So sleep, choosing sleep and this is, this is our first session and I just want to share a few, a few thoughts. One of the ways that you sometimes is a useful way to think about sleep as being the seed bed of good mental health. And what I mean by that is if we can get the, if we can sort of get to a point where we're no longer worrying about our sleep when we're, Getting quality sleep, we don't think too much about how long we're sleeping.
We're waking feeling more refreshed, and the thought of sleep and the ramifications of perhaps not sleeping just no longer enters our mind or very, very, very infrequently enters our mind. And for myself, I've suffered with My own mental health difficulties for many, many years, but not for about 12 years now, but sleep was always my precursor to a dip in functioning, and I think I became very over preoccupied with my sleep and it was that over preoccupation that is that the is at the root of most people's, sleep problems actually. So we will be looking at that in some detail.
So in tonight's session we're going to start off by Just reminding you all that Sleeplessness on its own isn't a very useful or a diagnosis of sleep latency or insomnia. It's usually a little bit misleading because it's as rare as hen's teeth that I work with someone who is struggling with their sleep. Isn't either worrying too much about stuff or ruminating too much about stuff or perhaps has lost their sense of balance about what's most important in their lives and very often the sleep is more of a sort of response to the other stuff that's happening.
Now as a profession you are really very blessed to have The vet health helpline which I've just put up on the screen there and if as part of the course or if during the course you sort of start to look at this and say, you know, well, my sleep is bad, but you know, maybe I need some more help in other areas, then please do contact the the Vettlife helpline and make use of it. You can either use the email or you can use that telephone number. And So let's start off with our questionnaire now.
There, there is another questionnaire which I'll talk about a bit later on, which will be, which we will ask you please to actually complete, but this one here is one really for us to do as part of our, our experience together. And what I'm going to do in a minute is I'm going to go through each one of these questions, and Megan very kindly is going to launch the, the poll. Facility that we have via webinar which allows you to score for each question that we have, and there it is for the first one there.
So this first question that comes up is Over the past, and this is really going to help me because what I'm going to ask is, once we, is, is if I can have a look at these polls at what comes up and have a look at a a sort of snapshot of this, I will design the rest of the course around what you guys come up with this evening. So, that's the way I like to work these. So if we find out that a lot of you are having more problems getting off to sleep, rather than, staying asleep or waking too early.
And then I, I can shift the sort of content of the course to meet more of those needs, but not only those needs. So for this first question, what I'm interested in is over the past two weeks, just wanting to have a look at whether or not the, the, The severity of your problems associated with difficulty falling asleep. So if people wouldn't mind just clicking the box.
So in terms of having difficulty falling asleep, where 0 is no difficulty at all, and 4 is it's a very severe problem, you know, not being able to fall asleep when we first go to bed, then if you wouldn't mind just scoring that one for me. OK, so if you'd just like to put your votes in. And this will be really, really interesting because you'll see there that these are the three main types of sleep problems that we come across difficulty falling asleep, staying asleep, and waking up too early.
And I'll talk about each one as we go through them. So OK. Oh, sorry, Mike.
How many people, Megan, seem to have difficulty with actually falling asleep to a sort of severe level? We've got quite similar percentages, so, we have the least percent of 1% said very severe, which is good. That's good news.
Mhm. I am 14% severe. Yeah.
And then 26% said moderate. So there's a few of you actually having a few problems getting off to sleep. That's interesting.
Yeah, and then the next was 28% said 0, so none, and then the highest percent was mild at 30%, so there wasn't much difference in it, but. OK, thank you so much everybody for that. Now that's really interesting because when people have a, have, we call that sleep latency.
So that's when we can't get off to sleep and nearly always that's that's associated with an inability to put the day to bed as such. And if we think about that, that, that, that stuff, it's, it's, it's, I just think it's so interesting. So the second one we're going to ask you about is the severity of your problems with staying asleep.
This means that people have problems with. Staying asleep means you might wake 3 or 4 times in the night, so you get off to sleep OK, but some people will wake up an hour later or 2 hours later. So just subjectively, how severe is your problem with actually having a difficulty staying asleep once you've got off?
And again, if you wouldn't mind scoring that one, there's only 7 questions. Today. And Difficulty staying asleep is very often associated with muscular tension.
So again, it's a bit like it's not that dissimilar, but it's because we go to bed and we have too much muscle tension when we actually go to sleep. So just out of sheer tiredness we sleep, but maybe we get aches and pains which wake us up and we'll talk a little bit more about that as the course progresses. Any ideas there, Megan?
Yeah, absolutely. So we had a few more extra people voting. So there was Let's have a look.
So at least was 7%, very severe. Right. And then 12% none.
So definitely different to last time. 20% severe. 29% miles.
And then the highest was moderate at 33%. Moderate to severe and very severe. We've got quite a few people waking, haven't we?
God, that's interesting. And that's, that's very different to some of the other professions that I would, I would work with with sleep difficulties. Gosh, what is it about people in the veterinary profession that you, that's, that's very interesting.
OK. And the next one is, the how often the extent in terms of severity of the problem of waking up too early. And what we mean by too early is before you're actually ready to wake, you know, that you wake up and there's a sense of, oh my word, I need more sleep.
So, That if you wouldn't mind scoring that one, how severe a problem is it for you, when you consider waking up to a And the waking up too early or early morning wakening is very often associated with either too much worry going on or sometimes it can be linked to a prolonged period of low mood and even clinical depression, but not, this is not a diagnostic, you know, if you wake up early, it doesn't mean you're depressed, but it would be something that I would be interested in. And if you've scored, let's have a look at what comes up from that. OK, we just had a couple of people still.
Oh we're finished now, I think. Oh no, still a few more. OK, so I'm gonna end the poll now just make sure you pop your vote in.
Fantastic, I think that was everybody. So, that is interesting. So we have 11% split between 0 and 4, so severe and none.
