What relaxation techniques, Sleepio and beyond, do you use to deal with the stress of everyday life?
Many of the Prof's interventions address stress, and in particular wind-down routines. Following some extra help I recently received in reducing my stress levels, and the positive effect that's had on my sleep, I'd find it useful to share this with other Sleepios, and to hear how they use, adapt, and support all the techniques the Prof. suggests for stress-reduction, and the manner in which that has impacted their sleep experiences.
Doodle’s doodles on stress
Part 1 Stress and insomnia
Part 2 A personal model of stress: a stress-sleep story
Part 3 Identifying where you are on the stressometer through symptoms, action and avoidances
Part 4 The vagus nerve
Part 5 Intervening to break the stress cycle
Part 6 Stress hormones and the autonomic nervous system
Part 7 A personal account
*Doodle’s doodles on Stress *
Part 1 of 7
Stress and Insomnia.
I recently realised I was at that part of the Sleepio programme where the Prof’s advice about dealing with any other known condition which affects insomnia first applied. So I’ve been working specifically on stress.
In fact I’ve come to wonder if stress, in its widest sense, is responsible for all insomnia. After all, if we have insomnia then something has caused our sleep homeostasis to malfunction, and that’s, presumably, some sort of stressor. It might be physical (like RLS) or emotional (worry) or environmental (noisy neighbours). I think this idea that all insomnia is caused by stress of some sort is borne out by looking at the Prof’s sleep-strategies. Sleep hygiene addresses environmental stressors, putting the day to rest detoxifies worry, and PR gives rest to tense muscles. I hope I’m not mislocating a quote by Dr Creanor at an expert session on 30.8.17, where she said “stress and poor sleep are very much linked….both can cause the other and also serve to keep the other going too”.
For me, it was necessary to target specific aspects of stress, so I went to see a psychologist, who helped me identify and intervene in acquired coping strategies which I’d learned when I had ME, and were now proving to be unhelpful to my new-found health. I’ve just had my 5th visit and the overall result has been, I feel, an enormous reduction in my stress levels. My sleep is, once more, improving in quantity – just a little, moderately well in quality (from poor/fair to fair/good), whilst my sleep-associated feelings, mood, and next-day functionality are vastly improved. This was the greatest, and most-welcome effect. Whereas pre-destressing, 6 hours sleep was barely bearable, now it’s fine, absolutely fine.
It appears to me that the psychologist has helped me to regain the improvements Sleepio had given me, but which stalled when a greater degree of stress kicked in. My experience of coping better on fewer hours sleep than I thought I needed seems to be a common Sleepio experience. Read what experienced Sleepios are chatting about, and they’ll nearly all say that they sleep fewer hours than they hoped for at the outset, but that their sleep has become more restorative. Most, if not all, of these expert Sleepios will emphasise the importance of winddown routines, sleep hygiene etc….i.e. destressors.
For me, I think, the key to the de-stressing (that’s de-stressing, not distressing(!), although it could be that too), effect of Sleepio is encapsulated in a phrase from Tired but Wired by Nerina Ramlakhan, who says “Insomnia isn’t created at night”. For me personally, sleep is about destressing constantly throughout the day.
*Doodle’s doodles on Stress *
Part 2 of 7
A personal model of stress; a stress-sleep story.
The psychologist I’m seeing was talking about stress, and he said that a panic attack happens when accumulated stress reaches a critical level. I now think of a panic attack as being the tip of the stress iceberg.
I wonder too whether insomnia is like that too. Our bodies and minds will suffer a considerable amount of stress, but too much will culminate in insomnia. Perhaps whether the insomniac point is reached before or after the panic point is different for each person…for me sleeplessness comes before a PA.
I’ve also come to realise that stress isn’t just about how I feel at night, and the things preventing me from sleeping. Stress is happening all day, and so if I’m going to reduce my stress levels below that which triggers insomnia or a panic attack, I need to be working on stress reduction all day.
I’d like to tell you a story. Are you sitting comfortably? Then I’ll begin.
Call me Noddy. You might know me as Hypnos, Morpheus, or Sandman, but I’m mighty ruler here in the land of Nod, so …..call me Noddy. You will never have seen me, nor my land, because all visitors here are asleep.
To get to this land is easy, some people get here while sitting in front of the telly, or relaxing in the garden, but most are lying in their beds. They close their eyes, begin to drift, and before they realise what’s happening they float upwards, and arrive here in the land of Nod. The first I know of it is when I see them gently emerging through the clouds. They look so calm and relaxed, and the clouds cradle them gently upwards, so that their rest is peacefully undisturbed.
Eventually, after a few hours, they begin to stir and float back down to their beds, waking refreshed and ready for the day ahead.
