In this episode Dr Tara Quinn-Cirillo (of “The Adversity Psychologist Podcast“) talks to Dr Stuart Sadler, Clinical Psychologist and Sleep Specialist. I am sure we have al experienced difficulties with our sleep at times. During the pandemic sleep issues were more commonplace. This episode will help you understand more about sleep and how it can be impacted by the world around us.
- Why sleep is important
- The physiology of sleep
- Stress and the impact on sleep
- Strategies for better sleep
- How sleep affects us in day to day life
- Why sleep has been such a huge issue during the pandemic
- How sleep can be impacted by life events.
Some takeaways from this episode:
“De-myth the magic 8 hours”
“ Allow sleep to come to you”
Dr Tara Quinn-Cirillo: Welcome to the adversity psychologist podcast, a podcast incorporating narratives about facing and navigating adversity, a mixture of people, their experiences and professional, psychological discussion. I’m Dr. Tara Quinn-Cirillo, I’m a qualified and regulated psychologist with over 20 years experience of mental health, disability, and human behaviour.
I want to share people’s stories of navigating adversity in the hope that through being heard a dose of compassion and some understanding we can help others in the face of adversity. Hi, everybody. Welcome to the Adversity psychologist podcast. I’m Tara Quinn-Cirillo. And today I am so thrilled to have Dr. Stuart Sadler with me, who I call the sleep guru, but I’m gonna let him introduce himself.
Welcome Stuart and thank you for coming on.
Stuart: Oh, thank you for inviting me, Tara. It’s an absolute pleasure to be able to speak to you and your listeners.
Dr Tara Q-C: Tell us a little bit about you. Who are you? What do you do? And what have I managed to get you on here today?
Stuart: I’m Stuart Sadler. I’m a clinical psychologist who specializes in sleep, depression and anxiety, and the reason I tend to specialize in those three areas is cause quite often they form like a bit of a three-legged stool where if there’s trouble with one, there might be problems with one or the other.
And, similarly, some of the mechanisms that underpin each of those overlap quite a bit. So quite often we find that even if people don’t have an anxiety problem, they might have some of the mechanisms there that interfere with their sleep. And similarly, if people don’t have trouble with depression, there might be similarly some of the behaviors or some of the things that occur in depression that affects their sleep.
Sleep — it’s a kind of very different area of psychology. It’s, uh, you know, the sleep medicine in itself, it’s an entire massive area. That’s very different in its approach. It’s not just talking about thoughts and feelings about sleep. There’s very practical things that go with it.
Dr Tara Q-C: You know what that’s, what really struck me.
So I, as part of my core training, we had sleep was introduced, but exactly, as you said, it was introduced in terms of, if you have anxiety or depression or a mental health problem, it may impact your sleep. And it went straight into strategies to manage, but there wasn’t a lot about science — the physiology behind it.
And I did a seminar probably about eight years ago and it literally changed my view on sleep and how I discuss it with patients and the person that did that seminar said to us, how often a psychologist do you literally spend a session on sleep and no hands went up and it literally changed my practice cause I was like, I did used to do it as a tick box.
How’s your sleep? Fine. Are you okay, dropping off. Do you wake in the night? Right? We’re done. And that’s the reason I wanted to have you on today is to kind of talk about why sleep’s important, the dreaded P word sleep in the pandemic, but also perhaps how our sleep may be impacted by what we’re going through as human beings.
And I’m sure a lot of people listening at some point in their life will have had issues with their sleep. You know, whether it’s more formal things like insomnia or a few disturbed days or nights, or we’ve just had a heat wave, haven’t we? So many people I’m sure the beginning of this week, would’ve struggled.
So can you share some of your wisdom around, why is it important to think about sleep, how can it impact us.
Stuart: Yeah. I think like you were describing there, so sleep it’s usually or previously was considered a bit of an afterthought when it comes. Yeah. It’s just something that everyone does. It’s like a tick box, like asking about people’s appetite or something like that.
But the research that we know now is that sleep gets affected. Quite a lot of things, both mental health, both in day to day life, you mentioned about the heat and yeah, I think even in this last week or two, people that I know who don’t have any trouble, no one seem no one’s particularly slept that well because of the heat, you know, and it kind of fits with all the science we know about sleep medicine that we have to be cool in order to sleep and, and so on.
