Ep 14: Key sleep tips for nurses and midwives

Posted March 14, 2023

Show Notes —

In this episode, Nathan talks about the importance of sleep for wellbeing and shares some insights into some of his favourite tips to get better sleep.

This episode is part of a series that will cover general sleep tips (today’s episode); ways to tackle insomnia; and how to improve sleep for night shift workers.

Here is a summary of key points from the episode:

>Sleep has been shown to be a significant predictor of both mental and physical health problems.

>People who regularly sleep less than 7 hours per night are at risk of health conditions. If you sleep less than 6 hours per night this risk increases dramatically.

>Sleep is an evolutionary behavior that developed over millions of years. In brief, it helps restore the body/mind and repair cells.

>Sleep is controlled largely by light from the sunlight and dark cycles trigger processes in the brain that lead to the feelings of sleepiness we experience and our need to sleep/when we sleep.

>The two key things needed for sleep are: sleep pressure (tiredness) and low arousal (i.e. not feeling stressed or on ‘high alert’)

>Nathan shares several sleep tips for people working regular schedules (i.e. not night shifts):

  1. Get morning sunlight for around 10-15 mins per day by going for a walk. This helps stop the release of melatonin in the morning and helps with its production later in the day.
  2. Get daily exercise. Cardio and resistance training both help improve sleep quality. Ideally, combine exercise with outdoor light exposure to get a double whammy effect.
  3. Bedtime routine – try to go to bed at the same time/wake same time each day. This creates a natural rhythm for your brain to get used to and makes sleep come easier and more efficient.
  4. Don’t withhold on sleep during the week and think that you can “make up for it” at weekend. Whilst weekend lie ins provide short-term relief, they don’t undo the damage done during the week from mild sleep deprivation. The negative effects will show in the medium to long term.
  5. Limit screen and phone use before bed and try to avoid having a phone in the bedroom for 30 minutes before bed. Use an alarm clock to wake you and leave your phone outside the bedroom.
  6. Avoid alcohol before bed. It is a myth that alcohol helps you sleep. Whilst it helps you fall asleep, it becomes a stimulant and wakes you up more in the night, leading to poorer quality sleep, even if you don’t feel like it’s having a negative effect.
  7. Avoid sugar in the evening, especially right before bed. Sugar interrupts sleep rhythms. Try eating something less sweet or try fruit-based alternatives to the usual candy or chocolate you might have.

There are tons more ways we can improve sleep but these tips are a great starting point for anyone, so pick one and give it a go!

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Transcription —

Nathan Illman  00:05

Welcome to the Nurse Wellbeing Mission podcast hosted by me Nathan Illman. This is the place where nurse and midwife well being at the top of the agenda. Each episode aims to help nurses and midwives around the world flourish through informative, inspiring, and practical content and conversations.


Nathan Illman  00:24

Hey, everyone, welcome back to nurse wellbeing mission podcast. I am Nathan Illman. I am your host for today, it’s great to be back doing a solo episode. It’s been several months since I’ve been here doing one of these. I’ve just been enjoying interviewing other guests who have conducted research and am very interested in some great aspects of nurse and midwife wellbeing. And we’ve been sharing their work as well as some of my own reflections on that over the past few months. But here I am today to talk to you about something I’m very passionate about. It’s an area of my own expertise and special interest stemming from when I did my doctoral research many years ago. And it’s something that I truly believe all nurses and midwives should be provided education and training in. Can you guess what it is? It’s sleep.


Nathan Illman  01:17

So sleep is this crucial thing that we all do every day, or hopefully, at least once a day, and is so vital for our well-being, for our mental and physical well being but it’s just not talked about enough, in my opinion. So I’m going to be doing a number of different episodes over the months. And I guess here is talking about sleep and tapping into specific aspects of sleep because it is a huge topic. But today, I’m going to be focusing on the basics about why sleep is important, why we sleep sort of how we sleep and talking through some important Sleep Tips. Pretty sure some of these you wouldn’t have heard before as well. And towards the end, I’m going to be getting you to reflect on your own sleep and your own sleep routine and invite you to consider how you might want to try doing things differently to improve your own sleep. So me doing this podcast episode comes off the back of me preparing a workshop that I’m delivering this week, in fact to a group of mental health nursing students, and I really can’t wait to do this. Sleep is a tool which we can all utilize to improve not just our well-being but our performance as well in the workplace.