They're both at 11%, and then we have. 1 mild at 20%. 29% is severe, number 3, and then the top one is 30% at moderate.
So moderate, gosh, that's really interesting, isn't it? So with you guys, I'd sort of summarise that as saying there's less people, struggling to get off to sleep, and more people, waking when they don't want to wake, and a significant, significant percentage of people actually, waking up too early. That's been really helpful, thank you for that.
So now how satisfied or dissatisfied are you with your current sleep pattern? And what I mean by the pattern is, is, you know, I go, you know, that I go to bed at a certain time and I get a good night's sleep and I get up at the same sort of time. Does your sleep pattern feel satisfying or dissatisfying?
So 0 is I'm very satisfied with my sleep pattern. 1 is I'm satisfied, moderately satisfied. 3 is dissatisfied, and 4 was very dissatisfied with your sleep pattern.
And, and you know, that's when you, one day you go to sleep and it's fine, and the next day you don't sleep at all, and the next 2 days you sleep, and then the day it feels like you haven't slept at all. That would be a disrupted sleep pattern. OK, so if everybody like to finish off voting?
Fabulous, and the hall. Oh wow, OK, so we have, I'll start at the bottom again. 0 is 1%, very satisfied.
That's interesting. Satisfied #1 at 4%. Then very dissatisfied is 16%.
Number 2, moderately satisfied at 31%, and then number 3, dissatisfied at 48%. And that's why you're on a sleep course. That's interesting.
And do you know what, what we're gonna find over the over the course of our, our time together is that pattern is so, so important, but not so important that we get hung up on it, but if we can get our patterns of sleep right, then, everything begins to fall into place. This is a question of perception. So how noticeable to others do you think your sleep problem is in terms of how it impairs the quality of your life?
Not at all noticeable, 0, a little noticeable, somewhat noticeable, much or very much noticeable. And this is a real perception thing because most of us don't go around asking, you know, can you see that I haven't slept well, or can you see that I'm OK with my sleep. Let's see what you think about that one.
So let's have a look. We have starting at the bottom again, number 4, very much noticeable is 8%. And then following that is split between 3, much at 13% as well as 0%, not not at all noticeable at 13%.
And following that, there's two somewhat, which is 30%, and then the top one is a little at 36%. You know that, that tells me a lot about you as a group. Now, in some groups of people, what you find is that that's, that's such an issue, you know, other people's perceptions and about worrying that other people think they look tired.
When I work with, I have quite a lot of GPs who are, come to me for their mental health at the moment. And, and they are, they get really quite hung up on the fact that if they're not sleeping, their patients will sort of pick up on that or see it. That's really interesting.
So this next one is how worried or distressed are you about your current sleep problems? And a little worried, somewhat worried, much or very, very much worried. And that's the level of worry or distress that you have about your sleep.
And this is going to be really interesting because my perception is my kind of second guess is that this will be quite high in terms of quite worried because that's usually why people decide to come onto a course like this that they have got a little bit over preoccupied and worried about their sleep. OK. I'm gonna end the pollen now.
OK, again, starting at the bottom at 4, very much worried, which is 8%. Then we have following that. Is not worried at all at 10%.
3 much, so they are worried at 19% and a little at 27% and the highest is number 2, somewhat. What percentage was that? Sorry, 37%.
So interesting. Again, you're quite a mentally well bunch because, in other groups, you know, people very much worried is a very high score. So, yeah, you know, feel pleased with yourselves.
And the last one is, to what extent do you consider your sleep problem interferes with your daily functioning, . And that would be daytime fatigue, your mood, your ability to function at work, chores, concentration, memory, etc. And that's currently.
Do you think that it's not at all interfering? It's a little interfering, and somewhat much or very interfering. You know, this is going to be so useful.
I think Megan, you could, is it possible to send those percentages to me just so I can have a. Yeah, I think that should absolutely fine. Yeah, absolutely.
We can, I'll have a better analysis of it when I've finished, you know, I'll, I'll sit down one day, probably over the weekend and, and have a look at these scores. And, design the rest of the course a little bit around them, but not entirely. Yeah, you'll be able to see them all together then a bit more clearly.
Yeah, that'll be really helpful. So what do they think about this one? Right, so we have 3%, so not at all interfering.
Then they jump up to 16% at very much interfering, 22% a little. And then 29% is much number 3, and then the final one again is 30% somewhat. So that middle sort of ground somewhat to much, so sleep is, is significant, isn't it?
Now, thank you all so much for participating in that. That's been really helpful to me, but I hope it's also been really helpful to you to clarify the sort of nature and . You know, bring a bit of mindfulness into this issue of sleep, really.
And what's going to be really helpful is if you could just score your scores for the different items. If I go back, so if you score yourself now, so add up the scores for the difficulty falling asleep. But staying asleep.
The waking too early, add those, those 3. Add on how satisfied you are with your current sleep pattern 1. And how noticeable to others you think your sleep problem is.
The level of distress, the score for that one. And the extent to which it interferes with your functioning and add them all together and you may want to just make a note of that score and at the end of the course when we come back and have a look at this, let's have a look and see what changes and which areas change most, OK. And thank you again very, very much for that.
So let's go on and . And think about our course, what we're going to discover as, as part of this course. And what, what we're going to discover and what we're going to be working about, it will change as a result of, Of, of that poll is we're going to have a look at the reality of sleep and all of the catastrophic myths that surround the issue of not getting our full 8 hours and that's where I'm going to start actually that's a myth, you know, as humans, as healthy.
Humans that are well, we eat well, we exercise, perhaps we have good jobs, we're relatively content with our lives, then we do not actually need a full 8 hours sleep every night. That's an absolute sleep myth. What we do need is we need a mixture of rapid eye movement sleep and deep wave sleep that leaves us feeling a little bit more restored, and we should be waking up feeling somewhat refreshed.
