West Lothian

Community Wellbeing Hub

Moving towards a better night's sleep

 Improve lifestyle factors known to
impact sleep

Reduce stress associated with

sleep

Improve sleep routine & habits

What happens when we sleep?

Why am I not sleeping well?

Creating a sleep schedule

Dealing with a racing mind

Soothing techniques

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What happens when we sleep?
The sleep cycle
Stage 0: Wake
Wake time is the time spent in bed before and after
falling asleep. It also includes brief awakenings during
the night. These episodes are completely normal for
healthy adults.

Stages 1 and 2: Light sleep

Light sleep initiates your sleep cycle and acts as a transition to deeper
sleep stages. During this stage your muscles begin to relax, your heart
rate and breathing slow down, and you wake up easily during light
sleep, you can expect the following:
• Muscles relax and may jerk
• Respiration slows
• Heart rate decreases
• Body temperature drops
• Sleep begins.

Stages 3 and 4: Deep sleep

Deep sleep focuses on your body. It is the most rejuvenating and
restorative sleep stage, promoting muscle growth and repair as well
as waste removal in your brain. In this stage, you have difficulty
waking up and are disoriented or groggy if awoken. During deep
sleep, you can expect the following:
• Blood pressure drops
• Blood flow increases to muscles
• Repair hormones (growth hormone) are released
• Tissue growth and cell repair occurs
• Long, slow brain waves
• Brain flushes out waste.

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Stage R: REM sleep
REM sleep is essential to re-energising your mind. REM is associated
with dreaming, memory consolidation, learning, and problem solving.
The time spent in this sleep stage usually decreases with age. During
REM sleep, you can expect the following:
• Respiration increases
• Heart rate increases
• Temperature regulation is switched off
• Brain activity is high; vivid dreams may occur
• Blood flow increases to genitals
• Body becomes immobile to stop you from acting out dreams.

Each night you take a rollercoaster ride through the different phases of
sleep.
Though you’re unaware of what goes on while you’re sleeping, your
brain and body are in an active state. Each stage of sleep has distinct
restorative qualities and how you move through each phase plays a
large role in your body’s status the next day.
During an ideal night’s sleep of 7-8 hours, you go through 4 to 5 ninety
minute cycles that sample each phase of sleep. Each cycle plays an
essential role in maintaining your mental and physical health. The
amount of each phase of sleep can vary significantly between nights
and individuals. If we are having broken sleep it can mean we are not
getting our deep sleep as we always go back to the start of the cycle.

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Why am I not sleeping well?
Let’s think about your environment

Light: How dark is your room?

Your bedroom should be dark as too much light can cause
wakefulness. Using thick curtains or black out blinds can
eliminate strong streetlights. Some people find they sleep
better with an eye mask to ensure complete darkness.
Do you use your phone during bedtime?
The light from electronic gadgets can impact your body clock and
reduce the hormone melatonin. This causes wakefulness.

Comfort: Is your bed comfortable?

Your bed and mattress should be in a comfortable place
where you are happy to sleep. If you can feel springs or
have a sore back, try buying a mattress topper. It is a cheap
alternative to purchasing a new mattress.

Temperature: Is your room temperature comfortable

enough to sleep in?
The recommended room temperature to promote good sleep is
around 18°C. A cold room (below 12°C) can cause wakefulness and
more unpleasant and emotional dreams. A hot room (Above 24°C)
can cause us to have restless body movements, less deep sleep and
more waking. Investing in a thermometer can help you keep the
room at a comfortable temperature.

Noise: Is your sleep environment noisy during bedtime?

Noise is a common enemy of sleep. Loud and unexpected
noises can waken people from even deep sleep. Some people
may identify as light sleepers and find it important to eliminate noise
in the bedroom. You can do so by wearing ear plugs. If your phone is
in your room put it on silent, so alerts don’t disrupt your sleep.

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Clock watching: Do you catch yourself constantly checking
the time at night?
When unable to sleep straight away we may find ourselves watching
the clock. This can cause us to worry excessively and become hyper-
aroused. Try to remove clocks and devices that tell time from your
bedroom. Relax, sleep will come naturally.

Let’s think about your lifestyle

Technology: Are you browsing on your phone before bed?

Technology, such as mobile phones, is used regularly during
the day by most people. We often continue using technology
before and during bedtime. Avoiding screen time one hour before
you go to sleep means your brain has time to turn off. Having your
phone or tablet in your bedroom at night can impact your ability to
get back to sleep easily.

