Tag Archives: sleep

Resilience – dirty word?

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It sometimes feels like resilience is a dirty word. Whispered in hushed tones in corridors in case over heard. Or spoken out loud as a rallying call to try harder and be stronger. It shouldn’t be this way. Resilience is crucial to a productive life but in social work it is in danger of being shouted down as a take over bid by mangers to make staff do more with less.

The claim I hear most is just that. Managers want to individualise the problem to the social worker, make them be more resilient, and therefore be able to give them more work. I don’t find this to be the case. At worst managers clutch at the straw offered by resilience as a way of keeping their teams well and intact. At best they see it as a real opportunity to develop a confident, satisfied workforce, comfortable with being at work.

Resilience isn’t a silver bullet to fix all of the problems in social work, or indeed to ensure everyone stays well – we all have our point at which resilience gives out. But, by enhancing people’s ability to cope with the rigours of life we do enhance their resilience and they have a better, but maybe not perfect, time of it at home and at work. You can’t separate the two. Stress created at work is carried home and stress created at home is carried to work. We need to embrace the challenge of being resilient everywhere and not artificially separate the two.

It’s about more than emotions. While emotional resilience is important it is underpinned by,and functions alongside, practical and physical resilience.  These are what I describe as the three pillars of resilience:

Physical
Practical
Emotional

And I place them in that order deliberately because that’s how I see them operating. 

Physical
You must be sleeping well, eating well and being physically active. If you are going to focus on one thing first you must get your sleep right. You can read more HERE and HERE. Then you can work on nutrition and exercise. Without getting sleep right you are unlikely to have the motivation to get these other things on track. The social work office can be a minefield when it comes to eating well and I share some tips HERE. We also can’t overlook the reality of the connection between our gut and our brain MORE HERE. Finally you need to move some, or more, depending on how much you are moving already. Research has shown that regular exercise (in the study it was three 40 minute power walks a week for a year) causes growth in your hippocampus. This is part of your brain that is key in memory, emotional regulation and more. It can be referred to as the brake to your amygdala which is the part of your brain that is largely responsible for your fight or flight response to stress. You can read more HERE 

Image result for resilience

Practical
You are not going to be able to fit everything in to your time without being organised. Clinically organised I’d suggest! How you manage your diary, how you allocate your time and how you keep track of all of the things you do is crucial. Have a look through the PRODUCTIVITY section of this web site. Or the BEING ORGANISED section of our sister web site Self Care Shorts.

What you will find in the links above is that all of these things promote our ability to manage our emotional responses to what we are confronted with in all areas of our lives.

Small steps repeated over time lead to big changes.

None of these things in isolation will make a great deal of difference but add lots of small changes together and you will bring down what I refer to as ‘base line’ stress – the stress we carry with is all of the time. The good stress that motivates us. By bringing this level down through implementing strategies in relation to our physical well-being and our productivity we will have more headroom to ride the challenges without hitting our stress ceiling and becoming unwell. Long before we become unwell we become demotivated and prone to procrastination and that simply makes matters worse.

“Control it or it will control you”, as David Allen says.

Stephen

Stephen is the co-author of ‘How to Thrive in Professional Practice”
Available for pre-order from https://www.criticalpublishing.com/how-to-thrive-in-professional-practice for publication in early May

Night Owls?

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I recently did a Facebook Live on Sleep – which is here – and I was asked afterwards whether being a ‘night owl’ was damaging to your health. My instinctive reaction was ‘yes’ because I’m always telling people that the best sleeping pattern is to be in bed by about 10.30 and to rise at 6.30. I genuinely believe this on a personal so my answer is ‘yes’. The reason I believe this is because of what I’ve read. But a simple ‘yes’ is simply not good enough. So, as it’s been a while since I’ve read about sleep, I had to go back to the literature to find out a better answer than ‘yes’. Although the answer is still ‘yes’…… kind of.