And, you know, we might end up talking about that. But a lot of the research that’s coming up more recently sleep in the last, maybe 10, 15 years has had a lot more research focused on it. And some of that research that’s come out has been really interesting. So a lot of the research is showing that now if you improve people’s sleep, it improves people’s depression and anxiety without even touching right.
Or trying to intervene with any of. Any of those anxiety or depression strategies. We know that if we don’t sleep very well, it’s harder to regulate our emotions the next day. Again, whether we have trouble with our mental health or not, and I’m. We all have experience of feeling groggy the next day and feeling less motivated.
But for people with mental health problems, and we know that stress tends to be a trigger for, for exacerbation, for things getting worse again. And, I often describe it as being a little bit like a kind of bucket where, I mean, we have that kind of stress bucket idea where it fills up with water, but lack of sleep actually can.
Even temporarily the size of that bucket and make us more prone to experiencing difficulties due to stress. You know, if we have a stressful life, which 2022, it’s pretty much impossible to get rid of stress, isn’t it? You know? Yeah. Day to day stress. If we, if we manage okay with it just a few nights of bad sleep can make that regular day to day stress feel overwhelming and, you know, send us into difficulty.
Dr Tara Q-C: I’m just thinking Wednesday this week. So after Sunday was fairly hot and then we had the kind of official heat wave, just looking at, you know, coffee cues, my temper, my very short fuse, just for a couple of nights of disturbed sleep, the heat, the impact of that on our bodies as well. And then our cognition.
And that was just, you know, considered, I consider that a transient temporary thing. So, you know, we look at something like the pandemic, particularly. I know that I got asked in interviews about why is everybody struggling to sleep? And I think what’s really important. And the reason I wanted to have you on here today is to try and help people understand that it’s important to learn about your own sleep or your own formulation, what can impact it?
And you mentioned something there again about, you know, kind of we’d call it in psychology relapse that we may have quite okay. Sleep patterns, but then something might happen externally or internally that there might need to dip in the quality of our sleep or sleep routine, whatever that might be.
Stuart: Yeah, absolutely.
And, and there’s, there’s the kind of two types of problem that occur. So if we start having trouble with our sleep, there’s the direct effects. Like you say, we feel we’re a bit, you know, we might feel a little bit more angry or frustrated, or we don’t. We don’t function as well. Yeah. But then there’s also the type two or the indirect effects, which is where we start worrying about our sleep, where we we’ve not been sleeping.
What if I don’t sleep tonight? I won’t be able to function if I don’t sleep. And. With that we can get into like cycles or loops, uh, that happen quite commonly, where it gets to the point we start worrying about our sleep. And I think one really important concept is that we need to remember that in order to sleep well, we have to feel safe and calm and relaxed and protected.
Yes. And if we’ve got all these thoughts about what if I don’t sleep, I’m not gonna sleep. I won’t function tomorrow. You know, we really activate that threat system, part of our brain that then just caught us all starts flooding our system. And, you know, it’s like stress. It’s one of the, it’s one of the worst things really for sleep.
It’s this idea about why would my sleep, if the thought cats were around, right? Yes. You know, it’s like if we think there’s danger, whether it’s perceived or whether it’s genuine danger, it doesn’t make Ary sense for us to fall asleep.
Dr Tara Q-C: Absolutely. Do you know what? I’m sure. That the majority of people will not know this, you know, that unless you’re working in the industry, you’re doing a job.
Like we do that actually, that kind of secondary worry, you know, the what ifs… I’m trying to think when I was working in NHS and getting up at like six in the morning, quite often, that really resonated with me. Then I can remember waking up. At four o’clock I’m thinking, well, what’s the point now I I’m gonna get sleep.
And then, oh, when I do that IQ test, I’m not gonna do that very well. And the whole day’s gonna be wrong. And sometimes you could catapult to three months down the line. I’m not gonna be good at my job. And, and it’s so easy to get sucked in that rabbit hole or that vortex isn’t it. So if there is something isn’t there about.
Kind of psychoeducation then, and I guess that’s what you sort about today is that trying to help people understand what the brain does that helps them stroke and helpful friends. So I guess, you know, if you are struggling with sleep and then your appraisal of the fact. That you’re having issues with your sleep.
