Sleep Expert

How to manage your racing mind and get a good night’s sleep

Most people can remember a time when they have struggled to sleep because of a racing mind. This classic symptom of insomnia, referred to as hyperarousal, is common during times of stress. It may even be accompanied by the frustrating experience of feeling tired before going to bed but then feeling wired when your head hits the pillow.

A racing mind can be due to stress or anxiety but it is more likely to occur if you have not prepared well for sleep. You may need to make some changes to your usual bedtime routine to calm your mind as well as manage any stress you may be holding.

Worry Time

Scheduling worry time teaches your brain to deal with your stressors during your waking hours so you are less likely to ruminate about them in bed. Set aside 10-20 minutes in the early evening (not close to bedtime) to go through your worries. Write a list of issues then what you can do about these problems and when you will deal with them. Think about the day you have had and anything you are left worrying about. Think about what is coming up tomorrow and anything you need to add to your to do list. For big problems, break these down into manageable steps and schedule a time to deal with the next step.

Have a notebook by your bed, to capture any additional worries you think of when heading to bed. If you notice you are worrying in bed, remind yourself these thoughts are not helpful for sleep and you have a set time to go through any problems tomorrow then distract yourself with some relaxation techniques (see below).

Dim the lights

Light has the ability to suppress melatonin, the hormone that helps you to know when to go to sleep. Dimming the lights an hour before bed should be part of your bedtime routine as bright light at night can keep you alert. Use lamps instead of overhead lights and avoid light-emitting devices in this time.

Disconnect and wind down

Not only are light-emitting devices problematic because of the effect of light on the sleep systems, what you do on these devices tends to be mentally stimulating and can contribute to a racing mind. Sleep is not like turning off a light switch. You need to take time to relax before sleep. If you work up until bedtime or are racing around doing tasks, you are setting yourself up for a racing mind when you try to sleep. Reading the news, can also set off worries while social media and browsing information on your phone can keep your brain alert. Aim to finish work at a reasonable time to allow yourself to relax in the evening and have a set time, an hour before sleep, when you turn off electronics. Then stick to non-stimulating activities like reading, listening to something, meditation or a jigsaw.

Relaxation techniques

As well as helping to relax the body, relaxation exercises can help with a racing mind. Deep or diaphragmatic breathing involves a slow, regular breath from the belly. Progressive muscle relaxation is a sequence of tensing then relaxing different muscle groups around the body while working with your breath. Visit our previous post, ‘relaxation techniques to help you sleep‘ for more information on these techniques.

Going to bed when you are sleepy

Sometimes people may experience a racing mind because they are not ready to go to sleep. The timing of sleep is controlled in the body by two biological systems, the circadian rhythm which is your internal body clock, and the sleep homeostat which balances wakefulness with sleep. If you go to bed too early, these systems may not allow you to sleep. By going to bed when you feel sleepy -tired (eyes feel heavy and you feel you might nod off), you are less likely to have a racing mind and are more likely to get to sleep. This may be later than your usual time so continue to wind down in dim lights.

No clock watching

It’s tempting to check the time when you can’t sleep but this can enhance the racing mind. Clock watching leads to thoughts about how long you have been awake, how many hours you have left to sleep and how you must get to sleep soon. These thoughts can cause anxiety and frustration, emotions that don’t pair well with sleep. If you really can’t keep the phone out of the bedroom, at least keep it out of reach so you can’t check the time. Position clocks so you can’t see them in bed or remove them from the bedroom completely.

Caffeine

Caffeine is a stimulant; it suppresses sleepiness and keeps you alert. It has a long half-life so it takes a while for it to be broken down in the body. If you are experiencing a racing mind at night, try cutting out caffeine ten hours before bedtime.

Keep the bed for sleep

If you do lots of things in bed like browsing on the phone, checking emails, watching TV, drinking cups of tea, the purpose of the bed becomes confused in your brain. You want to keep the bed for sleep (sex is the only exception) so these things become associated together.

For this reason, it’s also a good idea to get out of bed if you are struggling to sleep for more than an estimated 20 minutes (remember no clock watching). Do something relaxing, in dim lights until you feel sleepy then head back to bed.

Christabel Majendie November 2022.

Christabel is a Bristol based sleep therapist and consultant, specialising in helping individuals experiencing a wide range of sleep problems. For more information on her work you can visit her website.

Christabel Majendie is not a brand ambassador and does not endorse any product of Sleep Well Drinks Limited.

Complaints about sleep quality are one of the most common symptoms of the menopause, affecting 39-45% of women perimenopausal and 35- 60% postmenopausal.

Women report more sleep complaints and are more likely to have insomnia compared to men at all stages in their lives. One of the major influences on women’s sleep is hormones. Hormones affect sleep during puberty, the menstrual cycle, pregnancy and in the menopause transition. In the perimenopausal years, huge changes in hormones start to occur, together with a change in neurotransmitters, the chemicals that transmit messages in the brain.

