Sleep problems and insomnia: help

Good sleep is a cornerstone of mental and physical health. Yet from time to time many people find that falling asleep takes ages, their sleep is broken or they do not feel rested when they wake up in the morning. A few bad nights are normal, but if sleep problems persist, it is worth addressing the causes. Sleep can often be improved once we understand what is disturbing it.

Why is sleep disturbed?

Sleep problems can show up in many ways: difficulty falling asleep, frequent waking at night, waking too early or broken sleep. The causes are often intertwined and may be linked to lifestyle, environment or mental state:

• Stress and anxiety that keep the mind active at night too
• An irregular sleep schedule and late screen time
• Caffeine, alcohol or a heavy meal in the evening
• Noise, light or an uncomfortable sleeping environment
• Worrying thoughts and tension that build up during the day

The link between sleep and stress

Sleep and stress are closely connected. Tension and anxiety raise the body's level of alertness, which makes it hard to relax and fall asleep. Poor sleep in turn reduces the ability to cope with stress, creating a cycle in which sleep problems and tension feed each other. That is why, when improving sleep, it is also important to deal with the sources of stress and anxiety. You can read more on our page about burnout and stress.

Sleep hygiene tips

Often simple habits alone can noticeably improve sleep:

• Go to bed and wake up at the same time every day, including at the weekend
• Create a calm evening routine and avoid screens for an hour before sleep
• Keep the bedroom dark, quiet and cool
• Avoid caffeine, alcohol and heavy meals in the evening
• If you cannot fall asleep within 20 minutes, get up and do something calm until you feel sleepy

How can a psychologist and therapy help?

If sleep hygiene is not enough, cognitive behavioural therapy for insomnia (CBT-I) is an effective form of help. It is a scientifically proven method that helps you notice and change the thoughts and habits that get in the way of sleep and restore a natural sleep pattern without medication. A psychologist also helps you find and address the sources of stress or anxiety behind your sleep problems.

Who to talk to?

At Heaolu Keskus, you can talk about sleep problems with, for example:

Kaidi Kõiv 🇬🇧 🇪🇪

How sleep actually works

Sleep is not a uniform state of unconsciousness but consists of repeating cycles that alternate roughly every hour and a half during the night. In each cycle, lighter sleep alternates with deep sleep and dream sleep, or REM sleep. Deep sleep restores the body and the immune system, while REM sleep organises memory and emotional life.

Deep sleep dominates the first half of the night and REM sleep the second half. This is why sleep quality is not only a question of the number of hours: what matters is that the cycles can run through undisturbed. Frequent waking interrupts these cycles, which is why a person may feel tired even after an apparently sufficient number of hours of sleep.

Sleep is regulated by two main systems: sleep pressure, which builds up while we are awake, and the internal biological clock, which links sleep to darkness and light. When the two are in balance, sleep comes naturally. An irregular rhythm, a long daytime nap or too little morning light can upset this balance.

The effects of sleep deprivation on health and daily life

The consequences of one or two bad nights are usually temporary, but long-term lack of sleep has wide-ranging effects on health. Attention, concentration and judgement suffer first: when tired, we make more mistakes and react more slowly. Chronic sleep deprivation also affects:

• Mood and emotional regulation, increasing irritability and anxiety.
• The immune system, making the body more susceptible to illness.
• Metabolism and appetite, which can affect weight in the long run.
• Memory and the ability to learn, because information is consolidated during sleep.

That is why sleep is not a luxury but the foundation of health. The good news is that in most cases the body recovers quickly once sleep returns to normal. Even small changes in your sleep rhythm can noticeably improve how you feel.

How to calm the mind before falling asleep

For many people, the biggest obstacle to falling asleep is a restless mind: thoughts keep circling around the day's events and tomorrow's worries. Calming the mind can be learned and practised, so that in the evening the body and brain get the signal that it is time to rest.

• Write worrying thoughts down on paper before bed so they do not keep spinning in your head.
• Set aside a separate "worry time" during the day to deal with issues that need solving, so they do not come up at night.
• Try slow breathing, for example breathing in while counting to four and out while counting to six.
• Use relaxation, such as progressive muscle relaxation (tensing and releasing the muscles in turn).
• If you wake up at night, avoid looking at the clock or your phone, as this increases anxiety.

These techniques are worth practising regularly, not only on sleepless nights, because then they become a familiar signal for the brain to calm down. If worrying thoughts remain strong and disturb your sleep for a long time, a psychologist's support can help you find their roots and learn to cope with them.

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