Sleep and relaxation

Sleep routines

• Try to wake up and go to bed the same time each day.
• Avoid day time naps, or limit them to no more than 30 minutes.
• Create a pre-sleep ritual (e.g. bath, relaxation, reading) to relax before bed.

Sleep environment

• Try and keep bed just for sleeping (and sex) no TV, computer, reading etc.
• If an uncomfortable bed or bedding is the problem… change it!
• Ensure the room temperature is not too hot or too cold.
• Sharing a bed may be a problem- try sleeping alone and see if this is better for you. Changing environments and sleeping in a different room can also help.
• Turn your clock away from you and replace a ticking clock with a silent one- it avoids ‘clock watching’.
• Keep the room quiet- block out distracting noises (use ear plugs etc.).
• Dim the lights for a few hours before bedtime, darkness releases hormones that make you sleepy.

Exercise

• Regular exercise helps you fall asleep more quickly and sleep more deeply.
• Try to exercise in the afternoon or early evening and avoid exercising before bedtime – you may need to wind down for 30-60 minutes before bed.
• Daily exposure to outdoor sunlight (e.g. going for a walk).

Drink

•  If you wake needing the toilet during the night try to limit your fluid intake for a couple of hours before going to bed.
• Avoid alcohol, it causes poor quality sleep.
• Cut down/out caffeine (found in chocolate, coffee, tea etc.).

Nicotine

• Nicotine is a stimulant and can therefore affect your sleep.
• Insomnia is often reported in smokers.
• Smoking raises the blood pressure, speeds up the heart rate and stimulates brain activity, all of which make it harder to sleep.

Eating habits

• Don’t eat too late as digestion can affect sleep.
• Have a light evening meal that contains protein (such as lean chicken or fish) to stop you waking up hungry in the night.
• Spicy foods can cause heartburn or stomach discomfort during the night
• Having a carbohydrate-based snack if hungry before bedtime may help you to sleep because it triggers the release of serotonin (a hormone that aids sleep).

Attitudes/beliefs

• Worrying in bed will prevent you getting to sleep, try to setting some ‘thinking time’ (20-60 mins) during the day to focus on any worries you may have.
• Keep a worry diary at the side of your bed, for noting worrying thoughts that happen at night and deal with them in the morning.

Prescribed medication

• Some prescribed medication can cause sleep disturbance, ask your doctor or pharmacist to review your medication to see if this is the case.
• Sleeping tablets may help. However, consult with your GP before starting new medication.

What if you still can’t sleep?...

If you don’t fall asleep within 15 to 30 minutes get up and go to another room. Read a book, watch TV or try relaxation techniques until you feel tired enough to sleep. Lying in bed for longer than 30 minutes trying to sleep rarely leads to sleep.

Relaxation - a pain management skill and stress buster

Relaxation refers to relaxed muscles or peaceful thoughts. It is characterised by feelings of peace and release from tension, anxiety or fear.

Relaxation techniques are used as a:

• Preventative measure - to protect the body from stress and health problems (protects the organs from the effects of stress)
• Treatment - to help relieve stress and tension in conditions such as hypertension, insomnia, panic attacks, headaches and chronic pain
• Coping skill - to calm the mind and allow clearer thinking.

Being able to use these techniques is a skill that needs to be practiced and mastered. You should set time aside in your daily routine (at least 20 minutes) to practice relaxation skills. There are

a variety of techniques available, some of which we will teach you on this programme... it’s about finding the right techniques for you.

Some points about relaxation….

• Relaxation should be completed in a quiet and warm environment. Gentle background noise, such as relaxation music, and dimmed lighting may help
• Relaxation techniques are often completed lying down. But can also be done sitting in a chair. It is most effective if you are in a position where your body can be fully supported so that you can fully relax your muscles
• Most people find relaxation more effective with their eyes closed. However, if you are uncomfortable with this you should ensure that there are no visual distractions (i.e. blank wall, TV off etc.)
• Do not practice relaxation if you are hungry or have just eaten - relaxation is best completed at least one hour after a light meal
• Relaxation should help you feel calm in body and mind. Relaxation however, is not the same as hypnosis and you will not lose consciousness at any point
• Try not to fall asleep while you are practising relaxation techniques - relaxation should be something that you are in control of.

Incorporating relaxation into everyday life

• Try not to rush - you will achieve more if you stop to think about what you need to do and are calm
• Make sure that you take regular short breaks to relax, stretch muscles etc.
• Plan time for yourself in your daily routine to do things that you enjoy and find relaxing (e.g. reading, going for a walk etc.)
• Try to notice any muscle tension and deliberately relax your posture - drop your shoulders, relax your arms, unclench your hands, sit back in your chair etc.
• If you don’t have time, make time. Plan time to relax in your daily routine.

When you are asleep all your muscles are relaxed and your breathing naturally slows and becomes deeper. This is the type of breathing that is used in breathing techniques. These exercises can be carried out as a stress management technique or at the start of a relaxation session. We will practice breathing techniques at the start of each relaxation session.

1. First, remove any restrictive clothing (such as belt or shoes).
2. Lie on your back or sit in a supportive chair with your feet a comfortable width apart and your eyes closed.
3. Place one hand on your stomach, just below your navel, and the other hand on your chest.
4. Breathe slowly and deeply, in through your nose then slowly out through your mouth, thinking about the sound of each breath as you breathe in and out.
5. As you breathe you should notice that the hand on your stomach gently rises and falls while the hand on your chest remains quite still.

Take time to practice this and ensure that you have mastered the technique for deep breathing.