Nathan Illman  02:36

Let’s kick off then with a bit more of an understanding about the importance of sleep. I’m not going to go into the details of all of the research on this topic, because there’s just too much quite frankly, to cover. But needless to say, sleep has been found in countless research studies and systematic reviews, and meta-analyses. These are big studies that basically pull together all of the data that we know about the effect of sleep on different kinds of variables like our immune functioning, for example or the likelihood that we’re going to develop something like depression. And the data is so clear that getting between seven to nine hours of sleep regularly per night is absolutely crucial for protecting against pretty much any physical or mental health condition that you can think of really. So what we see in the research literature is that people who regularly get less than six and definitely less than five hours of sleep per night have increased all-cause mortality risks. Basically, you’re going to die younger, if you have a lifetime full of chronically short sleep. You have an increased risk of developing dementia, different cancers, cardiovascular disease, and the list just goes on and on and on. So chronically short sleep or heavily interrupted sleep leads to problems with inflammation in the body that leads to a deterioration in our immune functioning makes us more susceptible to stress. And that makes us more likely to develop some of these conditions. And the same is true for mental health problems as well.


Nathan Illman  04:14

So some of you may know this, you may be experiencing a mental health difficulty right now actually. You may perhaps you’re feeling depressed right now. And you may know that actually, your sleep is somewhat off since you’ve been depressed, perhaps you’re sleeping more than usual or less than usual. So we know that mental health conditions actually interact with sleep and they can make sleep longer or shorter. But actually poor sleep also predicts mental ill health. So we know that people who have a history of insomnia and sleep difficulties are much more likely to then go on and develop things like depression. Really interesting research looks at sleep difficulties in adolescents and young people and actually sleep difficulties can predict the extent to which someone has more likely to develop something like schizophrenia psychosis. This is a really serious mental health condition.


Nathan Illman  04:14

So all of this points to the importance of understanding sleep and improving our sleep. It’s what we call a preventative mental health measure, if we can get in early and help people understand more about their own sleep, and perhaps what’s getting in the way of them getting better sleep, if we can intervene early, we can cut off and prevent many of these difficulties as a nurse or midwife. whatever stage you’re at in your career, whether you are training you’re newly qualified, or whether you’re very experienced, you probably would have already experienced some degree of sleep difficulty at some stage because of one common factor that is a thread throughout the career of the nurse or midwife. And that’s a higher level of stress than most other occupations. You would have experienced at some stage, whether it’s stress during exams when you’re a student or stress in your day job working in a particularly uncertain or threatening environment. And this is, of course, something that can impact nurses’ and midwives’ sleep quality. And what we know from the research as well, is that rates of insomnia, which I’m going to go into in a little bit will sort of give you a definition of insomnia, rates of insomnia and sleep difficulties are higher in nurses and midwives than the general population. And there are certain aspects related to the job role hours that people work to contribute to this. But this ongoing stress is largely a contributing factor.


Nathan Illman  06:38

So when I talk about insomnia, what I mean is, when someone has difficulty getting off to sleep, it takes longer than half an hour or so each night, or they have difficulties waking up in the middle of the night. So waking up multiple times. And being aware of that, when you wake up being awake for a long time to being awake for longer than like 20 minutes at a time or waking up very early in the morning, and then not being able to get back to sleep at all. So for example, going to bed at 10 pm. And you wake up at say 4 am. And you just cannot get back to sleep at all, or maybe it takes you hours to get back to sleep. And then finally you do and then another sort of key defining feature of insomnia is that has an impact on you day to day you feel sleepy and tired, and it’s affecting perhaps the quality of your relationships, or it’s affecting your work performance. Now, insomnia is the most common what’s called sleep disorder is something that can be diagnosed by doctors, psychologists, by psychiatrists, and it really makes up the largest proportion of all of his sleep disorders.


