Sleep Disorders Answers

Hi Lily bee, Sleep-Trich or sleep related trichotillomania can be body-focused repetitive behaviour from when you're awake. From your question, if it's just sleep focused hair pulling, it can occur during different sleep stages. Such as when your brain pattern slows, which is thought to be associated with an alert, but daydreaming mind. Showing that when your neurological wakefulness changes it can relate to hair pulling. Of course, this is my opinion of what some research has made me believe.   In terms of trauma from your past life being a cause it can be, which tells us that it would be a response behaviour from your past trauma. It could also be from more frequent stressors such as low self-esteem, for both the hair pulling act can be a release from anxiety and tension for you. It can be a bit of a vicious cycle with the hair pulling in turn becoming a source of repeat anxiety. It can be a type of addiction in giving you that release and can be difficult to stop.   An added obsession of what today's hair perfection culture wants us to feel can make it difficult to stop and the cycle begins again. New traumas can increase the need of release and it can start to feel isolating as people around us don't understand.   Cognitive behavioural therapy has been seen to be the most effective intervention of working with trichotillomania as it works with the underlying thoughts and emotions around the trauma rather than just the behaviour itself. Some negative symptoms you may be experiencing are shame, guilt, anxiety, embarrassment, depression, low self-esteem, isolation or even social withdrawal.   Some things that might be worth considering are a diary to help you understand any patterns that may appear, for example certain days of the week, after certain events or alcohol/sugars. This could help you understand what you may need to avoid or what may increase the frequency for you, your triggers. This could link to your past trauma and what triggers you have around that, therapy could really help with this as it could be a safer environment for you to explore with someone.   I do hope this helps you understand it a little clearer.

Hi, thank you for your question, which is a common question many ask. How to improve your sleeping routine? So many factors contribute to why your sleep may be disrupted, and there are fundamental things you can begin doing to eliminate habits that might be disrupting your sleep. You also mentioned struggling to communicate, which is something I will help you to understand as well. I am sorry that you have felt the need to isolate yourself and feel alone because you cannot communicate your feelings in ways others understand. A lack of sleep can impact your ability to focus, process thoughts, and concentrate.  First, anxiety and stress can harm your sleep schedule. Poor habits and stressful environments can make falling asleep and staying asleep difficult. Check your environments, such as lighting, room temperature, and noises, and reduce blue lighting. The blue light shifts your circadian rhythms when you use your phone or tablet later in the night. REM cycles start later, and we are less likely to reach extended REM sleep cycles. As a result of a disrupted sleep schedule, you may find that you're sleeping more than usual and still feeling exhausted. Or, you may find that you struggle to sleep at night. Either way, you may end up feeling tired and not having the energy you need to make other improvements in your life. Another factor is to consider your actual sleep schedule. What time do you sleep each night? Try to have a daily and nightly routine so that your body knows when it is time to rest. Go to bed around the same time each night, assess your environment and try to create and be consistent with the same daily routine. Another factor that may impact your sleep is ruminating at night when it is time to sleep. Rumination is when you replay different experiences and situations that have happened, and you fixate on them. You are playing out conversations and thinking about the things that have occurred, often with guilt, shame, judgment, and resentment. It's a fixation on things that happened, and doing this at night, adds anxiety and can leave you feeling restless. When we ruminate, our minds are repeatedly caught thinking about the negatives. If we think about the situation in a new way, we can sometimes stop the ruminative cycle. One way to challenge rumination is using cognitive reappraisal. Cognitive reappraisal involves recognizing your thoughts' negative pattern and changing that pattern to one that is more effective. Instead of playing out this unpleasant, seemingly automatic cycle, take a moment to consider another perspective (reappraisal) you might have in this situation. In other words, am I seeing the worst-case scenario and all of the negatives, or am I acting impulsively with my feelings and drawing conclusions without all the evidence? What is another way to see this situation? So shifting your perspective to see if there is another possible outcome. You mentioned wanting to improve your communication and express yourself so that you are understood by those you care about. To communicate effectively, you have to first know what your needs are. Your emotions will tell you what you need. For example, if you feel rejected, your feelings tell you that you want to feel accepted. Take time to reflect on your feelings, recognize the need, and know your goal. By communicating what is your goal and expected outcome for the message you are trying to convey? These are questions to ask yourself before expressing your needs. Asking questions and learning is a good way to improve personal development and interpersonal relationships. Thank you for your question, and I wish you well on your well-being journey. 