How might that affect as human beings in terms of maybe our moods, our emotions, but also our bodies as well? I’m thinking.
Stuart: Yeah. When we don’t sleep very well, we know that there’s, there’s kind of two types really broadly. Speaking of sleep, there’s, what’s called non-REM sleep, which used to be considered fast stages, but now it’s really three, three stages three, and quite similar, so they’re grouped together now. And that non-REM sleep is really for our physical recovery. So our tissues are healing. Our hormone levels are being kind of normalized and stabilized. Right. And we have what’s called REM sleep, which is usually the one most people have heard of. And that’s really comes after non-REM sleep in the sleep cycle.
And that’s more mental recovery. That’s where our memories are getting filtered and learning is being consolidated from a day. Our concentration and our attentional pool is being refilled ready for the next day. So we tend to find that. If we’re struggling with our sleep, I’ve worked with athletes and you know, that kind of sleep is really important for them, for their recovery so they can perform well, imagine, you know, trend well the next day.
Similarly, if we’re not sleeping, the cognitive effects can affect us. Just in regular day to day life, you know, we found that our memory’s not as good. We found our concentration’s not as good. And there was an interesting study done with air airport security staff, where people who only work night shift, they were asked to monitor what was going through the x-rays.
The researchers found that on a night. They missed more contraband items, you know? Oh, more things like, and some were quite blatant. Things like guns, you know, that were actually gunships and all of that. They missed more of those than they did during the day. And what we’ve gotta remember is that these are people who were used to only working night shift.
So it’s not that we do adapt fully to functioning at night. It is more that our brain and body goes into a bit of a, a change, a biological change at night. It goes into a process what’s called down regulation, which is where some of our problem solving our planning. What we call in the industry is the executive functions.
They tend to switch off a little bit. Even if we are used to working or functioning at night, we’re still never as good as we are during the day. Cause
Dr Tara Q-C: that’s so interesting. You might think, you know, as a psychologist, my first thought, I wonder if those people are new tonight, just then what’s the change.
But you know, when we’re looking at variables, actually, that’s just the way it is. And presumably well, does that mean for change? You know, is there a possibility then that, that is gonna stay the.
Stuart: Mm, well, we kind of experience it ourselves as well. If we, to a smaller degree where if we wake up on a night and it’s two in the morning, we can’t sleep.
We find that we do tend to kind of worry, mark catastrophize more. And then the next day, broad daylight we think to ourself. Why was I even thinking about that? Right. You know, it’s like our brain does work quite differently, but certainly when it comes to everyday function, we are biologically disposed to have all of our important, stressful and functional stuff during the day.
And the nighttime, our DAC periods has been for relax session and recovery.
Dr Tara Q-C: There’s so literally I’m just thinking we could probably four or five episodes on this. Couldn’t we there’s something for me about helping people understand then. You know, a few disturbed nights might be very different from someone who has, I suppose we could always go into that little bit, what the difference is between insomnia.
There might be people listening that thing, or what’s insomnia versus, you know, a few disturbed nights. When might, I need to look at interventions for example, but just how much sleep can have an impact on our mind and our bodies and perhaps not everyone would, would realize that. Do you think, is it useful?
Is it something we can do in a kind of snapshot? Just I’m just thinking if there’s people listening, going well, actually what’s the difference between Inso. And maybe more temporary sleep problems when might something become problematic. Yeah. In terms of sleep deprivation or disturbed sleep.
Stuart: Well, come to the textbooks. Insomnia is when it’s been several weeks or so of, and has to impact on like day to day function. And yeah. You know, whether that’s relationships, our occupational function or just activities that we’re doing, usually though, people binds that. If they’re having trouble with their sleep, they tend to want a solution a bit quicker.
You know? Yes. And, for most people, the journey starts with going to their GP, which is a perfectly reasonable thing to do. What we kind of know now though, about a lot of sleeping medication is that there’s, there’s several things about it. So one of the things about sleeping medication is that similar with alcohol, it does help us often fall asleep quicker, but it really knocks off the quality of the.
Right. One thing that isn’t really talked about so much is that we live very much in a society where we focus on number of hours, but it’s actually the quality that’s more important. And what we know both from the research from people’s experience and probably even our own experience, if we reflect on it that six or seven hours of good quality consolidated sleep is better than eight or nine hours of broken sleep.