Changes to estrogen

The level of reproductive hormone, estrogen, fluctuates then reduces from the perimenopausal years onwards, which leads to hot flashes. In order to get to sleep and stay asleep, your core body temperature drops and this triggers a release of melatonin, the hormone that tells your body it’s time to sleep. For this reason, sleep hygiene advice suggests sleeping in a cool room. When hot flashes happen at night, the increase in temperature can cause an awakening as well as making it very hard to get back to sleep.

Changes to progesterone

Progesterone, is another reproductive hormone that plays a role in initiating and maintaining sleep. Progesterone promotes sleep by its effect on GABA, a neurotransmitter that reduces activity in the brain and nervous system. The change in levels of progesterone that starts in the perimenopausal years leads to problems inhibiting brain activity that is essential for sleep.

Changes to neurotransmitters

There are many chemicals in the brain that influence mood. When estrogen levels are low, this affects the production of serotonin which can lead to feelings of depression. The level of neurotransmitters, dopamine and norepinephrine, are also affected by changes in estrogen. An imbalance in these hormones can lead to anxiety, commonly seen during the menopause.

There is a bi-directional relationship between mood and sleep, with low mood and anxiety affecting sleep, and sleep problems affecting emotion regulation. 

Furthermore, estrogen affects the level of cortisol, a stress hormone that influences mood and sleep. When estrogen drops, cortisol levels increase, leading to problems with anxiety. When we sleep, cortisol levels drop so sleep is directly affected by the change in this stress hormone. But all the neurotransmitters mentioned above also play a role in sleep.

Other factors

There are some differences seen in the mechanisms that drive sleep in women compared to men. The circadian rhythm, the internal body clock, is a bit more variable in women and often the circadian period is slightly shorter, so this could make them more vulnerable to sleep issues. During the menopause, problems with circadian rhythm disruption occur, possibly due to changes in melatonin, causing problems with the timing of sleep.

Age is a major factor. Sleep problems unfortunately increase as we get older for both men and women. This is because the systems that regulate our sleep weaken and melatonin production reduces, resulting in more fragmented sleep and more problems initiating and maintaining sleep.

During the menopause changes in hormones and neurotransmitters lead to higher risk of developing the sleep disorders obstructive sleep apnea and restless leg syndrome. These both can significantly disrupt sleep, the former by interfering with breathing during sleep and the latter with uncomfortable sensations in the legs at nighttime that can only be relieved by movement.

What can women do to help prevent sleep disturbance?

There are several medical options that may help but also several behavioural influences that can make a big difference. It’s helpful to remember that, although there are clear biological changes occurring in the menopause transition, our behaviours influence our neurotransmitters which then influence how we feel and our ability to relax and sleep.

Hormone replacement therapy, antidepressants and sleep medication can reduce symptoms of menopause, reduce hot flashes and sleep disruption. If you want to explore these options, speak to your doctor about risks and benefits.

There is growing evidence that soy-based foods can reduce menopausal symptoms and improve sleep quality as they contain phytoestrogens. Try out soya milk and yogurt, tofu and edamame beans. For supplements containing phytoestrogen, there is some evidence that ginseng and black cohosh can help, but more research is really needed for conclusive evidence.

There is good evidence that yoga helps to reduce menopausal symptoms and improve sleep quality. The evidence for acupuncture is promising but is limited and more research is needed.

Lifestyle factors

Lifestyle factors can make a huge difference. Avoid caffeine eight to ten hours before sleep and nicotine one hour before bedtime, limit alcohol and avoid heavy meals two hours before bed. Be aware of spicy or acidic foods which can trigger hot flashes. Reduce fluid intake in the few hours before bed to avoid trips to the bathroom at night.

Regular exercise can benefit sleep but avoid intense exercise two hours before bed to allow your body temperature to cool down for sleep. Gentle stretching completed two hours before bedtime may help as can a warm bath as both these can gently increase the body temperature which leads to a drop prior to bedtime.

Sleep in a cool room (16-18 degrees) and use layers of bedding, made from natural fibres, to regulate body temperature at night. Use “sweat management” bed clothes or none at all and have a change of clothing by the bed with a glass of water to prepare for hot flashes.

Avoid using your bedroom excessively to relax in the evening or during the day and avoid working in the bedroom. Electronics are best kept out of the bedroom to reduce cognitive arousal and light, both which can negatively affect sleep. For more tips on how to improve your sleep routine, click here.

If you struggle with a racing mind or anxiety, try writing down your thoughts in a worry journal in the early evening but then make sure you wind down for at least an hour before sleep with some relaxing, non-stimulating, activities.  

If you are still struggling to sleep despite all of this, you could try a course of Cognitive Behavioural Therapy for Insomnia (CBT-i). A wealth of research shows that this treatment improves sleep in most adults, including women going through the menopause transition.

Christabel Majendie October 2022.

Christabel is a Bristol based sleep therapist and consultant, specialising in helping individuals experiencing a wide range of sleep problems. For more information on her work you can visit her website.

Christabel Majendie is not a brand ambassador and does not endorse any product of Sleep Well Drinks Limited.

