ABSTRACT
Topics addressed this week:
Activity 11: A Review of Skills We Have Been Learning
Activity 12: Sources of Daytime Tiredness
Activity 13: How Behaviour and Activity Affect Energy Levels
Activity 14: How Can We Generate Energy during the Day?
Activity 15: Use of Bright Light during the Day
Activity 16: Beliefs about Sleep
Activity 17: Seven Strategies to Manage Unpleasant Images and Nightmares
Activity 18: Sleep and Mental Health
Activity 19: The Main Things I Learned today
Activity 20: My Action Plan for the Week
<target id="page_220" target-type="page">220</target>Maximising Energy and Working with Unhelpful Beliefs about Sleep Topics Addressed this Week https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig17_1.tif"/> <target id="page_221" target-type="page">221</target>A Review of Skills We Have Been LearningLast week we learned about:
facts about sleep;
sleep hygiene (everyday habits to improve sleep at night);
winding down before bed (to help fall asleep);
getting out of bed if you can’t sleep (Goobics);
having a regular wake-up time (not oversleeping and limiting naps);
winding up into the day.
What went well?
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What was challenging?
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Let’s brainstorm ways to get around these challenges:
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<target id="page_222" target-type="page">222</target>Sources of Daytime Tiredness https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig17_2.tif"/> <target id="page_223" target-type="page">223</target>How Behaviour and Activity Affect Energy LevelsFirst, how energised are you feeling now, on a scale of 0–10 (please circle)?
https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig17_3.tif"/>Try a couple of these quick activities:
Go for a short walk around the building or do some star jumps.
Have a small, healthy snack (e.g. a piece of fruit).
Tell some jokes.
Stretch your neck, arm, legs.
Have a cold drink.
Get into some light.
Listen to some music that makes you feel happy or energised.
Watch a video that makes you laugh.
Now, how do you rate your energy levels after trying these activities? Was one activity more effective than another (please circle)?
https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig17_4.tif"/>We should find that tiredness levels decrease as activity increases.
<target id="page_224" target-type="page">224</target>How Can We Generate Energy during the Day?That’s right: It is possible to generate energy during the day! Often, people think that doing activity will take energy away and make them feel more tired, but actually there are many forms of activity that you can do to help you feel more energised.
Energy-generating activities and strategies to try out during the week (what I should do):
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Energy-depleting activities and behaviours to minimise (what I should avoid):
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<target id="page_225" target-type="page">225</target>Use of Bright Light during the DayExposure to bright light during the day has many benefits, including:
aligning your body clock with the time of the day;
improved mood;
improved alertness and concentration.
For good, natural sleep, it is important to have both a healthy sleep routine and a body clock that works at the right time. Morning exposure to bright light (i.e. 30 minutes of natural sunlight) helps to reduce drowsiness and increase alertness for the day by reducing the level of hormones that usually make our bodies feel sleepy at night (e.g. melatonin).
To help your body clock, make sure you get in some bright light (sunlight or a light box) each day. You may even find that getting more sunlight during the day improves your mood.
If you feel very tired most mornings, try getting some sunlight after waking up to help start your day (e.g. take a walk or have breakfast outside, in the sun).
What things can I do to get more light during the day?
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What things can I do to reduce bright lights at night?
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<target id="page_226" target-type="page">226</target>Beliefs about SleepThe statements below reflect some beliefs and attitudes that people may have about sleep. Show how much you agree or disagree with these statements by placing a mark (/) along the line to reflect your answer for each.
When I don’t get a proper amount of sleep on a given night, I need to catch up on the next day by napping or by sleeping longer the next night.
Strongly Disagree ↔ Strongly Agree
I am worried that, if I go for one or two nights without sleep, I may have a nervous breakdown.
Strongly Disagree ↔ Strongly Agree
I have little ability to manage the negative consequences of disturbed sleep.
Strongly Disagree ↔ Strongly Agree
When I feel tired, have no energy, or just seem not to function well during the day, it is generally because I did not sleep well the night before.
Strongly Disagree ↔ Strongly Agree
Medication is probably the only solution to sleeplessness.
Strongly Disagree ↔ Strongly Agree
The only way to improve my energy is to rest or sleep more.
Strongly Disagree ↔ Strongly Agree
I believe Insomnia is essentially the result of a chemical imbalance.