Right. And we need to bear in mind that few nights of not sleeping very well, especially if there’s something happened, you know, if we’ve been out that night or if there’s a big thing, the next day, it’s perfectly normal to have a few sleepless nights, even good sleepers have that. I guess, for a lot of people, the problems seem to start when either they have a run of bad nights.
and they might start getting into some dysfunctional or unhelpful patterns where they’re trying to deal with it. Yes. And then that in itself becomes problematic, or problems start when they start kind of ruminating or dwelling or thinking about it. What does this mean? And that’s when we get into that cycle.
That, what if thing that you’re talking about earlier? What if I don’t sleep tonight and, and, and that in itself, I mean, you know, a big part of it, it’s not just the behavioral, what can I do to sleep better? A big part of it’s also that kind of cognitive. To get people out of those patterns of thinking or how to help them get out of those patterns of thinking
Dr Tara Q-C: It is. Cause I think sometimes people might be, I know if you, you, you Google sleep. For example, a lot of what you read are very practical, logistical things, which are very useful. And I know if. You did. We should say actually the reason that we kind of got to know each other is through an international toolkit.
That’s another psychologist set up and a few of us just helped you in the pandemic. Didn’t we with, with things to help people get through, including sleep. And you did a really fantastic talk didn’t you on sleep, and looking at practical tools, but also the difference between a psychologist talking about that.
If it’s right to say, it’s bringing it all together, looking at the formulation behind it, what can you do to manage things like that? Not just about the logistics of your bedroom and, and those things as well. But there was a couple, so many points I wanna pick up on, but there was a couple of things that you’d said there there’s something isn’t there around am I allowed to use that word, normalizing the fact that sometimes we have disturbed sleep.
So as you say, we’ve all been out, perhaps, you know, had a later night or I went to a concert last night, for example, and I was so kind of thrilled to be there. And it was the first one. So it was a pandemic that actually, it took me ages to fall. A little bit more tired today, which is ironic, cuz I’m talking to you.
But that’s okay. I’m not hooking with that and going, oh no. Why didn’t I get to sleep? And it must have been about 2:00 AM at the time I fell asleep because I was thinking about what I’d heard and how good it was and that’s okay. And kind of normalizing when sleep, maybe. Has a, is it dip the right word with use, or we have a little bit of a roadblock.
And I’m also thinking about if there are people who perhaps have what we call a spikey profile. So they might have a few nights of disturbed sleep every now and again. But if you’ve had perhaps a period where it really has caused you, worry is how some people might hook with that. Oh no. Is it happening again?
Is it gonna be like large? Does that make sense? Is that difference between just normalizing little blip? Sleep, but also when people may have had real impact and a worry, this is happening again, but it might just be one of those little blips. Does that make sense?
Stuart: It makes perfect sense. And it fits a lot with my expense of working with people in the sense that right.
You know, at the beginning, we, we, we obviously do a really good thorough of assessment, not just of like the sleep environment, but also as well their worries or thoughts about sleep and some of their routines, their patterns that they do. Quite often, it starts off people, you know, what can I do on a night to sleep better?
But what we’ve gotta remember is that we don’t, we don’t run to a 16 hour daytime life. And then an eight hour nighttime life, we run to a 24, it’s actually a 24 hour 0.2 cycle, the circadian rhythm. So what that means is that what we do during the day affects how we sleep at night. Yes. And similarly, just like how we sleep at night affects how we feel the next day and, and so on.
And the reason I always like draw attention to. Is because a lot of people, especially during the pandemic, what we found is they would work right up until bedtime and then expect to be able to just get into bed and fall asleep straight away. And yes, we think about that. We need a wind down time. We need time for our brain and body to be able to say, right, that’s done.
I’m gonna gradually transition into this relaxing state now. So we, we do find that at the very beginning, when we’ve done that assessment, we find that one of the best things to do is to try and hit a big reset button. You know, we talk about things like using the bed only for sleep, so that we’re maintaining that sleep bed association.
We talk about things like making sure that you’re only going to bed when you’re tired. Which is often quite later. And you know, the number of times that I seem to tell people that they’re going to bed too early, and then they say, oh, but I’ve got a bed I’ve always gone to bed at this time, you know?