There are some people I see regularly, some who can’t get here routinely, and some people that I rarely see.
To people on earth sleep is a mystery. To me it’s obvious – people are so full of hot air that as soon as they relax control of their minds and bodies they naturally drift into the land of Nod. Conversely the reason some people can’t get here is that they’re weighed down. All sorts of things can prevent them reaching me here – the worries of the day, the discomfort of a hot bedroom, fluctuations in hormone levels, coffee, arguments, exams…all these things tie them to the earth, and prevent them floating into sleep. It actually takes a lot of weight to stop people getting here……some people only get halfway each night, and in the morning they’re not sure whether they’ve been awake or asleep – all they know is they feel awful. They’re the people who have never reached the land of Nod, but have hovered between “half sleep, half waking”. My friend Shakey knew all about that, and wrote about it in his Midsummer Night’s Dream.
Some people realise that the stresses of life stop them reaching the land of Nod, so they start to cut the ties which bind them to wakefulness. This can be very hard, and sometimes they give up before they’ve lightened the load enough. Just giving up coffee is probably not enough. Just lightening the load before bed is probably not enough. Some people need to dump tons of stress before they get lift off. Lots of hard effort needs to be put in, over many weeks, before some people who are very weighed down can reach Nod.
Over the last few years things have started to change, and I’ve seen more and more new people called Sleepios. They tend to arrive in groups…..lone Sleepios are rare, because they all support each other. They’re strangers to the land of Nod, and arrive here after such determined effort and hard work that I reserve a specially comfy place for them. What I like about Sleepios is that they never take the land of Nod for granted, and are so very grateful for each visit. They treasure it, and tell their friends what a wonderful place it is. Although they never see it, they feel it through and through.
I started investigating the reasons these Sleepios had started to arrive, and discovered it was through the work of one man. They call him the Prof. His mission is to teach Sleepios how to lighten the load of accumulated stress, and jettison all the weights which prevent them reaching Nod. It takes them a long time. Sometimes they feel like giving up, but through the wisdom of the Prof, and the support of their friends they get here eventually. And once they’ve tasted the delights of the land discover that they are able to stay for longer and longer.
*Doodle’s doodles on Stress *
Part 3 of 7
Identifying where you are on the stressometer through symptoms, actions and avoidances.
My model for sleep (see Part 2) assumes that if I can jettison enough of the weight of stress I will get lift-off and float up to the Land of Nod. So the first step is to assess overall stress levels, so that stressors can be identified and corrected.
For me assessing my overall stress levels and identifying stressors wasn’t straightforward. This meant it was difficult for me to assess how much stress-baggage weight I was carrying. Here are some tips I picked along the way as I tried to get a feel for how high my stress levels were.
1. Assessing stress levels through symptoms.
You won’t be surprised when I say that my primary reason for believing I was stressed was through the symptoms of panic attacks and insomnia. As time went by I began to realise that there were precursors to panic attacks. These included (roughly in chronological order)…worry during the day, something preying on my mind, breathing more quickly and shallowly, sweating, trembling/pins and needles in hands and feet before bed, and a mind switch which suddenly went to “on” when I hit the pillow or woke in the night. It was at that point that the hamster woke up….that’s the hamster which lives in the centre of my chest. First he stirs, then he rolls over, then he fidgets, and then he gets on his wheel and goes round and round…the vibrations reverberate through my chest. The next moment I’m in the middle of a panic attack.
Discovering these things was a great help to me. First I discover that “the hamster effect” is associated with the vagus nerve (see Part 4) and that had implications for understanding and reducing stress generally, second I discovered that early identification enabled early intervention (see Part 5), which could ultimately prevent a panic attack if I had managed some sort of overall stress-reduction throughout the preceeding days.
Other symptoms of stress which you might notice are insomnia (of course), poor temperature control, hot flushes, sweating, over eating, over consumption of sugar and/or coffee, tics, obsessive comfort behaviours, remembering a past event and not being able to remember the good things about it any more etc. etc. These might indicate a variety of causes, but they are all stimulated by, and in turn stimulate stress hormones like cortisol. They cause a vicious circle of stress. So, an easy example is the caffeine in coffee…..the boss gives us a bad day, and we feel a bit stressed so we have a cup of consolation coffee. The caffeine stimulates us. Because we’re stimulated our body thinks “eh up, what’s going on….action stations, get ready for fight or flight”. Cortisol and adrenaline kick in…..we get more stressed so we medicate it with more coffee….and on it goes. Kicking the coffee breaks that cycle, albeit painfully, and stress levels go down a notch.
I’ve done more notes on cortisol and the nervous system in Part 6.
