Tuesday, July 27, 2010

Why Aren't We Sleeping?

I ran across a cute article in last Sunday's New York Times called "Bedtime Stories" that got me thinking of all the concerns we have around getting a good night's sleep. So many of us aren't sleeping well. I always ask my patients how they are sleeping, because it can be an indicator of anxiety or depression. If you have trouble falling asleep, staying asleep, or don't wake up feeling rested in the morning, it can mean something is wrong. Sleeping too much, or hypersomnia, or too little, insomnia, can also be cause for concern.

Almost everybody does better with a sleep routine. Try to go to sleep and wake up at about the same time every day if you can. When I am working with families with school-age children, I encourage the parents to set bedtimes. Since school will start again in the next month or so, I like parents to reset the bedtime for school a week or so ahead to give children time to adjust their sleep cycle. Children do well with bedtime routines like bathtime, storytime, cuddling, prayers, lights out. Be sure to rotate Mom and Dad into the routine, so children learn bedtime is an equal opportunity for bonding. Parents need to agree on the bedtime so we have adult time after that.

Most adults I know need to wind down to bedtime. Watch the caffeine after mid-day. Limit the exercise late at night, which can be activating. Consider the environment in your bedroom as well. It needs to be a pleasant temperature, a soothing color scheme, and free of clutter, toys, or work gear, like computers. If you are in close confines, like a dorm room, clear your desk as much as you can so it is not in your line of sight as you try to sleep.If you go to sleep and can't fall asleep after 15-20 minutes, get back up, and go into another room to read until you feel tired. Then go back to your bedroom to sleep. We don't want your unconscious mind to associate your bedroom with tossing and turning.

Some years back I enjoyed hearing Boston psychoanalyst and writer Thomas Moore, who wrote Care of the Soul, speak about the bedrooms couples sleep in. Moore considers the master bedroom sacred space, and encourages couples to revere it, be mindful of protecting it for you as a couple, and not making it a workspace or family gathering area. Make your bedroom your sanctuary.

Children are wonderful, but not after 9pm, and not in their parents' bedroom, please. Apparently Brad and Angelina disagree with me on this one, but I saw in a recent interview that she admits they are both exhausted. I want children to begin to feel capable of self-soothing and sleeping on their own---or with a sibling---but not needing to sleep with Mom and Dad. I am trained as a structural family therapist, and I like some boundaries and happy, well-rested parents. Single parents often feel vulnerable and can be too willing to have a child sleep with them. Not good for your child, and what happens if you remarry later?

I prefer that couples sleep together. The New York Times article this week spotted a new trend for couples to sleep separately, but most researchers agree this is not healthy or best for most couples. Why would you want to miss spending the last few minutes of the day together? Sometimes there are medical issues like snoring, sleep apnea machines, or medically-required sleep postioning which complicate your ability to sleep all night in the same room, but being aggressive and creative in finding solutions is important to keeping couples close. At times I work with couples who need different amounts of sleep. Thinking creatively together about how you can cuddle before the first partner drifts off to sleep, or having the early riser come back to bed a while later, is all it takes to meet in the middle.

Think also about the choreography of your evening routine. Doing peaceful, calming activities before bed, like listening to calming music, or giving your partner a backrub, are much better for your falling asleep easily. Inviting the 11:00 news into your bedroom and falling asleep to your subconscious focusing on the BP oil spill is a recipe for a difficult night's sleep. Children also love to have parents massage their worries out of their backs or shoulders at bedtime. Even for a few minutes. Wind down from focused activities, computer work, e-mail and financial paperwork at least an hour before bed as well.

Keep paper and a pen by your bedside table. We all dream every night, but the dream material slips away if you don't catch it right away and note the images down. Dreams can be a powerful tool to understanding more about what is going on for you at a subconscious level.

There are lots of reasons people don't sleep well. Before you ask your doctor for medication, which can be addictive, it is essential to establish these good sleep patterns and see if that will help. Understanding your natural sleep cycle, and what you can do to help yourself, is good self-care in this part of your life. Speaking of which, it is late tonight, and I am off to dreamland myself. Sleep well.

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