Yes. That’s part of the problem. It, it’s not just what causes the sleep problem. It’s what keeps it going. And I often describe it as being a little bit like you know, going to bed. When you’re not tired, it’s a bit like hanging around the dinner table when you’re not hungry. Yeah, you know, or hanging around the fridge when you’re not hungry.
So really we only wanna be going to bed when we are tired or when we, we, we Essent sleep medicine when you’re sleepy, which is different from when you’re tired, sleep is way that falling on the, off, falling asleep on the surfer type feeling. But when we get all those sort of things, right, and we hit that reset button.
It gives a bit of a kind of clean slate, and then we can start to look at what it is that’s maybe been affecting that person’s sleep and it’s not forever. You know, it’s not that people can never lie in bed watching TV, or they must never drink coffee. It’s more getting rid of these things so that we can get those routines and habits just right.
And then those things can be gradually introduced and quite often people will learn. In that way that, oh, actually whenever I drink alcohol, that affects my sleep. Or if I have coffee, even at 10 in the morning, I don’t sleep well that night. So people get to learn what it is. That causes their own sleep problem.
And that becomes really important in normalizing, because if we’re able to say to ourselves, right, it’s a birthday party tonight, I’m going out, I’m gonna have a drink. I know. I probably won’t sleep that well. It makes it more okay. And we, we don’t, we don’t worry about it. I think it’s when we don’t have an explanation for it, that that’s when we start to panic.
Cause we feel less in control and sleep is a very unpredictable thing. Anyway, you know, we go chasing it, but really. The best we can do is set the conditions and allow sleep to come to us. I love that.
Dr Tara Q-C: There’s so much of what you said there. I just think will make sense for so many people that what you said a few minutes ago as well, actually, in terms of, you know, I was kind of brought up with this magic eight hours and, you know, sometimes you can get really hooked with that rather than actually, until you start to learn about circadian rhythm and kind of finding actually, what, what do I need moving away from that, but actually, you know, so much about just giving yourself permission to be in the moment let’s enjoy this party.
Let’s enjoy this late night thing. That actually doing some of the leg work for you? Yeah. I think sometimes, you know, just helping people to identify women, maybe overthinking about saying, what do we know about brains? We talk about this all the time. Don’t we I’m sure. Some of my patients are like, we’ve talked about this so much, but I don’t think you can over talk about the fact of brain quite often goes into threat mode.
We don’t like not being in control. So if it wants to know, when are we gonna go to sleep? How long are we gonna be asleep or how tomorrow gonna be? And that actually then from what you’re saying, causes more of an. Because, yeah.
Stuart: Remember the brain, it’s a problem solving machine, right? Yes. That’s kind of what it’s for. And. If we have a problem, i.e. we can’t sleep. And our burn then starts trying to think about how to solve it. It’s a bit like trying to solve the problem with the thing that’s causing it. You know, I mean, overthinking is one of the big things that stops people from sleeping.
Yeah. And it’s obviously not as simple as saying, oh, don’t think about it. You know what I mean? That’d be. That’d be stupid to say that, but we do get really hooked into this idea about if I think about it, then I’ll be able to solve it. But with sleep, it’s kind of more the opposite. It’s that we need to relax.
We need to let it come. My, our brain and body it’s perfectly capable and actually predisposed to take sleep without us having to chase. It’s just that we create the barrier sometimes by thinking about it all a bit too much, or, or doing stuff that might get in the way of good sleep.
Dr Tara Q-C: So I think there’s so much that people could take away today, particularly from this idea of trying to recognize when we are in threat mode or that panic showing up.
I’m gonna bring the dreaded P word in, but during the pandemic, so many people experienced sleep issues, and I guess that’s a whole other podcast in itself. I’m sure. But I’m just wondering the role of panic and threat mode in that pandemic. When a lot of people were trying to adapt their lives, work at home.
A lot of people were dealing with a lot more because they could fit lots of zooms in, they weren’t having those natural transition points in the day. We couldn’t go. We restricted for a lot of it. Weren’t we, do you have a nugget of advice on what it is about the pandemic that might have impacted our sleep and, and what it is people might have had showing up in terms of their threat mode, particularly during that time rather than other times.