As you may be aware we all have a circadian rhythm. An internal clock that keeps everything ticking over nicely, driven by the chemical and biological rhythms of our bodies.
And it is true that some of us have a propensity towards being morning larks and some of us have a propensity towards being night owls. That’s the way our circadian rhythms are. The other factor we need to consider is that we need about 8 hours of sleep. Now – from what I read – I’d say – the 8 hours is a little more important than the timing of when we start and end sleep. To a degree if you are a night owl and like to go to bed at 12 then this is ok. You are programmed to go to bed at that time by your circadian rhythms. I’m not sure I wholly agree with this – I think we artificially keep ourselves awake beyond a sensible time to retire – but I’m going to go with it! So – if you are a night owl and want to go to bed at 12 then fine. But – and here’s where it starts to get interesting and where the problem lies – you still need 8 hours sleep. So that will take you to 8 a.m. The problem with this is that for the majority of people sleeping until 8 is not an option. Most of us start work at 9 (or earlier) and have to travel to work. So, at best, your morning, starting at 8, is going to be a hurried affair with little time to take stock of the day, have breakfast, and emerge into the day slowly and deliberately.

A study by Northumbria University in 2018 found that it is such social factors, or the choices that people engage in when being night owls, that causes some of the problems. They found that people who go to bed later tend to have unhealthier diets, consume more alcohol, sugars, caffeinated drinks and fast food than early risers. You are maybe more inclined to drink coffee later because all of the other signs that your body relies on to get to sleep, for example it being dark, are pushing you to go to sleep – but you don’t. Also if you go to bed at 12 and need to be up at 6 then you have lost two hours sleep so maybe you then drink more coffee (or caffeine) to stay awake during the day. When tired and stressed we tend to grab high sugar high fat snacks because these are easy sources for our bodies. I’m confident that at 11 p.m. you are unlikely to think – ‘tell you what, I’ll rustle up a salad!’?

In the Northumbria University study night owls consistently reported more erratic eating patterns as they had a tendency to miss breakfast and eat later in the day. Probably, I imagine, because they didn’t have time for breakfast with getting up later or were tired and lacking motivation to make something. Fatigue has a huge impact on motivation. Also, possibly as a consequence of erratic diet, the diet of night owls was found to contain less grains, rye and vegetables and they ate fewer, but larger, meals. Morning larks, interestingly, eat slightly more fruit and vegetables per day.

This could explain why night owls have a higher risk of suffering from chronic disease. Eating late in the day was linked to an increased risk of type 2 diabetes because circadian rhythms influence the way glucose is metabolised in in the body. Night owls often eat close to going to bed which increases blood glucose levels just before they go to bed which could negatively effect metabolism as this is not in tune with biological processes. People with an evening preference were 2.5 times more likely to have type 2 diabetes than those with a morning preference.

Why is 8 hours important? In his book ‘Why We Sleep’ Matthew Walker explains that we have a pattern to our sleep. At the start of the night our sleep is predominantly NREM (Deep Sleep) heavy and at the end of the night (or early morning) our sleep is REM heavy. Both have important functions that we can’t afford to miss. So, assuming whatever your bedtime is – let’s say you are definitely a midnight person (bear in mind I’m not convinced by this argument – I still say 10.30 is the best time for us biologically!) and you stop up late till 2 in the morning, your body started to try and do what it needed to do at 12, so you have lost what it was trying to do between 12 and 2. You’ve lost that NREM sleep that does a lot of sorting out of memories before consolidating them.

One thing that night owls do is sleep less during the week and then catch up on a weekend. Walker is clear. What you have lost as a consequence of the shortened nights sleep can not be caught up by sleeping for longer on a weekend. Not only that but you then end up losing lots of hours from your weekend which could have been used more productively and can put you further out of step with the society you are living in.

One thing that is worthy of consideration though, if we accept that it’s ok to be a night owl and sleep 12 till 8 or 2 till 10, or whatever, is that if this works for you then maybe we need more flexible working and social arrangements so that night owls are not placed in this position of their biological chemistry being badly aligned to social expectations? Personally I’m not convinced that staying up till 2 in the morning is good for you. But maybe the problem is that night owls have to live a life of misalignment?