So we need to get right away from counting the hours that we sleep each night because it's, it's, it's a very false way of indicating whether or not, you know, you have a sleep problem or not. I will normally manage very, very well these days or maybe 5, sometimes 6 hours of sleep overall in a night. And that, that, that's, I mean, I'm older now and we need less sleep as we do get older.
So we are going to start to look at some of these myths that surround sleep and we'll look at that each week and, and, and debunk some of them. And we're going to learn a whole range of tools aimed at just calming your worrying mind, and we're going to be helping you to live more in the now rather than worrying about the impact of sleep or how awful I may feel if I don't sleep tonight, tomorrow. So we will really be .
Shifting the emphasis towards a more mindful way of responding to the way that we sleep. We're going to help you to notice and let go of the scripts in your head that remind you that you're not a sleeper or that constantly remind you of how many hours that you've got left to sleep. So quite a few of you said that you had interrupted sleep, so you wake up and I wonder how many of you at that point grab hold of the alarm clock and very quickly go, Oh my word, I've only got 3 hours, and then Sort of put your head back down and try to get to sleep quickly because you only have 3 hours and you know, as you can hear me.
Talking about that, I'm sure you two recognise that that's that's quite an unhelpful way of being. We're going to learn to manage the emotions that perhaps are keeping you awake at night. So we're going to do some work around the emotions of frustration, guilt, despair, even, and the emotions associated with not sleeping that in, in paradoxically keep us awake.
We're gonna Help you all get to a place of acceptance that the feelings that you might get before going to bed before a very important meeting or a particularly different difficult client the next morning or the tight chest or the knot in your stomach, we're going to help you accept that that is just a knot in the stomach, that it is just a bit of anxiety. But it is not a decree that means that you are going to have a bad night because I am experiencing this physical symptom. We're going to work and help you to learn to smile at and ignore the unhelpful urges that you may get to engage in something.
You know, Unhelpful in order to sleep. That might be to go downstairs and eat 1010 digestive biscuits because you've been lying there and Somehow you've convinced yourself that you're hungry perhaps, and we're going to help you to shift your focus towards really living your life and focus on what constitutes this wonderful valued life that we we have waiting for us rather than struggling with our sleep. So it's much more really than just a sleep course.
You could say this is an effective living course. And We're also gonna to discover, a little bit more about this, incredible thing called, the paradoxical sleep effect. And you're, you're going to be sent, and you can access, and you can also access from the, the.
The webinar that website, those of you who are linked into the course, you'll be able to access the course manual that goes with this course. It's called Choosing Sleep. There's a PDF of the course manual which has the questionnaires in it and has lots of literature about sleep and lots of the exercises that we'll be doing.
But we're also going to be asked if you please, if you would, it'd be fantastic to complete the . A, a, a scale for some research I'd like to get involved in, which is about the anxiety and preoccupation about sleep. So I'd like to try and, because a lot of the stuff we do will be about helping you to worry less.
So question one on the APSQ scale is about how worried you are about your sleep, . The effect that your sleep has on your performance. The effect your sleep might be having on your health.
The effect your sleep is having on your social, your social life, the effect it has on your mood. The amount you worry about your inability to control sleep. The worry about staying awake and alert during the day, and we're going to teach you some tips for when you are feeling over drowsy, how to actually wake yourself up effectively without without damaging your sleep pattern.
So there's only 10 questions on the APSQ, which is the anxiety and preoccupation about sleep questionnaire. And that questionnaire will be sent out to you by the webinar that they're really good like this, but you can also access it, I believe, from the website. If you wouldn't mind completing it over the next couple of days or ideally tonight or as soon as you get the questionnaire sent to you.
I, I did, it's all anonymized and it's done in a research friendly way, and the whole questionnaire takes about 3 minutes. To complete. And when you go on, you just have to put your unique identifier in, which is your initials and then your date of birth.
So thank you all in advance for helping us with that, and I'd like to really look at this because my perception is in working with lots and lots of vets now, and I have worked with a really good number of vets that sleep is a really significant issue with you, but also the worry about sleep is quite important. So let's start making it better. Let's start to think about your natural sleep cycle.
In your manual you'll see that there's a link to a TED Talk by Jessica Gamble, and Jessica Gamble is a is a professor of sleep in one of the American universities, I think, and she did this wonderful experiment, and she talks a lot about sleep patterns, but particularly about the biological indicators. That are telling us when we need to be going to sleep. So let's start there first.
So, You may know this, but because of your anatomy and physiology, but . We, there's a retinal response that happens in humans. I'm not sure if it happens in animals actually.
I'd be interested to find that out, but we certainly have a retinal response, so . The way we are wired and the way we're built is I'm looking outside now, so I guess it's probably about 8:20 now. I've got no idea, but I should think it's about 8:20 and it's still pretty light here in Northamptonshire, but it'll go dusky by about 8:30, 20 to 9, and as dusk descends, my, my, my retinal response will register that the dusk is descending.
And it will send a signal to my pineal gland, and my pineal gland will then start to produce higher quantities of melatonin, and that melatonin and the and the melatonin and that design means that that's my chemical signal to say Mike Scanlon, the day is ending, go to sleep now. The problem with that is, is that about 25 to 9 or 9 o'clock when I finish the webinar, I'll go through to the other room and I'll watch some television and I'll switch the lights on and I may do a couple of emails and so I'm actually my natural sleep cycle is being is being overridden by 21st century life. So What's interesting is that once dusk has descended and once we have started to produce melatonin, that sleep window, and that's what I'm going to call it now, that sleep window, it lasts for probably about sort of, you know, half an hour to an hour, and the idea would be is that if we were sleeping as humans are meant to sleep, we would all be going to sleep at about sort of.
