Be Well, Feel Well blog: Sleep – June

How does sleep affect mental health?

Generally speaking, there are two types of sleep (there's actually more like seven, but it's easier to think of two): deep sleep, which is when our body is recovering, cells are repairing themselves, etc; and REM (Rapid Eye Movement) sleep, which is when we dream to discharge emotional arousal from during the day. If we have a lot going on, if we're worried or anxious, we need more REM sleep and consequently get less deep sleep. Around 20% of our sleep should be REM, usually, but when we're struggling it can go up to as much as 50%. And as it takes more energy, we wake up feeling exhausted

What are the main causes of poor sleep?

Stress caused by unmet emotional needs can lead to increased REM sleep, which can impact on the quality of our sleep overall. Making a life that works to meet your emotional needs is the first step to ensuring a good night's sleep. Other than that, there are various physical factors - like the temperature of your bedroom, the number of distractions in the room, etc. We have renamed mobile phones as 'attention harvesting devices' at Suffolk Mind (and in my household) - they certainly don't help you get a good night's sleep. Ideally, we should have no screens for at least an hour before going to bed. Read a book or chat to family or friends instead.

Are there any treatments for long term sleep problems?

At Suffolk Mind we tend not to suggest sleeping pills or anything like that. There are lots of tips on our website, but if you are really struggling to sleep, then try your GP and try to challenge them not to prescribe pills but to seek other solutions. It's not easy, but it is important to get a good night's sleep. Carer, shift workers and others all struggle with a routine or with being undisturbed, so I know it can be a challenge. Another option for some people is to try and find two-hour blocks of time in which to try and get a 90-minute sleep cycle, during which time you'll have some deep sleep and some REM sleep.
I am dealing with poor sleep after a traumatic couple of years, I am now able to fall asleep but wake between 6 and 8 times a night, is there anything I can do to help with this?
The best thing to do when you wake up the first time is get up and do something boring. The brain would rather be asleep than bored. So, try cleaning the oven, or washing the windows...something that you don't find stimulating. Do it for ten minutes, then go back to bed. The key is to break the association your brain might make between being in bed and lying awake worrying or thinking about things. Other things to try include; reducing caffeine intake, making your bedroom a temple to sleep (so do nothing else in bed, other than sleep), keep to a routine - go to bed at the same time and aim to get up at the same time.

If you can’t sleep well what are the knock-on effects of poor sleep?

In older people, the risk of dementia is one effect. In younger people, there is evidence of increased risk of Borderline Personality Disorder and of suicidal ideation. This is the case if poor sleep continues for a long period of time. More immediately the knock-on effects will be loss of concentration, lethargy, lack of ability to think creatively and problem-solve...which can be an issue when it comes to finding solutions to the stress that might be causing poor sleep. So, it can become a cycle that needs to be broken.

What have you found are the triggers for bad sleep and how many hours a night should we be getting?

Adults should, ideally, be getting around 8 hours' sleep. Younger people need more, and we often tend to need less as we get older. There is a lot of evidence to suggest the difference between 6 and 8 hours sleep in your 50s, 60s and 70s equates to a 30% increase in dementia risk in your 80s.

Loads of things can cause a poor night's sleep - in particular, stress caused by unmet emotional needs. If you go to bed and lay awake worrying, it won't help you get to sleep. But there are also physical barriers, especially during the summer months when the days are longer. So, things like blackout curtains, or an eye mask, can help. You should also try to maintain a cool temperature in the bedroom - about 19C is perfect.

What is the best way to unwind prior to sleep to ensure a restful night?

Relaxation exercises can really help. Do some 7/11 breathing (which is where you breath in for the count of 7 and out for 11) for a few minutes before getting into bed. Then, when you're in bed, do some 'muscle tension relaxation' exercises. This is where you tense all your muscles, starting with your toes and working your way up your body, hold it for a few seconds, then relax again. Your muscles will revert to a more relaxed state than they were before you did the exercise.
You could also try a warm bath, reading a book (not in bed, but in a chair next to your bed so that your brain associated being in bed with sleeping, not reading). Most importantly, leave your mobile phone downstairs!
For more information, support and advice visit: https://www.suffolkmind.org.uk/resource-category/sleep/

Firstly, do you have any advice on how to deal with the light evenings to support my child to sleep?