Stuart: Yeah, I think it’s a really good example about how we, how a big change can really knock us for six. I mean, all through that time. I actually saw very few people who were worried about catching COVID, even the people with health, anxiety, or OCD, they weren’t particularly worried about catching COVID.
It was more the indirect effects of not being able to go out. Yes, not being able to work, not being able to go to the gym. Especially during that first lockdown where we could only go out for exercise and it, you know, it was limited to 20 minutes and what we gradually saw. Were that people would start on a slippery slope, their bedtime, or they’re getting out of bedtime, I should say, would start getting later and later, and then they would start bringing.
Daytime activities into bed, they would start, you know, they would maybe start, they’d get up, still be in their pajamas and maybe start working. But then that would gradually move into, I would start, you know, just put, bring the laptop next to the bed and then. Set it or pop in bed. So they’d start working in bed and then they would start, oh, well, I’ll have breakfast while I’m working.
And you know, they’d be there drinking coffee or whatever, whilst working bed. And it, it did become a really slippery slope for people where it’s understandable because, you know, I mean, we like comfort human beings, like comfort don’t we? Yeah, the problem is though, just like mentioned a bit earlier.
We need to have a bit of a separation between bed and non bed because we, we normally have a sleep bed association. If you think about what a bed is, there’s nothing particularly special about the bed. It’s just a piece of wood with the soft covering that we rely on and then sleep. But we do build up associations really easily and really quickly.
So that piece of wood with the soft covering that becomes associated with the place we sleep. If we start doing non sleep stuff in. Things like eating things like watching TV, things like reading, things like working, especially using our phones. We start breaking down that sleep bed association. We actually often start building what’s called a stress bed association where the bed starts to become associated with stress.
Interesting. And this, this is part of the reason why sleep medicine. We say, even if it’s middle of the night, if you’re not asleep, then get out of bed. Because the more we spend more time, we spend in bed getting agitated and frustrated, trying to sleep again. We’re building that stress bed association and the getting out of bed.
It’s largely to break that cycle. You know, it, it is to do that. And one of the things that we have to do, that’s actually really, really helpful is again, make the bed somewhere that’s only used for sleep and relax session. We usually say, I mean, yeah, really sleep medicine. We, we usually say sleep sex and relax session.
We only say sex is okay because it helps people relax. But anything else that isn’t sleep or relaxation, we kind of want to be outta the bed. We can still be done in the bedroom. I mean, not ideally. but during the pandemic, I saw a lot of people who lived in one bedroom or studio.
Dr Tara Q-C: I was gonna say that yeah. When the kind of logistics or the setting. Yeah. And I know actually some people. That I’m working with now with hybrid working, I was gonna bring that in actually that a lot of people are choosing to work at home. And there’s many benefits to that for some people, but they are still in spaces in the home.
If they’re, especially if they’re living with someone else who’s working from home or they’ve got kids that there are many people working in bedrooms and during the pandemic, particularly we couldn’t pop anywhere and buy a desk or do much with furniture. Could we? So a lot of people were sat. Beds using that as a desk, as you say, in that association building up.
And, and if you say, you know, when we are looking at basic kind of sleep hygiene during the pandemic, you couldn’t suddenly go out and buy blackout blinds, or you couldn’t, you couldn’t source things as easily. So people who did notice things early on in the pandemic, and I know from my own caseload, when we were looking at basics were a bit more limited in what we could do about those basics, because some people were going, I have to work in the bedroom.
Homeschool is going on in the only other room that we have, or someone else is working in the kitchen. So then immediately at nighttime that room’s associated with the day’s meetings or people saying visually as well, I had patients I was working with, there it is. There’s the monitor staring at me at night.
And we did work about, you know, just getting a blanket and just throwing it over. Or, you know, at the end of the days I did work with some of my patients. It’s probably gonna sound really silly, but it worked. I’d get them to get changed in an outfit to zoom, to work and then get changed. After they finished at the chair, leave the clothes on that chair, or even change, put outside shoes on, do your zooms, take them off at the end.
There’s little things for people where they really were limited, really helped, you know, just thinking outside the box a bit, but I’m thinking as well. Cause one of the things I am still seeing are sleep issues. Don’t actually know we’ve had this conversation this morning with someone else. What we call this phase with the pandemic really doesn’t really have a name, does it, but I’m still seeing a lot of people with sleep issues.
