“What’s your sleep like?” is one of the first questions I ask my clients if they’ve come to see me with an issue relating to anxiety, stress or depression. They usually reply with one of two answers:
“Rubbish – I’ve never been good at sleeping. I can’t turn my brain off.”
“I can fall asleep ok, but I wake up after a few hours and can’t go back to sleep”
The next question I ask is “do you dream a lot?”, at which point they ruefully grin, nod and think I’m a mind reader, which would be awesome but sadly I’m not.
The need to sleep is well known to be a fundamental requirement for us to function. According to a 2010 study in the International Journal of Occupational Medicine and Environmental Health after just 24 hours without sleep “judgment is affected, memory is impaired, there is deterioration in decision making, and a decline in eye-hand coordination,” Cralle says. “You’re more emotional, attention is decreased, hearing is impaired, and there is an increase in your risk of death from a fatal accident.”
So what does our sleep look like?
There are two very distinct kinds of sleep: REM (rapid eye movement sleep when we dream) and slow wave sleep. During REM sleep in basic terms our body muscles become paralysed and parts of our brain become highly aroused.
Slow wave sleep is the part of sleep where our body heals itself. The mind/body system rebuilds itself after a hard day surviving in the world. Importantly, in this period of sleep hormones are released to help repair wear and tear in tissues and muscles and our immune system is boosted. Additionally, and really importantly the glial cells in our brain are replenished with sugars. This restores the brain with our motivational energy for the next day.
In total contrast REM sleep consumes large amounts of the brain’s energy reserves which are used for dreaming. REM sleep occupies about a quarter of a healthy adult’s sleep time and on a scan the brain pattern while dreaming looks very similar to our brain pattern when we’re awake.
What does dream sleep do for us?
We all dream for about two hours a night, even though we often don’t recall having done so when we wake up the next morning. The latest scientific evidence shows that dreaming exists to act out and discharge any emotional arousal from the day before. So for example your boss was being a jerk but you couldn’t tell him, or a car cut you up and you couldn’t swear and scream loudly as your child was in the back. All of the stuff that you had to suppress.
Interestingly the emotion that you expressed and vented during the day is not part of this – the huge row with your partner for bringing home Chinese takeaway instead of Indian for example (How dare they? You’d fancied curry all day). In terms of emotional arousal this was discharged by the argument, not pent up.
The evidence shows that the reason we dream is to discharge the emotional arousal of the previous day to free up our brain to deal with the next day.
What does this have to do with depression, anxiety and stress?
In depression particularly, but also in anxious and stressed people, the sleep process goes dramatically wrong. Instead of having about 25% REM sleep and 75% slow wave sleep (which boosts energy levels in the brain), these proportions switch round, so that the depressed person has far too much REM sleep and too little slow wave sleep. There’s a simple reason for this.
Depressed, anxious and stressed people tend to spend a LOT of time worrying and introspecting. This leads to much higher emotional arousal levels and therefore a greater need for this to be discharged during dreaming. The first period of REM sleep occurs much earlier and lasts much longer in depressed people, because the pressure for discharge is so great.
However, so much time spent in dream sleep means that the brain is receiving much less ‘down time’ in slow wave sleep. This means that the brain is working throughout much of the night and therefore waking up exhausted. It also means that the time spent healing the body and refilling the glial cells is significantly reduced, leaving depressed and anxious people frequently waking up feeling exhausted and lacking motivation. This then begins to create yet another issue for them to worry about and therefore helps keep this unhelpful cycle in place.
So what needs to change?
The main task in any work with depression and anxiety is to lower emotional arousal and help people to stop their worrying and introspection as quickly as possible. This will begin to switch the sleep cycle back towards a healthy pattern, which has a huge knock on effect with our energy levels, mood and emotions.
I work by using behavioural, cognitive and interpersonal approaches with relaxation and visualisation techniques, to motivate people to widen their life view, raise their self-esteem and solve problems. I work with clients giving practical guidance for breaking problems down into manageable chunks and focusing forwards and outwards on solving the problem, not worrying about what started it in the first place (though sometimes it can be helpful to know). I set practical ‘homework’ and give strategies and agree goals to get to where they want to be. Clients leave sessions having clear goals and plans in place to put into practice before our next meeting.
I use the client’s imagination in guided imagery or hypnotherapy to help them vividly see themselves making the changes they need to make in order to overcome their difficulties. This works on the time honoured principle that the human brain tries to bring about what it focuses on.
You can find out more information about me on my website or connect with me on social media:
Or you can drop me an email or give me a call.
For more information around the topic of sleep and dreaming I highly recommend you look at Joe Griffins research and his work in creating the Human Givens institute. There is a wonderful free introductory webinar available here:
About the author
HPD, DipHPsych, DipNLP&Coaching, FRTC, CertSM, Nutritional Therapist
Roxy is a psychotherapist, coach and clinical hypnotherapist, with a private practice in Clowne, Chesterfield. She also creates and runs stress management and well-being courses for businesses and is a speaker at seminars and events. She sees clients both face to face in her office and increasingly worldwide using Skype. Her clients present with a wide range of issues including anxiety, stress, depression, panic attacks, phobias and addictions. Roxy is passionate about her work and much of her client base is now built through recommendations and referrals.