We hear a lot of families say how the lighter evenings have disrupted bedtime and equally; lighter mornings have caused an earlier waking. You may want to use heavy lined curtains or a black out blind to make their bedroom room as dark as possible. Focussing on the lighter evenings, In the hour before bedtime close curtains and blinds to create a darker environment. Another suggestion is to follow a relaxing bedtime routine, which gives your child cues that bedtime is approaching and helps to prepare their body for sleep

Can you help me to have some ideas on how to create a healthy sleep routine for my child?

In the hour before bed, you want to create a calming environment for your child to relax and prepare for sleep. Avoiding screens and stimulating activities during this time is very important. A bedtime routine will often have 3-4 activities that you repeat in the same order and at the same time every night, consistency is key. Here are some common bedtime routine activities. Colouring, reading stories, having a bath, putting on pyjamas, having a drink of milk and brushing teeth. Once the child is in bed, some parents choose to sing a bedtime song or say the same phrase to them every night to signal that it is now time to sleep. A regular wake time is also important in helping a child develop a healthy sleep routine.

Can screen time affect my child’s sleep?

Yes, screen time can affect everybody’s sleep. For children It is recommended that during the hour before bedtime screens are avoided. The blue light from screens can be stimulating and keeps them alert. This in turn hinders the production of a hormone called melatonin which our bodies produce to promote sleepiness. Using screens just before bedtime is likely to delay the time a child falls asleep and cause a more restless sleep.

What is developmentally normal sleep for a baby under one?

It is expected that your newborn baby will sleep for, on average, up to 18 hours per day. However, because newborn baby’s stomachs are so small you can expect them to have to feed regularly, around 2-3 hourly. Because of this, your sleep will be disjointed and if possible, it is worth arranging to take shifts with someone else, to ensure you get enough unbroken sleep to get through the day (average of 4 hours). As your baby gets older, their tummies grow, and it becomes more likely they will sleep for a longer period. You may also start to notice a routine develop, as they develop circadian rhythm (a body clock here they start to build understanding of night and day). At approximately 4 months, 8 months and 12 months it is common that your baby will have normal changes in their sleep which is as a result of them learning new skills and reaching different milestones. These are often referred to as ‘sleep regressions’, but don’t worry, these are developmentally normal and will pass.

Should I bath my child before bedtime every night?

Some families prefer to include bath time as part of their regular bedtime routine. If this is the case and your baby enjoys this, there is no reason to change this. If you feel that your baby does not enjoy bath time, or bathing every night is not achievable for you, this is also ok. You may find you choose to do a ‘topping and tailing’ wash instead, in between baths. You can find more information on the NHS website in regard to bathing your baby.

My child will nap if their dad puts them down, but for me the nap lasts 10 minutes and then they are up again. I am with my baby alone for 8 hours per day so it is always me that puts them down unless it’s the weekend. What am I doing wrong?

Firstly, I would like to reassure you that it is definitely not that you are doing something wrong. It is not uncommon for babies to become more fussy when they are with their primary caregiver and this is often because they trust you so much and share their true emotions with you. My biggest tip is, try to stay calm – babies can sense very easily if you are experiencing stress of anxiety around their nap time, and are very clever at feeding off this and therefore becoming distressed themselves. It may be worth tapping into your support network to offer you a break or trying to find some activities that help you to relax, such as mindfulness or creative journaling. Consistency is key and if you keep offering your baby their nap at the same time and have confidence in yourself, I hope things will become easier for you.

My health visitor has told me that my baby should sleep in a clear cot or sleep space, is this true?

Yes, this is correct and it is important that your baby sleeps in a clear cot of sleep space such as a Moses basket or travel cot. Babies require a firm, waterproof mattress and to sleep alone on their back in their crib to reduce the risk of SIDS. This is often referred to as the ABC of safe sleep. You can find more information about safe sleeping guidance on the Lullaby trust website at: Lullaby trust

My baby rolls from his back to his tummy during his sleep, I am worried because I have always followed the ABCs of safe sleep. Should I roll him back onto his back each time?