There is a well research health impact. Shift work, which often places people into the night owl bracket whether they like it or not, is the only non-chemical item on the American Cancer Society’s carcinogens list, and other evidence shows that night owls can experience weight gain and diabetes because of diet, and are more susceptible to depression and psychiatric disorders. Now this is an interesting conundrum. Usually we associate a poor sleep pattern with being a symptom of depression and poor mental health. But actually, Walker says that we need to start exploring if it is in-fact poor sleep that is a cause of these things. The reality is it probably works both ways.

This is not fatalistic though! If you are a night owl and you want to stick to being a night owl then so be it but be conscious of what you can do to mitigate any negative factors – in essence that’s what all self care is about.

Make sure that you get 8 hours of sleep a night. I’m convinced this is a mush more decisive factor in your well being than whether you go to bed at 10, 11 or 12. This will give you a problem though depending on what time you need to be up the next day. But it is crucial as you can’t catch up on what you lost at the weekend.

So, second, don’t try and catch up on weekend! Get 8 hours and get them at the same time day in day out!

Next, watch what you eat. Be particularly careful what you eat late on a night and don’t eat just before you go to bed. Also, try and give yourself some space on a morning to eat breakfast. Watch your choices throughout the day. It seems to me that this is a significant factor rather than simply the time you go to bed. Are you making poor choices because you are tired because you are not getting your 8 hours because you went to bed at such a time that you couldn’t get them?

If you want to change your sleep pattern it is doable I believe. But, like everything, it takes time. There are idea in these blogs that might help:
How do you sleep?
And Sleep….
They both contain the same information

The secret to success is not to suddenly try to change from going to bed at midnight to going to bed at 10! That’s not going to work and will lead to frustration. Try to adjust your going to bed time by about 20 minutes a week. Crucially go to bed at the same time every night and once you have adjusted to that try another 20 minutes.

Episode 2 of How to Thrive is all about sleep




And sleep….

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Let’s look at the first and, I’d say, the most important element of the Mordue’s Self Care Triangle!

A good nights sleep sorts out all sorts of things! Sleep can be difficult for all sorts of reasons. This heat at the moment probably isn’t helping a lot of us. Then there’s things preying on your mind that you keep mulling over when you should be asleep. For some, sleep isn’t an easy thing to achieve but it’s absolutely crucial to well-being in ways that go far beyond you being grumpy the following day!

It is estimated that 1 in 2 people are not getting sufficient sleep!Physically our body uses the time to recover and replenish and sleep has an essential role in the consolidation of memories. “Routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer. Insufficient sleep is a key lifestyle factor determining whether or not you develop Alzheimer’s disease. Inadequate sleep – even moderate reduction for just one week – disrupts blood sugar levels so profoundly that you would be classified as pre-diabetic…” and the list goes on [from Matthew Walker’s ‘Why We Sleep’ (Page 3)] So, what advice is out there on getting to sleep!

Keep to a regular bedtime routine
As a parent I’ve said it myself and heard others say it. “Babies, they love a routine! Keeps them right!” Much as we kick against habit as adults we are creatures of routine. Your body is programmed into a chemical routine that does its best to achieve sleep, rest, and waking. And what do we do!? We ignore it. We stop up late and wonder why we are tired the next day. We get up late and wonder why we then can’t get to sleep the next night. Then there’s the impact of alcohol and caffeine. What we end up achieving is the disruption of our programmed chemical clock. And when we don’t attend to it for long enough the situation becomes chronic.

Sleep at regular times
Walker (2017) suggests that we need 7 to 8 hours of sleep a night and that we should be sleeping from about 10 to 10.30 until 6 to 6.30. These timings are in tune with our natural rhythm. So that’s your starting point. You should also maintain this 7 days a week. Lost sleep is lost sleep. In terms of what your body is trying to achieve with sleep you can’t catch it up on a weekend. The opportunity has gone.

Don’t go to bed hyped
While exercise is an important aspect of self care you should avoid it for 2 or 3 hours before bed time. A good way to wind down is to have a warm bath – again…. isn’t that part of the routine we give babies. This clever little trick prepares your body for sleep. It’s not the heat on its own that creates the sleepy mood. It’s the impact of the heat on your core temperature. Do you feel cold when you are tired or when it’s late on a night? Part of your programmed sleep preparation is a drop in core body temperature. The hot bath draws the blood to the surface of your body and therefore reduces your core temperature. Clever body!

