to get up for each day.

Set your body clock

  • Get into a routine of staying awake during the day and sleeping at night. Staying up late and sleeping in does not give the same quality of sleep. Avoid ‘all nighters’ and inconsistent patterns of eating.
  • Make sure you get outside, even briefly, during daylight hours. Exposure to natural light helps keep the body clock regular.
  • The light and flicker from TVs and computer screens draw our attention subliminally and can make it harder to get to sleep. Turn them off at least half an hour before you go to bed.

Challenge depressed thinking

Avoid getting into a rigid expectation about sleep. The more pressure you put on yourself to fall asleep the less likely it is to happen. Remind yourself that it is almost as useful to lie down and rest. Learn more about depressed thinking and how to challenge it, so as not to build up too much internal stress. Write down a list of the thoughts that habitually bother you when trying to go to sleep, or the ones which are relevant that day. Work through them from a reasoned, realistic perspective, then set them aside to be dealt with the next day.

Use other strategies to help your body sleep

Brain chemicals controlling sleep can also be better regulated by taking regular exercise, eating good mood food, avoiding caffeine, nicotine and alcohol and practising relaxation techniques.

Next: Understanding food and mood

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Depressed thinking
Challenging depressed thinking
Taking care of yourself