Getting Enough Sleep

from Worcestershire NOW - DEC 21 - JAN 22

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When’s your bedtime? All over the shop? Join the club... We all know that for people of any age having a healthy, consistent sleep routine is important.

What time should people sleep for their heart health? It turns out, it shouldn’t be too late but not too early, either. Cardiovascular disease (CVD) is the “most significant cause of mortality” across the world, the researchers of a new study published Tuesday in European Heart Journal - Digital Health said. There has also been evidence linking poor sleep and cardiovascular risk.

For their study, the researchers collected data on 88,026 people in the U.K. Biobank who were recruited from 2006 to 2010. Instead of getting data via self-report, the researchers collected data on the participants’ sleep onset and waking times by making them wear a wristworn accelerometer for seven days.

During a mean follow-up of 5.7 years, researchers identified 3,172 cases of cardiovascular diseases among the participants. Interestingly, the risk was lowest for those whose sleep onset was between 10pm and 10:59pm.

Compared to them, those who went to bed between 11:00 to 11:59 had a 12% higher risk for cardiovascular disease while those who hit the sack at midnight or even later had a 25% higher risk. But those who fell asleep earlier than 10pm also had a 24% greater risk.

When the researchers analyzed the data by sex, they found that the risk was particularly strong among women. In fact, only the sleep onset risk for those who fell asleep earlier than 10pm was considered “significant” in men.

“Our findings suggest the possibility of a relationship between sleep onset timing and risk of developing CVD, particularly for women,” the researchers wrote. It’s possible that going to bed after midnight may be the “riskiest” because it lessens the chances of seeing morning sunlight, “which resets the body clock,” the study’s co-author, Dr. David Plans of the University of Exeter in the U.K., noted in the ESC news release. As for why the association appears to be stronger in women, Plans said that this is “unclear,” citing the participants’ older age since women tend to have an increased risk after menopause.

Remember, there are numerous factors which influence our risk of heart disease – the most important being family history, diet and lifestyle and other health issues like high blood pressure and type 2 diabetes. However if this newly published research makes you more conscious of needing more sleep sometimes it is easier said than done.

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Take the pressure off Perfect sleep? It doesn’t exist. So while you may really want to nail your sleep routine, taking the pressure off is important – especially if you’re feeling trapped in a cycle of insomnia.

“If you take a ‘normal’ person’s sleep, it’s not perfect all the time,” says Dr Guy Meadows of Sleep School the UK’s leading expert (sleepschool.org).

“It’s very easy [for an insomniac] to think the grass is always greener and it must be perfect all the time, but the reality is that normal sleep is disturbed for a multitude of reasons, whether that’s a stressful day, aches and pains, whatever it is.”

Being told things like ‘just relax’ and ‘you’re over-thinking this’ can be immensely frustrating. But the harder we try to sleep and the more we worry about it, the further away that peaceful slumber can seem (thanks brains!).

Meadows reassures though, this is not about blaming yourself. Human brains are designed to identify sources of worry and getting into an anxious cycle with it is very normal. The trouble is, this can put is in a state of hyperarousal – aka our own personal sleep-blocker. We can also begin to obsess about it.

Meadows explains: “You might be lying in bed going, ‘Well I’ve had the perfect bedtime routine, I’ve done the yoga, I’ve done the meditation, etc’ – and inadvertently what happens is, it puts sleep on a pedestal. It’s like, ‘I have to do all of this otherwise I won’t get to sleep’. That just heightens people’s anxiety and alertness.

“I had one client who was winding down for four hours from 6pm, and their brain effectively was going: ‘Crumbs, what’s coming!’ It sort of becomes this really scary prospect.”

Take the focus off bedtime Dr Lindsay Browning, psychologist, neuroscientist and sleep expert for And So To Bed (andsotobed.co.uk/dr-lindsay-browning) says: “When someone starts to struggle with sleep, they often begin to worry about it during the daytime and dread night-time coming, [and] the increased anxiety makes the problem worse.”

There are some lifestyle adjustments that can be genuinely useful, Browning notes – such as reducing caffeine intake or only having it before lunch, and doing something that’s physically and emotionally relaxing before bed, like a nice warm bath.

Increasingly your daytime exercise could help too.

“Exercise directly impacts your need for ‘deep sleep’ at night,” says Browning. “The more you exercise, the more deep sleep you will have. Deep sleep helps you feel refreshed when you wake up and helps with sleep continuity.” (Just don’t do it too close to bedtime, as this may be “disruptive to sleep”.)

Time to ACT The Sleep School pros are pioneers of a system called Acceptance and Commitment Therapy (ACT) – a more evolved version of cognitive behaviour therapy (CBT), in a sense. “It’s about taking the struggle out of sleep. Putting your effort into the things you care about in your life, rather than putting it into the struggle [to sleep],” explains Meadows (they launched a Sleep School app earlier in 2021 where users can tap into this).

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This isn’t about avoidance or not letting yourself admit that struggling to sleep is impacting you (it’s hard!). It’s about slowly, slowly shifting the focus away from fixating on the sleep struggle, giving that space to grow, and taking the power back.

Meadows says one of the key components of ACT is “present moment awareness”, so noticing and accepting what’s happening in that specific point in time. This doesn’t mean we’ll find it pleasant noticing we’re having a bad night’s sleep, but it does help us move away from catastrophising and freaking out that we’re ‘never’ going to sleep again and the next day will be a disaster.

“Often people will take acceptance as a sign of weakness and giving in, but it’s not at all. When you’re able to go, ‘Ok, right now my sleep is a bit rubbish’, you’re keeping that pain in its original form, you’re not amplifying it.”

Another key element in ACT is to focus on your values and stay connected with those – even when you’re knackered. For example, Meadows says it could sound like this:

“I am in a bad place with sleep right now but that doesn’t mean I’m going to completely not care about the things that are important for my health. I am shattered so I might not go for that big run, but I’ll go for a walk around the block. That’s movement towards my values, and I’m being kind to myself.”

And self-kindness/compassion are very powerful tools when it comes to breaking any sort of anxiety cycle; Meadows notes there’s even research on how self-compassion can aid sleep. Little acts of self-kindness during the day – like a 10-minute walk, making a nourishing lunch and watching a movie – “might seem relatively mundane and small, [but] they actually help to promote a better mental environment from which sleep can emerge”, says Meadows. Put that phone away (or at least try) Lost count of the times you’ve vowed to stop looking at your phone before bed, only to find yourself engrossed in a lamb-herding video two hours later? Yes, we know these dopamine-triggering devices trap us into sleep-sapping spirals and mess with our melatonin (sleep hormone). But, well, we’re still doing it.

“Instead of simply saying, ‘Don’t touch your phone’, start by taking small steps to become less dependent on it at night,” suggests Browning.

“Turn on ‘do not disturb’ and make sure that’s set to come on at the same time each evening an hour or so before bedtime. If you’re nervous about family not being able to contact about emergencies, most phones allow for this to be set to allow certain contacts through.”

“Invest in an alarm clock,” Browning adds, “so the phone can be placed somewhere else, rather than next to the bed. Lastly, break the habit of your phone being the last thing you look at before bed and get into the habit of reading a book or magazine instead.” n