Improving Your Sleep Course. Session 1 Understanding Sleep and Assessing Your Difficulties

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1 Improving Your Sleep Course Session 1 Understanding Sleep and Assessing Your Difficulties

2 Course Information

3 Session Details Sessions Session 1 Session 2 Session 3 Session 4 Optional Review Session 5 Session 6 Content Understanding sleep and assessing your sleep difficulties Scheduling a new sleep pattern Sleep hygiene Dealing with a racing mind Optional daytime 1:1 session to review progress Dealing with nightmares and recurrent dreams Putting it all together

4 Info About The Course Housekeeping. DNA / Cancellations procedure. What is CBT? Treatment with best evidence of success for persistent Insomnia is CBT. Homework tasks.

5 Week 1 Understanding and Assessing Your Sleep Difficulties This session will: Measure the level of your Insomnia (baseline measurement) Tell you some facts about sleep, Insomnia and how much sleep we need Introduce you to using a sleep diary on a daily basis and show you how to calculate your sleep efficiency rating Help you to set yourself some individual goals to work towards

6 All About Insomnia

7 Features of Insomnia Difficulty getting to sleep. Difficulty maintaining sleep frequent awakenings / early morning awakenings with inability to return to sleep. Sleep that is not refreshing. Sleep onset is more than 30 minutes after retiring to bed. Duration is for longer than 1 month (usually longer). Early Experience of significant distress or impairment in occupational, educational, academic, behavioural, or other important area of functioning. The sleep difficulty occurs at least 3 nights a week.

8 Statistics and Facts! Sleep disorders are among the most common psychological disorders and are core symptoms of a range of mental health problems such as depression or anxiety disorders. The Great British Sleep Survey found that people with insomnia are twice as likely to lack energy in their everyday life, three times more likely to have low mood or lack concentration and four times as likely to experience relationship problems as people who sleep well (From the Great British Sleep Survey ongoing at Sleepio.com).

9 Statistics and Facts! Research has found that non-depressed people with insomnia have double the chance of developing depression in the future, compared with those that reported no sleep difficulties (Journal of Affective Disorders, 2011). One in 10 of the adult population have persistent problems in getting to sleep or staying asleep. One in 5 adults over the age of 65 have this difficulty. You can survive for three times as long without food as you could without sleep.

10 Stages of Sleep Stage Stage W - Wakefulness REM sleep (light sleep) Details Periods of being awake Characteristic eye movements; where we do most of our dreaming, occurs after each stage and more frequent towards morning Stage 1 (light sleep) Relaxed muscles and slow eye movements, lasts a couple of minutes before moving onto Stage 2 Stage 2 (light sleep) Stage 3 and 4 (Deep Sleep) Occupies the largest proportion of time (50-60%) though the first phase is usually short Deepest part of our sleep, occurring during the first third of the night

11 Changes in Sleep Patterns Over A Lifetime % of Sleep Light Sleep Deep Sleep Awake Time 20 0 Age 0 Age 20 Age 40 Age 60 Age 80 Age 100

12 What Controls Our Sleep Pattern? Sleep homeostat this controls our drive for sleep. Circadian rhythm this is the sleep/wake cycle, also known as the body clock, controls when we sleep. The interaction of these two influences good sleep. Automatic sleep also involved good sleepers usually don t know why their sleep is good, because they usually don t put effort into sleeping. Insomnia is maintained by effort to sleep.

13 How Much Sleep Is Needed? Newborn Young Child Child Teenager Young Adult Adult Older Adult Age Range Average Amount of Sleep Required Up to 18 hours across 24 hour period 12 hours at night + up to 2 hours during daytime naps hours at night 9 hours with variation of when sleep is taken (go to bed late, rise later) hours sleep 7-8 hours hours with a tendency for daytime naps

14 What Are You Like When You Lose Sleep? Cognitions (how you think) Emotions (how you feel) Behaviours (what you do) This Cognitive Behavioural Therapy course will help you to change thoughts and behaviours to improve your sleep and the way you feel.

15 Consequences of Insomnia Disorientation Fatigue and Tiredness Lower life expectancy Bad Nights Sleep Consequences Relationship impact What are the consequences for you? Ill Health Poor concentration Irritability and Mood Memory problems

16 Insomnia and PTSD Treatment focusing on sleep does alleviate both sleep disturbances and PTSD symptom severity. It is not enough to treat the PTSD symptoms without treating insomnia.

17 Good Sleep! Good sleep is automatic we don t think about it persistent sleep problems occur when we make sleep a process full of effort, attention and determination Colin Espie

18 Insomnia Stages - How It Takes Hold Sub-Acute Attention Acute Attention 1) 2) Insomnia Intention 3) Sub Chronic Attention Intention 4) Chronic Attention Insomnia Evaluation Insomnia Intention Evaluation Effort

19 Sleeping Tablets Only recommended for short-term insomnia, not persistent insomnia. Not recommended for older adults whose bodies are slower to break down the chemical compounds in the drugs. Sleep problems return when ceased. Benefits wear off, needing a higher dose or different drug.

20 Quick Break Session 5 Summary

21 Sleep Diary

22 Sleep Diary Important to measure both sleep pattern and quality. Diary will help you to identify where your difficulties lie. As it measures across the week, you ll be able to see variability and patterns. It will also help you to monitor changes that occur as you complete this course. Keep your diary from tonight right until the end of the course. Pick a new one up at every session for the coming week.

23 Completing Your Diary DO Complete the diary within 1 hour of rising from bed. Write down the times to the nearest 5 to 10 minutes if you can. Double-check your answers. Calculate your sleep efficiency and make a note of it in your workbook. DON T Worry about it (it is just a record of your sleep). Make up answers (it s ok to leave a blank if you forgot). Adult Community

24 Sleep Efficiency

25 Calculating Sleep Efficiency Total time asleep x 100 Total time in bed Aiming for above 85% Please bring your diary back next week with details of your sleep efficiency and average number of sleep hours for the week!

26 Goals

27 Setting Sleep Goals Your success in overcoming your problems will be partly determined by your goals. Is my sleep goal achievable? Is my sleep goal measurable? Possible Goals: More Sleep A More Satisfying Sleep A More Restorative Sleep A More Reliable Sleep A More Normal Sleep Write down your personal sleep goals.

28 Setting Sleep Goals Must get out of any selfdefeating perspective that leave you feeling powerless. Move firmly towards solving this problem, and away from a position of defeat! Your frustration and anger with insomnia will likely keep it going!

29 Session 1 Summary

30 Thought For The Week Ahead

31 Session 1 Homework Sleep Efficiency Calculation Sleep Diary Goals of Therapy What s Coming Next Session? How to use your sleep efficiency and average sleep hours calculations to improve your sleep. Learn how to schedule sleep and change thoughts that are affecting sleep.

32

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