You know, lying down, settling down, teeth brushed in our gym jams, ready to go to sleep at about sort of 9 o'clock at night in the summer. But we would also be getting up and starting our day's labour at about 4:30 in the morning. Because that's what the way that we are wired to sleep, and Jessica Gamble's film goes into this in a lot more detail, but suffice to say, you know, we don't live our lives like that anymore.
But the good news is that if I miss my sleep window at about 9 o'clock, about 2 hours later there will be another release of melatonin. If I'm still awake, so if I know, if I can discover where my sleep window is, and my sleep window tends to be at about 2011, so I, I, I pretty much know that. So if I'm in bed.
I've done some reading, I've maybe done a meditation. I meditate a lot. Then as long as I'm in bed, roughly, you know, not, we don't ever get too hung up on this stuff, but if ideally I can be in bed relaxed by about sort of 2011, that's the beginning of my good sleep pattern, because that's when I'm chemically ready to sleep.
I'm not ready to go to bed at 8:45. You know, it's just not feasible for me to go to bed then, but 1:20 past 11 is a good time. Now if I miss that 20, you know, if I'm watching the horror channel or something awful, which I do, I quite like all that stuff, but if I'm watching something like that and it goes on till sort of midnight, quite often what I find is I go to bed and that's when I will lie and not be able to get off to sleep for an hour or so.
But if you think about it, I've missed my sleep window, which will come back around 2 hours later. So if my sleep window is 1:20 past 11, it's going to come back round again at, you know, sort of 120, really. So if I miss my sleep window, I understand that, and I don't need to get hit up or too worried if I'm lying in bed not sleeping because my next surge of melatonin will be, hopefully, coming back round quite soon.
So I hope that's helpful because perhaps one of the first things we need to do, and you'll see your home task this week is to be mindfully aware and curious about any changes I could make as a, you know, as a result of this first session of the sleep course. And one change you might make is to start to be really mindful about when that real drowsiness, that heavy sleepy feeling comes across you at night. When does it first come across you, you know, and I'm not talking about that post supper malaise that most of us get if we've eaten a big tea.
This is different. So, you know, and when is my sleep window? Let's see this week if those of you participating in this course can actually begin to identify when your sleep window is.
Now once we do actually drop off to sleep, we surface sleep usually, and what I mean by that is it's it's sometimes people will say to me, you know, Mike, I didn't sleep at all last week, and eventually they go to the Cambridge Sleep centre and they get wired up to somnographic. A somnographic sort of findings and and and we go and look at their graphs and what we see is they have been asleep, but it's been surface sleep and they haven't, it's felt like you're awake, but actually you are asleep. So After 5 to 15 minutes of just surface sleeping, and at that point, it's very easy to get woken because we're not deep at all.
After 5 to 15 minutes, ideally this is, and it's not the same for everybody, but this is what the sort of generalised sleep cycle. Our heart rate slows down, our brain does a bit less, and we start to just begin to process stuff, yeah, and then we start to make. Some repairs, so we go into a bit of a deeper sleep.
And then we move into REM sleep about 90 minutes after we first sort of dropped off. And what's interesting is that the REM sleep is when we actually start to process a lot of the stuff of the day, and if you notice then your body temperature actually begins to decrease and your BP comes down a bit, your blood pressure drops a little bit. A bit later on we have more increased rapid eye movement sleep, and then we slide back into that sort of surface sleeping before we wake again.
Now there's some really interesting pointers here. Some of those are things like You know, if you're dropping off in that first stage where there's that interim period between consciousness and sleep, all it needs is for a phone to buzz or for, you know, there to be a noise, a loud sharp noise somewhere in our, in our home just to wake us. So, you know, my wife quite often will take her mobile phone.
To speak of the devil, she just phoned them and I've got to keep my phone on just in case this goes back down. So, my wife will take the phone in case one of my children, who are both left home now in case they want to, and quite often I'll just be dropping off and then there'll be a WhatsApp buzz or something. And if it comes a bit later on, it doesn't even wake me, but if it comes in that 1st 5 to 15 minutes, it wakes me and, you know.
You know that that that that that's less good. So sleep cycle, I hope you found that interesting and a little bit illuminating and maybe have a little think about about yourselves and any shifts. The other one to think about is notice that about sort of 90 minutes in, our body temperature comes right down and what we do know is that a cool bedroom.
And Not being over hot or over warm, you know, in a sort of 20 tog duvet, if you're, if you're someone who doesn't sleep well, then if you can get a window open in the bedroom as long as it's not too noisy, think about whether or not you're over hot, maybe just kick the duvet off your feet, just thinking about optimum ways of sleeping. So let's just take you a little bit into the underlying theoretical framework really with this course of mine, I like to use acceptance and commitment therapy as being the main sort of psychological approach to govern what we're going to do. And if any of you are interested and you want to have a look at the London Sleep centre.
The London Sleep centre is run by Doctor Guy Meadows, and the London Sleep Centre primarily also use acceptance and commitment therapy as the modality for helping people, . Improve their sleep. And, and, and why I think act works so well is because we know that human behaviour is overregulated by inflexible cognition.
What I mean by that is I must get to bed by 11 o'clock or I will be in a terrible state tomorrow. I must not wake more than twice tonight or I'll be terrible tomorrow. I must have a milky drink or I will struggle to get to sleep.
I must have the fan on in my bedroom, or I can't possibly sleep. Some of this inflexibility is what's behind an awful lot of sleep problems, and one of the problems about this is that the process of actually falling asleep. People can't describe verbally, so it feels a little bit mysterious and odd.
And what we need to understand is that falling asleep is actually a pretty automatic process. It's chemically driven. If we just stop worrying about it and we relax into it, most of us will just fall asleep.