Exercise: How does exercise impact your sleep?

Exercise causes you to have increased deep sleep, allowing
your body to repair and grow. It also reduces the amount of
time it takes you to fall asleep. Avoid strenuous exercise before
bedtime, as this activates our nervous system leading to problems
falling and staying asleep. Try gentle stretching exercises before bed.
This can be relaxing and support sleep.

Alcohol: Is your ‘night cap’ disturbing your sleep?

Although a ‘night cap’ may seem initially relaxing, drinking too
much can impact your sleep. Drinking causes you to wake up
during the night for increased toilet visits. It also causes you to wake
up because you feel dehydrated. Try to avoid drinking alcohol within
3 hours of bedtime.

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Nicotine: Do you smoke before bedtime?
Nicotine is a stimulant and has similar effects to caffeine on
sleep. You may find you wake up in the middle of the night
because of a nicotine craving. It is important not to smoke at this
time, as nicotine leaves the body quickly and another craving may
occur later. Try to have your last cigarette 2 hours before bedtime as
this is how long it takes nicotine to leave your body. Stopping
smoking can help improve sleep and health. Your GP can provide you
with support.

Caffeine: Do you consume caffeine products before

bedtime?
Caffeine is a stimulant that impacts our nervous system causing us to
‘perk up’ which keeps us awake. We should avoid products containing
caffeine for 6 hours before bed. Caffeine can be found in various
products other than coffee and tea, e.g. medication (consult your GP
for alternatives). Try drinking decaffeinated tea, coffee, or cola to cut
down or eliminate caffeine.

Diet: Do your eating habits affect your sleep?

Having heavy foods close to bedtime or not eating at all can
cause wakefulness. This is caused by your body processes
involved in digestion and hunger. It is also best to avoid eating if you
wake up during the night as your body may start expecting food at
this time, causing regular wakefulness. Try some foods that contain
melatonin and promote sleep e.g. milk, yoghurt, and peanut butter.

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For your information
Did you know some foods contain melatonin
derivatives so they promote sleep.

Did you know caffeine is found in various foods, drinks, and medicines.
The caffeine limit for adults is 300-400mg.

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An experiment
Schedule your evening phone and technology time:

I will stop using my phone at: e.g. 9pm

Alternative activities I can e.g. Relaxation, stretches, light reading

complete are:

The location where I will store e.g. Dining table, hallway cabinet, wardrobe
my phone at night is:

Can you recognise any lifestyle choices that impact your sleep? What
could you change to improve your sleep?

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Creating a sleep schedule
Hints and tips
Get out of bed around the same time
every day, including weekends
Go to bed when you feel sleepy or
tired
Limit naps

Only use your bed for sleep

Importantly, this may mean temporarily reducing the amount of time

spent in bed overall to build up a better sleep system.
“Why I am grateful”
A powerful tool to force you to pay attention to the good things:
I am grateful for my family because

I am grateful for my friendship with _________ because

Something good that happened this week

Something silly that I am grateful for

Something else I am grateful for

I am grateful for who I am because

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Dealing with a racing mind
What triggers a racing mind?

Reflecting on past events

Worrying about future events

Worrying about not being able to sleep

Worry about worrying

What maintains a racing mind?

Fight or flight gets triggered

Body feels alert and ready for action

Worry increases

How to cope with a racing mind:

Use soothing techniques to turn volume down

Writing things down; daytime problem-solving

Worry time.

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Soothing techniques
Progressive muscle relaxation
How often have you thought, “If only I could
relax, I would be able to sleep”? One way of
achieving this is progressive muscle relaxation.
Progressive muscle relaxation is based on the tensing and relaxing of
the main muscle groups of the body. This leads to a decrease in muscle
activity, heart rate, and blood pressure.

Practicing progressive muscle relaxation

Sit back or lie down in a comfortable position. For each area of the
body listed below, you will tense your muscles tightly, but not to the
point of strain. Hold the tension for 10 seconds, and pay close
attention to how it feels. Then, release the tension, and notice how the
feeling of relaxation differs from the feeling of tension.
Feet Curl your toes tightly into your feet then release them.
Calves Point or flex your feet, then let them relax.
Thighs Squeeze your thighs together tightly then let them relax.
Torso Suck in your abdomen then release the tension and let it
fall.
Back Squeeze your shoulder blades together then release
them.