Strongly Disagree ↔ Strongly Agree
<target id="page_227" target-type="page">227</target>Establishing Helpful Beliefs about Sleep228Unhelpful Belief
Helpful Thoughts and Strategies to Try Instead
When I don’t get a proper amount of sleep on a given night, I need to catch up the next day by napping or by sleeping longer the next night
If we always try to catch up on lost sleep by napping or sleeping longer the next night, this may actually make it harder for us to get into a good sleep pattern. A good sleep pattern is important for helping to relieve Insomnia
Try generating energy by going for a walk or eating something healthy instead
If you do need to nap, keep it short (less than 30 minutes, ideally) and more than 8 hours before you go to bed that night
I am worried that if I go for one or two nights without sleep, I may have a nervous breakdown
Worrying about not having enough sleep can make it even harder to get to sleep at night
Winding down each night will help you start feeling more relaxed again and sleep better
Although short-term lack of sleep can make mood and anxiety worse, it generally won’t lead to a nervous breakdown. Remember that, if you can stay relaxed, poor sleep on one night will make it more likely you will sleep better the next night (as your body will want to catch up)
There are things you can do during the day to help prevent worse mood and anxiety. For example, talk to someone about worries, get some light exercise, or try relaxation strategies
The only way to improve my energy is to rest or sleep more
There are actually lots of ways to improve your energy, aside from sleep, such as doing some exercise or eating a healthy snack (e.g. apple, banana, celery, carrots, oats, nuts, and dried fruit)
I have little ability to manage the negative consequences of disturbed sleep
We can’t force sleep to happen, but there are many things we can do to set up good conditions for sleep and lessen the impact of poor sleep on health
Research shows that people with Insomnia can successfully learn to manage their sleep using various skills and coping strategies. This programme aims to teach you these skills. Can you tell me a couple of ideas?
When I feel tired, have no energy, or just seem not to function well during the day, it is generally because I did not sleep well the night before
Poor sleep can lead to feeling more tired and less energetic during the day, but is not always the main culprit
Think about what other factors could also be making you feel tired and less energetic, such as: exercise levels, diet, hormones, medications, or boredom, etc.
Medication is probably the only solution to sleeplessness
Medications are not the only solution to sleeplessness. Making some healthy changes to our thinking and lifestyle is often just as useful. Remind yourself that sometimes other good solutions just take a bit more time and practice
I believe Insomnia is essentially the result of a chemical imbalance
It is not helpful to focus solely on external causes for your sleep problem, as they are not in your control
Regardless of the initial cause of your Insomnia, there are likely to be things that you could change about your thinking and daily habits to improve your sleep and daytime energy
<target id="page_229" target-type="page">229</target>Seven Strategies to Manage Unpleasant Images and NightmaresStop: Clap hands while saying ‘Stop!’.
Breathe: Breathe in deeply, and exhale the image away.
Ground yourself: Open your eyes, put your feet on the floor, and focus on your immediate environment. Perhaps turn on a dim light. What can you see, feel, hear, and smell?
Talk it out: Talk to a friend or family member about the images or nightmares.
Write it down: Write down images or nightmares in a diary.
Acknowledge and move on: Without accepting or denying, acknowledge the unpleasant image and then return to the pleasant ones.
Choose: Consciously choose to return to the pleasant images without feeling that it is a struggle to do so.
What are some pleasant images that you can think of?
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ReferenceKrakow, B. (2002) Turning nightmares into dreams: The authorized audio series and treatment workbook for New Dream Therapy [CDs]. USA: The New Sleepy Times.
<target id="page_230" target-type="page">230</target>Sleep and Mental HealthMany people believe that their sleep problem cannot get better because of their mental health problems. This belief can leave people feeling powerless and reduce motivation to be active in searching for solutions to tackle the sleep problem.
On a scale of 0–10, how much do you believe that having a mental illness makes your sleep unchangeable? _____
If you scored 6 or above, let’s think about how this belief may be unhelpful, and whether it forms part of your cycle of Insomnia.
Mental health problems are often linked to difficulties with sleep. However, this does not mean that your Insomnia will not get better. It is important to know that your sleep can be improved—you just need a little time and the right tools to help you with it!
Symptom Safety PlanWhat do I do if I notice my symptoms (voices, visions, etc.) getting worse as a result of the sleep skills I’m trying?
Let the group facilitator know as soon as you can.
Talk to a family member, friend, or case manager about it.
Write about it in the comments section of your sleep diary for the week.
The Main Things I Learned Today________________________________________________________________
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<target id="page_231" target-type="page">231</target>My Action Plan for the WeekContinue winding down before bed.
Continue with Goobics.
My regular rising time for each morning is: __________
Changes to my sleep hygiene that I will work towards:
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Plan for generating energy this week:
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Main unhelpful ‘beliefs about sleep’ to be aware of:
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Work with nightmares (if applicable).
Confidence RulerImagine that this ruler shows how confident you are that you can improve your sleep. On this scale of 0–10, where are you at now?
https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig17_5.tif"/>Remind yourself of the positive things that you’ve learned over the week to help motivate your sleep skills training.