Do something that relaxes you
There are a huge range of yoga and relaxation CD’s and Apps out there that might help you. Anything that calms your mind and distracts you from your ‘racing’ thoughts. You could try audio books, or read a book, or maybe listen to the radio. You should try to avoid TV and smart phones as, not only do the stimulate, but the light they emit kids your brain into thinking it’s not dark out there! We need to prepare our bodies for sleep with a darkened environment.

Be comfortable and create a ‘clean’ environment
It sounds obvious I guess, but, have the best mattress and pillows you can afford. Try different numbers of pillows and different types. You may find a harder or softer pillow helps. You should keep your bedroom for sleep (and sex…. unlike most other vigorous activity sex makes you sleepy!) Avoid distractions like TV’s and ticking clocks and keep the room tidy. Make your bed when you first get up so when you eventually get to bed after that hard day it looks clean, tidy, and inviting. Your bedroom should be cool (between 18 and 24 centigrade – but go low) and dark. No glowing lights from inside or outside the bedroom.

and my favourite…. Write ‘to do‘ lists for tomorrow
One of the main things that keeps people awake is trying to remember things they need to do tomorrow. Before you go to bed (or ideally at the end of your working day… more on that in an upcoming blog) write down everything you need to do the next day, safely leaving them so you can find them when you need to, without having them going round and round in your head. Keep a note pad by your bed. If you think of something while in bed, write it down. There’s good evidence that externalising memories in this way can help us ‘put them to bed’ to help put us ‘to bed’!

What else…
Inevitably for some making such self care changes isn’t enough. These ideas are effective for many and you need to give them a good month or so to see what the impact is. But if you find that you are consistently trying these things and they are not working then you should seek medical advice. Walker (2017) has concern that this simply leads to the prescription pad and, in his view, drugs don’t work as they don’t achieve the right sort of sleep but are more of a sedative than good quality sleep. So, you feel you have been asleep, but have missed many of the benefits. Your GP should be able to refer you to sleep specialists. It would be useful while trying to make changes that you keep a sleep diary. This should detail what you have done during the day, how you have prepared for sleep, what it is that’s keeping you awake, how often do you wake – make sure you document as much as you can.

Try these things out… what have you got to lose?

Let me introduce you to the triangle!

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Here it is! Your route map to self care. My self care model (lovingly drawn for me by one of our fabulous students Anna Short). It’s simple and straightforward but it’s what you need to get sorted. And over the next few days I’ll tackle each element of the triangle in turn and then we can get on to figuring out how to organise it all!

The three things in the triangle won’t come as any surprise to you. In fact most of what I have to tell you won’t come as a huge surprise. Looking after yourself is one of those things where we all know what to do but we don’t always do it. And we don’t always fully understand the impact on us and our productivity.

So… we’ll talk about sleep, we’ll talk about exercise, and we’ll talk about nutrition. This is not to turn you into tofu eating (although I like tofu), marathon running (although I’ve ran marathons), zen like (although I like some meditation) creatures, but rather to show you how these three things interact and have a massive impact on your productivity in your job and in your home life.

Current research tells us that lack of sleep has a significant impact on the risk of us developing things like cancer or alzheimers, never mind the impact of a poor nights sleep on the next day. Your brain and your gut are connected directly by the vagus nerve and scientists are showing how the quality of what is going on in your gut directly effects your mood. And exercise has been shown to be effective in reducing levels of stress. Also, they are are interlinked….

I’ll tell you more…. stay tuned!

How do you sleep?

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It is estimated that 1 in 2 people are not getting sufficient sleep! Sleep is crucial to our wellbeing. Physically our body uses the time to recover and replenish and sleep has an essential role in the consolidation of memories. So, what advice is out there on getting to sleep!

Keep to a regular bedtime routine
As a parent I’ve said it myself and heard others say it. “Babies, they love a routine! Keeps them right!” It’s not just babies that need a routine it’s any human being. Much as we kick against it as adults we are creatures of habit and routine. Your body is programmed into a chemical routine that does its best to achieve sleep, rest, and waking. And what do we do!? We ignore it. We stop up late and wonder why we are tired the next day. We get up late and wonder why we then can’t get to sleep the next night. We self medicate with alcohol and caffeine to get that little bit more out of the day and out of our social life. And all we achieve is the disruption of our programmed chemical clock. And when we don’t attend to it for long enough the situation becomes chronic.