Nathan Illman  07:44

In this podcast episode, we’re not going to go into other sleep difficulties. One of the most common other sleep difficulties is obstructive sleep apnea. And this is essentially a breathing difficulty. I’m not going to go into that here, we’re just going to be talking about regular sleep and how to get better sleep. And so I’m actually going to be specifically focusing on insomnia in another episode. In this episode, we’re just going to be going through some basic sleep tips that should help to optimize sleep for people who are relatively regular kind of sleep patterns.


Nathan Illman  08:20

So again, because shift work is quite a specific area, and shift work Sleep Disorder is another potential diagnosis that people can have as well as insomnia that really warrants specific attention, which I’ll cover in another episode. So let’s just do a quick basic overview of how sleep works. Because I guess a lot of people probably haven’t even got much of an understanding of this. We’re all human beings, right? And we all sleep, we all do this thing, we all go to bed, and we close our eyes. And hopefully, we’ve all slept. And we wake up feeling refreshed in the morning. And we know that we tend to do this at night. And sometimes we do it during the day if we’re feeling sleepy and we want to nap. But we’re not really aware of exactly how it works. So I want to give you really just a basic overview of this without going too much into the neurobiology of it just enough to hopefully help you an understanding of how sleep works.


Nathan Illman  09:17

So you may have guessed that sleep is largely influenced and triggered by light and dark cycles. You probably have an intuitive understanding of this already, because you know that you go to sleep when it’s dark, generally far from the summer when it’s a bit lighter in the evenings. So something is important to understand is this sleep is an evolutionary mechanism. We often forget that we evolved over millions of years. So all these things that we do now all of our behaviors and the way our body works are the result of millions of years of evolution of starting our single-celled organisms and coming all the way up to what we are now. So sleep is classed as a behavior just as walking, talking or thinking is a behavior or our behaviors as well. So it’s a behavior that human beings and some but not all animals in the animal kingdom also developed as an evolutionary mechanism. And whilst scientists still trying to understand exactly all of the reasons we sleep, one of the basic ways of understanding this is that it serves a restorative function for us.


Nathan Illman  09:27

You know, I mentioned at the beginning there, if we don’t sleep, we develop all of these problems with our health physically and mentally therefore, when we sleep, there is a cascade of neurobiological processes happening in our brain and body that serves to do things like repair DNA, to grow muscle, to repair injuries, for example, and to get rid of the buildup of stuff in our brain that has been happening during the day to refresh us and to help us be more cognitively able the following day. Now, when we wake up in the morning, what happens is daylight enters our brain via our eyes. And that sets off a neurobiological process that continues throughout the rest of the day. Sleep is a behavior that is very much influenced by sunlight. And that’s going to lead us to one of our sleep tips later on when our brain starts receiving this sunlight input, which leads to certain things happening in our brain. So I’ll just explain one of them. Because many people have heard of melatonin. Many people these days take melatonin as a supplement in the evening to help them get off to sleep. So let’s just quickly cover what melatonin is and why it’s important. And actually, what happens in our body naturally without us taking it?


Nathan Illman  11:44

So in the morning, when we wake up in daylight, sunlight that enters our brain helps to stop the production and the release of melatonin. And then what happens after that is we have a period of high arousal in the morning. So basically, in the stress response, we have cortisol, which gets pumped around our bodies and helps to make us alert. And then our body temperature is very much influenced by this light and dark dark cycle as well. Not going to go too much into that. But essentially what happens is, when we’re feeling sleepy, our body temperature has often dipped, and we need our body temperature to be slightly lower, when we’re going to sleep otherwise, we really struggle. And that’s why it’s difficult to sleep in the summer. So for most people, you wake up in the morning, this melatonin production stops, you start to feel more alert, and your alertness tends to increase. And then what happens is we all have this natural point in the afternoon around between two and 4 pm, where our body temperature takes another natural dip, and we start to feel sleepy again.


