Healthy Sleep, Healthy Soul

By Madison Thomas

Tick…tock…tick…tock. We all know that feeling, the one where we’re staring blankly at the ceiling, wide awake,  watching time go by. You’ve counted every sheep, and you just know it is going to be another night waiting for the sun to come up. Insomnia sets in. 

Those who have been called to serve on the front lines of combat, natural disasters, and other emergency situations, know this feeling all too well. Insomnia is a prevalent disorder marked by difficulty falling or staying asleep and/or poor sleep leading to daytime dysfunction. A published report found that in a study of more than 5,500 post-9/11 veterans, 57.2% had insomnia. This is much higher than the general population where it has been found that about 30% of non-veteran and first responder adults experience insomnia.

So why does insomnia affect veterans and first responders at such a staggering rate and what can you do to help ease these symptoms? First let’s talk about why. 

There is a strong association between insomnia symptoms and other common “war wounds” such as PTSD, depression, anxiety, and traumatic brain injury (TBI). A majority of combat war veterans experience insomnia which can affect your ability to be successful throughout your trauma healing journey. Your brain is constantly on overdrive just trying to make it through the day and you simply are unable to relax when your head hits the pillow. So where do we go from here? Let’s talk about a few ways that could help. 

1. Go to bed only when you are sleepy (not just tired and fatigued).
   1. Sleepiness refers to you being able to fall asleep when given the opportunity to do so. Being tired and fatigued refers to low physical and mental energy. Make sure you understand the difference, because this may be contributing to your difficulty with sleep. 
2. Use your bed and bedroom for sleep only.
   1. Participating in waking activities while in your bed creates an association between bed and wakefulness. Examples of activities to avoid in bed include watching tv, gaming, engaging in work activities, listening to music, and playing on a cell phone or tablet. 
3. Wake up and go to bed at the same time every day and get out of bed within 10-15 minutes of waking.
   1. Establishing a routine will reinforce your circadian rhythm, the system that allows your body to sleep and wake up.
4. Do NOT nap.
   1. As tempting as that nap sounds, try to avoid those quick snoozes in the middle of the day. You may be thinking, “Why? I want to catch every amount of sleep my body will allow!” But, catching up on sleep with naps is unfortunately a myth because napping during the day decreases your ability to sleep at night. 
5. If you are unable to sleep, get out of bed, and only return when you feel sleepy.
   1. If you begin to feel that frustration set in, get out of bed. Do not dwell on your inability to sleep, instead choose a calming activity outside of bed such as reading, listening to an audiobook, or watching a light program on tv.  

Next, here are a few relaxation techniques that you can implement in the hours before heading to bed to assist your brain and body in getting the sleep you need and deserve. There is no singular relaxation technique that works for everyone, so here are just a few options for you to try with sources available to try when you feel ready.

1. Progressive Muscle Relaxation (See example)
   • This technique focuses on slowly tensing and then relaxing each muscle group.
2. Guided Imagery (See example)
   • An auditory (something you can hear) stimulus that helps to form a calming and peaceful mental imagery while promoting positive thoughts. 
3. Deep Diaphragmatic (the muscle that helps you breathe) Breathing (See example)
   • This technique helps lower stress and sends a message to your brain to calm down. 
4. Deep Pressure
   • This includes activities such as laying down with a weighted blanket (anywhere but your bed!). This provides firm sensory input that relaxes your brain and will help you feel calm. If you do not have a weighted blanket another option is to pile a few large blankets on top of you to get the same effect. 
5. Tapping (See example)
   • This technique is interesting, but there are specific areas on our face that, if tapped in a sequence, allow for reduced anxiety, pain, and stress. 

Not being able to sleep is often discouraging, stressful and frustrating. Poor sleep affects your ability to participate in daily tasks and can compound the negative symptoms of the stress and anxiety you already face on a daily basis. 

These tips and resources can help you achieve a good night’s rest in the near future. Finally, here is a bible verse that may bring you a bit of peace on the nights where insomnia just feels like it may be too heavy of a burden to bear. “I lay down and slept, yet I woke up in safety, for the Lord was watching over me” (Psalm 3:5). 

Sleep well.

Madison Thomas is a capstone student completing her doctorate of Occupational Therapy degree at Cleveland State University