From night terrors to insomnia: how to improve sleep issues

Kate Wills

Whether it’s eating well, working out, or using Headspace on the Tube, most of us have built a few hacks into our daily routine to protect ourselves from stress. But the latest research suggests what we do in the night can have the most impact on our minds during the day.

“There’s a huge link between sleep and mental health,” says sleep scientist Dr Sophie Bostock, who is currently working with the app Sleepio, which uses cognitive behavioural therapy to treat insomnia. “The dominant view used to be that sleep problems were a symptom of mental health issues such as depression but recent research suggests that lack of sleep or disordered sleep might be one of the contributing causes.”

And forget the notion of getting your beauty sleep, we might soon be talking about “brainy sleep”. According to Christopher Barnes, an associate professor at the University of Washington who focuses on tiredness in the workplace, lack of sleep affects the part of the brain used for managing emotions. “There are two regions of the brain which are especially important: the amygdala and the prefrontal cortex. Sleep deprivation leads to decrements in the pre-frontal cortex, and also negatively influences the manner in which the prefrontal cortex and the amygdala work together. Due to their fatigue, people struggle to regulate their emotions, and further negative feelings often come up as a result, leading the cycle to continue.

“Sleep deprivation can not only lead to more negative emotions but greater variability in mood and more emotional reactivity.” In his book Why We Sleep, Matthew Walker, professor of neuroscience and neurology at the University of California, Berkeley, explains the causal relationship between a lack of sleep and mental-health issues. “Sleep disruption contributes to the instigation and/or maintenance of numerous psychiatric illnesses, and has powerful diagnostic and therapeutic potential that we are yet to fully understand.”

Studies have shown that sleep deprivation can make people feel lonely, less able to make decisions and less able to exert self-control. And if your sleep deteriorates, it can be the first indicator that you might need help with your mental health. Left untreated, the sleep problems associated with mental health disorders can be dangerous.

A University of Michigan study found a strong correlation between insomnia and suicide. A recent paper in the British Medical Journal suggested that sleep has a greater impact on an adolescent’s mental well-being than bullying, physical activity and screen time, and schoolchildren in the UK may soon be offered “sleep classes”.

“Many sleep disorders such as night terrors can be symptomatic of underlying psychological issues such as anxiety,” explains Bostock. “Equally, depression, grief or difficulty dealing with change make you more likely to suffer from a sleep disorder.”

Here’s how to improve sleep issues and set your mind (and body) at rest.

Sleepwalking

Around four per cent of adults sleepwalk regularly, which equates to five million Brits, and people who suffer from a mental-health issue are five times more likely to sleepwalk. “Sleepwalking is a type of parasomnia,” explains Bostock. “This is sleep disorders characterised by abnormal movements, behaviours or emotions during sleep. While the exact cause lacks agreement, a number of things are known to trigger episodes. Not getting enough sleep, caffeine and high levels of stress or anxiety can all be causes.”

What you can do: “CBT helps you learn new ways of dealing with stress and anxiety,” says Bostock. “And practising good sleep hygiene — having a bedtime routine where you wind down for 90 minutes before bed, keeping your bedroom cool, dark and free of blue light — is essential.”

Night terrors

Like a nocturnal panic attack, night terrors are described as waking up feeling extreme panic or fear, which is sometimes accompanied by sweating, pain in the chest and an increased heart rate. You might also experience sleep paralysis, which is when you’re conscious but your brain behaves as if you’re asleep. “This is another type of parasomnia and can be a common side-effect of PTSD,” says Bostock. “They can also happen during periods of intense change or difficulty in your life.”

What you can do: “Start keeping a sleep diary where you log what time you go to bed or get up, what you did that day and how often night terrors occur,” Bostock explains. “This could also be a sign that you need to seek help such as counselling. Your GP can refer you to someone.”

Insomnia

Insomnia as a term is used a lot, but it technically means that for three nights a week or more, for more than three months, you struggle to fall asleep, stay asleep or wake up not feeling refreshed. “It’s usually triggered by stress,” says Bostock. “Anxious personality types tend to be more affected, and then lack of sleep itself becomes a worry. It’s a vicious cycle.”

What you can do: “CBT can give you techniques to address the racing mind and getting back to your natural sleeping pattern,” says Bostock. “Some insomniacs benefit from a sleep-restriction technique, where you set your alarm earlier. You’ll build up a need for sleep and can increase your sleep window gradually.”

Bruxism

You may have bruxism (teeth grinding) if you get facial pain or headaches when you awake, stiffness in the jaw, or have worn-down teeth. “Bruxism is often linked to stress

and anxiety,” says dentist Rhona Eskander. “Alcohol, caffeine, recreational drugs and certain medications can make it worse.”

What you can do: “Your dentist can fit you with night guards to stop you from clenching,” says Eskander.

“CBT, meditation and muscle-relaxation exercises can also help you manage stress before you go to bed.”

The ZZZ list

Yawn’s PJs are 100 per cent cotton (£80, loveyawn.com)

Yawn pyjamas

Opt for nightwear that takes heat and sweat away from the body, such as Yawn’s super-comfy PJs, which are 100 per cent cotton. £80, loveyawn.com

Ashwagandha

Add the adaptogen to warm almond milk to regulate sleep, or try Sleep Well, right, containing valerian root, that promotes good sleep.

£26.50, glowbarldn.com; £6.95, sleepwellmilk.com

Sleep Well milk (£6.95, sleepwellmilk.com)

Casper pillow

Pillows from Casper contain silky fibres that increase airflow and support the natural curve of your neck.

£60, caspar.com/uk

Cowshed Knackered Cow Relaxing Room Candle

Turn off the bedside light and let the lavender, chamomile and eucalyptus soothe you to sleep.

£36, cowshed.com