Nathan Illman  12:46

So everyone experiences this to some degree or another. It’s completely normal to feel sleepy around that time. And in fact, historically, it’s thought that human beings often would sleep during that time. So it’s only a more recent thing in our evolutionary past that we have this single block of sleep at night for eight hours, not even that long ago. So 100 years ago, there are records of humans in different cultures, different civilizations, and societies, actually sleeping two or three times throughout the day. So that natural dip in the afternoon is something that happens to all of us. And that’s why people in certain countries like in Central Europe, for example, I guess, Holland countries like Spain, have a siesta in the afternoon. So as the evening approaches, if we haven’t slept in the afternoon, sleep pressure increases. So that basically us feeling more sleepy. I mean, as it gets to the evening time that melatonin production starts again, and again, this is influenced by light and dark. So as it starts to get dark, melatonin increases, and we start to feel sleepy. And as long as we’re not too aroused. That means basically wired, as long as our brain is not kind of overactive. And we feel sleepy. If we’ve got good sleep habits, which we’ll explain, surely we go to bed, and fall asleep.


Nathan Illman  14:09

So just to let you know, there are two things I’ve mentioned there already that are quite important to know about how sleep works, and what actually can get in the way of sleep working, how it should do as well. So what the first is what I mentioned about sleep pressure, so sleep pressure or sleep drive is just that feeling of sleepiness that accrues throughout the day, it can be exacerbated or sped up, if you like by exerting more energy throughout the day. If you run a marathon in the morning and of course, you’re going to feel sleepier in the afternoon. And it can accumulate over time as well. So if we are if you’re working 12-hour shifts, and then you’re not sleeping well at night, of course, that sleep pressure is going to build and build and build or build. The only thing that can curiously pressure is to sleep so whilst resting with our eyes closed or resting is extremely beneficial. And we definitely all need to be doing more of that. That sleep pressure itself is not going to be taken away until we actually sleep. And we’re not going to get the beneficial effects and our mind and body until we sleep. If we’re napping in the afternoon, then that does reduce that sleep pressure.


Nathan Illman  15:22

So research suggests that we shouldn’t really nap after about 3 pm in the afternoon. And if you’re going to take a nap, we shouldn’t really be napping for longer than 20 to 30 minutes. And it isn’t there’s some variation between people here. Of course, the problem is that if we sleep too late, and for too long, it reduces the sleep pressure. And then when it gets to the evening time, you’re just not sleeping enough to go back to sleep. And then that might make you develop bad habits around staying up and watching television and doing other things. And that can affect your whole sleep schedule. So naps are good. Naps have been shown to be beneficial for giving you a boost of energy and for improving cognitive performance. So they’re definitely not something that we want to avoid if we’re sleepy and we have the opportunity to nap. But just keeping them short, and making sure they’re done at the right time is crucial and individual people can experiment with when they nap when it has the best effect for them, and how long they can nap for as well. So that’s sleep pressure.


Nathan Illman  16:23

The other one I mentioned was arousal. So arousal is something that is related to stress. And this is why it’s a really important thing I believe, for nurses and midwives to understand is that when we get towards the evening, our body is naturally trying to gear itself towards sleep. Because it’s such a natural process your brain and body want to sleep, it shouldn’t be something that we’re trying to control. It’s just as natural as opening your bowels or feeling hungry and eating. But when we’re experiencing a lot of stress, this can create arousal in our brain and our body. So stress hormones are released that interfere with their natural biological process. So you all would have had this experience at some stage in your life. Maybe now, if you’re unlucky, I’ve certainly had this myself where there’s been something on your mind. So it’s not even like a threat in the external world. It’s something perhaps that you’re worried about that is leading to the stress response being activated in your body, you feel tired, you feel shattered, you’ve been doing a long shift, you go to bed, and you just desperately want to sleep and then you’re lying that wide awake, and you cannot fall asleep. And that’s because the arousal level is too high.


Nathan Illman  17:42

So in the sleep tips that I’m about to go into, I’m going to talk a little bit about this and ways that you can address that and hopefully feel a bit more relaxed before you go to sleep. When I come back to insomnia specifically and talk about treatments and approaches for insomnia. I’ll go into much more detail about this arousal and how it relates to the relationship we have to sleep and the relationship we have to be in our bed as well. Because sometimes people develop almost a fear of sleeping, and it gets in the way of falling asleep.