And I’m just wondering whether you have any insight as to whether that might be related to the pandemic, or I guess we’ve had a lot of world events, but I’m certainly seeing a lot more sleep issues than I have in my 20 year career, I just find interesting. You notice anything similar?
Stuart: I think people are becoming really switched on to the effects of lack of sleep now because, because of the pandemic and the effects that it had, I think as well, there is like this more hybrid working approach.
Some more people are working from home. I guess, I mean, a lot of people, they don’t switch off at five o’clock anymore, or they don’t switch off at half, five anymore. You know, their laptops there, or their phones there, which usually has their work emails on there. And it becomes so easy just to, just to check.
So I think that there has been this carryover from where people are still maybe. Bring in some stress into their early evening, more than they used to do. And I think what you were saying earlier about changing clothes, I think that’s a great idea. You know, I suggesting that to people, myself, and making the room look a bit different as well, even if it’s just moving plants or getting rid of the office chair.
Yes. Yeah. Great. Just to create that separation, I think at the. A lot of people are feeling quite stressed about, you know, the financial situation. Yes. And I say, nothing causes insomnia, like worry. When I mentioned a beginning about anxiety, depression, and sleeping, like a three-legged stool, we know that one of the main drivers of anxiety is dwelling and going over stuff and thinking and overthinking.
And similarly, if we’ve got that stuff on our mind on a night, Our burden is in threat mode. You know, it’s, it’s, it’s sensing this danger and again, why would my sleep, if the thought cuts were around it.
Dr Tara Q-C: I’m gonna take that away with, I think that’s a really good metaphor, isn’t it? And I’m thinking just, if we look at this, this year, you know, war in Ukraine, financial crisis pandemic, I’m just wondering whether people are just, almost getting to a point where they’re thinking what’s next.
You know, life’s thrown quite a few curve balls away. Hasn’t. I really like that idea as well though, that perhaps people are becoming a bit more aware of sleep. And thinking about it more. And I guess one of the reasons we were both attracted to the toolkit that we were working on is that you can get information out there that it’s a lot of, it was psychoeducation based as well as just reactive, how to cope with things that maybe people are thinking about it.
And then I certainly have patients will say to me, now I’ve learned about it. I’m noticing more, or I don’t know whether that’s helpful or unhelpful, but in the long term it’s helpful. You know, you might sometimes be, it is easier to avoid for a little bit, isn’t it? And sometimes things go away, but with things like sleep, if you ignore it, if you sit on.
Quite often. Yeah, a problem doesn’t go away and sometimes it can get worse. And then sometimes as well, for some people, it does have an impact on their job, their ability to do their job. And some people really need to have that sharp cognitive functioning. And if you throw in as well, I’m not on huge fan of the term, but it’s quite useful, but the zoom fatigue that people have talked about, and there’s been some research on that people aren’t having those natural breaks in the working day, they might be going from zoom to zoom, to zoom.
And I certainly know I’ve had people I’ve worked with, who’ve just spent the. Eight nine hours of the day on zoom and you’re working so much harder to read people online and maybe straining for audio, probably be sat in the same position, probably not moving or even aware of how much you’ve drunk, how much hydrated if you throw that on top.
I think it’s really good. And that’s why I wanted to have you on today to kind of help people know that difference between perhaps, you know, reactive things, things that we can do if we are noticing sleep issues, but also what can we be doing? Even if we don’t have sleep issues to try and promote. Good quality sleep, getting to good habits and routines.
And do you have a little nugget that you could share with us? Do you, I like to ask all my guests for what I call their one adversity takeaway. Is there something that people can take away today in terms of sleep?
Stuart: Yeah, I think that it’s always useful to think about. In order to mention about sleep quality of a number of hours.
Yes. I think that that is really key because it just opens up a lot of other areas or encapsulates a lot of areas. Cause people often talk about, and even in sleep medicine, we talk about having a routine, but obviously on the internet, it’s very big about, you know, having a certain bedtime, all that. It’s good to have a routine, but it’s gotta be the right routine.
So I could start going to bed at three o’clock every afternoon. And that would be a routine, but it wouldn’t necessarily be a helpful routine or a good one. So it’s always good to look at what time you’re going to bed. If you’re having trouble falling asleep or you find yourself waking up during the night, a good place to start is always going to bed later.