Most parents of teenagers remember a time when their child used to wake up early. There is a clear change in sleep timing in the teenage years, with children going to bed later, struggling to wake in the morning and sleeping later at the weekends. Why is this?

The drivers of sleep

Sleep is regulated by two systems in the body. Firstly, there is the circadian rhythm. This is an internal body clock which controls the timing of many bodily processes, including the release of a hormone called melatonin. Melatonin is a hormone produced in the brain to tell you it’s time for sleep. During the day, melatonin is suppressed, but in the evening, in dim lights it will start to be released. The clock is set to a 24-hour cycle but the timing of the clock varies from person to person, so we get sleepy at different times and the time we naturally wake is not the same.

The second system is the homeostatic sleep drive. This system works like a pressure cooker: when you are awake, sleep pressure builds up due to a metabolite called adenosine, a by-product of energy production. This sleep pressure becomes stronger the longer you are awake. Then when you sleep, the pressure is relieved, like steam being released from the valve of a pressure cooker.

These two systems work together to give you the right amount of sleep at the right time. Teenagers need more sleep than adults, with sleep experts recommending 8-10 hours every night. However, many teenagers struggle to get enough sleep due to the changes that occur to the biological drivers of sleep. During adolescence, hormonal changes affect these systems and the timing of sleep. The circadian rhythm becomes delayed so the release of melatonin happens later in the evening. In addition, the homeostatic sleep drive builds more slowly. Both these changes result in teenagers not feeling sleepy until later and finding it hard to wake up early in the morning.

Exacerbating factors

It’s important to understand that this change in sleep timing is driven mainly by biology. However, the picture is more complex because there are environmental influences that will exacerbate the problem. The timing of the clock is strongly influenced by the timing of light. The clock expects darkness at night and this allows the release of melatonin. The circadian rhythm needs light in the morning and during the day to keep it to time, as well as a reduction in light intensity during the evening.

When teenagers don’t feel sleepy in the evening, they want something to do. They often reach for their phone which is a light-emitting device. There are receptors behind the retina which can detect the brightness of light and this information is sent to the area of the brain where the “master” body clock sits. So light-emitting devices held close to the eyes have the ability to push the body clock later if used late at night. In addition, using a phone at night is a stimulating activity; social media, games and browsing keeps the brain alert. Before sleep it’s advisable to do non-stimulating activities like reading or listening to music to wind down.

The timing of when you eat is another “zeitgeber” or time keeper for the circadian rhythm. Eating breakfast helps to kick start the circadian rhythm. However, it’s common for teenagers to skip breakfast as they don’t have time in the morning and don’t feel hungry. The circadian rhythm also influences appetite so with a delayed circadian rhythm comes a lack of hunger in the morning. However, skipping breakfast and eating late into the evening can cause the circadian clock to drift later.

Most teenagers have to wake up for school far earlier than their natural body clock would dictate. This, combined with late nights, results in teenagers not getting enough sleep during the week. Several studies have shown that starting school later in the morning results in better academic performance, improved attendance, more sleep and better health outcomes, with little evidence that this results in later nights. The evidence is so strong that both the American Academy of Pediatrics and the Centers for Disease Control and Prevention have advocated for delayed school start times for adolescents.

What can parents do to help teenagers to get enough sleep?

It can be helpful to explain to teenagers how the sleep drivers change during adolescence. This acknowledgement can validate their experience: that they are not necessarily trying to go to bed late but are just not sleepy. Equally they are not being lazy in the morning but are really struggling to wake up early.

Agree a set bed time, eight to ten hours before the time they have to wake. Some research shows teens get more sleep if their parents set a firm bedtime. Try not to deviate too far from this bedtime at the weekend and reduce Sunday lying in to just an hour more than usual.

Encourage them to not use their phone in their bedroom or to put it on flight mode at least one hour before bed, explaining the rationale for this. Discuss alternative ways to wind down before sleep like reading a book or magazine or listening to something with the lights low. Discourage homework too late into the evening, allowing at least an hour to wind down.

Explain how caffeine can cause problems getting to sleep if drunk too late in the afternoon or evening and provide alternatives (although not ideal, non-caffeinated fizzy drinks at least will not affect sleep).

Getting outside in the morning can really help to promote sleep later so walking to school is a good idea, if possible. If not, some outside time in the morning is advisable, such as breakfast outside.

Anxiety and problems with mood can negatively affect sleep so be there to talk about any stresses or problems your child is going through. Speak to a doctor if you feel mental health problems are behind any sleep issues.

Rather than setting rigid rules for them, encourage teenagers to take ownership of these behaviours by explaining why sleep is important and the effects of sleep deprivation. Sleep affects so many things so choose what is important to your child: health, mood, academic performance, athletic ability.

Christabel Majendie August 2022.

Christabel is a Bristol based sleep therapist and consultant, specialising in helping individuals experiencing a wide range of sleep problems. For more information on her work you can visit her website.

Christabel is not a brand ambassador and does not endorse any product of Sleep Well Drinks Limited.