Sleep at regular times
Walker (2017) suggests that we need 7 to 8 hours of sleep a night and that we should be sleeping from about 10 to 10.30 until 6 to 6.30. These timings are in tune with our natural rhythm. So that’s your starting point. You should also maintain this 7 days a week.

Don’t go to bed hyped
While exercise is an important aspect of self care you should avoid it for 2 or 3 hours before bed time. A good way to wind down is to have a warm bath – again…. isn’t that part of the routine we give babies. This is a clever little trick to prepare your body for sleep. It’s not the heat on its own that creates the sleepy mood. It’s the impact of the heat on your core temperature. Do you feel cold when you are tired or when it’s late on a night? Part of your programmed sleep preparation is a drop in core body temperature. The hot bath draws the blood to the surface of your body and therefore reduces your core temperature. Clever body!

Do something that relaxes you
There are a huge range of yoga and relaxation CD’s and Apps out there that might help you. Anything that calms your mind and distracts you from your ‘racing’ thoughts. You could try audio books, or read a book, or maybe listen to the radio. You should try to avoid TV and smart phones as, not only do the stimulate, but the light they emit kids your brain into thinking it’s not dark out there!

Be comfortable and create a ‘clean’ environment
It sounds obvious I guess, but, have the best mattress and pillows you can afford. Try different numbers of pillows and different types. You may find a harder or softer pillow helps. You should keep your bedroom for sleep (and sex…. unlike most other vigorous activity sex makes you sleepy!) Avoid distractions like TV’s and ticking clocks and keep the room tidy. Make your bed when you first get up so when you eventually get to bed after that hard day it looks clean, tidy, and inviting. Your bedroom should be cool (between 18 and 24 centigrade – but go low) and dark. No glowing lights from inside or outside the bedroom.

and my favourite…. Write ‘to do‘ lists for tomorrow
One of the main things that keeps people awake is trying to remember things they need to do tomorrow. Before you go to bed (or ideally at the end of your working day) write down everything you need to do the next day, safely leaving them so you can find them when you need to, without having them going round and round in your head. Keep a note pad by your bed. If you think of something while in bed, write it down. There’s good evidence that externalising memories in this way can help us ‘put them to bed’ to help put us ‘to bed’!

What else…
Inevitably for some making such self care changes isn’t enough. These ideas are effective for many and you need to give them a good month or so to see what the impact is. But if you find that you are consistently trying these things and they are not working then you should seek medical advice. Walker (2017) has concern that this simply leads to the prescription pad and, in his view, drugs don’t work as they don’t achieve the right sort of sleep but are more of a sedative than good quality sleep. So, you feel you have been asleep, but have missed many of the benefits. Your GP should be able to refer you to sleep specialists. It would be useful while trying to make changes that you keep a sleep diary. This should detail what you have done during the day, how you have prepared for sleep, what it is that’s keeping you awake, how often do you wake – make sure you document as much as you can.

Try these things out… what have you got to lose?

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In consideration of sleep….

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In a way what I’m about to write is more a book review because everything I’m going to point you to are things that struck me while reading Matthew Walker’s exceptional book ‘Why We Sleep’

In an article on self care I recently quoted Walker saying….“Routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer. Insufficient sleep is a key lifestyle factor determining whether or not you develop Alzheimer’s disease. Inadequate sleep – even moderate reduction for just one week – disrupts blood sugar levels so profoundly that you would be classified as pre-diabetic…” and the list goes on [from Matthew Walker’s ‘Why We Sleep’ (Page 3)]

When I quoted this I was thinking mainly about how social workers manage themselves away from work in order to maintain a healthy lifestyle in order to improve their ability to, well, live! But more than that how to be productive as social workers, husbands, wives, parents etc etc….

