Sleep

• Depression & Anxiety
• Difficulty falling asleep
• Waking up frequently during the night
• Falling asleep at inappropriate times even after a night of adequate sleep
• Sleeping too much (more than 9 hours)
• Having sudden attacks of uncontrollable sleep or muscle weakness
• Having nightmares or night terrors (the experience of awakening in a terrified state without recollection of a dream) that interrupt your sleep
• Sleep-walking
• Weakened immune system
• Sleep Loss & Depression
  • Loss of sleep can be linked not only to sleep problems but depression as well. When sleep problems persist for more than two weeks there is an increased risk of developing depression. More than 80% of people who suffer from depression also have difficulty sleeping, and if sleep problems persist after depression has subsided, the risk of relapse increases.

• a) Try going to sleep and walking up at the same time each day.
  - Trying to "catch up on sleep" during the weekends does not work, in fact it disrupts your circadian rhythms making it harder to fall asleep on time on Sunday
  -Following a consistent sleep schedule will help your body develop natural sleep patterns which will improve the quality of sleep you are getting during the week.
• b) Limit napping time
  -While naps can be a great way to manage sleep, limiting the amount of time spent napping can improve overall sleep quality. Limit nap time to 15-45 minutes.
  -Additionally naps in the late afternoon, and early evening may disrupt your nighttime sleep schedule. To avoid disrupting your nighttime sleep schedule try napping midday to early afternoon (12pm-2pm).
• c) Get up and try again.
  -If you are struggling to get to sleep, try getting up and engaging in a quiet activity for ~20 minutes.
  -Keep the lights dim, and avoid using electronic devices during this time.
  -Example activities can include reading a book, journaling, breathing exercises, stretching, etc.

• a) Create a positive sleep space.
  - Cooler temperatures are better for sleep, if possible lower the heat during the night to promote better sleep conditions.
  -Fans, ear plugs, and white noise machines can reduce noise that may be preventing you from falling asleep or staying asleep.
  - Certain essential oils such as lavender, chamomile, or eucalyptus help promote sleep, using a diffuser with these scents can be beneficial when trying to fall asleep.
  - When going to bed make sure your sleeping area is dark. Blackout curtains and sleep masks prevent light from coming in and waking you up.
• b) Turn off screens
  -Electronic devices such as phones and tablets emit blue light which stimulate the brain, making it harder to fall asleep.
  -At least 1-hour prior to going to bed, avoid screen time. Disconnect from your phone, laptop, or other electronic devices as a way to help your brain naturally relax.
• c) Set up a nighttime routine.
  -Having a regular nighttime routine can help signal to your body it is time to get ready to go to sleep. Do the same things in the same order before going to bed to cue your body to slow down and relax.
  -During this time engage in self-care practices that are easy and make you feel good such as taking a warm bath/shower, drinking hot tea (caffeine free), brushing your teeth or hair, putting on lotion, doing a face mask, etc.
• d) Give yourself time to wind down and clear your mind 
  - Prior to going to bed give yourself time to relax and unwind from the day. Avoid trying to sleep immediately after doing a mentally and/or physically demanding task. Stop studying and don’t get into any stimulating discussions or activities a half hour or hour before bed.
  - Try engaging in some mindfulness practices such as listening to quiet music, mindful listening, guided meditation, or journaling as a way to de-stress and clear your mind before going to sleep.