It's usually our own thoughts and our own cognitions and our own sort of paradoxical fear about sleep that keeps us awake. Look at this that sleep is inhibited by attention, intention, and effort, and this comes from a really good study by SSI who talked about the paradoxical sleep effect, you know, that the more effort you put into trying to be a great sleeper, the less well you will sleep. Fascinating stuff, I think.
So when we are asleep, contact with actual experience is often lost. Now many years ago, no, about 4 years ago, I had a chap from South Africa come to see me, and he sat down and he said, Mike, he said, I haven't slept a wink in 6 years. Now sitting opposite me was the healthiest bronzed god of a man that I'd seen in a long, long time, and not a bag under his eye looked like he could, you know, jog around the world without too much problems.
But he sat there and he said, I don't sleep and I haven't slept a wink in 6 years. And eventually with him we just got him over to and and we took some somnographic findings because he wouldn't hear it that, you know, this was this contact with your actual experience is lost. And the sleep centre findings showed very clearly that he slept probably certainly longer than I sleep, but the quality of his sleep was very sort of surface sleeping, so he didn't, it felt like he wasn't sleeping.
What we also know is that people with sleep problems overestimate the amount of time they spend awake, almost always, and they absolutely overestimate the daytime impairment that results as a response to not sleeping, but the bigin from Wigan, the one that they really get into, is once we start to label ourselves as being a poor sleeper, we ruminate over the past and we ruminate over the future. Specifically about, oh please, please, please let me sleep. Oh yesterday was terrible and the week before was terrible, so we lose our sort of perceptions.
So we would say that the 5 maintaining factors that keep somebody in a place of poor sleep, the first really important one is worry. The second one is these unhelpful and inaccurate beliefs about sleep. And let me just tell you that one.
I had one of the GPs that I worked with, and he, he was talking to me about his way he deals with, I think my dog is about to bark. Did he go away. And, and is, is, and he was saying that he had a client in the other day, he said, you know, she comes in all the time worrying about her sleep, and in the end I said to her that if you don't start sleeping, it'll start to affect your liver function, your kidneys, and possibly even your heart.
And I kind of left it a beat and I said, did her sleep improve? And he said, Not at all. She was back the next week and her sleep was much worse and what a surprise.
The other reason or maintaining factor for problems with sleep is this selective attention and monitoring. So it's that thing about only focusing on the on the poor nights and just letting the good nights go and very counterproductive safety behaviours, you know, I can only sleep if this is occurring. I must have this sort of pillow.
I cannot have a single *** of light coming in. And then I've spoken about this before, but this misperception of the deficits and the and the functioning as a result of poor sleep. So really the purpose of our course is to reverse these maintaining processes.
But before we can do that, before we get into the psychology of all of this, which starts in session 2, we really need to get our sleep hygiene sorted. So, I'm gonna take you through the 9 sleep hygiene tips. Now these sleep hygiene tips are all in the manual that you can either download or will be emailed to you by the webinar vet.
And if you go into the manual, you'll see these are at the beginning of the manual. So, but I'm just gonna take you through the really important ones. So the first one is I, I, I, just let me just explain.
My, I'm going to ask you all, let me just go to the home task. I'm going to ask you all to please make some of the changes linked to sleep hygiene. So as I'm going through these, if you are, if you are someone, the first one is reduce your caffeine.
Think about Your alcohol intake, especially at night. If you're a smoker, think about decreasing, you know, decreasing the amount you smoke before you go to bed. So as any coffee lover knows, caffeine is a stimulant that will keep you awake.
So ideally start to Reduce your caffeine intake up to 6 hours before bedtime or ideally don't have any more caffeinated drinks 6 hours before you are planning to go to bed when your sleep window is indicating that level of drowsiness telling you that I really should be in bed by now. So Although alcohol makes you drowsy and can get you off to sleep, it quite often then switches and actually starts to be stimulating. So quite a lot of people find that their dream process becomes a little bit more interactive even, and so we wake a lot more in the night.
So try and limit alcohol consumption to just one or two drinks, or less ideally. And avoid drinking within 3 hours of your bedtime. So have a think, you know, could I switch to Stopping any caffeine, caffeinated drinks by, I don't know if we go to sleep at like I do about 11:15, maybe the last I try and not have any more caffeinated drinks after about 3 or 4 o'clock, you know, I'm not ever regimented on any of this stuff because that doesn't help.
So first sleep hygiene tip is think about your capping. The second sleep hygiene tip is turn your bedroom into a sleep friendly environment. So ideally make sure your bedroom is quiet, restful and dark.
And above all cool, we're really beginning to learn a lot more about the importance of temperature. You know, ideally have a lovely comfortable bed, and a lot of people, a lot of sleep therapists say that we should only use our bedroom for sleep and sex, you know, that that's pretty much all we should do in our, in our bedrooms, and a lot of us watch telly, listen to the radio. What I'd say about that is I'm not nearly so strict.
It's just if you're going to watch television, don't watch something alerting. If you're going to listen to the radio, listen to something that is soporific perhaps. I was just saying earlier the archers, I don't think I've ever listened to a whole episode of The Arches which I play on the iPlayer before bed.
So, you know, make sure your bedroom is cool, dark, restful, make sure that, there's no sudden noises, around. Really important now is start to establish a soothing pre-sleep routine, so Do you know, the other, the other week I was at a conference with a Scottish friend of mine who tells me he's a terrible sleeper and he was getting really, really sort of drowsy over his drinks at about sort of 10:30 at night at the conference and we were going up to bed, you know, I said, oh, let's just take the stairs because there was a queue at the lift and we got to the stairs and he bounded up the stairs. And I just said to him, What are you doing?
And he went, I'm just running up the stairs. I said, Well, you know, you're going to try and go to sleep in about 10 minutes, and you've just completely woken yourself up. So your pre-sleep routine needs to be beginning to turn the lights down, turn the volume down on the telly if you're watching telly.
