Client Resource Pack Session 4 | 19 | Maintaining Wellness and Working

ABSTRACT

Topics addressed this week:

Activity 36: A Review of the Skills We Have Been Learning

Activity 37: Effects of Medications on Sleep and Energy

Activity 38: Effects of Caffeine or Smoking

Activity 39: Effects of Alcohol on Sleep

Activity 40: Effects of Drugs on Sleep

Activity 41: Stress Management—Values Exercise

Activity 42: Working towards Balance

Activity 43: Things to Consider to Create Better Balance

Activity 44: Coping with Demands

Activity 45: My Coping Resources

Activity 46: Keeping Your Progress Going—Relapse Prevention

Activity 47: Blueprint Summary

Activity 48: Planning for Setbacks

Activity 49: The Motivation Boost

Activity 50: Action Plan and Goal Setting

Session 4 <target id="page_249" target-type="page">249</target>Maintaining Wellness and Working with Triggers for Poor 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/fig19_1.tif"/> Activity 36 <target id="page_250" target-type="page">250</target>A Review of the Skills We Have Been Learning

Last week, we learned about:

dealing with a busy mind (managing intrusive thoughts and voices, winding down, not clock watching, journal writing, to-do lists, and relaxation);

working with overly negative thoughts—Catch it, Check it, Change it!

The other sleep skills we have also been learning are:

sleep hygiene (everyday habits to help us sleep better at night);

winding down before bed (to help fall asleep);

getting out of bed if you can’t sleep (Goobics);

regular rising time (not oversleeping and limiting naps);

winding up into the day in the morning;

maximising daytime energy;

establishing helpful beliefs and attitudes about sleep;

managing nightmares.

What went well?

_____________________________________________________________________

What was challenging?

_____________________________________________________________________

Let’s brainstorm ways to get around these challenges:

_____________________________________________________________________

Activity 37 <target id="page_251" target-type="page">251</target>Effects of Medications on Sleep and Energy

It is important to take prescribed medications according to your doctor’s instructions and at a regular time. Sometimes, however, these medications can have side effects that impact on sleep. For example, some medications can cause bad dreams or drowsiness in the day.

If these side effects worry you, let your doctor know about your side effects so that he/she can make good decisions about whether a medication is right for you, and whether the timing of the medications can be changed.

What are the benefits and disadvantages of your medications for Sleep?

Benefits

Disadvantages

________________________________

Coping Strategies to Reduce the Side Effects of My Medications

_____________________________________________________________________________

On a scale of 0–10, how confident do you feel about applying these strategies (circle)?

_____________________________________________________________________________ https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig19_2a.tif"/>

_____________________________________________________________________________

General Guidelines for Sleep

Take prescribed medications only as directed (correct time, correct dose).

Be proactive in managing side effects and discuss any ongoing problematic side effects with your doctor

Activity 38 <target id="page_252" target-type="page">252</target>Effects of Caffeine or Smoking

Caffeine and nicotine in cigarettes have a stimulant effect on your brain and body and can cause you to feel more alert and awake.

Do you ever use cigarettes/caffeine to cope with tiredness, stress, or low mood?

Although caffeine and smoking may be enjoyable and help increase alertness in the day, it is unhelpful to drink caffeine or smoke during the evening. Having these at night makes it harder to fall or stay asleep, which can make you feel more tired, low, or anxious the next day. This may lead to more caffeine and nicotine use, becoming a vicious cycle.

What are the benefits and disadvantages of caffeine and smoking for Sleep?

Benefits

Disadvantages

________________________________

Strategies to Reduce the Use of Caffeine or Cigarettes at Night

_____________________________________________________________________________

On a scale of 0–10, how confident do you feel about applying these strategies (circle)?

_____________________________________________________________________________

General Guidelines for Sleep

Avoid caffeine 5 hours before bed.

Avoid nicotine 2 hours before bed: Work towards quitting smoking or reducing the number of cigarettes you smoke over the day.