2. Assessing stress levels through actions.
There are some things which, even though they don’t feel like it, cause stress. So, as I understand it, if you do these things you can assume you’re adding to stress, even if the effects aren’t felt. For me an epiphany came when I realised that multi-tasking, although it’s a solution to time pressures and constraints, always leads to stress, even when it feels like it’s part of a solution it’s really part of a problem too. I guess a good antidote to this is mindfulness/awareness which causes us to concentrate on one thing at a time.
Other things which are said to be stressful, even if we’re not aware of the stress they cause are disagreements, food intolerances, too much/too little exercise, too much/too little stress (!), going too long without food, overeating, poor diet, not getting enough sunshine, not enough social interaction, poor/inadequate living conditions, difficult working circumstances, moving house, crying children, snoring partners……..
3. Assessing stress levels through avoidance
It was a revelation to me to learn that if I look carefully at the things I avoid, or the things I say “I don’t do” or “I can’t do”, that will give a big clue to my stressors and stress levels. We naturally avoid things which stress us if we can, however I found I’d become good at conning myself as to the reasons, and even concerning the fact of my avoidance. For example, I was avoiding driving in town…..”I don’t like town”, “I can’t find a place to park”, “my husband likes to drive”….it all sounded very reasonable, until I realised that I’d become nervous about getting away from home, becoming tired, and not being able to remember how to get back, or to be so tired I just couldn’t do it physically. That hadn’t happened to me for 5 years, yet I’d allow it to affect my behaviour. And because I was avoiding the behaviour my mind was thinking “this must be really dangerous because I’m avoiding it”, so it just escalated the anxiety. Challenging the thoughts and behaviour step by step (see Part 5 on intervening in the stress behaviour) allowed me to drive to town once more, and now I don’t think twice about it.
Each of these things gave me an idea of how high my stress levels were….the result….PD high! I couldn’t measure it in numbers, but I got the idea that I was going to have to work very hard at my stress levels (sometimes I began to wonder if all that ruminating on stress was a contributor to stress as well….I expect it was, but I saw it as an investment in future sleep).
Naively, at the outset, I thought the remedy would be clear…if something is stressing me, then to reduce stress I just stop doing it. I soon discovered it’s not as easy as that. More clues follow in Parts 4, 5, and 6.
As a guide to assessing your stress levels I would think that if you only experienced stress-actions (item 2) your stress was lower and easier to handle – just stop/reduce those actions as far as possible. However, you’re reading this because you’re on Sleepio, so you have insomnia, which means you have at least one stress-symptom (item1), so your stress levels are, as a minimum, moderate. If you have moderate stress than I would suggest that Sleepio is your go-to fixer. However if you have factors listed in each of items 1,2, and 3 above the chances are your stress levels are sky high, and, like me you might need to give Sleepio’s destressors a boost….hence the reason I’m writing this. We’re all different and have to find our own place on our own personal stressometer, so that we can find effective stress-reduction strategies.
*Doodle’s doodles on Stress *
Part 4 of 7
The vagus nerve
I hope that as you’re reading this you’re keeping in mind that, to quote a line by Manuel in Fawlty Towers, “I know naaahthing”…..everything I’m saying here is my own experience, or understanding….I’m like you, I’ve read a bit and am trying to apply it to fix insomnia. Nowhere is my ignorance more evident than on the subject of biology, so if in doubt please check this out for yourself.
Stress comes under the governance of the autonomous nervous system. There are two parts to this automatic system: the parasympathetic nervous system (PNS), a.k.a. “rest and digest”, because that’s the sort of processes it governs, and the sympathetic nervous system (SNS), a.k.a “flight, fight, faint or freeze”. The latter we all recognise as the stressy one, and personally I know where I’d rather be getting my “sympathy” from! As far as I understand it, operating one of these systems disarms the other. So if you want to switch off stress you activate “rest and digest” (PNS). An SNS which is stuck at “on” leaves us tired but wired. This is why so many of the Prof’s tools are to do with rest and relaxation, because they switch off stress (SNS).
The vagus nerve is important in all this. It wanders around the body stimulating the PNS, i.e it counteracts the hamster effect, palpitations, butterflies in the tummy, sweating, gagging, overwhelming hunger…..all the horrid things which are associated with stress. So, if I want to minimise the effects of stress I need to strengthen my vagus nerve. Apparently this can be done by giving it a workout. There’s a huge article on this in https://selfhacked.com/blog/28-ways-to-stimulate-your-vagus-nerve-and-all-you-need-to-know-about-it/
I am currently using singing (or humming on one note, but only on my own in the car!), yoga, meditation, paying more attention to social relationships, abdominal breathing, laughter (comedy programmes, ajokeaday.com), prayer, probiotics (and prebiotics too), exercise (1 1/2h+ walking and an hour gardening whenever possible), I also take a lot of supplements (many I took at first to help recover from ME. Now, specifically for sleep, I take cherry extract, L-Theanine, magnolia bark, lots of antioxidants incl. vit C, omega 3, multi vit). Oh on the subject of B vitamins, they’re really odd…some people sleep better with them, and some people (like me) get wired on too high a dose. This is especially true for people with the MTHFR gene variant. I found I had to experiment quite a lot with B vitamins. I do best on a half dose of methylated (body-ready) B vits. I understand that men and post menopausal women may not need extra iron in their multi vit/mineral tablet….you might like to check this out for yourself.
