I don't know about you, but if I don't sleep well, or enough, I am, shall we say politely, cranky. I find myself unable to concentrate properly, irritable, unmotivated and also, hungry. So hungry! (Poor sleep increases the hunger hormone, ghrelin, and decreases the satiety hormone, leptin - so we reach for carb heavy, nutrient dense food to compensate for the fatigue, and eat more of it). Thankfully for me, and everyone around me, I'm not often someone that lays awake at night unable to nod off anymore, but I have been in the past. That feeling of being so exhausted but my brain just not wanting to shut off, reliving conversations, cringing at embarrassing things I've said or rewriting the script with all the things I wished I'd thought of saying in the moment, ruminating on the what ifs and whatever worst case scenario wouldn't get out of my head and leave me alone long enough to give me the blessed relief of being unconscious for a few hours. Sometimes it would affect me getting to sleep in the first place, other times I'd crash out, exhausted, only to find myself awake again at 3am and unable to get back off to sleep. It's a story I hear repeatedly from my clients. This anxiety related insomnia creates a vicious cycle of frustration at not being able to sleep, making us anxious about bed time which then keeps us awake even longer.

Most of us have heard a parent (or been the parent) of a grumpy, whiny child say 'oh it's because they're tired, they missed their nap/were awake in the night/got up at 5:30' as an explanation for why they've just thrown their lunch on the floor or some other such display of frustration, which is perfectly true even though it sounds like an excuse. Lack of sleep affects how the emotional centres of the brain work together. The amygdala works as an emotional accelerator, particularly involved in processing fear, anger, sadness and aggression. The prefrontal cortex acts as a brake, mediating these reactions as the logical thinking part of the brain. On a good sleep, these two brain areas communicate pretty well; think of the prefrontal cortex as the parent, trying to soothe the toddler amygdala from getting carried away with their emotions. When we lose sleep, these two just don't work so well together. Mama PC is just about sick of Amygdala's tantrums and just wants to lie down in a dark room for a while, thank you very much. Unfortunately as adults, it's not really socially acceptable to have a paddy because we're tired, but hopefully you can see it would be a perfectly reasonable response to a bad night, and maybe explain why a lack of sleep can make you feel way more emotional and less rational than you would normally be.

In addition, waking early in the morning robs us of crucial REM (rapid eye movement) sleep. This is the time during sleep that we dream, and recent research shows that dreaming is far more than our brain showing us random images that make no sense. No, it is actually the brain's way of processing information from the day, creating memories and and linking information from present to past, creating connections that we may not make in our waking lives. This inspires creativity and aids memory - anecdotally I can say that I've often got stuck on an essay and woken up at 6am having found the answer in my sleep. Never go to bed without a notebook if you're working on something! It is also the only time that your brain completely shuts down a key stress related neurotransmitter, noradrenaline. What this means is that REM sleep is imperative for processing traumatic and stressful memories - by taking away the stress hormone the mind can strip away the emotion from the memory, making recall easier and less painful. Most of us have experienced feeling better for a good sleep after a stressful day, and this explains why. It also goes some way to explain why poor sleep and mental health issues go hand in hand. Not getting that REM sleep robs us of processing time, leaving those emotions just as vivid and distressing as they were the day before. There is lots of evidence to show that severe mental health issues such as schizophrenia and post traumatic stress are intrinsically linked, and if you'd like to start learning more I'd really recommend reading 'Why We Sleep' by Matthew Walker, which inspired this blog.

Being able to get good sleep should be seen as a cornerstone of good health, both mental and physical. Fortunately, there are things you can do to give yourself the best possible chance at a good night's sleep. Commonly called 'sleep hygiene' there are several habits that you can build in to your life to encourage your body to know it's time to nod off. Consistency is key, and it may take several nights for your body to understand the cues, but for most people, these habits will help (adapted from Why We Sleep, M Walker, 2017).

1. Go to bed at the same time every day, and set your alarm for the same time every morning, even at weekends. Lie ins don't help, even though it can feel tempting to try and catch up. Aim for between 7-9 hours a night and if you're suffering from not being able to fall asleep, go for the lower end to start with and head to bed later to ensure you're really ready for sleep.

2. Regular exercise will help, but not too close to bed time. Try to make sure your workout ends a minimum of two hours before you turn the light out.

3. Caffeine and nicotine inhibit your sleep neurotransmitter (adenosine) from working properly to let you nod off, and take hours to come out of your system. This means coffee, tea, cola and even chocolate can be stopping you from sleeping soundly. It's worth cutting down as much as you possibly can and ideally, stop all together if you're able, and try not to have any past lunch time.

4. Alcohol might make you feel relaxed enough to drop off, but it inhibits crucial REM sleep which is there to help you process emotions and events from the day into memory. Even small amounts can have a detrimental effect, if your sleep doesn't leave you well rested, this could be why. Try to give it a miss, at least until you've settled into a regular pattern again.

5. Sounds obvious, but try not to eat a large meal or drink too many fluids before bed. Indigestion and waking up for a toilet visit are big sleep inhibitors.

6. Check any medications you are taking. Some have side effects which can cause insomnia. Check with your pharmacist or doctor to see if you can take them early in the day to help.

7. Naps can be beneficial, but try to time it no later than 3pm, if you're going to bed at 10pm, for example. Napping too close to bed time doesn't allow time for adenosine to build back up, so you may have trouble falling asleep later.

8. Have a hot bath. Sleep needs your body temperature to drop, getting in for a soak, warming yourself up, then hopping back out causes this necessary drop in temperature. Likewise, keep your bedroom cool.

9. Keep other distractions out. Your bedroom is for sleep (and other adult pursuits, but that's another story), so you should keep it gadget free (no TV, phones, or tablets) and the lights down low. If you need an alarm, keep the clock face turned the other way so you're not clock watching.

10. Keep screen time for earlier in the day. Reading before sleep, or doing another mindful but relaxing activity, avoids the light from a screen from preventing another sleep hormone from kicking in and also helps you to relax and unwind. Journalling can also be good in the evening as a way to release the thoughts whirring around that might be keeping you awake.

11. Daylight early in the day can help keep your circadian rhythm in check. Consider a morning walk if you're able or eating breakfast in the garden if you have one (and the weather isn't terrible). Turning the lights down low in the evening aids this at the other end of the day.

12. The anxiety of not being able to fall asleep can make it really hard to fall asleep. If you find yourself unable to nod off within 20 minutes, get out of bed and go back to your relaxing activity for a while until you're sleepy again. Then give it another go.

I hope this goes some way to explain how sleep and your mental and emotional health are linked together, and that if you decide to build these new habits into your routine, they help set you up for better sleep. Happy snoozing!

Samantha Eastwood