Our American culture has an odd attitude towards sleep. It is seen as unproductive and passive. Sleep health is not something we teach in public school. Even doctors in medical schools take pride in sleeplessness! Yet sleep is a direct predictor of our overall health. When we sleep better we eat healthier food, we felt brighter, happier and more positive, we have better relationship interactions, our sex life is better, we accomplish more in less time, we get sick less, and our weight, blood pressure and medication use are all lower.
Sleep is one of four main biological drives, along with eating, drinking and reproducing. Across the animal kingdom every species on our planet sleeps. We humans spend less time asleep than other primates, but we have more REM sleep. Sleep is divided into non rapid eye movement sleep (NREM) and rapid eye movement sleep (REM).
Scientists have discovered that one of the cool things REM sleep does is that it recalibrates and fine-tunes the emotional circuits in our brains. So, the ability to regulate our emotions each day depends upon getting sufficient REM sleep each night. Inadequate sleep can cultivate mental illness symptoms to the point where REM sleep is literally what stands between sanity and insanity. Sleep health and mental health are bedfellows. Without sleep health we do not have mental health. It’s as simple as that.
I worked with a young woman who knew nothing about sleep health until she got to college. In Maya’s public school health class, the students learned about diet, exercise, and sex-education, but absolutely nothing about sleep. Maya was the first member of her family to be attending college and so she was very proud. She wanted to make the most of the opportunity. Yet Maya was acutely sleep deprived.
By requiring public schools start so early, and not educating students about the importance of sleep health, we may be creating a generation of youth who are in a chronic state of sleep deprivation at a very susceptible phase of life for developing chronic mental illnesses. The most effective non-pharmacological method for improving sleep is cognitive behavioral therapy for insomnia (or CBT-I). Maya’s sleep disturbances had not quite reached the point of insomnia so we used the basic methods of CBT.
Maya started by recognizing that she first wanted to improve her sleep hygiene. Roughly speaking good sleep hygiene involves: 1) a sleep schedule, 2) exercising regularly, 3) avoiding caffeine, nicotine, alcohol and large meals before bed, 4) avoiding medications that interrupt sleep, 5) not napping after 3:00 pm, 6) at bedtime, making sure your bedroom is technology-free or technology-turned-off, cool, and darkened, 7) not lying in bed awake, and 8) using rituals to help you feel ready for sleep.
Within a few weeks Maya felt better, having broken some “bad” sleep habits and made some new “good” habits. Treating sleep disturbances can impact our mood and hers felt improved. So, next we began working on anxieties more specifically that sometimes kept her up. Maya tended to catastrophize at night. Catastrophizing is when we believe “cognitive distortions”, or unrealistic scenarios that we imagine will turn into catastrophes. At night this is much more likely to occur. In other words, in the middle of the night we are more likely to believe our stressful thoughts! Maya had first improved her sleep hygiene, and then worked on her nighttime stressful thoughts.
The final thing she wanted to do was to create a sleep routine for herself. When we are little children there are rituals for bedtime, such as bathing, praying, or reading. The children’s book “GOODNIGHT MOON”, by Margaret Wise Brown, is about a young bunny’s ritual of saying goodnight to everything before falling asleep. This was one of Maya’s favorite childhood books and so she decided to read it to herself before bedtime.
Maya was still living at home, attending a local community college, and so she was able to modify her bedroom to her own needs. She was able to attend to her sleep and make it a priority in a way she never had before. She created a few sleep rituals that were easy and enjoyable such as journaling, putting lavender essential oil on her pillow, and reading “GOOD NIGHT MOON”. Maya ultimately felt so much better she became interested in a career path that included developing campaigns for educating people about sleep!
Sleep solutions need not be complicated. And even after a prolonged period of sleep deprivation, it takes a relatively short time to find sleep health once again. Attending to our sleep is the exact opposite of unproductive and passive. Since sleep recalibrates our emotional brain circuits, it is in fact the bedrock of emotional intelligence. Sleeping is smart.
Morin, C.M., Blais, F., & Savard, J. (2002). Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behaviour Research and Therapy, 40 (7), 741-752.
Kodsi, A., Bullock, B., Kennedy, G.A. & Tirlea, L. (2021). Psychological interventions to improve sleep in young adults: A systematic review and meta-analysis of randomized controlled trials. Behavioral Sleep Medicine. 20(1), 125-142.