This is a good question and one I have been asked by many parents. I can understand why you are worried because we should always lay our babies onto their back, to sleep. However, babies who can roll from their back to their front independently will often, as you say, roll onto their tummy to sleep. This is ok provided that baby has put themselves in this position, as they will be able to roll back if needed. Please continue to place baby on their back and try not to worry about this new skill your baby has developed.

Is it ok for my baby to have their favourite cuddly toy in their cot? They absolutely love it and wants us to bring it wherever we go!

Thank you for asking this question. It is important that your baby does not sleep with their cuddly toy, because this can increase the risk of SIDS. Your baby should sleep in a clear cot or sleep space with nothing but themselves and a dummy if they use one. It may be worth thinking about including a hug goodnight and saying goodbye to the teddy as part of your bedtime routine.

Finally, are there any contacts or resources that might be useful?

We would recommend looking at the links that we have shared throughout the questions, and parents may also find the following helpful:

• https://www.nhs.uk/conditions/baby/caring-for-a-newborn/helping-your-baby-to-sleep/
• https://thesleepcharity.org.uk/information-support/children/
• https://www.lullabytrust.org.uk/

Join Tara Rudd from the Suffolk Safeguarding Partnership for a chat about Sudden Infant Death Syndrome and safe sleep.

“In this episode I wanted to share all the information I remember being given in order to keep my first baby safe and well. I am lucky enough to be joined by Jackie who is an expert on the subject and a mum herself so this is the most well-informed mum chat you will hear on SIDS. I remember learning a lot from talks like this with other friends who were pregnant, and it occurs to me that not everyone has that. Listen to this with your parents or grandparents to get everyone on board with the Safe Sleep guidance ready for your when your baby arrives.”

Live online workshops particularly helpful for anyone who is experiencing problems with their sleep, regardless of age or physical health difficulties. During periods of stress, it’s natural to be having difficulty getting to sleep, staying asleep and/or getting the quality of sleep we need. Research tells us that poor sleep can negatively affect both our mental and physical wellbeing and focusing on ways to look after this is important.

If you live in Suffolk
If you live in Norfolk  and Waveny

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The Source

A wellbeing resource for young people in Suffolk

Video of young people sharing their views on trouble sleeping

• Teenage sleep tips (padlet)

The Sleep Charity, provide advice and support to empower the nation to sleep better

To raise awareness of the value of a good night’s sleep and promote understanding around the complexities of sleep

• A bedtime routine is important in getting a good night’s sleep. Information and advice sheets, you can download 
• If you have a child with additional needs and sleep issues, bedtime can be tricky. Infomation and advice sheets you can download

• Insomnia (NHS)  - Insomnia means you regularly have problems sleeping. It usually gets better by changing your sleeping habits
• How to fall asleep faster and sleep better (NHS)

How sleep can improve your immunity 

YMCA Join this months FREE webinar on sleep

 Wednesday 28th June 1pm -2pm

 Tips for rest and recharge This webinar is an exploration of good sleep hygiene, the impacts of disturbed sleep and its links to other conditions.
 We hope to give you a better understanding of why teenagers sleep so much and how we can promote great sleep for all of us.
 Book a place at https://www.eventbrite.co.uk/e/tips-for-rest-and-recharge-registration-592394025477

 Wednesday 30th August 1pm-2pm

One community: Challenging the stigma of mental health. In this webinar we explore the themes of community and what stigma around mental health means. What impact does stigma have and tips to help reduce this stigma and nurture our sense of community. Book a place at https://www.eventbrite.co.uk/e/one-community-challenging-the-stigma-of-mental-health-registration-592405640217

Tuesday 24th October 1pm-2pm

Firm and fair - Why boundaries are important.
In this webinar we will look at why children of all ages need boundaries and how it helps their growth as well as explore the idea of privacy and how respecting and encouraging privacy can enhance family life.
Book a place at https://www.eventbrite.co.uk/e/firm-and-fair-why-boundaries-are-important-registration-592428277927 

 Tuesday 19th December  1pm-2pm

The power of noticing (Suitable for 11- 18 year olds & parents)
How does being present boost our wellbeing and relationships?
Join us in this webinar to explore the links between the power of noticing and the impact on our wellbeing and mood, including being in control of where we direct our focus. Book a place at https://www.eventbrite.co.uk/e/the-power-of-noticing-registration-592446221597