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Shoulders Lift and squeeze your shoulders
toward your ears, then let them drop.
Arms Make fists and squeeze them toward
your shoulders, then let them drop.
Hands Make a fist by curling your fingers
into your palm then relax your fingers.

Face Scrunch your facial features to the centre of your face

then relax.
Full body Squeeze all muscles together then release all tension.
Tips
• You should use your progressive muscle relaxation technique as
often as you like but it would be ideal to do it before bed. This will
help you unwind before bedtime.
• You should make sure you feel the tension but never tense your
muscles to the extent that you feel pain.
Guided imagery

Another relaxation technique, known as guided imagery, can help to

switch off racing thoughts at bedtime by creating your own imagery
story. This technique is particularly helpful if you find it difficult to
switch off your thoughts when you are trying to sleep. It involves
visualising a relaxing scene or place that is safe, familiar and easy to
recall. Imagery works best if engaged through a multi-sensory
perspective focusing on senses such as smell, taste, and touch.

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Practicing guided imagery
Think of a place that you find comforting. It could
be a secluded beach, your bedroom, a quiet
mountaintop, or even a loud concert. For 5 to 10
minutes, use all your senses to imagine this
setting in great detail. Don’t just think fleetingly
about this place- really imagine it.
What do you see around you? What do you notice in the
distance? Look all around to take in all your surroundings. Look
for small details you would usually miss.
What sounds can you hear? Are they soft or loud? Listen closely
to everything around you. Keep listening to see if you notice any
distant sounds.
What is the flavour like? Are you eating or drinking something
enjoyable? How does it taste? Savour all the tastes of the food
or drink.
What can you feel? What is the temperature like? Think of how
the air feels on your skin, and how your clothes feel on your
body. Soak in all these sensations.
What scents are present? Are they strong or faint? What does
the air smell like? Take some time to appreciate the scents.
Tips
Preparing your story in advance will make it easier to practice guided
imagery.
• Practice guided imagery before your bedtime
• It takes practice to get used to guided imagery
• Don’t give up if you didn’t get it at your first try.

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An experiment
Prepare a unique and individual story that you can
use for your guided imagery

Start with your location and its description then gradually add
sensory detail…

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Deep breathing
Deep breathing is a simple technique that’s
excellent for managing emotions. Not only is deep
breathing effective, it’s also discreet and easy to
use at any time or place.
Practicing deep breathing
1. Sit comfortably and place one hand on your abdomen
2. Breathe in through your nose, deeply enough that the hand on
your abdomen rises
3. Hold the air in your lungs
4. And then exhale slowly through your mouth, with your lips
puckered as if you are blowing through a straw.
Tips
The secret is to go slow. Time the inhalation (4 seconds), pause (4
seconds), and exhalation (6 seconds). Practice for 3 to 5 minutes.

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Helpful apps
Be Mindful (£30.00)
Be Mindful is an online course for reducing stress,
depression and anxiety. It guides you through elements of
mindfulness-based cognitive therapy (MBCT). Mindfulness
involves paying attention to our thoughts and feelings in a
way that increases our ability to manage difficult situations.

Chill Panda (Free)

Chill Panda measures your heart rate, tracks your mood and
suggests tasks such as breathing techniques and light
exercises to take your mind off your worries.

Sleepio (Free)
Sleepio is an online sleep improvement programme,
clinically proven to help you fall asleep faster, stay asleep
through the night, and give you more energy during the day.
The programme is based on Cognitive Behavioural Therapy.
You will learn cognitive techniques to help tackle the racing
mind and behavioural strategies to help reset sleeping
patterns naturally.

Sleepstation (Free with GP referral)

Sleepstation is a 6-week online course for people who
struggle to fall asleep or stay asleep through the night. The
course is tailored to your needs, using the information you
provide, and gives you access to a team of sleep experts who
will offer helpful advice and support throughout.

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Key messages
• Good sleep is an essential part of looking after
yourself
• Your lifestyle behaviour and sleep
preparation can impact your quality of
sleep. Making simple changes in these areas
can improve your sleep– consider changing something this
week
• Relaxation techniques such as progressive muscle relaxation,
guided imagery, and deep breathing can help switch off racing
thoughts in the evening, increasing sleep quality
• Start to think about your bedtime schedule/routine. Bed = sleep.
Sleep diaries can help with this.
Planning for the future

What are your next steps? What key changes are you going to take
forward?
Change 1:

Change 2:

V1.0 approved by NHS Lothian Patient Information Team, Feb 2022.

Review date, Feb 2025. LOT2353
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