But it got me thinking about sleep and the impact on adults who become users of social services and I pondered, in the myriad of things we ask people about, how often do we ask about sleep. Maybe we do? I worked with older people so I would routinely ask about how well they were sleeping but I don’t think I ever really did anything with this or considered it’s impact. Nothing at least beyond suggesting a trip to the doctor. And Walker would probably say to me that that might be the worst thing to suggest as doctors are quite prone to reach for the sleeping pills to resolve such an issue. And as Walker talks about in his book sleeping pills do not promote the right sort of sleep. They promote (and he puts it much more eloquently than I will here… and in more detail) a medical cosh that doesn’t in anyway reflect the right quality of sleep we require.

Walker suggests (p.148) that lack of sleep doesn’t necessarily throw us into a negative mood state but may well lead to a sea-saw of emotions. He points out that any extremity of emotion, positive or negative, can be dangerous. He points out that depression can lead to feelings of worthlessness and a questioning of the value of ones life. I wonder how often when working with someone with depression we truly understand the impact of lack of sleep. He states that “studies of adolescents have identified a link between sleep disruption and suicidal thoughts, suicide attempts, and, tragically, suicide completion in the days after” (p.148). He also links insufficient sleep to violent acts in children across the age range and within the adult prison population.

Psychiatrist, Walker says, has always considered that sleep disruption is a consequence of mental illness rather than exploring whether it is actually a factor, or the factor, causing it (p.149).

In relation to older generations and thinking about my particular area of interest dementia Walker points out that “lack of sleep is fast becoming recognised as a key lifestyle factor determining whether or not you will develop Alzheimer’s disease” (p. 157). He explains that deep sleep deteriorates with age and a lack of this type of sleep is linked to a decline in memory. He notes that poor sleep often precedes the onset of Alzheimers but this isn’t often picked up. To compound the problem he says that 60 percent of patients with Alzheimers have at least one clinical sleep disorder with insomnia being particularly common. Note also that this will have an impact on the care giver in terms of the quality of their sleep with all of the negative impact on health that goes with that (p.158).

I would definitely recommend his book in terms of both your own self care and thinking about the care of others. It is illuminating, fascinating, and a real call to arms with regard to improving sleep quality.

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No one else is going to do it for you so what are you are going to do… Self Care

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As a social worker, albeit a one who now teaches social work rather than does it, I watch from the side lines and see people clearly stressed about the work they are doing, caught up in that Sunday night feeling of ‘what waits for me tomorrow’, and clearly feeling a sense of overwhelm.

I recently wrote an article on self care for Cache Alumni and started it like this….

“You can not see your reflection in running water”. I love this Taoist proverb as it reminds me that sometimes we have to slow down, take a break, and take stock. For me that’s the starting point of self care. Dodd (2007) says self care is “the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health and well being” (Grafton and Coyne 2012).

I wonder what you do to ‘self care’

For me I do a range of things. I try to eat a healthy diet, I try to exercise daily, and I try to practice mindfulness and yoga. And most importantly I try to get a good nights sleep!

Did you know…
“Routinely sleeping less than six or seven hours a night demolishes your immune system, more than doubling your risk of cancer. Insufficient sleep is a key lifestyle factor determining whether or not you develop Alzheimer’s disease. Inadequate sleep – even moderate reduction for just one week – disrupts blood sugar levels so profoundly that you would be classified as pre-diabetic…” and the list goes on [from Matthew Walker’s ‘Why We Sleep’ (Page 3)]

I like to refer to sleep, nutrition and exercise as the holy trinity of self care. Read about it here. So, I ask you… What are you doing?

 

 

 

Nutrition

Here’s a few articles to have a look at:

https://www.selfcareshorts.com/2019/05/06/3-best-breakfasts/

https://www.selfcareshorts.com/2019/08/17/you-are-what-you-eat/

https://www.selfcareshorts.com/2019/08/26/kombucha-fizzy-goodness/

https://www.selfcareshorts.com/2020/01/26/take-it-with-a-pinch-of-salt/

Fitness

https://www.selfcareshorts.com/2019/07/30/gonna-make-you-sweat/

https://www.selfcareshorts.com/2019/09/03/discipline-lets-get-to-work/

https://www.selfcareshorts.com/2019/10/25/small-steps-end-in-big-results/

 

……make a start ….do something ….you owe it to yourself!