I did the cold water face splashes recommended on selfhacked.com for a while, but was too wimpy to continue, and you certainly won’t find me standing under a cold shower…come to think of it I hope you never come upon me standing in any shower or any kind……the memories would give you bad dreams!
I can’t say which if any of these strategies is best, but I get the feeling that they all help, or I wouldn’t continue with them. Take care because somewhere I think I read Selfhacked was recommending manual manipulation of the vagus nerve and others were vigorously disputing this, saying it was unsafe. I havn’t tried it myself, and wouldn’t either – there’s plenty else to do without experimenting on stuff which might not be helpful.
In addition to the above the following need a particular note….
I read a lovely book by Gayatri Devi M.D., called A calm brain. She particularly mentions yoga…the inverted poses which put your head below your heart. I guess that if you have any specific medical condition (e.g. heart, balance, blood pressure, bad back etc) this would be contraindicated. For me the legs-up-the-wall-with-eyes-closed-pose is magic – it’s the joint-best thing at helping me feel relaxed. In this same book there’s also an extremely helpful outline of how busy working people can tweak their day to make it much more restful by trading activities (rather like those unhealthy/healthy food swaps you read about in magazines).
The other joint-best-relaxing activity I’ve found is Autogenic Training (AT). The Prof. has one which is great because we get to listen to his lovely voice, and don’t have to remember what to do next. I’ve found another one which is used in a different way…it’s a self-training strategy (so is more adaptable, but for long term use). It takes several weeks to learn, but for me, at the moment when, as part of the AT, I say “I am supremely calm”, I discover I actually do feel that. I now use this version of AT to send me to sleep in bed, but I also practice it 5 times during the day. You can find this version at http://www.guidetopsychology.com/autogen.htm
I’ve also found that exercising outside gives better value in sleep terms than exercising inside, so in addition to walking I also do about an hour of digging, weeding or chopping wood in the garden.
In my hunt for things which help switch off stress by stimulating the vagus nerve I came across the strategies Seth Roberts used. His tips don’t all work on me, …tips are like that aren’t they – what works for one won’t necessarily work for another. On the subject of socialising, Seth Roberts (see his blog) discovered that looking at faces on a TV chat show was as effective as socialising. In fact for him the timing of looking at faces was more important than the manner of socialisation.
At one point I was intermittent fasting (eating only in a restricted window), now I’m trying Seth Roberts’ recommendation of eating within half an hour of rising and eating again just before bed….the jury is still out on which suits me better, I think it will come down to measuring the effect on my blood sugar. I definitely find that too much sugar makes me jittery (see Part 6 on cortisol).
On the subject of exercise I’ve been reading about a studyon people with insomnia. Apparently if a good sleeper goes for an all-day walk they sleep like a top that night (has anyone actually seen a sleeping top?). However it doesn’t necessarily work like that for an insomniac. In fact they found that on average insomniacs took 3 to 4 months before they noticed the effects of exercise. The good news is that, on average, the increase in sleep those insomniacs experienced after 3-4 months was a whole hour…. Aaaah, bliss!
On the subject of meditation I’ve also come across a study which found that people who meditate need less sleep. Those who meditated 2-3 hours a day, and whose nightly sleep averaged 7 to 8 hours, found that after a course of meditation their average sleep had dropped to just over 5 hours. If we’ve been meditating more to try to sleep and aren’t expecting sleep requirements to diminish we might be worried by this.
So, exercise more, meditate more, and we get more sleep and need less sleep, that sounds like a fantastic way of increasing sleep efficiency.
They say that pets are great stress relievers too…..that may be the case, but in my experience to date this only applies to felines. The canines I’ve had have been mad or bad – either way they havn’t enhanced my equanimity at all. Since starting Sleepio, however, I have discovered the best dog in the world….Doodle (a poodle cross of course)….the virtual dog who accompanies me on my visualisation walks, who snuffles along the paths through the woods, always returns when calls, and never get mucky, smells, or even poos…the perfect dog!