Hi Ethel! Thank you so much for asking this vital question! I can tell that you are feeling curious and are interested in discovering some tips, perhaps some new ideas, as well as guidance, on how to manage insomnia. I can certainly relate to your concern that you have been experiencing trouble sleeping throughout the night. What is your current evening routine? It sounds like you are having trouble staying asleep. Are you also having trouble falling asleep, as well? I know that you mentioned in your question that you have recently been experiencing insomnia. How long have you been experiencing insomnia? These are some of the important questions that you may want to address with your therapist or primary care doctor. The first thing that comes to mind for me when it comes to managing insomnia is to establish a sleep routine. Take some time to identify the patterns of sleep that you notice that you are experiencing. Start by simply observing your sleep patterns and begin to make changes as you go. I recommend keeping a sleep diary, if that is at all possible. The BetterHelp platform offers a worksheet on sleep hygiene as well as an example of a sleep diary that may be helpful for you. In addition to starting a sleep diary, I recommend utilizing aromatherapy techniques. This strategy may help you to feel more relaxed and calm in the evenings. For example, you may want to purchase a scented pillow, a body or room spray, or a scented eye mask. I believe that lavender is a popular scent for people to use to stay asleep. It may be a good idea to test a few different scents out and see which one appeals to you and which one brings you the feeling of relaxation. Perhaps vanilla or jasmine might be other scents that you could try. If you are waking up in the middle of the night, you can utilize aromatherapy in order to focus on falling back to sleep. I am not sure if you were doing this already, but it would be a good idea to shut off all electronics and screens an hour or two before bed. Turning off your cell phone, the TV and any other blue light device, such as a laptop or computer, will likely be beneficial for you and your sleep cycle. Sleep education is going to be key so do what you can to learn about the various stages of sleep. It would be great if you could read a book or a magazine as a means to relax before bed. Keep a consistent schedule, such as adhering to the same bedtime and wake time every day. These ideas will hopefully be beneficial for you! In addition to the aforementioned strategies, I recommend relaxation strategies. Relaxation techniques include mindfulness meditation, progressive muscle relaxation, deep breathing, and guided visualization. These are just some examples of relaxation techniques that you can try any time, from the comfort of your home. Listening to audio clips on the topic of mindfulness might be a great idea for you! Here is a resource to a website that I recommend: https://wellness.mcmaster.ca/your-health/mindfulness-and-relaxation/ It may be a good idea to practice these techniques while you are awake and during the day in order to feel more comfortable with implementing these strategies in the moment when you are awakening at night. One thing that I tell my clients is that if you are awake, laying in bed and can not sleep for more than thirty minutes, take about twenty minutes to get out of bed and do a different task, such as an epsom salt foot bath, listening to music or reading a story. The idea is that it is best to leave the bed and the room you are sleeping in, refocus your energy on something else and return to the bed feeling refreshed and ready to try to sleep again. You can certainly learn more about these strategies and techniques in individual therapy sessions. You may want to try some holistic modalities, as well. This may include massage therapy, acupuncture, art therapy, herbal supplements and more! It is up to you what you decide to try and be patient with yourself in the process! Thank you for giving me more information about what you have been worried about. I think it makes sense that you are worried about your son. It can be difficult, as a parent, to stop worrying about a child, no matter what age they are at. In order to combat your feelings of worry, I recommend making a worry chest. You can design a container to your liking and use sticky notes or scrap pieces of paper to write your worries on and fold them up and place them in the container. Know that your worries are safe in a place that you have made for them. Allow the worries to exist and give yourself the time you need to rest. You can always revisit your worries again in the morning. I can tell that you are feeling lonely. What is it like for you to live alone? I can only imagine what it must be like for you to be a widow for fifteen years. What has that experience been like for you? I think that it is a great goal to try to meet someone new and go on a few dates. That seems like it would be helpful for you! I recommend utilizing a positive affirmation in the evening as a means to comfort yourself and wind down before you go to sleep. An example of a positive affirmation for sleep could be: "I will get a good night sleep tonight. I give myself permission to rest. I know that when I feel tired, that it is time to relax my mind and body and get some sleep." It sounds like a positive aspect of your life is taking classes at the local YMCA and spending a good amount of time with your friends. I encourage you to keep doing that! Thank you again, Ethel, for your time in asking this important question related to insomnia!

Hi Pony,   I am sorry to hear that you are struggling the way that you are.  It is not at all uncommon to experience anxiety and depression together.  Finding some new self-care strategies might benefit you along with improving your sleep hygiene.  For example, what are some of the things you do prior to bedtime to prepare your mind and body to settle down?  Having a consistent practice of washing your face, brushing your teeth, etc. is one way to help the brain to know it is time to quiet down however there are additional strategies that are sometimes overlooked.  This includes having the temperature set at a comfortable level, avoiding any screen time at least 30 minutes before bedtime, and also avoiding naps during the day. You also want to use your bed just for sleeping and sexual activity.  So for example, if you are one that tends to do other activities in bed such as eating, reading or watching television, your brain may then correlate the bed to more stimulating activity making it difficult to fall or stay asleep.    I would also be curious to know what sort of thoughts you are waking with since you mention such a feeling of dread.  Cognitive-Behavioral Therapy (CBT) involves paying attention to how our thoughts, feelings and behavior are all connected.  Often times, unhealthy or unhelpful behaviors are the result of unhealthy/unhelpful thoughts, and gaining insight into this could be quite helpful for you.    I have listed some additional general self-help tips below, some of which I commonly share with my clients and in my responses. o   Talking to a professional or reading some literature may be helpful for you.  The book Self Compassion: The Proven Power of Being Kind to Yourself by Kristen Neff is one that comes to mind, and some reputable online sources I would recommend when it comes to finding additional tips on sleep include Healthline, WebMD, and Psychology Today. o   Having a consistent self-care practice as well as self-esteem practice is critical.  What do you do for your self-care?  Consider having short mindful moments throughout the day, seeking out some creature comforts and pampering, or finding what you truly enjoy and getting lost in it. And physical activity can help reduce stress and anxiety as it releases endorphins and enhances chemicals in our brains that help us to feel better, like serotonin and dopamine.  When done on a regular basis, it can help to lower your overall level of anxiety. o   Practice relaxation skills.  I know I am repeating myself when I say self-care is so key! Try such calming and meditative exercises as deep-breathing, imagery of a relaxing scene, and guided meditations.  Sometimes it can be helpful to repeat a calming word or mantra you create for yourself such as “I can get through this… I am at peace.”  Journaling thoughts and feelings can also be useful.  And if sign up for BetterHelp, there is a journal feature that would be available to you, which can include daily prompts if you want.   I hope you find some of this helpful.  There are a number of qualified mental health professionals on this platform who I am confident would be able to help you further.  I wish you all the best for the rest of your 2022!  Think about what was helpful and harmful for you this past year and incorporate more of what can help so that it can be a great year for you.  Good luck and be well!   -Alicia