• a) Exercise. 
  - Individuals who exercise regularly find that they are sleeping better at night and feeling less drowsy during the day. While vigorous exercises promote the best quality of sleep, even light exercise like walking 10 minutes a day can improve sleep quality.
  -Working out in the morning, and early afternoon is most beneficial when trying to improve sleep quality. Avoid doing a work-out right before bed as it can raise your heart rate making it harder to fall asleep. If you have to exercise in the evening or night, try to finish demanding work-outs at least 3 hours prior to going to bed. If possible, in the evenings try stretching or yoga instead of high intensity work-outs as a way to relax and calm your body.
• b) Watch what you eat and drink. 
  -There are three major food/drink items to avoid before going to bed; caffeine, alcohol, and sugar.
  -Caffeine can be a major culprit in disrupting your sleep, affecting some people up to 12 hours after intake. Stimulants interfere with your ability to fall asleep and progress into deep sleep.Try cutting back your daily caffeine levels as well as reducing your intake of caffeine and nicotine 4–6 hours before going to sleep.
  - While alcohol may be a depressant, it can significantly impact the quality of sleep you are getting. Drinking alcohol right before bed prevents you from entering the restorative stage of sleep. Avoid consuming alcohol 2-3 hours before bed.
  - Sugar and refined carbs can also influence your quality of sleep by promoting wakefulness. Stop your sugar and refined carb intake at least 2 hours before going to bed.
  - Avoid large meals three hours before bed. Limit yourself to light snacks when studying late at night.
• c) Try and get outside. 
  -Natural sunlight can be incredibly beneficial for overall well-being. Getting natural sunlight ensures your circadian rhythm and sleep/wake patterns are properly set.
  -In the morning try to expose yourself to natural light to signal to your body it is time to wake up (ie: having coffee outside, sitting by the window). Letting natural light into your living space throughout the day can also help regulate your sleep/wake patterns naturally. If natural light isn’t possible look into a light box machine as a supplement. Another way to try to get natural light is walking and exercising outside when possible.
• d) Make sleep a priority. 
  -Avoid all-nighters by planning to study and work on classes during the day, giving yourself enough time at night to get sufficient sleep.
  - It is recommended to get at least 7-9 hours of sleep in order to see the positive benefits of sleep (ie: improved memory, increased energy throughout the day)

• a) Stay out of your head. 
  - Worrying about getting back to sleep can stimulate your brain enough to keep you awake. Try to avoid negative thoughts by instead focusing on feelings in your body or engaging in breathing exercises.
  -If you wake up worrying about a particular task or activity you need to complete (ie: homework, a paper, a project), try making a written note of it, then telling yourself you will tackle the task in the morning. Remind yourself that you will be much more productive in the morning after getting sufficient sleep, thus being able to complete the task more efficiently.
• b) Focus on relaxation and not sleep.
  -When you are trying to get back to sleep focus on relaxation over the actual idea of falling asleep. Instead focus on relaxing different parts of your body. Engaging in mediation, body-scan activities, and deep breathing exercises may help you better tackle relaxation.
  -If you are still struggling to fall back asleep it is important to remember that even though it’s not a replacement for sleep, relaxation can still help rejuvenate your body.
• c) Keep the room dim
  -If you find yourself regularly waking up at night to go to the bathroom, avoid turning on bright overhead lights. Too much light can stimulate your brain and send signals to it that it is time to wake up. Instead use dim nightlights, or a small flashlight as a way to safely travel from room to room.

If you are curious about if it is time to receive further assistance for your sleep habits… try taking this sleep assessment.

Stress from the pandemic and COVID-19 virus has impacted sleep habits of U-M students significantly. Check out the ways COVID is impacting sleep on campus.

• Weakened immune system due to lack of sleep: During the pandemic lack of sleep can have major health consequences. Insufficient sleep over long- and short- term periods can impact our immune system negatively, weakening it, making you more susceptible to contracting illnesses such as the cold, flu, or COVID-19. It is important to work towards getting enough sleep to maintain a healthy immune system.
• More screen time: During the pandemic there has been a significant increase in blue-light screen consumption. This increase is due to a variety of factors such as remote learning and work using electronic devices (ie: phones, laptops, tablets, etc), virtual social events and meet-ups, online services only being provided (ie: telehealth meetings with doctors and therapists).
• Increased mental health concerns: During the pandemic there has been a surge of mental health concerns such as increased levels of stress, worry, anxiety, depression and isolation. These concerns impact sleep in many ways. Stress, worry, and anxiety can prevent people from getting you to sleep due to concepts like overthinking. Depression can impact how much sleep you are getting varying from too much to too little.

If you are noticing that mental health concerns relating to COVID-19 are keeping you from getting sufficient sleep consider reaching out to CAPS to make an appointment with a counselor to address these concerns.