Activity 39 <target id="page_253" target-type="page">253</target>Effects of Alcohol on Sleep

Another lifestyle and health factor that could be affecting your sleep is alcohol.

Why Shouldn’t You Use Alcohol to Get to Sleep at Night?

Alcohol can interfere with your mood and the quality of your sleep. You might think that drinking alcohol would help you sleep. But, in fact:

Alcohol digestion at night can wake you up.

Alcohol gets in the way of achieving a deep sleep.

You would be more likely to wake up feeling tired and unrefreshed in the morning.

What makes you reach for alcohol in the evening?

What Are the Benefits and Disadvantages of Alcohol for Sleep?

Benefits

Disadvantages

________________________________

Strategies to Reduce Reliance on Alcohol for Getting to Sleep

_____________________________________________________________________________

On a scale of 0–10, how confident do you feel about applying these strategies (circle)?

_____________________________________________________________________________

General Guidelines for Sleep

Avoid alcohol 4 hours before bed.

Drink plenty of water after heavy drinking.

Activity 40 <target id="page_254" target-type="page">254</target>Effects of Drugs on Sleep

Many drugs can cause either sleepiness (sedatives such as marijuana and heroin) or increased alertness (stimulants such as meth, speed, and ecstasy), and impact on mood and sleep patterns.

Let’s take the example of marijuana and discuss the benefits for sleep, and the disadvantages.

Benefits

Disadvantages

Can help people fall asleep faster and get a deeper sleep

Difficulties waking up at a regular time

Less motivation during the day to study, work, exercise, and socialise

May become reliant on marijuana to go to sleep

Overall, marijuana may help deal with sleep problems in the short term, but it can actually make sleep worse in the long term and make it harder to follow good sleep habits.

What Are the Benefits and Disadvantages of Drugs (e.g. Meth, Heroin, Ecstasy) for Sleep?

Benefits

Disadvantages

________________________________

Strategies to Reduce the Use of Drugs that Affect Sleep

_____________________________________________________________________________

On a scale of 0–10, how confident do you feel about applying these strategies (circle)?

_____________________________________________________________________________

Activity 41 <target id="page_255" target-type="page">255</target>Stress Management—Values Exercise

An important way to promote good sleep is to have a balanced lifestyle. This means not concentrating on only one part of your life to the detriment of other areas of your life.

It is also about doing things that bring you happiness or satisfaction, and looking after yourself.

Exercise: Close your eyes and say the first answer that pops into your mind for the following questions:

What’s important to me?

What do I value?

When do I feel happy or relaxed?

I spend too much time worrying about . . .

I spend too little time doing things such as . . .

What I would like to do differently from today is . . .

Activity 42 Working towards Balance

Identify areas of your life that you feel are out of balance.

Rate Each of the Life Areas as:

Lacking

About Right

Overpowering

Health (including mental health)

□

Hobbies, leisure, holidays

□

Families, carers, friends

□

Work, study

□

Money, finances

□

Creativity

□

Other

□

Can you select a top 2 to work on from those that you ticked in the table?

Think about what changes might be made and work towards small goals for change.

It is helpful to check in with yourself regularly to think about your life balance.

If you’re not living a life that reflects your values, it’s more likely that it will feel stressful.

Activity 43 <target id="page_256" target-type="page">256</target>Things to Consider to Create Better Balance

We tend to be able to accept difficulties better when they occur in pursuit of something that we truly value.

In the table, circle the areas that you would like to make a change in and write about possible changes/goals.

Area

Immediate (Today)

Short Term (Next Week)

Mid Term (Next Month)

Health

Hobbies, leisure, holidays

Family, carers, friends

Work, study

Money, finances

Creativity

Other

Activity 44 <target id="page_257" target-type="page">257</target>Coping with Demands

Did you know that there is both good stress and bad stress?

Too little stress leads to boredom and reduced interest (under-stressed).

Too much stress can cause distress, when there are too many demands, or when we feel that we don’t have the right coping skills and assistance to deal with the demand (overstressed).

Not all stress is bad!