Nathan Illman  18:12

So I’m gonna run through my top sleep tips for you guys. We’re going to start in the morning from when you wake up. So when you wake up in the morning, I’ve explained that sleep is influenced very heavily by the natural chaining rhythm of light and dark cycles. And this is something that a lot of people don’t know. But getting exposure to early morning light outside so is actually going into your eyes and your brain actually helps to sleep at night. And if you think about this, from an evolutionary perspective, it makes sense. So it took hundreds and millions of years for us to get to where we are now with our sleep and the way our brains work. And historically, we were spending much more time outside and the evolutionary process adapted us to his 24-hour cycle and to the sun and darkness. So there is something about the wavelength or morning light which helps to trigger this cascade of neurobiological events in our brain that actually helps us sleep better at night. It helps us get off to sleep better because of the melatonin and then that can help us have better quality sleep. So my tip number one is to get out in the morning and go for a walk. If you’ve got a dog maybe you do this already. For me, I’ve got a toddler. I like to take him outside on the road to play football. This is ideally before about 9 am We’re doing this too so on a sunny day in the morning. Even just 10 minutes can be enough for this really cloudy, overcast day 20 to 30 minutes, ideally, but still even if you can just get outside and go for a walk that will help with the sleep process. And it’s also good just to be outdoors. You might be outside with nature if you do that and you might also be getting exercise if you’re able to go for a walk. So if you can build that into your routine that is going to have beneficial effects for you.


Nathan Illman  20:07

Moving on from that, and very much related is exercise. So the research that looks at the relationship between physical activity, exercise, and sleep is just so clear. So whether it’s a cardiovascular exercise where we’re moving our body quite intensely, and our heart rates getting up, and we’re sweating, or even strength training, or even things like yoga, which are a bit more restorative, it might involve bit more stretching, slower movements. Really, any kind of activity that gets our body moving quite a bit is beneficial for sleep. So I like to exercise every day, even if it’s only for 15 minutes because I know that it’s going to benefit my sleep later at night. So the best way to do this, if you’re not already doing regular exercise is to combine those two things that I just said. So go for a brisk walk in the morning for 20 minutes before you start your shift, for example, and that is going to be beneficial for your sleep, it’s going to be a double whammy, you’re going to get the morning light, you’re going to get your heart rate up and that is going to help you sleep at night to find something that is enjoyable for you don’t feel like you have to go running or you have to lift weights because everyone else is doing that even taking dance classes or doing like I said doing yoga, for example, has also been found beneficial for sleep.


Nathan Illman  21:32

So moving throughout the rest of the day, we’re getting towards the evening period now. So let’s talk about some tips for evening time screen use. Now the research on screen use is a little bit more nuanced and complex than what people might have originally thought different people react differently to different things they’re watching or consuming. In the evening. Some people might be able to scroll through their phones on social media and be relatively unaffected by things. Some people might be able to watch a horror movie, but then be able to kind of calm down quite easily afterward. Each individual person is quite different.


Nathan Illman  22:06

First, I want to tell you about one piece of research which I read recently, which I think is really relevant and helpful to know about the use of smartphones. Now let’s face it, most of the time, if we are using our phone before bed, it’s probably not helping us relax, there’s probably some degree of social comparison going on if you’re on Facebook or Instagram or something like that. And that is leading to this increase in arousal and anxiety which you don’t want before you go to sleep. So setting yourself a rule of not looking at your phone after a certain time in the evening is really helpful. One recent research study found that one group of people who were asked to stop using their phones 30 minutes before bed and to leave outside their bedroom. This was compared to a group of people who are allowed to just continue with their smartphone use. The no phone-in-room overnight group after four weeks had improved sleep quality, they got off to sleep quicker, and they felt more refreshed. And they even had a better cognitive performance on one task because they were getting better sleep too. This is something I’ve started doing recently, as well as leaving my phone downstairs to charge I bought myself a lamp, that’s light to wake me up because I used to use my phone as an alarm. So you can buy an alarm clock to prevent the need for having a phone. This can be a really really helpful thing especially if you know you’re someone who can like to scroll you get sucked into your phone and you start to feel anxious and aroused from that in the evenings.