Maybe just take the brightness down just a little bit, but doing all this in a calm, relaxed way. Definitely not. I must get the brightness down.
I must turn off all the lights just really lightly, really gently, just getting yourselves into a pretty sleep routine, and I tend to have a warm bath and then I always do just to meditate, just a bit of a meditation, just to relax me before I start to. Listen to some radio before I sleep or read. Really important that you're actually choosing when you go to sleep and that your choice of when you go to sleep again, ideally should be driven by your feelings of drowsiness.
So do try and find your sleep window. Try and make the most of natural light, because natural light keeps your internal circadian rhythms in place. So let in the light first thing in the morning.
That, that, that'll definitely help. So let the light in first in the morning and, you know, if you're stuck in an office all day, try and get outside into the sunlight 2 or 3 times in the day. Now this is going to sound a bit draconian, but if you're on this course because currently you're not a great sleeper, let's try and cut out the naps.
Yeah, some people like Mrs. Scanlon, my wife, can nap, you know, 23 times a day, and then she's just out spark every single night. She's never had a problem with sleep ever.
So, but for me, if I nap, it really upsets my, my, my, my sleep pattern and my rhythms. There's a lot of myths about exercise, but without a doubt, lots and lots of good, lots of research that tells us that if we exercise in the morning, and that might just mean walking the dog for a good hour outside in the fresh air, or it might be doing something aerobic in the mornings. Exercise in the morning stimulates the secretion of cortisol, so it's great to do it in the morning, but whatever you do, don't exercise at least 3 hours before bed.
Yeah, try and work out in the morning. The 8th sleep tip, which we will get to, and don't you worry about this too much, is start to introduce some mindfulness into your life. And we'll talk about that a bit more on the course.
And finally, patience and persistence. Now because we're going to be working with some pretty stuck patterns within your minds, don't get into this thing that I'm on a sleep course. Therefore I've got to be sleeping well immediately, you know, it's been designed this course, and I'm going to make some changes.
But the idea is, is, is that, you know, we've got, I think 6 weeks together, and by the end of that period you will be. Much more relaxed about your sleep. You will be worrying less.
You will be calmer. You'll be more in touch with what's important to you, and the issue of sleep will no longer be quite such a problematic issue for you. And just by dint of that and the other changes that you're going to make.
And, you know, thinking about your sleep window and the sleep hygiene changes that we've talked about tonight, just that will improve your sleep. So that brings us to your home task. Please have a look at this first at your sleep hygiene tips.
You can either listen again to this recording, or we can download the manual and have a look at the sleep hygiene tips and let's make a real commitment to make some changes. And when you make those changes, don't review them with anything other than curiosity, a lovely mindful curiosity. So, you know, what difference is it making?
You know, why do you think this isn't making the difference I want it to be? Am I going into this with the right kind of level of relaxedness, you know, because this any change that we make needs to be made. With a smile, holding it lightly and with curiosity.
So that pretty much brings us to the end of tonight's session. I hope you found it interesting. I would recommend you watch the Jessica Gamble, film.
It's only about 12 minutes, I think. It's one of the TED Talks and the, link to it is in the manual. Or you just Google Jessica Gamble, .
Natural sleep and that that that will come up. But please, it'll help enormously for the course if you can get your sleep hygiene really sorted and if you can try and work out when your sleep window is. So I'll hand back to Megan and please, please, if you've got questions, thoughts, responses, use this opportunity now to ask questions, and I shall answer as many of them as I possibly can.
I'll hand you back to Megan. Oh, thank you, Mike. That was brilliant, really, really interesting and.
I'm lucky. I, I don't struggle too much, sleeping, but now and again, there will be the odd nights where either I wake up or I struggle to get to sleep, and I definitely, fall into the, 8 hour rule. And I definitely look at my phone, you know, if I get to sleep in the next 10 minutes, then I'll have 8 hours.
So that's, that's really, really interesting. I'll definitely, next time that happens, not rely on those, 8 hours. So thank you for that.
So, Mike mentioned earlier about the 3 minutes, just a quick questionnaire. So we've posted that into the chat box if you can see that. We will email that out as well, this week, but if you would like to answer it this evening, then that is in the chat box.
And it should only take 3 or 4 minutes, including the, identifier thing. We're using the Bristol Research survey tool, which is really quick and efficient. Fabulous, yeah, so if you have any problems accessing it, just let us know and we will be emailing it out as well, so don't worry too much.
We've also Got another questionnaire as well, a short survey, sorry, rather than a questionnaire, which should have popped up just in another browser. If you could just provide any feedback about this evening's webinar, and just to assist Mike and ourselves as well, just would be great because it is, first sleep series, so any feedback would be wonderful. And as always, if you have any questions, just pop those into either the Q&A or the chat box and I'll read those out.
I have a few minutes just at the end, so please feel free to pop in any questions. I noticed that a couple of people have already, so I'll just read over those if that's OK, Mike. Yeah.
Let me have a look. A. So we've had somebody, mention about slow and fast, accelerators, a question about that.
We can't view that at the moment. So if you could pop that question back in, for a second time, that would be wonderful, and I will, I'll read that out for you. And if anybody would like their names to be read out, please just, post them underneath.
Somebody's asked, any advice for those, whose sleep problems are caused by non-sleeping children? I remember it well. Do you know, I think the main one there is going to be around, relax, you know, take your sleep when you, when you can, when you can get it, but really relax into that sense that this too shall pass, you know, and, and, .
That if we're going for, if we can shift so we don't worry about being woken by the children and we can get to that deep wave sleep just a little bit quicker and Maybe For me, I think that that one there is, is getting to a real, which it is an acceptance and commitment therapy course, it's really getting to recognise is does this worry me that the kids wake me? Does it, does it, does it cause me anxiety? And then what we'll do is we'll have a look at any thoughts that might be lurking, but I just, you just have my sympathies.
