1. May 2014 Dr Stanley C Rodski NeuroPsychologist

3. ◦ TRANSIENT (Sometimes) POOR SLEEP:  Most of us suffer from this from time to time.  Can’t sleep for a few nights – about a week at the most.  Usually because we are excited or nervous about something/ specific event.

4. ◦ SHORT TERM POOR SLEEP  Can’t sleep for a few weeks  Usually due to things going on in your life.  This is where you can develop bad habits which lead to long term sleep problems.

5. ◦ CHRONIC (LONG TERM) POOR SLEEP  Poor sleep has lasted for at least 3 months.  Poor sleep has become a habit

6.  Is there a PATTERN to my poor sleep? ◦ Poor sleep has a pattern to it that you need to understand. ◦ Knowing the causes and patterns of your poor sleep will help you improve. LET’S LOOK AT SOME OF THESE...........

7. ◦ TROUBLE FALLING ASLEEP  This is a very common problem for poor sleepers  This is a symptom of poor sleep habits  Can be improved by replacing poor habits with good habits/behaviours ◦ TROUBLE FALLING ASLEEP & WAKING UP  This is a result of a disturbed body clock and poor habits before sleep  Can also be the result of “restless legs Syndrome” and various breathing disorders.

8. ◦ NO TROUBLE FALLING ASLEEP BUT WAKE UP DURING THE NIGHT  Waking during the night is NORMAL.  If you stay awake and feel daytime fatigue then this is a problem  Waking during the night can become a habit which worsens with worry  This is made worse by alcohol, caffeine, nicotine, sleeping pills, various medications, noise and light.

10.  GOOD SLEEP PRACTICE ◦ BEFORE GOING TO BED  Avoid caffeine in the late afternoon and early evening  Avoid alcohol. It may help you fall asleep but the effects wear off in a few hours, causing withdrawal and awakenings during the night  Avoid nicotine. It is a stimulant.

11.  Avoid Food high in protein( meat, nuts etc)  If you have to eat before bed then high carbohydrates such as cereal, bread etc (small carbo snack)

12.  Milk can induce sleep because of the amino acids (tryptophan)  If you are waking up in the night combine milk with Horlicks. This reduces restlessness.  Well balanced meal, 3 to 5 hours before bed is optimum for sleep.

13.  Have a bedtime ritual. This lets your body know you are getting ready to sleep  A bath before bed helps improve sleep QUALITY. Not too hot and stay in for 15 to 20 minutes (physically relaxing and affects the body clock)  Don’t go to bed too early. Only go to bed when you are feeling sleepy( yawning, eyes closing)  Don’t have a fixed bedtime. Having a fixed bedtime increases your anxiety making it harder to fall asleep

14.  IN BED ◦ Get rid of the bedroom clock.  When you have trouble sleeping watching the clock just makes you more anxious. ◦ Limit your activities in bed.  Lap top computers and “to do ” conversations with your partner should be avoided. -You want to strengthen the link between bed and sleep. Not weaken it.

15. ◦ Don’t stay in bed if you are awake.  If you are not asleep in 15 minutes ( approx), get up, go into another room and do something relaxing ( magazine, television, music) until you feel sleepy again  Don’t eat, drink alcohol or smoke when you get up because your body will learn to wake you for this.

16. ◦ Don’t worry if you can’t sleep.  Accept that sleep needs vary a lot and that you can function quite well with a lot less than you might like to have. ◦ Don’t spend too much time in bed.  Spreading a night’s sleep over too long a period will lead to shallow, fragmented sleep and more time in bed worrying about sleep.  Plan to stay in bed for only the length of time of your typical sleep.  Once the quality of sleep is improved you can lengthen the time in bed.

17. ◦ Do have a fixed getting up time  Try to get up at the same time everyday  When you get up expose yourself to outside light as soon as possible  This helps your body clock and stops the development of delayed sleep phase syndrome

18.  DURING THE DAY ◦ Avoid long naps (half an hour or more)  These interfere with your night sleep  Make you feel ‘groggy’ or more sleepy during the day ◦ Avoid lying down except when you are trying to sleep  This leads to a weakening of the association of lying down and going to sleep  Sit up when watching TV or reading ( unless you are about to go to sleep)

19.  Sometimes we find it difficult to sleep because we are VERY ANXIOUS & WORRIED and/or SAD & MISERABLE In these circumstances we need to practice a DEEP RELAXATION TECHNIQUE

20.  Deep relaxation is about controlling the AUTONOMIC NERVOUS SYSTEM (ANS) through BREATHING

21. THANK YOU for your time today and GOOD SLEEPING