*Doodle’s doodles on Stress *
Part 5 of 7
Intervening to break the stress cycle
I put in all the things in Part 3 about stress levels, because I found that when I knew how high my stress levels were (on a rough low-medium-high scale) I could work out whether I’d need to do a little, or a lot to get them back under control.
The things on the vagus nerve in Part 4 then gave me a list of interventions I could make to dial up my PNS and dampen down the stress which was kicking off insomnia.
That’s all dandy as far as it goes. However, for me more intervention was needed. I’m going to quote Shakey here (apologies, but it helps me get my brain in gear). Hamlet said “there is nothing either good no bad, but thinking makes it so”. I don’t read this as some sort of existential denial of evil. Rather, for me, it highlights how my mind can turn something neutral into something good or bad. For example, when I was badly in the dumps I found that even memories which, in the past had been happy, came to hold only unhappy memories for me. Now that my equanimity is restored they’re happy memories once more. So for me it was necessary to break my bad thought-cycles as well as my bad habit-cycles before I could dial down stress.
This is the more difficult thing to do, because, unlike actions, we can’t always identify our thoughts; they hide away, or disguise themselves as something else. Also, there are no hard and fast rules, because each person’s thoughts and circumstances will be entirely different.
When we get pulled into a thought we give it power. For me I was alerted to unhelpful thoughts when I caught myself thinking sentences like this….. “I can’t…..” “I don’t…..” “I/it always…..”. Perfection was an unhelpful thought too…..thinking I couldn’t do something/anything until I got all my ducks in a line, and in particular, that my life was on hold until I was sleeping properly. I think psychologists talk about catastrophising…. certainly I noticed that my mind would go on a bender of imagining the worst until I hated most of the things which were around me. I was like the story of the neighbour and the lawnmower…have you heard that one? Doodle wants to mow the lawn. “I’ll ask if I can borrow Jo’s mower”, thinks Doodle. Doodle gets half-way down the path….”maybe Jo’s using the mower today…..maybe it’s not convenient for Jo to lend me the mower, maybe Jo’s out, maybe Jo noticed that I didn’t clean the mower last time I borrowed it, maybe Jo doesn’t want to lend me the mower, maybe Jo will be nasty about it” . Doodle knocks on Jo’s door. Jo answers, and Doodle says, “You can keep your bleep, bleep mower!”
So, for me, I had to stop these thoughts, but that’s no easier than if I say to you “don’t think about an elephant”…..see!.... what colour was yours?!
My psychologist taught me that the way to get rid of these thoughts is to interrupt them……that’s what meditation does I guess, however at that point meditation was too gentle for me and/or I was too inexperienced in the art.
Please feel free to omit the following paragraph if you feel it’s “too much information”!
Once when I had a condition which left me temporarily with a very weak bladder I had difficulty getting to the smallest room in time. I was OK until my mind started thinking, “nearly there”. However I found that if I sang a song, making sure I got all the words and the tune right, there was no problem….interrupting thoughts has a powerful effect on the body and well as the mind.
When I was very down I found it helpful to look around the room naming ten objects, then I got to thinking about why I liked them, and from there I pinned each one to a happy memory. Gradually I moved my observations and thoughts out of the room, into the garden, and from there into the wider space of the world and my memory. The psychologist gave all this a name, but I can’t remember what it was….it ended up as a sort of “count your blessings”, however if I’d tried to do that at the outset I would have failed – I had to work up to it by going the long way around.
Now if I find myself in a situation where my mind is on the rampage I interrupt the thought. To do that I use two hand signals to myself – they’re so everyday that, if I was talking to you, you wouldn’t notice them. To me one of them means “pause” and the other means “cut”. It’s as if I’m the director of my own film, in which I’m the leading actress (a bit like Kate Winslet (Iris) in Holiday). “Pause” tells me to “take 5”, breathe, reassess and redefine the threat situation, widen my focus to listen to a noise or watch something just outside the situation (e.g. can I hear a bird or a car?). “Cut” is my alternative panic response to “beam me up Scottie”. It recognises that I don’t want to be in this situation, but that I have some control over it. I might be able to change the subject of the conversation, walk away naturally, or, even more powerfully I might be able to face it and change my attitude to it…tough it out and so score points off it. Or I might be able to just bail out in my head. Yes, “pause” and “cut” seem similar as I write them down, but to me “cut” is more powerful than “pause”….and it’s only an example. You’ll find ways of interrupting your thoughts which are meaningful and effective for you.
The other way of disarming thoughts is to face them head on…..confront them like the bullies they are, and watch them slink away. So for example, the psychologist pointed out that I had retained lots of coping strategies which got me through ME, but which just weren’t working when I wasn’t fatigued in that way. I would walk into a room and scan it for signs of danger…..was there a chair to sink into after a few minutes, was there a person there who would talk and talk, that I wouldn’t be able to get away from, was there food or drink on offer which was on the “forbidden” list of my elimination diet, was there someone in the kitchen about to drop a pile of plates and send my nerves screaming up the wall?