My, my daughter is. 19 or 20, I can't remember. And the other one, and the other one is 22.
So, my problems are then crashing, crashing in through the door at 4 o'clock in the morning, worse for wear, but, it, it doesn't get any easier. Thanks, Mike. We've had two questions actually.
11 lady has asked if it would be possible to include a section over the next 6 weeks on tips that may help with night shift work, and that links to another question as well. So somebody said that they're really struggling. With sleep being disturbed when they're on call, they don't like being in bed for 2 to 3 hours and having to work the next day, and they actually struggle.
That's one of their struggles with being a vet. Yeah, yeah, we will, I will, thank you for that. I will specifically look at ways of helping those of you that that work with shifts.
Some of that will be around mimicking, tricking your, tricking your brain to produce the melatonin when we want it to produce the melatonin, but we'll, we'll come on to that in more detail, certainly. Thank you for that. Thanks, Mike.
We've had. Look. Any tip for mini minimising nocturnal lu visits with advancing age without getting dehydrated.
Yeah, I'm there, . You know, the, it's that, you, you'll know this, I think, but it's that hydrating ourselves throughout the day rather than sort of, getting towards the end of the evening and then drinking vast quantities, at that point. But you know, there's been some really interesting studies around this that quite often, we don't, you, you know, that, that I don't know about you, but you know, we get to the loo.
And it feels like we really need to go and you get there and there's and you know there's only a trickle and so some of this is our brain telling us because you know we're just that little bit more sensitive if we are a little bit more anxious or worrying about it. So as the worry about our sleep starts to decrease, so does the nocturnal visits and That that's, that's something I've observed quite a lot. So, some of it's in your hands, but some of it is being triggered by, by our sort of worry brain.
So if we're waking because we're not, you know, we're going to bed too tense, for example, then we wake up and, you know, our mind goes straight and we almost like find ourselves scanning down to our bladder, you know, do I need to go for a week? And, and so making some changes there is something we will certainly look at. Fantastic.
Thanks, Mike. Let's have a look. We've got a few more.
Somebody said that they're watching from Spain and they really enjoyed the webinar, so thank you for that comment. Thank you. Another lovely comment from somebody and they've asked about the manual, so we will be, we've we've already emailed that out and we will be doing that again as well, .
I think with the manual, try not to get, ahead of yourselves because it'll make a lot more sense if we sort of, so at the moment, when you get the manual, have a look at the first bit, have a look at the sleep hygiene tips and a little bit about, You know, about what we're trying to do on the course, but I think it would be unhelpful to go into some of the later exercises too early. So, you know, but, that's just my thoughts on that really. Brilliant.
OK. Absolutely. I'm, I generally sleep OK until I do a night shift, so it's another night shift one.
When I do the nights, I end up not sleeping or walking lots, as I'm worried I might miss a call. So that links in with the, a couple of other questions and so I think. Yeah, I mean, I think what I understand by that is, is that you go to sleep when there's nothing much happening, but you surface sleep, so you're surface sleeping, and part of your brain is sort of waiting in case you miss a call.
Yeah, we will look at some of the way we're thinking about our sleep because . You know, there is some very simple stuff there which would be just, you know, have a look at the evidence of that, you know, have you ever actually slept through a call? Have you, has anyone ever complained and said the phone rang for ages and no one picked up and you suddenly think, oh my word, that's because I was asleep.
You know, some of that will be perception and because you're very dedicated to your job and it matters a lot to you. And, and sometimes what we might need to do is to look at some of those thoughts that are pushing you around a bit there, and we'll certainly do that. Fabulous, thank you.
I think, yeah, that seems to be a a pattern, in the questions, so that'd be fantastic. Thank you, Mike. Just a few more.
I know we have gone over this evening, so thank you everybody. Are you OK to stay a little bit, longer, just a couple of more minutes, Mike. I'm on my own so we've had we've had plenty of questions coming in, which is great.
Thank you everybody. Somebody's mentioned that it's, it's having an awful impact on their memory and concentration. Which, that, that, you know, that gets better so much, so quickly, that the, your memory and your concentration, but it might also be that that might be mood affected as well.
So we'll, you know, start looking into that a bit more over the course of the course, but stop worrying about your mood and, and, and that, that, that's going to improve. Fabulous. I was wondering if Mike could offer any advice in the course for coping with disturbed sleep when on call.
I struggle to sleep when I have a patient at the practise awesome. Yeah, I think we've kind of covered that a little bit. So when, when you are, does that mean on call help me with this, perhaps, does that mean you're at home and, you're, you're waiting for somebody and you might ring, or are you usually at the veterinary surgery and you, you're actually in situ at the, at the vet.
I think, I think normally on call, correct me if I'm wrong, is, being at home and having a call and then working a late shift is spending the whole night in the practise. So there's a mixture of the two. Yeah, I think that there's very simply 11 of the one of the other sleep hygiene tips is if you lie in bed and you can't sleep, you know, if you wake up midnight or, you know, you've been asleep, you get a call because you're on call.
You speak to somebody on the telephone or you deal with it and then you come back wanting to go to sleep. You're much better to deliberately and on purpose have a wind down period before you actually try to go to sleep, but putting in a little period before you sort of leap back into bed. And losing that sense of hurry up that, you know, I must get back to sleep really, really quickly.
No, no, no, we'll do some progressive muscular relaxation next week, which I think will help an awful lot, but there's some other very simple ones. So I, I'm going to just share something with you now, which is magnesium oil. So there's, the, the, the, the, the very easily diffused magnesium oils.
So it's magnesium is a wonderful relaxant, and, but the problem with it is a lot of people take magnesium pills, you know, tablets to help just relax their body to help with sleep, but unfortunately that also relaxes the bowel, so you, you know, you get diarrhoea and An unpleasant looseness. However, if you use the magnesium topical oil, you know, so you might get back from an on-call situation and then use the magnesium oil, just spray it on, you know, like women do when they put perfume on, they sort of put it on the . The wrists, don't they, on the sort of the soft bit of their wrists and they sort of rub it in.
