Understanding Sleep Quality and Insomnia

by | Jun 12, 2024 | Sleep and Insomnia

Sleep is important for overall health and wellbeing. Not getting enough sleep can affect learning, memory, and mood. 1 Additionally, it also impacts physical health, such as heart health, the immune system, and muscle repair. 1, 2 Nonetheless, approximately 33-42% of Australian adults reported trouble falling or staying asleep a few times a week in the 2016 national survey. 3As a result, improving sleep quality can help reduce these difficulties and support overall health.

How do we define insomnia and how does sleep quality affect it?

Insomnia happens when you experience one of these sleep difficulties at least 3 nights per week: 4

  • Trouble falling or staying asleep.
  • Waking up too early and not falling back asleep.

People with insomnia often feel unhappy with their sleep, even when they have enough time to rest. If symptoms last more than three months, it is considered persistent. Around 12-15% of Australians experience chronic insomnia. 5 Enhancing sleep quality through good sleep habits and treatments can help manage these symptoms.

Struggling to sleep or waking up often can be frustrating. You may worry about feeling tired the next day and how it will affect your focus and tasks. These worries can cause anxiety, making it harder to relax and fall asleep. The cycle on insomnia can lead to stress and problems at work, school, or in social situations. Therefore, focusing on sleep quality can help break this cycle and improve overall rest.

Understanding sleep to improve sleep quality

Many believe the brain and body shut down during sleep. In reality, sleep is complex. The brain stays active and moves through different sleep stages. It has periods of Rapid Eye Movement (REM) sleep and non-REM sleep (please see Figure 1). 6

Figure 1. A hypnogram that illustrates the pattern of brain activities in different sleep stages and cycles. From “Stages of Sleep”, by Australian Psychological Society, 2023, topic 1, point 19. 6

  1. Non-REM sleep stage 1: Your body shifts from wakefulness to sleep. This lasts about 5-10 minutes.
  2. Non-REM sleep stage 2: Light sleep happens. This stage helps with learning and memory.
  3. Non-REM sleep stage 3: Deep sleep happens. Your body repairs tissues and boosts the immune system.
  4. REM sleep: Your eyes move quickly, and most dreams happen in this stage. Brain activity looks like wakefulness, but the body stays still to prevent movement during dreams.

You go through 3-5 sleep cycles every night. Most deep sleep happens in the first half of the night. As we age, deep sleep decreases while light sleep increases. Maintaining sleep quality a we get older can help with restorative rest.

Sleep pressure builds throughout the day and lowers when you sleep. Melatonin and sunlight help regulate your body's internal clock. Your body produces melatonin in darkness to help you sleep, while exposure to sunlight is associated with an increase in serotonin levels. Serotonin plays a key role in regulating body functions, including mood and sleep. 7 Optimising sleep quality involves balancing these natural rhythms and avoiding disruptions.

Drinking alcohol, using nicotine, or having caffeine before bed can disturb sleep and lower sleep quality. 8, 9, 10, 11

How can your psychologist help you with insomnia and sleep quality?

Cognitive Behavioural Therapy for insomnia (CBTi) is the best long-term treatment from chronic insomnia. 3, 12 Your psychologist will guide you through strategies such as:

  • Using behavioural strategies to retrain your brain to connect bed with sleep instead of wakefulness (i.e., Sleep Efficiency Training and Bed Equals Sleep Therapy).
  • Challenging negative thoughts about sleep. This helps lower anxiety and wakefulness at night.
  • Practicing healthy sleep habits and relaxation techniques. For more details, check out our previous blog on sleep and mindfulness.

If you recover from insomnia after treatment, well done! Reviewing the strategies used can help you manage future sleep troubles if needed. Prioritising sleep quality can prevent future disruptions and improve long-term wellbeing.

Insomnia affects both mental and physical health. However, our psychologists, Sharon Li and Anita Missiha, are here to support you. They create CBTi treatment plans tailored to your needs.

Author: Insightful Living Co. Psychologist Sharon Li

References

  1. National Institutes of Health. (2011). Your guide to healthy sleep. (11-5271). https://www.nhlbi.nih.gov/resources/your-guide-healthy-sleep
  2. Australian Institute of Health and Welfare. (2021). Sleep Problems as a risk factor for chronic conditions. (Catalogue number PHE 296). https://www.aihw.gov.au/reports/risk-factors/sleep-problems-as-a-risk-factor/summary
  3. Adams, R. J., Appleton, S. L., Taylor, A. W., Gill, T. K., Lang, C., McEvoy, R. D., & Antic, N. A. (2017). Sleep health of Australian adults in 2016: Results of the 2016 Sleep Health Foundation national survey. Sleep health, 3(1), 35–42. https://doi.org/10.1016/j.sleh.2016.11.005
  4. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
  5. Reynolds, A. C., Appleton, S. L., Gill, T. K., Adams, R. J. (2019). Chronic insomnia disorder in Australia: A report to the Sleep Health Foundation. https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia
  6. Australian Psychological Society. (2023). Cognitive behavioural therapy for insomnia (CBTi) certified skills course.
  7. Rhee, H. J., Vries, E., Coomans, C. P., & Velde, P. (2016). Sunlight: For better or for worse? A review of positive and negative effects of sun exposure. Cancer Research Frontiers, 2(2), 156-183. https://doi.org/10.17980/2016.156
  8. Garcia, A. N. & Salloum, I. M. (2015). Polysomnographic sleep disturbances in nicotine, caffeine, alcohol, cocaine, opioid, and cannabis use: A focused review. The American Journal on Addictions, 24, 590-598. https://doi.org/10.1111/ajad.12291
  9. Colrain, I. M., Nicholas, C. L., & Baker, F. C. (2014). Alcohol and the sleeping brain. Handbook of Clinical Neurology, 125, 415-431. https://doi.org/10.1016/B978-0-444-62619-6.00024-0
  10. Singh, N., Wanjari, A., & Sinha, A. H. (2023). Effects of Nicotine on the Central Nervous System and Sleep Quality in Relation to Other Stimulants: A Narrative Review. Cureus, 15(11), e49162. https://doi.org/10.7759/cureus.49162
  11. Gardiner, C., Weakley, J., Burke, L. M., Roach, G. D., Sargent, C., Maniar, N., Townshend, A., & Halson, S. L. (2023). The effect of caffeine on subsequent sleep: A systematic review and meta-analysis. Sleep medicine reviews, 69, 101764. https://doi.org/10.1016/j.smrv.2023.101764
  12. Australian Psychological Society. (2018). Evidence-based psychological interventions in the treatment of mental disorders: A review of the literature (4th ed). https://psychology.org.au/getmedia/23c6a11b-2600-4e19-9a1d-6ff9c2f26fae/evidence-based-psych-interventions.pdf