To combat this I framed the psychologists advice into a military campaign. First a plan of campaign, then scout it out (check out the lie of the land), then a skirmish (test the strength of the enemy), then a first engagement, and after that, another and another engagement, until I no longer had any fear, and, in most cases, actually enjoyed the task. For each of these steps (the plan of campaign, scouting, skirmishing etc) I monitored my anxiety/stress levels and did the interrupting/hand signals thing. Also I kept asking myself whose voice I was hearing in my head…..I was amazed to discover how many times it was my mother or some generalised fear about what “people” think.
So, for a real life example, ….going into a local café….
Plan of campaign – decide to go. Put the date in my diary and don’t let anything change it.
Scout it out – check the internet to confirm its open, make sure I have some money, think about where I’ll park, decide to go at a time of day when I’m at my best.
Skirmish – walk through the senarios in my mind…where will I sit, who might be there, what are the threats, how will I cope? Practice linking the thoughts and the hand signals.
First engagement – I went and immediately bumped into people I knew, perceived a threat, monitored physical signs; breathing chaotically, sweating, wished I could faint. Tried to interrupt thoughts but was too panicked to know what I was doing. Recovered a bit, said a few words, moved on (naturally I think), sat at another table and obsessed about what went wrong. Got my novel out and tried to read, but constantly aware of the people at the other table. Reassured myself that in spite of everything I was doing better than if I’d not tried. Drank tea and left, albeit feeling panicky.
Second skirmish – re-ran the engagement and re-ran the coping strategies in my mind. Confident if it happened that way again I’d be OK.
Second engagement – immediately I walked in the door I met a friend who said “would you like to join me for coffee” said “yes I’d love to“, then realise I meant it. Sat and chatted. Used hand signals a couple of times, but really enjoyed the time. She said, “we must do this again sometime”, I said, “I’d love to”, and realised I meant it.
Future engagements – I’ve sought out all sorts of similar occasions now and really enjoyed them. In fact, they’re no longer military campaigns, they’re fun times with friends.
I also find that challenging the situation works in panic attacks for me. Over time I’ve gradually been able to focus on the main bodily sensation I’m feeling – usually the hamster doing cartwheels in my chest. I focus hard on that feeling, and try to trace it back to its source…is it really coming from my chest?...how deep down is it?...is it a fluttering or a flapping feeling….? Then I try to feel it more and more intensely. I say to it, “is that the worst you can do? Come on you beep beep, show me what you’ve got”. I soon discover that the attack has backed down, and left me so tired I sleep well afterwards. I don’t know how radical that suggestion is – think hard before doing it, especially if you are alone when you have your attacks.
*Doodle’s Doodles on Stress *
Part 6 of 7
Stress hormones and the autonomic nervous system
When our bodies get stressed and prepare for fight or flight they release stress hormones. I’m not clued up on the actual hormones..…they’re things like cortisol and adrenaline, but I’m very hazy over the distinction between these stress hormones, and usually end up calling them all “cortisol”. Please pitch in with a correction where I’m getting this badly wrong.
Conversely if something stimulates the release of these hormones we get stressed. So if we can dampen down the release of stress hormones we get less stressed, and because we get less stressed we release fewer hormones. At least, I think that’s the way it works. The brake is the PNS which I was thinking about in Part 4: The vagus nerve.
Increasing blood sugar levels also increase cortisol and cortisol increases blood sugar and so stress just goes up and up. Insulin will regulate the process, but if it all goes on too long we lose insulin sensitivity and start to become diabetic. Personally I find that sugar makes me stressy if I have too much.
Brian Mowll on the subject of sugar says sugar acts on the pleasure centre of the brain which stimulates dopamine which releases a stress response. He says sugar develops a tolerance to dopamine, downregulating it. He advocates gradually replacing our sugar-reward system with another reward. On a recent webinar he also said “if you’re not sleeping well it’s nearly impossible to regulate and control blood sugar properly”. My own experience is also that insomnia serves to drive blood sugar levels too, however intervention which address both these matters can invert the spiral, reducing blood sugar and enhancing sleep.
Other websites I’ve read recommend eating something with tryptophan in before bed – this includes bananas, yogurt, milk, turkey….however bananas have a lot of carbs, and that will increase blood sugar more than turkey, say, which is protein.