It’s OK to have some stress in your life.

We all need a little bit of stress to give us motivation to function. In fact, we need it to perform well.

The amount of stress that we can cope with varies from person to person and depends on our personalities, coping styles, and the way our bodies respond to stress.

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Which describes you best?

https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig19_3.tif"/> Activity 45 <target id="page_258" target-type="page">258</target>My Coping Resources

What coping resources do I have for:

managing overstress (how can I relax, problem-solve, get organised, worry less, seek support, use my strengths?):

_________________________________________________________________

managing under-stress (how can I re-engage in life?):

_________________________________________________________________

Activity 46 <target id="page_259" target-type="page">259</target>Keeping Your Progress Going—Relapse Prevention

Well done on your progress through this programme! It is now important keeping your progress going. This can be done by:

reading over what you have learned at least once a month;

planning for any setbacks that may happen;

setting goals to guide what you will do over the coming months;

keeping using the skills you learned in therapy;

coming back to this workbook if you need to get your sleep back on track.

People don’t plan to fail; they simply fail to plan.

Knowing the Difference between a Bad Night and a Relapse

It is important to understand the difference between the odd bad night’s sleep (or two or three), which everyone gets, and the signs that Insomnia may be coming back.

Planning for Setbacks

Setbacks are an inevitable part of progress, but they do not mean that you are relapsing back into Insomnia. Setbacks simply reflect that it is very normal to have ups and downs in the quality and amount of your sleep. Recovery from Insomnia is a gradual process over time that typically follows a pattern with lots of ups and downs, like in the graph below.

Be Realistic

It is unrealistic to expect to sleep well every single night. Instead, you should expect some phases of feeling like you are sleeping very well, and other phases where you feel that your sleep is more unstable. Setbacks are a normal part of overcoming Insomnia, rather than a sign of ‘going back to square one’. So, when you go through a period of more unsteady sleep, try not to become discouraged or concerned.

The Pattern of Recovery https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig19_4.tif"/> Activity 47 <target id="page_260" target-type="page">260</target>Blueprint Summary

How did the problem develop?

____________________________________________________________________

What kept it going?

____________________________________________________________________

What did you learn during the programme about sleep, and what is important in managing it?

____________________________________________________________________

What were your most unhelpful habits and thoughts about sleep?

Habit: _______________________________________________________________

Thought: _____________________________________________________________

What are the alternatives to these?

____________________________________________________________________

What are the most important things to remember to keep your progress going?

____________________________________________________________________

Activity 48 <target id="page_261" target-type="page">261</target>Planning for Setbacks

Be aware of your own ‘high-risk’ situations.

If you expect possible setbacks, then it becomes easier to prepare for them. Let’s look at what are some ‘high-risk’ situations for you—i.e. factors that made your sleep and tiredness worse in the past.

There’s no need for a setback to lead to a complete tumble back into Insomnia (i.e. relapse). A good way to reduce the impact of setbacks is to have a backup plan of strategies to use when they occur. Setbacks remind you to use the skills that you have learned in therapy.

Possible Problem or Setback

Plan/Strategy

Example: After not sleeping well for a few nights, I’m getting worried about my sleep. I’m feeling very tired during the day and having longer naps

_______________________________________

Activity 49 The Motivation Boost

If you’re faced with a high-risk time for your sleep, try these strategies:

Remind yourself why you wanted to tackle your Insomnia in the first place— the reasons are probably just as relevant now as they were then.

Talk to someone supportive.

Who would this be for you? _____________________________________

Think of what helped with improving your Insomnia in the past—chances are, whatever worked then will help you now too.

Activity 50 <target id="page_262" target-type="page">262</target>Action Plan and Goal Setting My Plan for the Coming Month

The changes I want to make (or continue making) are:

____________________________________________________________________

The reasons why I want to make these changes are:

____________________________________________________________________

I will know that my plan is working if:

____________________________________________________________________

Each day, ask yourself: What can I do today that will take me towards better sleep and energy and away from poor sleep and tiredness?

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