Sleeping in the wake of the news: Advice from a Ukrainian researcher at Salzburg’s Sleep Lab
«Simple Words»
Podcast about mental health
How often do you wake up every night? How much sleep do you need to stay in good mental and physical health? What matters more, how much sleep you get or the quality of that sleep? Is it possible to get quality sleep during wartime, and how can people in Ukraine make sense of expert advice on good sleeping practices in their circumstances? You can find answers to these questions and more in the new episode of the In Simple Words podcast with Anton Kurapov, a researcher at the Laboratory for Sleep & Consciousness Research at the Centre for Cognitive Neuroscience (CCNS) in Salzburg, Austria and an Associate Professor of Experimental and Applied Psychology at the Taras Shevchenko National University in Kyiv, Ukraine.
The ‘Science of Resilience’ season of the In Simple Words podcast is supported by Ukraine’s First Lady, Olena Zelenska’s How Are You? mental health initiative, the Coordination Centre for Mental Health of the Cabinet of Ministers of Ukraine, and the World Health Organization.
You can find the episode wherever you listen to podcasts
Insomnia is the malady of our times
76.3% of respondents in a recent Ukrainian study reported that they have experienced sleep disturbances in the wake of Russia’s full-scale invasion. However, according to Kurapov, sleep problems of varying degrees of intensity are prevalent worldwide, with approximately 70% of people globally experiencing them.
What happens if you don’t address sleep issues?
Sleep is the body’s only way to recover and regenerate, Kurapov explains. Disrupted sleep will ultimately lead to all sorts of other problems.
Lack of sleep has a cumulative effect on the body: if you only get four hours of sleep one night, and the next, and then the next, you’ll feel worse each day. At some point, in the absence of deep restorative sleep, your body will simply begin to shut down.
Insomnia has many side effects, depression and anxiety being the most prominent among them, while you are also more likely to have a heightened perception of stress.
Research shows that a lack of sleep leads to heightened anxiety in healthy adults. Just one night of disrupted sleep leads to a 30% increase in anxiety. Those with anxiety disorders experience boosts in stress hormones like cortisol in the absence of quality sleep; this, in turn, leads to surges of anxiety even before beginning your day.
Studies also show that the amount of sleep you get is related to the functioning of your immune system. Study participants who slept for less than seven hours a day were almost three times more likely to suffer from severe acute respiratory syndrome (SARS).
That’s why we have to prioritize sleep, however difficult it may seem. There is simply no other way to maintain your physical and mental health, Kurapov says.
Does usual advice on sleep apply in wartime?
Overnight airstrikes and air-raid alarms make it impossible for people across Ukraine to obtain the kind of sleep that sleep scientists consider the golden standard.
Still, according to Kurapov, research shows that using simple cognitive-behavioral techniques and following sleep hygiene recommendations can help significantly improve your quality of sleep even in wartime.
Your perception of the quality of your sleep matters
Researchers at the Laboratory for Sleep & Consciousness Research have moved beyond simply asking people about their perceived quality of sleep to a more comparative framework. The lab has developed an algorithm that determines the quality of a person’s sleep based on their heart rate. This method is as effective as traditional polysomnography, the application of sensors to patients that monitor brain activity, heart rate, breathing, muscle movements, blood oxygen levels, and other parameters, Kurapov says.
The Sleep Lab’s algorithm allows researchers to compare an objective measure of sleep quality (heart rate) and participants’ self-reported quality of sleep. The results reveal two things: first, even if there is no objective improvement in the quality of sleep of a person undergoing sleep therapy, their subjective perception of sleep quality significantly improves. Second, the worse a person’s insomnia symptoms, the more pronounced the positive effect of simple sleep therapy exercises on their sleep quality.
What can you do to sleep better?
Monitor your caffeine intake. Ideally, you should drink your last coffee or caffeinated beverage at least 10 hours before going to bed.
Don’t use alcohol as a sleep aid. Alcohol might help you fall asleep, but it makes sleep more fragmented, making you wake up more often and undermining the quality of sleep.
Consider taking magnesium supplements. However, keep in mind that magnesium has a cumulative effect. If you’re particularly stressed, don’t expect a significant improvement on the first night after you start taking the supplement.
Drink herbal teas and infusions. Valerian root, lavender, lemon balm, and chamomile are particularly effective in relieving anxiety.
Turn down your phone's screen brightness. Though make sure you can still use your phone without straining your eyes. Don’t turn bright lights on.
Avoid eating four hours before going to bed. Have your last meal at least two, but ideally four, hours before your desired sleep time.
What to do if you’re struggling to fall asleep?
Kurapov suggests that there are a few simple techniques you can try if you struggle to fall asleep within 15-20 minutes.
Avoid checking the time. Leave the bedroom, but don’t turn on the bright lights. Do something that doesn’t require a lot of physical exertion: now is not the time for a workout. Reading or listening to instrumental music or white noise can help you fall asleep.
Falling asleep is all about relaxation
Relaxation is the primary focus of sleep therapy, Kurapov says. Simple breathing exercises can help you relax. One of the most straightforward ones is called 4-4-6 breathing and is a tool commonly used by therapists. You count to four on an inhale, then hold your breath for another four counts, and then slowly exhale for six counts. You should feel calmer after several rounds of the 4-4-6 breathing technique.