Seth Roberts recommends raw honey (a teaspoon or two) at night. Because I love honey I’ve been trying it with banana and yogurt at night. I havn’t seen any effect on my sleep, and I’m still trying to compare the effect on blood sugar. All I can say is that it’s a very yummy bedtime treat, and has become part of my routine, helping me to look forward to bedtime. Seth also says that we should eat within 30 minutes of waking, otherwise adrenaline kicks in because our body thinks there’s a famine. He says that we seem to be programmed to wake about 3 hours before breakfast, and attributes the 4pm waking so loathed by all insomniacs to this cause.
I find that this business about food is a bit like walking through a minefield while juggling grenades……bloodsugar, tryptophan, intermittent fasting….it all depends on what I’m focussing on. I still havn’t got this sorted out, but I suspect that it’s different for everyone, and that my body response depends on whether I’m on an upward or downward sugar/stress cycle.
Another snippet I’ve picked up from the psychologist is that pain (physical and mental) releases stress hormones, and doubles our experience of anxiety. When we focus our attention away from the pain (as in meditation or diverting thoughts) we halve our experience of anxiety. If we don’t interrupt our thoughts about pain our conscious minds say “oh I’m thinking about this pain a lot, something must be really wrong”, so it all escalates out of control.
I have discovered that lack of sleep will raise cortisol, which will cause insomnia, and raise cortisol even more. Apparently 1 hour of lost sleep raises cortisol by 50% – that’s massive.
Conversely Nerina Ramlakhan (Tired but Wired) say that the odd disrupted night is not a bad thing; it reminds our body how to cope with the crisis of a lack of sleep, breaks our reliance on 7-8 hours, and kick-starts our sleep homeostat. She also observes that “caffeine acts very much like adrenaline”.
Joseph Cohen on a webinar says that waking at night is caused by blood sugar issues and poor energy metabolism at night.
Meditation also reduces stress and controls blood sugar. One study showed that 21 days after 1 hour of meditation a day serum cortisol levels fell from 14.8 to 10.6 (about 30%). A 16 week trial of obese women observed that their fasting blood sugar fell by 9.3mg/dL (0.5mmol/L) after 16 weeks meditation.
Breathing exercises too can reduce blood sugar. A study showed that after 3 weeks of breathing meditation postprandial blood sugar decreased by 20mg/dL (1.0mmol/L)
Exercise in itself can reduce cortisol, and it also supports the sensitivity of our bodies to turn cortisol down. Walking after a meal reduces the level to which blood sugar spikes. Diatribe.org says walking reduces blood sugar by 1mg/dl/minute, and each 2600 steps (about a mile) a day lowers A1c (the long-term measure of blood sugar) by 0.2%. Another study showed that meditation reduced A1c levels by 0.5%. This sounds to me as though exercise has both an acute and a chronic effect on cortisol reduction. I’ve also discovered that intense exercise increases cortisol, but this appears to just be a temporary effect.
Dehydration increases cortisol – the cure – drink more water.
Vitamin C dampens down cortisol. I guess other antioxidants will too because they are counteracting the stress effects of free radicals. Some nutritionists recommend taking antioxidants before bed (apparently this reduces the risks of heart attack and stroke), however I didn’t see benefits on sleep, and my sleep seemed more precarious. I now take antioxidants and sleep-supporting supplements at lunch time (9 hours before my SW starts).
For me one of the most effective ways of controlling my blood sugar, both spikes and fasting levels, is with a low carb diet. Eating fat with carbs, I notice, slows down sugar metabolism and dampens down spikes in blood sugar.
Doodle’s doodles on stress
Part 7 of 7
A personal account
Perhaps in this last section I ought to tell you how I’m getting on. After all if my sleep is still down at the 30% SE where I started with panic attacks most nights, then I’m not a good advert for the things I’ve written above. Actually I wouldn’t have written them if I hadn’t found them helpful…remember that none of these things were my own idea – I just grabbed what seemed to be the best bits of other people’s theories and put them together….it has helped me to get my thoughts in order, and, I hope , might help other Sleepios too. Remember too that this is a personal account seen from the point of view that my insomnia could not be fully-addressed without reducing stress levels. If your particular stressor is, for example, sleep apnoea on its own, then the above, will for you, be overkill and largely irrelevant. However, my theory is that the stressor of sleep apnoea alone would trigger other problems (like elevated blood sugar, cortisol etc) which compound insomnia and so if the sleep apnoea was not addressed in time this single cause could tip someone into all the problems outlined above.
Stress is immensely exhausting. And I’ve come to think that measuring our nights by hours slept, or even by sleep efficiency is not the end of the story. If we’re stressed our sleep won’t be as long or as restorative. However for any given number of hours sleep, that sleep will, in my experience, always be more restorative if it comes without a big dollop of anxiety.