And often when I tell people who have insomnia. That we want them to start going to bed later. They, the usual, I mean, obviously we do it kind of looking at all the data and all of that for the number of hours that they sleep and the amount of time that they spend in bed, you know, there’s actually a physical sleep efficiency, which is the percentage of time spent in bed actually asleep.
And ideally we want that to be around 85%, which is about 15 minutes between going to bed and falling asleep and 15 minutes between waking up and getting up based on an eight hour. Of sleep, but quite often we find people’s sleep efficiencies might be around like 60, 50. I, you know, I’ve seen people with sleep efficiencies of 30%, which if you think about that at 10 hours in bed, only three hours of sleep quite often, when we look at those numbers and when we say to people, you know, part of it is you’re spending too much time in bed.
You’re going to bed too early. They understandably panic, you know, I’m not sleeping and you know, you wanted me. To not go to bed earlier. And I also remind people that we’re not actually giving people less sleep. We’re just giving them less time in bed. There’s a big difference between the two. If we give less time in bed.
Then again, it’s a chance to build up that sleep bed association. We have an actual sleep drive. That means if we’ve got a bed later, we’re gonna be more tired. Everything points in that direction, as opposed to one of the things that people often do. When they’re not sleeping well, and it makes common sense.
You know, if I’m not sleeping well, I’ll go to bed earlier. Then at least I’ll get some sleep, but it doesn’t work like that. It just means we lie in bed awake and getting more annoyed, again, breaking down that sleep bed association and building up a stress bed association. So I think it’s really important and a good place to start for most people is go to bed a bit later.
Dr Tara Q-C: So much of what you’ve said makes so much sense. And even as a psychologist, that some days where I fall into the, oh, I better go to bed a bit earlier today because I was up late. So I’m even thinking this evening, right? Maybe I should have a bit more sleep cause I was up later, but trying to catch that, you know, some of it on paper could look really logical, but actually surely it makes more sense to go to bed just that bit earlier.
But I think that could be really quite profound for a lot of people. Listen, Just think outside that box to reframe, as we say in psychology, sometimes now there’s probably people listening, going, I need more, I need more of this guy. if people wanna find you find a more about what they do, where can they find you? How can we get ahold of you?
Stuart: Yeah. So I’m based in Newcastle upon Tyne in the UK. And I see people face to face in our clinic in Newcastle, but I also do a lot of work online. I do a lot of national and international work. I mean, that’s something that was really big before the pandemic.
There’s not many sleep focus in the UK, so yes. Yeah. You know, there’s always quite a lot of opportunity there. So our website is newcastlepsychologist.co.uk. And I can be reached at [email protected]. If you want to send a message, I will reply to all of them.
I do have a policy that I will reply, even if it’s something I can’t help with. Normally we try and point you in the direction someone might be able to. But if it is something that you know, that you want to work with me on, then normally what I do is just arrange a shop five or 10 minute call just to again, make sure it is something that I can help with before.
Schedule anything. And then, you know, we’ll kind of see where we get to with it. I’m sure.
Dr Tara Q-C: After listening to this, there’ll be a lot of people, very, very interested in that. And I’m also thinking. While we are recording and I need to get you on to talk about anxiety at some point as well, if you’re interested.
Because what I think actually would be really nice is that crossover, as you say, between sleep and anxiety and other conditions as well. Stuart, thank you so much. I’m so delighted that you came on and, and for us as well, I’ve said this with a few guests, but we’ve. Do bits of work together, but we haven’t met so it’s really nice to meet you face to face, even if it is through a screen.
So thank you so much for your time and hopefully you’ll come back on, talk about anxiety soon as well.
Stuart: Yeah, absolutely. It’s a pleasure to have spoken to you and to your audience.
Dr Tara Q-C: Thank you for listening to this episode of the adversity psychologist podcast. It’s so lovely to have you here. I’m Dr. Tara Quinn, and you can find me at drtara.co.uk. You’ll see everything I’m up to free resources. My media work and my new COVID recovery clinic, as well. Remember to please rate and review my podcast. It really helps. Narrative overcoming. If know where to find us, the adversity psychologist podcast, helping you one at a time.
Dr Stuart Sadler
Lead Clinical Psychologist