The Healing Power of Sleep (Part 2)

This column is the second installment in a two-part series that focuses on the importance of sound sleeping patterns in promoting optimal recovery while safeguarding against relapse. The first installment took a detailed look at common sleep problems experienced by practicing alcoholics and addicts as well as those in recovery. This final installment provides specific pointers for assisting your clients in attaining and maintaining a sound pattern of restful sleep. 

Basic Sleep Hygiene Principals   

As previously highlighted, frequent insomnia is often experienced during acute withdrawal, as well as throughout the post acute-withdrawal phase of recovery when the brain and body are struggling to attain a new state of equilibrium without reliance on alcohol or drugs (Gorski, 1989). It is important to advise clients that while some degree of sleep disruption is normal in early recovery, this difficulty can be minimized by following basic sleep hygiene principles. 

It goes without saying that a lifestyle conducive to serenity is important to promote restful sleep as well as to serve as a cornerstone for one’s overall recovery. As much as possible it is important to establish and maintain a regular sleep cycle, going to bed and arising the same time each day. Sound nutrition is critical to establishing healthy sleep patterns. It is especially important to avoid or moderate our ingestion of nutritional stressors, particularly sugar and caffeine, which are disruptive to both quality and quantity of sleep. Nicotine is another stimulant that should be avoided for a multitude of reasons. And from a general wellness perspective it is important to encourage clients to exercise regularly and strive to maintain a good balance between activity and rest, while incorporating effective time management and stress management skills into their lives. 

Pointers for Combating Insomnia  

A number of the following suggestions are adapted from Say Good Night to Insomnia by Gregg D. Jacobs, PhD.  

1. Establish a regular schedule of going to bed and getting up and stick to this, even on weekends. A regular sleep routine helps stabilize your biological clock, and your body forms the habit of going to sleep at a regular time. 
2. Develop a winding down routine before bedding down. Experiment to find what works best for you. Effective routines include relaxing, reading or listening to soothing music, cuddling with your partner or an evening prayer period. Avoid listening to loud music or watching a disturbing TV program close to bedtime (I never watch the 10:00 news), and at all costs avoid an angry confrontation prior to bedtime. 
3. Go to bed only when tired and make sure you are not spending too much time in bed. Many people suffering from insomnia go to bed early in the hope of getting more sleep. This is self-defeating, as going to bed before we are not tired reinforces our association of lying down with not being able to get to sleep. Jacobs encourages readers to keep a sleep log, recording when we go to bed and get up, together with an estimate of how much sleep we actually receive. The goal is to increase our sleep efficiency. For example, if you go to bed at 9:00 and arise at 6:00 but only experience six hours of sleep, you’d probably be better off going to bed at 10 or 10:30 to maximize your sleep time in relation to total time spent in bed. 
4.  Exercise regularly, while avoiding vigorous exercise prior to bedtime. We are most apt to drift peacefully off to sleep when our body temperature is on the cool side. Research indicates that following 30 minutes of vigorous exercise our body temperature remains elevated for about four hours, inhibiting sleep. When our bodies begin to cool down, however, the brain is signaled to produce melatonin, which promotes restful sleep. 
5. Avoid caffeine after 2 p.m. and avoid nicotine at all costs. Common sources of caffeine include coffee, tea, cola beverages and energy drinks. As caffeine is a stimulant that stays in the body for eight hours, it is best to take a pass on these beverages during midafternoon and evening. If you read this column regularly you are aware that nicotine addiction is the leading cause of death among people in recovery. Of specific relevance to sleep hygiene is the fact that the stimulant properties of nicotine often make it rather difficult to fall asleep. In addition, many smokers experience withdrawal pangs at night, causing them to get up for a nicotine fix. Numerous studies indicate that smokers are four times more likely than nonsmokers to report that they do not feel well rested when they get up. 
6. Avoid dependency on sleep medication. Many prescribed and over-the-counter sleeping pills carry with them unwanted side effects, including potential addictive properties. I strongly prefer occasional use of a homeopathic or herbal remedy to help induce a restful sleep. Two of my own favorites are the Hyland Calm Forte homeopathic remedy and an herbal remedy called valerian. Be sure to consult a physician or other trusted health advisor concerning appropriate use of any sleep aids. 
7. If possible, avoid working shifts that disrupt your body’s normal circadian rhythm, and avoid frequent travel across time zones. To minimize the effects of jet lag when traveling back east, I’ll book an outgoing flight that requires me to get up around 4 a.m. That way, when I hit the sack at 10 p.m. east coast time I generally go right to sleep when my head hits the pillow. 
8. Don’t obsess over lack of sleep. Generally speaking we can function at a level approaching normal efficiency when we attain 5 ½ hours of “core sleep” the night before. When you have a particularly bad night’s sleep, get up and go to bed at your regular time the next day. You will usually be so tired that you’ll fall back into your regular sleeping pattern that evening.  

As illustrated throughout this two-column series, the healing power of sleep works wonders in promoting overall vitality and quality of life in recovery, while forming a valuable safeguard against relapse. As always, feel free to share this column with your clients and others who may benefit from the message. Until next time–to your health! 

References   

Dumain, T. (u.d.). 20 ways to sleep better every night. www.prevention.com. 

Gorski, T. T. (1989). Passages through recovery: An action plan for preventing relapse. Center City, MN: Hazelden. 

Jacobs, G. D. (1998). Say good night to insomnia. New York: Henry Holt and Company.