Nerina Ramlakhan (Tired but Wired) has consoling words for insomniacs who feel terrible after a bad night. She says that our sleep is used first to support our physical needs, and then our emotional needs. So, we can be consoled that even if we feel terrible we will have the physical resources to get through the day. For me, just knowing that, help me mentally too.
To generalise my results I can say that the graph of my average sleep hours pre-Sleepio looked like a stormy sea and I felt in despair. The graph of my average sleep hours after graduating from Sleepio was calmer, but became increasingly choppy, however I felt it was possible I might be rescued! I had moments of low mood, which suddenly culminated in a return of despair…and some. At that point I sought further help from a psychologist. The graph of my average sleep hours two weeks after first seeing the psychologist looked like the ripples at the edge of a boating pond. My mood is restored, or maybe even improved on its pre-insomniac state. Hooray!
For those of you who like a bit more detail here it is….
Pre Sleepio my 6-day average sleep-hours function was sinusoidal with a consistent wavelength of 18 days, each wave having a range from peak to trough (i.e 2 x amplitude) which was between 2 to 4 hours. Sleep-hours generally during this period exhibited a downward trend.
After graduation from Sleepio my 6-day average sleep-hours function was still sinusoidal; the wavelength lengthened (25 to 35 days), with lower peak to trough ranges (between 1 ½ and 2 ½ hours). 30 day average sleep-hours exhibited a strong upward trend for 9 weeks, and then fell suddenly to the original W5 Sleepio value over the next two weeks…..I’d crashed out big time….more than a blip….I felt as though I was back pre-Sleepio. At that point I saw a psychologist for more help with stress reduction.
My sleep pattern started to improve two weeks after seeing the psychologist. I have only 4 weeks of data for this period. So far the function appears to be sinusoidal still, with an even shorter wavelength (12 days) and a very small high/low range (1/2 to ¾ hour). My long term average has just started to rise again, and I’ve been achieving 6 ½ to 7 ½ hours a night with some regularity.
The greatest improvement is in my mood and ability to function the next day. Even the day after a 3 hour night (when the cat died) I hardly noticed ill-effects the following day…once upon a time I would have been in the depths of despair.
So the way I’m (provisionally) interpreting this is that Sleepio did wonders for my sleep, and gave me some measure of improvement in mood…it started to get me back on track, until stress broke through again, and mood and sleep deteriorated badly once more. After interventions for stress reduction (a sort of “Sleepio with bells on” as outlined above) my sleep and mood have recovered very quickly. I’m amazed at the transformation. I sleep fewer hours than I ever have before, but my sleep is now restorative, and even when I considered myself a good sleeper, that sleep did not always leave me feeling energised for the next day.
I hope some of this long rambling makes sense, and you find something there to help you in your quest for sleep.. As the Prof. says every week “stick with the programme…ride out the rough patches”. The short version of my own recommendations, as you will have heard me say ad nauseam, is…..”keep on keeping on, and may Morpheus be with you”,
Every good wish my Sleepio friends,
Ahh, Doodle, what a godsend you are of a Sleepio morning. Thank you for the wise words of your dual posts--I found them eye-opening, inspirational, and very, very hopeful. (In other words, Doodle business as usual.) Cheers and happy sleeping betide you. --Lisa
Ooh Doodle, you are SUCH and asset to our community. Thanks so much for all the time and effort you spent putting this together. It will be such a big help to all of us and we will point all the newbies in this direction.
Big hug from
Well done, Doodle! I'm at the end of tonight's wind down and can't read it tonight, but I can hardly wait to read it all. I can already tell this is good. Just wanted to send a quick word.
This will be so helpful to so many people, Doodle. Thank you so much for taking so much time and trouble to share the results of your research and experience with the rest of the Community. I am sure this will information will be a godsend for so many strugglers here on Sleepio. You deserve to sleep well yourself after all that effort !
Taking a multifaceted approach has also been helpful for me, working on the issues that led to the insomnia spike in the first place as well as my approach to sleep. For me also, stress during the day plays a big role. I think in addition to getting expert help for dealing with sleep, if one can tap into resources for the day-to-day issues (such as a psychologist or good friend in dealing with difficult people, loss of a pet etc. or financial adviser if one is dealing with financial stresses etc.) this can be a big help.
It's also been helpful for me to plan time for fun as my schedule allows, and I think this helps later in the day with my sleep. A stressful work situation leading to all work and no play was counterproductive.
I think some variability in sleep is to be expected during stressful periods. Life isn't static, and sometimes throws us curveballs. But the tools we learn here can help buffer the effects the events of the day have on our sleep, so they have less impact.
Wow, Doodle this is amazing what you have posted, it must have taken ages to put this together. It is really impressive so thankyou so much for doing that for all the sleepio community.
When should you use these techniques? Is it during wind down routine or when you wake in the night?