How to tackle insomnia during times of stress.

Insomnia is a sleep disorder that means you have trouble falling and/or staying asleep. The condition can be short-term (acute) - lasting just one night through to a week - or it can last a long time (chronic) - multiple nights a week for many months.

Insomnia may also come and go from time to time without, it seems, any real rhyme or reason. I expect everyone has experienced this situation at some time in their life. For some people insomnia is likely to be related to stressful life events. For others it’s caused by mental health issues such as depression and anxiety; high caffeine, alcohol or tobacco use; some medications that interfere with sleep; excessive use of electronic devices in the evening; sleep apnea or menopause. In summary, insomnia is often caused by either a lifestyle or medical factor. But once you know what the trigger is, you are much better placed to treat it.

Enter COVID-19

If there was ever a ‘stressful life event’, I think we’d all agree that the current situation with COVID-19 is enough to negatively affect even the best sleepers! We are already feeling the negative effects this disease is having on our ‘normal’ way of life. Loss of income and livelihoods for many, mounting bills that cannot be paid (both for business owners and employees) and restrictions on our ability to move and live freely are all likely to be having significant impacts on our ability sleep. However, it is sleep that will be key in helping us keep physically and mentally strong and resilient during this stressful time.

If you are feeling low, you may not realise that a lack of sleep may be the culprit. Even small levels of sleep deprivation over time can chip away at your happiness. You might feel that you are less enthusiastic, more irritable, or even have some of the symptoms of clinical depression, such as feeling persistently sad or empty.

The relationship between sleep deprivation and depression is complex. Researchers believe this is because when sleep is disrupted over and over - due to insomnia or other sleep disorders such as sleep apnea - it can alter brain activity and the neurochemicals that affect a person’s mood and thinking. If you find yourself sleeping too much or too little on a regular basis, it’s important to bring this up with your doctor so they can decide if further tests are required.

With respect to tackling insomnia during times of stress, setting up a healthy bedtime ritual or routine is recommended in order to establish good sleep. Sticking to a regular bedtime is also very helpful as your body will learn to recognise the triggers that it is time to rest and sleep.

Get a routine

Start preparing for bed 1-2 hours before hitting the hay:

1. Turn bright lights down (limit your blue light exposure)
2. Try a herbal sleep tea instead of coffee or tea
3. Turn off electronic devices such as phones and laptops
4. Don’t eat a heavy meal too close to sleep time, but try not to go to bed hungry - if you need to eat, have a piece of cheese or small handful of nuts
5. Stay hydrated - keep a glass of water by the bed so you can take a sip if you wake at night
6. Stop drinking alcohol 2 hours before sleep as it affects our ability to stay in a deep sleep
7. Write down tomorrow’s ‘to do’ list
8. Have a warm shower half an hour before bed
9. Try mindfulness and sleep/relaxation apps - my favourite is Calm.

It’s also really important that you reserve being in bed for sleep and intimacy only. If your brain associates ‘bed time’ with reading a book, doing a crossword puzzle, watching TV, working and checking emails, eating or surfing the net, then your brain misreads ‘being in bed’ as time to be awake and mentally active.

If you can’t get to sleep - or have trouble getting back to sleep after waking during the night - the worst thing you can do is lie there worrying about it. If after 20 minutes you are still ‘wide awake’, get up and do a quiet activity such as reading a book or listening to music (not watching TV or surfing the net!) for 10-15 minutes or until you begin to feel sleepy, then try going to sleep again. Repeat until sleep comes.

If your sleep problems persist (happening more days than not) and they start to severely interfere with what you do during the day - or if you are feeling concerned or distressed about a lack of sleep - then reach out to a health professional. The Mental Heath Foundation website is also a great place to visit for more information.

What can you do as an employer?

Speaking with a Psychologist recently, she suggested that we are very likely to see people experiencing post-traumatic stress disorder (PTSD) as a result of COVID-19. ‘PTSD is a psychological reaction to experiencing or witnessing a significant stressful, traumatic or shocking event’1. Some workers are very likely to find COVID-19 ‘significantly stressful’, especially those on the front line such as emergency and health care workers.

‘PTSD can affect people of any age, gender or culture and if it goes unrecognised and untreated can lead to depression and suicidal thoughts. This is especially true for people with a history of depression. Sleep is often disturbed and they may feel irritable and angry with themselves and others. Memory, concentration and decision-making are often affected.’1

Thus it is incredibly important from a Health & Safety perspective that Managers have processes in place to help identify and support workers who may be experiencing a high level of distress. So be sure to keep the communication pathways open and perhaps engage in external health professionals to check in on the mental health and wellbeing of your workers. There are also PTSD questionnaires that could help to identify those most at risk.

With a background in natural health, Rachel has been specialising in the area of occupational fatigue management for the last 11 years, including regularly leading Fatigue Management Masterclasses, as well as presenting at a number of industry conferences to speak on the subject of fatigue management. Rachel facilitated NZ’s first research study on the prevalence of Obstructive Sleep Apnea in a Commercial Driver population, which was co-funded by ACC and the Log Transport Safety Council (LTSC). Rachel remains very involved with the LTSC’s efforts to identify & support high risk OSA drivers, and currently sits on the Sleep Apnea Association of NZ (SAANZ) committee. https://www.frms.co.nz/

References:

1. Mental Health Foundation of New Zealand. Post-traumatic stress disorder. https://www.mentalhealth.org.nz/get-help/a-z/resource/45/post-traumatic-stress-disorder