Jacobson’s Progressive Muscle Relaxation (PMR), where you alternately tense and release specific muscle groups, is another common relaxation technique. You can start from the top of your head and move down your body, or go the other way round, from your feet to the top of your head. The exercise usually takes about 10-15 minutes, and you’ll likely be asleep by the time you’re nearing completion.
What to do if you feel overwhelmed by your thoughts when trying to fall asleep
Many people say anxious thoughts plague them at bedtime. This is known as rumination and is like a snowball, Kurapov says. The more you’re immersed in these thoughts, the more you struggle to fall asleep, which in turn makes you anxious about your inability to sleep and how that will affect your mood and energy levels the next day.
If this happens to you, try externalizing these thoughts. That is, imagine detaching them from yourself and putting them away. Exercises that develop your imagination can help with that, even though you might be suspicious about their effectiveness at first. “At first I also wondered how on earth they could be effective,” Kurapov says.
One of these exercises invites you to imagine a serene spot somewhere outside, in nature, and a tree near a stream with falling leaves. You then imagine placing a thought on each of these leaves and watching them glide away in the wind or be carried away by the stream. According to cognitive psychology, this shift of focus to your imagination is able to assist in breaking the vicious circle of anxious thoughts.
Are phone notifications a no-go?
Keeping phone notifications on during the night means your brain remains vigilant and prepared to respond to external stimuli. Whenever you hear a notification, your brain thinks that it’s time for you to wake up and look at your phone. In theory, if the amount of sleep you get and its quality are adequate, you should be able to go to sleep after this interruption fairly easily.
The most sensible thing you can do to allow your brain to rest is to turn off all notifications bar those that are most important and to turn down the brightness of your phone screen.
Melatonin is not a magic pill
Kurapov says that the Sleep Lab, which has been studying sleep for 20 years, has a firm stance that drugs containing melatonin should only be used if you’re experiencing jet lag. For other sleep problems, cognitive behavioural therapy should be the first port of call. Drugs should only be taken when behavioural methods fail, Kurapov stresses.
How to assess your quality of sleep?
Quantity, Quality, Regularity, and Timing (QQRT) are the four key principles of good sleep, and each is equally important. Each is also surrounded by myths.
1. Amount of sleep
The amount of sleep and the amount of time you spend in bed are two different things. Kurapov says that when it comes to the amount of sleep, the popular claim that everyone needs 7-9 hours of sleep is not backed by evidence.
Only two factors can help you determine whether you are getting enough sleep. The first one is the way you feel in the morning. Waking up is usually accompanied by an increase in cortisol levels, which prepares you to start the day without feeling exhausted.
The second factor is your cognitive productivity throughout the day, or whether you can think, plan, and carry out the tasks you need to do.
The only real standard is at least six hours of sleep a day. Kurapov says that if you wake up at night and stay awake for half an hour but can get up 30 minutes later in the morning and experience the necessary number of different sleep phases, your quality of life will remain largely unaffected by that disruption.
2. Quality of sleep
Although it’s commonly believed that a good night’s sleep means that you’re sleeping through the night without waking up, research suggests that all of us experience frequent but brief wakings throughout the night. Moreover, studies show that the number of these wakings increases as you grow older. While teenagers on average experience 21 of these micro-wakings in one night, people aged 61-70 experience 42 of them, even in light of the fact that the overall duration of sleep decreases with age.
This is an evolutionary mechanism. Our brains have been shaped by 40,000 years of evolution and by our ancestors’ lifestyle, which required them to remain hyper vigilant even during the night, and although our lives are different now, these micro-wakings persist, Kurapov says. They normally last 2-30 seconds, and you only recall some of them, namely those that last two minutes or more. Ideally, you should be able to easily fall asleep after one of these wakings.
3. Sleep routine
It’s important to fall asleep and wake up at roughly the same time every day, deviating from those times by no more than 40 minutes.
Sleep rituals and routines are significant: they help your brain form sleep associations. Any activity that you undertake at a certain time before bed can signal to your brain that it’s time to sleep.
If you feel like you’re undersleeping during the work week, you can try catching up with sleep over the weekend, as long as that doesn’t disrupt your sleep routine too much.
4. Sleeping and waking times
Chronotypes are essential: there really are early birds and night owls. Kurapov says that if you want to find out which one you are, you should ask yourself when you would schedule an exam that your life depended on.
To find out more about your chronotype, you can also take this survey. Your chronotype is largely shaped by genetic factors, but it can also change throughout your life. The best way to improve your sleep is to make sure your lifestyle and sleep schedule align with your chronotype.
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THE SEASON "SCIENCE OF RESILIENCE" OF THE "IN SIMPLE WORDS" PODCAST IS RELEASED AS PART OF THE INITIATIVE OF FIRST LADY OLENA ZELENSKA TO IMPLEMENT THE ALL-UKRAINIAN MENTAL HEALTH PROGRAM "HOW ARE YOU?" THE PROJECT WAS IMPLEMENTED IN COOPERATION WITH THE COORDINATION CENTER FOR MENTAL HEALTH OF THE CABINET OF MINISTERS OF UKRAINE, WITH THE SUPPORT OF WHO
