By Maj Nadine Rancier, MSW, RSW,
CF H Svcs C (A)
With the 2020 Bell Let’s Talk campaign in full swing, the Mental Health Services team at Canadian Forces Health Services Centre (Atlantic) has produced an article to raise awareness of the importance of sleep and how individuals’ sleep patterns can be viewed as a barometer of mental wellness.
Sleep has been identified as a key component of wellbeing. Getting a decent quality rest helps to maintain physical and psychological health. For those who are already struggling with mental health issues and experience sleep issues, it can be particularly challenging to cope and recover from the associated symptoms.
Sleep can be viewed as a barometer of mental wellness and it is for this reason physicians always inquire about sleep behaviour when investigating a mental health conditions. Modern research has clearly demonstrated that optimal sleep is critical to mission success and that lack of sleep leads to impaired reaction time, poor judgement, increased numbers of preventable accidents and lower morale. Therefore, sleep is one of the four behavioural targets, referred as the Performance 4 (P4), within the Canadian Armed Forces physical performance strategy BALANCE.
Maintaining healthy sleep habits can make a significant difference in preserving mental health wellbeing. Indeed, the REM stage of sleep (deep and restorative) provides us with the cognitive and emotional benefits of sleep. With enough REM sleep, people feel emotionally balanced and able to regulate their emotions. Deprived from REM sleep, people are moodier, prone to irrationality and poor decision-making and have also difficulty to remember things. The extent of sleep disturbance in the general population is that over 50% of adults have difficulties sleeping, half of these chronically. Insomnia is defined as “disturbed sleep that’s persistent” lasting more than a month. It is more common than one would think as it is estimated that one in ten adults are affected by insomnia. Insomnia is described as having difficulty in falling asleep, staying asleep, waking too early and having poor quality of sleep. Sleep issues can lead to poor work performance, irritability, anxiety, headaches, fatigue, daytime sleepiness, and impair attention, concentration and memory.
In terms of treatment we know that sleeping pills are not the solution for insomnia and that it is possible to successfully treat insomnia using cognitive-behavioural therapy (CBT). CBT accomplishes these results as it is based on the idea that insomnia can only be treated successfully by addressing the underlying causes of insomnia – thoughts and behaviours – which are learned and can be unlearned. CBT has been recognised as an effective and preferred method for treating insomnia. Research on CBT identifies the following:
- 75% of insomnia patients experience significantly improved sleep
- The majority become normal sleepers
- 85-90% reduce or eliminate sleeping pills
- CBT is more effective than sleeping pills
Tips to put your sleep back on track:
- Go to bed only when sleepy
- Get up when you can’t sleep
- Wake up at a consistent time each morning (irrespective of how you slept)
- Use the bed only for sleeping (do not read, eat, watch TV, etc. in bed. Sex is the only exception)
- Avoid daytime napping
- Create a buffer zone (quiet time prior to bedtime)
- Don’t worry or plan in bed
- Don’t try too hard to sleep, just let sleep unfolds
A 5-session CBT treatment group for individuals with sleep difficulties is held at the Canadian Forces Health Services Centre (Atlantic), in Halifax. This program provides education about factors (environment, health habits, & sleep habits) that help/hurt sleep, addresses thoughts and beliefs that interfere with sleep and targets factors that contribute in maintaining insomnia such as: excessive time in bed, increase in non-sleep related behaviours occurring in the bedroom, naps, stimulant use, sleep aids, unhelpful and dysfunctional sleep related behaviour. If you believe you would benefit from sleep support, or mental health services, your medical officer or clinician can send a referral to the Mental Health Triage Team.
Maj Nadine Rancier, MSW, RSW
Carney, Colleen (2009) Quiet Your Mind and get to Sleep: Solutions to Insomnia for those with depression, anxiety, or chronic pain/ Colleen E Carney and Rachel Manber
Manber, R., Friedman, L., Siebern, A.T., Carney, C., Edinger, J., Epstein, D., Haynes, P., Pigeon, W., & Karlin, B. E., (2014). Cognitive Behavioral Therapy for insomnia in Veterans: Therapist manual. Washington, DC: U.S. Department of Veterans Affairs.