Just rub that in there and then do some relaxation, do something relaxing, not to sleep, just to relax, relax yourself and then go back to sleep. But the magnesium oil is something that a lot of clients I work with with sleep problems say is is helping them enormously. And you can get that at Holland and Barrett.
Am I allowed to advertise? Yeah, absolutely fine. Yeah, no, I've, I've got some magnesium oil.
That's, it's really good. Thank you for that, Mike. The questions are flying in, so I do apologise in advance if we don't get to cover everybody's.
Is it OK for people as well, Mike, to send some emails if they don't get, yeah, I always say I always I'm happy to put my email there. Really, thank you. .
Somebody's mentioned that they've had insomnia most of their working life and they've been on antidepressants, but which haven't made much difference. So thank you for sharing that with us. I mean it depends on the antidepressants, you know, nearly all of the antidepressants are actually alerting.
So, sometimes, and the GPs very rarely tell you this, but, most of the antidepressants are actually associated with increased insomnias, especially when we first start taking them, but some of them can actually be the cause of insomnia. Which is interesting, isn't it? You want a bit more 1 to 1 advice on that one.
I'm very happy for you to email me and let me know which one you're taking. You probably don't want to do that live tonight. But if you want to do a little bit of advice around that, then there's some, some, you know, take it a different time, that sort of stuff.
Yeah, one of, one of the webinar vet team have posted Mike's email address in the chat box for that person. So if you would like to view it, we've had someone else, I think they would definitely benefit from speaking to you, Mike, as well. They've said, how can I, how can I stop panicking?
I usually get, I usually get back to people within a day. Fabulous it is. Yeah.
So yeah, the person who's mentioned about their panic attacks with the insomniac, I definitely think, . Yeah, that would be, yeah, I mean, I think you'll find that we really will help with things like panic as part of this course. So I think week 3 we start to look at, diffusing thoughts, and as soon as you get master the diffusing of thoughts, and that, that stuff, the panic will start to get easier anyway.
So, you know, that's what I said earlier on, you know, a sleep course covers a, a myriad of different areas of, psychological well-being and, and, and happiness really. Fabulous. We'll, we'll get try and get all these questions over to you, Mike, so you've got a feeling of what everybody would like to, you know, their questions that would like answered over the course, .
Somebody else also mentioned, I'm just trying to find out about caffeine, given that slow and fast accelerators have different responses to caffeine, how do you adapt your advice? I think just go for a rule of thumb that if you're not a sleeper, if you're someone who doesn't sleep well, then make your last cup of coffee proper full caffeine. Make the last one sort of 3 o'clock, 34 o'clock, and then either if you want coffee switch to decaffeinated, remember that a lot of teas have quite high levels of caffeine.
And, and, and, you know, very gently without getting hit up about it, just begin to make that shift, you know, again, I think about Mrs. Scanlon, we can go out for a meal and she can have a couple of cups of very strong coffee at the end and then home and fall straight to sleep. But if you're someone who has a few problems with your sleep, Just bring, do cut that caffeine out, when you get past sort of 23 o'clock in the afternoon.
Thank you, Mike. That's brilliant. We have had quite a lot of, still got plenty of other questions.
So what we'll do is we do, apologise that we haven't been able to answer them all this evening on the webinar. I know a few people have mentioned about food, you know, what foods are best to eat and probably that would, involve the, you know, time for digestion as well. We will be looking into food and sleep.
I think . I think that's week 3, but we will be looking at that. But again, you know, just very quickly, there's, there's, there are certain foods like, bananas, are, are really very helpful for sleep.
There is some evidence base now for that old wives' tale. There's people used to say about a warm milky drink. Actually, yeah, a warm milky drink is, is, is pretty helpful.
lettuce, wild lettuce, particularly, is, is, and anything you're eating. Eating greens before bed is actually really rather good as well. You know, there's, there's, there's, there's, there's any, anything that contains tryptophan.
Bananas contain is, is good for sleep. But making a, making a, a changed diet is something that we will look at a bit more. OK, fabulous.
Thank you, Mike. As I say, Mike's kindly, very kindly popped his email address into the chat box. Some of you have .
You know, being really open and honest with your questions. So thank you for that and do do email Mike or even email into the webinar if you're happy for us to see your questions and if you don't get those answered this week or if Mike is, you know, has is bombarded with lots of emails, then, you know, please do ask the same question next week if it hasn't been answered. This week we will get it, we will get it covered.
Is that OK with you, Mike? Oh that's fine, that's lovely. Fabulous.
OK, just, we've got lots of thank yous and how wonderful the webinar is, so thanks it was it's, it's fantastic. Yeah, I'm really looking forward to this. It's a really great way to do it.
So, yeah, I'm sorry about that. No problem, we've, we've had some fantastic, feedback. So, and thank you for giving the extra time as well at the end to, answer everybody's questions.
So. Yeah, have a lovely rest of your evening, everybody. Is there anything else from you, Mike, just before we finish off?
No, just, you know, what I said, do, you know, have a think about your sleep window, and start to have a think about which sleep hygiene, hygiene changes you need, you, you need to make and be curious about them this week and then we'll get right into the psychology of all of this next week. Look forward to it, Mike. Thanks.
Thank you, everybody, and if you can do your, the research, the that research link, that would be absolutely fabulous. I'll get nagged like mad by the researcher if we get a few in. Quite quickly.
Yeah, that's been posted a couple of times in chatbox, so feel free to, I've just had a text from the researchers say she's had 19 responses already. Fantastic. So thank you everybody.
Yeah, thank you very much, everyone. Look forward to seeing you on next week's webinar.