Nathan Illman  23:30

Now the next one is about having a solid routine for going to sleep. So when I speak to lots of people, they often have this chopping and changing routine, even if they don’t do night shifts to remember how I’m talking or speaking to people listening to this who are currently not working night shift you’re working regular day shifts. Like I said, we’ll come back to the night shift in a separate episode. If you’re a nine-to-five-ish sort of person, really what we want to be doing is going to bed at the same time each evening and waking up at the same time. Because sleep is a behavior, you start to associate certain things with being sleepy, and your sleep quality will improve if your brain has that predictability of when it’s going to go to sleep. And when it’s going to get up quite simply your brain and body just get into a rhythm, and you will be able to fall asleep quicker because there is a level of expectancy with your brain that you’re going to go to bed at a certain time. You’ll feel sleepy at the same time and then you’ll be used to waking up at the same time. So in the morning, you’ll start to feel more alert as well because you’ll start getting more consistent sleep. So one of the problems I commonly see is people chopping and changing going to bed at midnight one night waking up early the next night then going to bed at 9 pm, waking up early, and then it kind of changes depending on what they’re doing.


Nathan Illman  24:58

Now that I’m aware that If you are a student, for example, or you might be an older person who enjoys your nightlife going out, it’s impossible to have the same routine every single night of the week I get it. I was there, I used to be that person. When I was younger, my sleep habits were absolutely terrible. I was out partying, doing all sorts, and staying up late into the night. But you know what I suffered because of it. And looking back, I wish that I had a bit more of an education and a bit more support around getting more regular sleep around the other days of the week when I wasn’t going out. Because those bad habits then spilled into the other nights when I wasn’t necessarily going out to a nightclub or something, I might have just been at home with my housemates or my flatmates. But bad habits persisted. And maybe I was getting a late night here, an early night, their late night here, and anything like that. So set yourself a reasonable bedtime, and then wake up at the same time in the morning. And in fact, that part has been shown to be the most effective thing. So if you wake yourself up at the same time when you get up out of bed, then what happens is, again, your brain gets used to this. And it leads to this kind of rhythm throughout the rest of the day that your body gets used to. And of course, if you get up at the same time every day without exception as a guarantee that by nighttime, you’re going to feel sleepy by a certain point as well. Whereas if you start sleeping on Sundays, and of course that shifts when you’re sleepier later on in the day.


Nathan Illman  26:30

Now related to this routine, sort of fine-tuning your routine, going to bed, and waking up at the same time. Let’s talk a little bit about sleep debt and sleeping on weekends. So whilst it may be tempting to cut yourself short of sleep during the week, and then sleep in for like, two or three hours extra on the weekend, again, research shows that yes, in the short term that might be beneficial for you might feel more refreshed on a Saturday, Sunday, you might feel, Yeah, so ready to attack the day or the weekend and have been full of beans and have lots of energy. Sleep is not like a bank, you cannot take a withdrawal from the sleep bank during the week and pay it back at the weekend and expect that that is going to be the same as having consistent sleep. So the long-term impact of that is detrimental for health because what you’re doing is if a five days a week and not sleeping enough, you’re sleeping for five or six hours per night. So that is having a chronic impact on your body. Whether you like it or not, unfortunately, that’s what science shows. So it’s creating inflammation and stuff during the week. And whilst it may feel good on the weekend, it’s a short-term benefit you’re getting. So that’s why whilst it may feel difficult, actually getting this more consistency seven nights a week is really important.


Nathan Illman  27:50

So the next tip is around diet and what we eat before we go to bed. And one thing, in particular, I want to talk about because again, this is quite a big topic and quite nuanced is sugar. Though I used to be a massive sugar fiend. My wife and I used to be lots of sweet treats before bed, we used to eat chocolate and cookies. And various things are some of that was related to stress and feeling like you know, at the end of the day, I just want to reward myself with something. But it became a really nasty habit that we both had. And the research shows that sugar is not good for your sleep at all, and interrupts the natural cycles we go through. And whilst you may not necessarily notice it too much, it does have that effect when people are observed with you know, kind of hooked up to specific monitors that are used for recording sleep quality. And again, there’s the long-term impact of this is really detrimental. 


