Improving Your Sleep

Course

Session 1 Understanding Sleep and Assessing Your

Difficulties

Course Information

Session Details

Sessions Content

Session 1 Understanding sleep and assessing your sleep difficulties Session 2 Scheduling a new sleep pattern Session 3 Sleep hygiene Session 4 Dealing with a racing mind Optional Review

Optional daytime 1:1 session to review progress

Session 5 Dealing with nightmares and recurrent dreams Session 6 Putting it all together

Info About The Course

• Housekeeping.

• DNA / Cancellations procedure.

• What is CBT? Treatment with best evidence of success

for persistent Insomnia is CBT.

• Homework tasks.

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

All About Insomnia

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.

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).

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.

Stages of Sleep Stage Details

Stage W - Wakefulness Periods of being awake REM sleep (light sleep) 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) Occupies the largest proportion of time (50-60%) though the first phase is usually short

Stage 3 and 4 (Deep Sleep) Deepest part of our sleep, occurring during the first third of the night

Changes in Sleep Patterns Over A Lifetime

0

20

40

60

80

100

Age 0 Age 20 Age 40 Age 60 Age 80 Age 100

% o

f Sle

ep

Light SleepDeep SleepAwake Time

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.

How Much Sleep Is Needed?

Age Range Average Amount of Sleep Required

Newborn Up to 18 hours across 24 hour period

Young Child 12 hours at night + up to 2 hours during daytime naps

Child 10-12 hours at night

Teenager 9 hours with variation of when sleep is taken (go to bed late, rise later)

Young Adult 7.5 – 8.5 hours sleep

Adult 7-8 hours

Older Adult 6-6.5 hours with a tendency for daytime naps

• 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.

What Are You Like When You Lose Sleep?

Consequences of Insomnia

Consequences

Disorientation

Lower life expectancy

Relationship impact

Poor concentration

Memory problems

Irritability and Mood

Ill Health

Bad Nights Sleep

Fatigue and

Tiredness

What are the consequences

for you?

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.

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

Insomnia Stages - How It Takes Hold

Sub-Acute • Attention Acute • Attention

Insomnia • Intention

Sub • Attention

Chronic • Intention

Insomnia • Evaluation

1) 2)

3) Chronic

• Attention

Insomnia • Intention

• Evaluation

• Effort

4)

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.

Session 5 Summary

Quick Break

Sleep Diary

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.

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

Completing Your Diary

Sleep Efficiency

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!

Goals

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.

Setting Sleep Goals

Must get out of any self-defeating 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!

Session 1 Summary

Thought For The Week Ahead

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.