Sleep and Insomnia

Sleep is a truly bizarre phenomenon. Every day, every single one of us, like clockwork – figuratively and literally, given that our sleep-wake patterns are governed by the roughly 24-hour internal clock called the circadian rhythm – has to power down and recharge for a bit.  

By Dr. Kayleigh-Ann Clegg, CloudMD

Understanding and managing sleep issues 

While researchers are still working to understand all the mechanisms and intricacies of sleep, what we do know is that it’s vital for maintaining our physical and mental well-being and functioning.

So, what happens when this vital process is disrupted? 

Undisrupted sleep 

What counts as a ‘normal’, healthy sleep process is incredibly subjective and complex, and depends on several factors, like age, genetics, individual needs, and individual circumstances. There is, for example, no magic number of hours we have to sleep. As a rule of thumb, however, research suggests that the average adult needs at least 6 - 9 hours of good quality – enough time spent in various sleep stages, not too many nighttime awakenings, and most importantly, waking feeling rested – sleep.  

Research does suggest that some people may feel rested on fewer hours of sleep, but this is incredibly uncommon, and the jury’s still out on whether natural short sleepers escape the negative health effects typically associated with sleep deprivation (so, try not to buy the rise-and-grind, hustle-culture hype!).

Disrupted sleep 

Sleep can be disrupted in many different ways – for example, you might experience difficulties falling asleep or staying asleep; difficulties waking up; waking up too early; or shallow, restless sleep that leaves you feeling drained and drowsy in your day-to-day. In many cases, these disruptions are temporary and normal to experience from time-to-time – they tend to resolve on their own or with very minimal steps taken.

There are, however, more chronic sleep disruptions and sleep disorders that tend to require more active intervention and professional support to diagnose and resolve. For example: 

  • Insomnia – which involves chronic difficulties getting to sleep or staying asleep and is the most common sleep disorder.  
  • Sleep apnea – which involves breathing issues that interrupt sleep and impair sleep quality.  
  • Parasomnias – a group of sleep disorders that involve experiences that interrupt sleep usually during either non-REM sleep (where we spend most of our time) or REM sleep (where we tend to dream). These disorders – including things like night terrors, sleepwalking, and chronic nightmares – tend to be more common in childhood but can persist into adulthood. 

What causes sleep disruptions?  

Many factors influence the quantity and quality of our sleep – our genes and biology, psychology, lifestyle, and environment all interact with one another and impact our sleep patterns.  

Sleep disruptions can be more likely to happen, for example, if: 

  • You’re experiencing a lot of stress in your day-to-day;  
  • You’re spending a lot of the day being sedentary;  
  • You’re living with a mental health condition like depression, anxiety, or substance use disorder – often a two-way street: sleep difficulties can contribute to mental health concerns, and mental health concerns can worsen sleep difficulties;  
  • You’re doing shiftwork, especially night shifts or inconsistent shifts;  
  • You’re living with a physical health condition;  
  • You’re sleeping in an environment that’s not very sleep-friendly (e.g., hot, noisy, bright);  
  • You’re experiencing things like hormone fluctuations (e.g., in pregnancy or menopause).  

What to do if your sleep is disrupted 

If you’re finding yourself counting sheep or haunting the halls of your home in the small hours, here are a couple of things you can do: 

First, don’t panic. You might not actually need to do anything. This might sound like unhelpful and uninspired counsel, but the reality is that sleep tends to be a pretty self-regulating process. Minor disruptions will often resolve themselves, whereas research suggests that fixating on sleep issues – constantly worrying about sleep, focusing on unhelpful sleep beliefs (e.g., “I have to get eight hours or I won’t be able to function), or trying to control sleep and manage anxiety around sleep with ‘sleep safety behaviours’ (e.g., clock-watching, vigilantly monitoring mood and energy during the day, being overly rigid about sleep-related routines) – can actually maintain and worsen what might otherwise be temporary disruptions. 

Practice good sleep hygiene. Sleep hygiene – habits and ways of setting up our sleep environments – uses what we know about the science of sleep to make good sleep more likely. It essentially involves programming our minds and bodies to associate bed and bedtime with a relaxed, ‘go-to-sleep’ state. For example: try to keep (but not obsess over) a consistent sleep and wake time; make sure your bedroom is dark, cool, and quiet; and minimize sleep disruptors like alcohol, caffeine, big meals, and blue lights from electronics too close to bedtime.  

Check your stress. Stress can interfere hugely with sleep. When we’re stressed, hormones like cortisol and other chemicals are coursing through our minds and bodies switching on lights (so to speak) to get us revved up and ready for action – basically the exact opposite of the state we need to be in to sleep. So, try to be mindful of your stress level and take steps to reduce it. For example, make sure to protect your personal time and leave room for things like exercise, un-hurried meals, breathing and meditation, and connecting with others. Try to keep reasonable work hours and resist the urge to answer after-hours emails – both for yourself, and in order not to perpetuate a pressurized, ‘always on’ work culture that might be keeping you and your colleagues up at night.   

Seek support. When sleep issues are becoming a consistent, chronic aspect of your life and aren’t improving even with healthy sleep habits, or if they pop up suddenly out of nowhere, it’s a good idea to talk to a professional about what you’re experiencing. Talking to a physician or participating in a sleep study are often good first steps to figure out what’s going on. From there, there are a number of well-established, effective treatments for sleep issues – for example, Cognitive-Behavioural Therapy for Insomnia (CBT-I) is considered the gold standard, first-line treatment for chronic insomnia.

After learning about the impact of sleep on your mental health and overall well-being, are there any changes you need to make? Remember, if you’re struggling to manage sleep challenges on your own, CloudMD’s experts are available to you through your workplace wellness program.  

Dr. Kayleigh-Ann Clegg is a Clinical Psychologist and Clinical Content Specialist at CloudMD.