Nathan Illman  28:47

So my recommendation is to think about other ways that you could treat yourself in the evenings. Are there things that don’t contain sugar? Or could you just reduce your sugar intake in the evening, something my wife and I did was the thought of cutting out anything sweet in the evening which was just awful. So what we started doing were baking other baked goods that use fruit kind of substitutes instead. So for example, making a brownie that uses mashed banana instead of refined sugar and eating less of it basically. So we’re just not having refined sugar, which is really the nasty type of sugar for our health, and using something more natural but having less of it. Now felt like a good compromise for us. So perhaps give that a go.


Nathan Illman  29:30

The next one related to diet I want to mention is alcohol. So there is a myth that alcohol helps you sleep. Now of course alcohol can help you get off to sleep. Everyone’s had that experience. If you’re a drinker. You have a couple of beers or glass of wine you start to feel sleepy and yes, it does initiate sleep because of its depressant effect on our nervous system for what actually happens later on in the night is when alcohol is synthesized in your body it becomes a stimulant and it wakes you up early and it actually leads to sleep disruption, so it is not good for our sleep at all. So even a small amount of alcohol at night is negative, is bad for our sleep. So people often convinced themselves that one glass of wine won’t make a difference. Well, I’m sorry to tell you that research shows that one glass of mine does make a difference. And the problem is, over time, you might get used to that for sleep. And you might think that your sleep is okay. But it’s not, it’s being negatively impacted by that alcohol. So replacing that drink in the evening with something else is going to be helpful. And one of the reasons that people drink and eat sugar and things in the evenings is because it, helping to manage stress or numb emotions or manage emotions. So again, this is something we’re going to cover in the insomnia episode because it’s really important to find ways to manage difficult feelings, especially in the evening is going to help with that sleep.


Nathan Illman  30:58

Something I’m going to focus on here briefly. And this will be our last tip. And this episode is around managing anxiety and stress and evening, and particularly worry. So as I mentioned, that arousal level increases in the evening if you’re feeling stressed, and that interrupts that natural ability to fall asleep. So something that I really believe in is getting things out of our heads, the more stuff is spinning around, this creates more stress. If you’re overthinking things, perhaps for example, or you’re thinking about an assignment that you’ve got to do, you’re thinking about your patients at work from the shift, these things are going to increase that arousal, it’s going to lead to cortisol being released into your body, and it’s going to make it harder for you to fall asleep. So getting things out of our heads. So one is talking to someone about things. So whether it’s your partner, or you can share it with a friend, whether you have a psychologist or coach or someone else who can support you obviously not going to do that every night of the week, I’d highly recommend that if you’re struggling because it will help with getting this stuff out and helping to manage that stress.


Nathan Illman  32:07

Another really basic thing you can do though if there’s no one that you can talk to in the evening is to write down what’s stressing you out, your worries to make it more tangible. Put your thoughts to bed before you go to bed. So do whatever planning and preparation you need to do for the next day before bed. Ideally, not just before you go to bed, but maybe an hour or so before, and write down any worries you have. You can literally just write in a journal. I am worried about this. I’m worried about that. Worried about that. And just give yourself permission to put them onto paper and tell yourself I’ve got my worries on paper. Now. I’ll give myself permission to think about those and deal with them tomorrow. Right now I’m going to allow myself to go to sleep or give myself permission to go to sleep just doing that can be really, really helpful.


Nathan Illman  32:57

Okay, so I’ve gone through quite a lot of tips there, there’s been quite a lot of information. I really hope that you found this interesting and helpful. Like I said, I truly believe that all nurses and midwives should be given more of an understanding of sleep and given an opportunity to reflect on their own sleep giving support and improving their sleep. And like I said, that’s what I’m going to be doing this week with one of my workshops for some nursing students. If you’re listening to this and you think wow, that’d be really good for me and my team then get in touch with me you can find this while being mission on Facebook. You can find our website at nurse wellbeing mission.com You can find me on Instagram @_nursewellbeingmission. You can find me on LinkedIn if you just search my name Nathan Illman I double L, M, A, N and what’s the other one, oh Twitter. Yes. So on Twitter, at nurse wellbeing, or again I think if you just search for my name, you’ll find me there and reach out. So I will be back very soon for some more sleep and other well-being tips and other amazing episode interviews and conversations with people excited to bring you I hope you’re well and see you soon.