This post is the first post in the sleep problem series. It provides an overview of the main types of sleeping difficulties at different stages throughout the night. Because we are a psychological practice, we will only focus on those sleep difficulties that can be assisted psychologically.
Quality and appropriate amount of sleep is critical for both physical and psychological health, and important for the quality of our relationships.
Sleep problems can be caused by many different factors, but roughly speaking the quality of sleep depends on two parallel processes – one is an actual sleep process and another one is how relaxed and safe the body feels. The more the body is relaxed and the longer it can stay relaxed – the deeper the sleep process is – therefore the better the quality of sleep is, and the more healing and recovery can take place during sleep.
When assessing sleep problems we always ask when and how the sleep problems occur, because it will likely indicate, or at least narrow down, what could be affecting our sleep.
Difficulty falling asleep
Usually difficulty falling sleep has to do with either being overstimulated and being detached from feeling tired (being tired, but not feeling it), or with problems with the sleeping routine. For now we will not go into the details about what the effective sleeping routine looks like. However it is important to mention here that what we do to help our body prepare for sleep and our pre-sleep and sleep environments, all significantly affect the quality of sleep.
First 3-4.5 hours of sleep
When we first fall asleep, our body should be relaxed enough to allow for the process of sleep to occur. In some cases this state can be a type of ‘fake relaxation’ experienced as flatness or numbness, which may occur due to physical exhaustion or the influence of alcohol or other substances.
After we fall asleep the majority of physical recovery occurs in the first 3-4.5 hours of sleep. During this time we usually have three cycles of deep sleep, each cycle lasting for approximately an hour – an hour and a half, and they gradually become less deep and shorter. Each cycle consists of several stages of sleep, and each stage corresponds to the depth of sleep. Many people do not know, that between the sleep cycles we are actually either very close to being awake or have micro-waking episodes. When we are relaxed and the quality of sleep is good we do not even register these micro-waking episodes. However, if the body is not relaxed properly – our awakening is more pronounced. During the deep sleep cycles our brain really is asleep to allow for maximum recovery. However, evolutionarily it was not always safe for a human to stay asleep for several hours straight (they could have been eaten) -so our mind is trained to scan for the signals of danger between the sleep cycles in order to make sure that we are safe to stay asleep. That is why when we experience anxiety – our subconscious mind registers danger signals and can be reluctant to go into the next cycle of deep sleep.
Difficulty in the second part of the night, REM phase, scary and unpleasant dreams
When sleep problems occur in the second half of the night, they most likely relate to emotional processing difficulties and anxiety, as deeper emotional processing and psychological recovery occur in the second part of the night. During the day we are usually too busy to pay full attention to the feelings and the emotional triggers that we experience. If emotional material has been blocked out during the day, ans if it was important enough – it will most likely surface while we are asleep. Difficulties that occur in the second part of the night usually manifest in waking up feeling fearful, with night-terrors or nightmares, waking feeling ‘weird’ or scared, or obsessively trying to understand something. You can read about these types of problems in more detail here.
Waking up too early
If we have issues that trigger complex emotions and anxiety – we usually wake up too early and feel instantaneously alert. The mechanism of early waking is a combination of difficulty falling asleep, being overstimulated, and processing complex emotions.
Did you know that we can accumulate sleep debt, from which we can recover later?
This means that even though it is great to have consistently good sleep – at times when we do not have such luxury, we can actually catch up on sleep later.
Sleep problems are frequently accompanied by anxiety problems, relationships problems. They can also come work together with depression and pain. You can read more about anxiety problems here and here, about depression here, about pain problems here, and about relationships problems here. In addition you might be interested in reading on a few things our clients reflected they wished they knew before entering therapy here. Please send us your comments or questions, and we will do our best to answer them.
