Monitor your sleep for mental wellbeing

Some of you might be having trouble sleeping. Trouble may be in either falling asleep or maintaining a sleep cycle. You might be waking up in the middle of the night, resulting in daytime sleepiness. You might be feeling low energy and low mood too. It may get so severe that it might start impacting your daily functioning.

Why do we need to sleep?

Sleep helps to heal your body and restore its chemical balance (Furniss, Miller & Bentovim, 1984). It also helps to retain memory.

Sleep deprivation can have a significant impact on your physical and cognitive functioning. It can put you at risk of obesity (Beccuti & Pannain, 2011), diabetes (Touma & Pannain, 2011), cardiovascular disease (Hoevenaar-Blom, Spijkerman, Kromhout & Verschuren, 2014) and stroke (Bassetti, 2005). It might also impact your immune functioning resulting in your body taking a longer time to recover from illness (Ganz, 2012). It can interfere with your thinking and learning ability. Your attention, reasoning, problem solving, judgment can be significantly impaired leading to poor performance (Ferrie, Shipley, Akbaraly, Marmot, Kivimäki & Singh-Manoux, 2011).

Apart from physical and cognitive functioning, sleep can also have an impact on your emotional well being. It can also contribute to symptoms of depression and anxiety (Kalmbach, Arnedt, Swanson, Rapier & Ciesla, 2017), especially if you sleep less than 6 hours on a regular basis.

Sleep loss often aggravates the symptoms of depression and anxiety which can make it more difficult to fall asleep. A study was done on 171 women who reported daily measures of mood, anxiety and sleep for 2 weeks. Findings suggest that when women had poor-quality sleep, they later experienced greater anhedonic depression and anxious arousal (Kalmbach, Arnedt, Swanson, Rapier & Ciesla, 2017).

Another study on 305 undergraduates revealed positive associations between emotional well-being and sleep (Howell et al., 2008). Similar findings were seen in a survey done by Mannki where 77 participants were asked what factors helped them during COVID 19 pandemic. Results indicate that 16% participants reported that good sleep helped them deal with COVID 19 stress. These studies indicate that for normal functioning of your body and brain you need adequate amounts of sleep. Hence, it is very important to get good quality sleep.

There are various medications which are available in the market. However, they can benefit us only in the short term. They can also cause our dependence on medication. So let's discuss some techniques that will help you get good sleep.

Get regular: Have a specified time for going to bed and waking up. This should be done even on weekends. Your body will have proper rhythm.

Sleep when sleepy: Go to bed only when you are sleepy and not otherwise. Else you will end up spending too much time awake in bed.

No baggage to bed: Do not take your concerns to bed. Focus on breathing or think about positive things, e.g. Gratitude journal. Sometimes, when we go to bed, we start thinking about problems and worries that we are having. It has been found that thinking about stressful situations interferes with your sleep as it makes your brain more active. It is advisable to have a specific worry time in the day much before going to bed. Remind yourself that you will worry only on specific time (say 6pm for half an hour). Another useful practice would be gratitude. Before going to bed think of 3 good things in your life that you are grateful about. This will keep your body relaxed and may help you get good sleep.

Get up and try again: If you are not feeling sleepy then get up and do something that is boring, for e.g.- staring at a blank wall, reading a book that is very boring. Avoid doing anything that excites you. This will automatically make you sleepy.

Avoid caffeine and nicotine: Avoid taking any caffeine products like tea, coffee, chocolates etc. at least 4-6 hours before you go to bed as they activate your brain. Nicotine energizes you and interferes with your sleep.

Avoid alcohol: Avoid taking alcohol as it can interfere with your sleep. Some people take alcohol before going to bed as they feel that it gives them good sleep. However, it interferes with the quality of your sleep and in the long run you might become dependent on it and might require a higher quantity of alcohol to get good sleep.

Avoid taking liquids at least 2-3 hours before going to bed: Avoid taking liquids 2-3 hours before bedtime as you might get the urge to urinate when you go to bed, causing disruption in sleep.

Using bed only for sleep and not for other activities like reading, eating, watching TV: Let your body learn the connection between sleep and bed. Do not engage in other activities like reading, working etc., (except sleep and sex) in bed. So, when you come to bed your body is also prepared to sleep.

No naps: Avoid taking naps in the day time as it might interfere with your night sleep. If you don’t take a nap then your body will be tired by night and prepared to sleep. However, if you still need a nap then make sure that it is for less than an hour.

Sleep ritual: Have your own rituals of sleep like reading books 15-20 minutes before sleeping, washing hands and feet before sleeping. This helps to prepare your body to sleep.

Warm bath: Take a warm bath 1-2 hours before bedtime can be useful to get good sleep. It initially raises your body temperature which later results in a drop in body temperature, which makes you sleepy. There is a strong connection between low body temperature and sleep.

No clock watching: Do not keep watching the clock if you are not sleepy. If you do so you will feel more anxious and thus your sleep will be impacted. Yes, anxiety or any kind of worry in bed should be avoided as they interfere with your sleep.

Exercise: Exercise daily, preferably in the morning. Avoid doing exercise 4 hours before sleep as it energizes your body which interferes with sleep. If you don’t prefer exercise then you can start with 20-30 minutes of morning walk.

Eat right: Eat a balanced diet. Do not eat a very heavy dinner. Do not go empty stomach to bed. If you feel hungry at night then substitute it with fruits or a glass of warm milk. Don’t forget to brush your teeth before sleeping.

Right space: control environment when going to bed like keeping light dim, keeping enough blankets in room, ensure good temperature of the room. Ensure that when you go to bed, the light in your room is dim. The room should be warm and enough blankets should be available. This kind of environmental control can help you in getting good sleep.

Regular routine: Ensure that you get into a daily regular routine even if you had bad night sleep. Don’t avoid any activity even if you are tired. Try to ensure that your day goes as planned.

You can track all of these by using a Sleep Diary, which can help you to see patterns in your routine.

Research studies have shown benefits from a Sleep Diary

A study conducted in 190 university students found that avoiding going to bed hungry and thirsty, avoiding anxiety and stress-provoking activity before bed, and making the bedroom and sleep environment (all of which monitored in the sleep diary) can help you to get good sleep (Todd & Mullan, 2013). During stressful times your sleep tends to increase or decrease, which can have significant impact in your well being if that continues. In a survey conducted by Mannki during COVID 19, the duration of sleep in participants ranged from as short as 2 hours to as long as 13 hours. We at Mannki are trying to build a solution using machine learning that will help you track your sleep and other behavioural markers, with the help of your smartphone, that will tell us about your mental well-being. These markers will be computed passively without your active input, thereby making it more data driven and accurate. Currently, we are in the research phase. We would be glad to have you in the process. You will be able not only to track your sleep and other behavioral markers but your inputs will also help us develop a better data driven solution.

These are some of the evidence-based techniques that can help you get sound sleep. Hope you start using them and benefit from them!

Join Mannki

Mannki is a mental health app available in the google play store for android phones. We at Mannki are trying to improve the screening and diagnosis of mental health in India by continuously tracking the user's mental wellness journey. The app uses clinician-recommended diagnostic tests alongside passive sensing through a user's smartphone to help them understand their sleep routine and mental health better.

Mannki aims to overcome many of the challenges like imprecise user inputs, lack of diagnostic markers, stigma, and poor access. We are trying to bring transparency and care for undiagnosed problems with precise and measurable inputs. Currently, we are in a research phase where we are trying to collaborate with institutes to understand behavioral markers and build algorithms for various psychiatric disorders.