Your sleep diary’s key the to success
Whether you only occasionally find yourself awake in the middle of the night or are at the end of your tether after years of broken sleep, a comprehensive sleep diary is the most important tool to fight insomnia.
In Saturday’s paper, we gave away a free 32-page sleep diary. A sleep diary is so integral to success that, when I am doing therapy (in practice or in research), I will start each session by asking to see the patient’s sleep diary. If there isn’t a diary, there is no therapy that day.
the diary is divided into two halves — a morning section you should fill in when you have brushed the sleep from your eyes (around 30 minutes after waking) and an evening session to fill in a few hours before you go to bed.
Keep it by your bed with a pen to hand (and your reading glasses if you need them) and make filling in your diary part of your morning and evening ritual — like brushing your teeth.
Don’t try to fill the morning section the moment you wake up as you may be dazed and sluggish and likely to be less accurate about your diary recordings.
It may seem time-consuming and even a little irritating at first, but I can’t emphasise enough how invaluable it will be. this diary is the key to truly personalising your sleep plan.
It is important to be able to gather data that is averaged over a whole week if possible, so that we can account for variability from night to night.
remember that even people with insomnia have the odd good night’s sleep, as well as an abnormally good or bad sleep period (which we all have from time to time).
the results you will have gathered in just a few days can help you identify any patterns in your sleep that may otherwise have gone unnoticed.
It pulls away the veils of confusion and within just a few days you’ll start to see a much clearer picture of how your insomnia is manifesting. Importantly, over time it will become an excellent marker of your progress. here’s how to use it . . .
WHAT TO DO IN THE MORNING
I went to bed at: Very often when sleep problems have been going on for quite some time, exhaustion drives people to slope off to bed earlier and earlier in the evening.
While this logically seems a great way to catch up on lost sleep, and a useful antidote to falling off to sleep on the sofa in front of the tV, it is not always a good idea.
One of the paradoxes of chronic insomnia is the longer you spend in bed — whether you are awake or asleep — the lighter and more fitful your sleep is likely to be.
An important part of my plan is working to consolidate your sleep to intensify the depth and quality.
With this in mind, it is important to write down the time you went to bed to be able to make a note of the amount of time you spend in bed each night. How long it took me to fall asleep: It’s common for someone with chronic insomnia to say that no matter how exhausted they are, they struggle to fall asleep at night.
One of the best-known measures of insomnia is when it takes more than 30 minutes from going to bed to falling asleep. I woke up at: Another common sign of insomnia is waking up in the early hours of the morning and being unable to fall asleep again.
So, record the time you accepted your night’s sleep was over. I got out of bed at: this is the time you need to get out of bed to get everything done in time to start your day. In the future this will be the time you set your alarm. Number of times I woke during the night: this is another common sign of insomnia and recording it becomes a useful gauge of how the quality of your sleep is improving during the course.
the aim is to minimise the disruption of nocturnal awakenings. Number of minutes I was awake for: I encourage everyone who does my sleep course to remove alarm clocks from the bedroom and to turn their phone face down on the bedside table so they are not tormented by numbers ticking away as they lie awake, serving only to remind them of how little sleep they might have had.
this makes an accurate assessment of the time spent awake tricky, but make the best estimate you can. Total sleep time: Simply add the number of minutes between falling asleep at night to waking up (for the final time) in the morning.
then subtract the total number of minutes you estimate you were awake during the night. this figure is important to keep track of. After a few days you should see a pattern starting to emerge. Sleep efficiency: this is a percentage score that quantifies how much of the time you are in bed is spent actually sleeping. You may need a calculator to help figure it out. take the score from your total sleep time (in minutes) and divide it by the number of minutes you spent in bed (count up from the moment you got into bed and turned out the light to the point where you threw back the covers and got up). then multiply this number by 100 to get your percentage score. If you sleep badly with frequent interruptions, you may find your sleep efficiency hovers at around 60 per cent. If you follow the recommendations in my plan, by this time next week you should be able to see your sleep efficiency score creep up to a more healthy 85 per cent — or even higher. How well I slept: this is your at-aglance guide to the sort of night you think you’ve had. How well I feel: this allows you to monitor your tiredness on waking. Your dreams: the two boxes in the morning section are for you to ‘download’ your dreams.
If you wake up with a vivid dream still in your head, jot it down in your diary. then — this is crucial — think how you would like to change the outcome to make it positive, happy or upbeat.
the how I’d change my dream section in the diary is there for you to ‘re-frame’ your dream to help alleviate its negative impact.
So, if you dreamt you were being chased by a monster, give it big clown shoes; if you felt water levels rising around you, put yourself in a boat. For more insight into your dreams, see Friday’s paper.
WHAT TO DO IN THE AFTERNOON
thIS is where you can monitor the daytime habits that may or may not be interfering with your sleep. Did I nap today? Write down whether you had a daytime sleep, what time it was and how long it lasted. I don’t recommend napping for more than 30 minutes and certainly not after 4pm. Last time I exercised: regular daily exercise is a great way to improve the quality of your sleep, and it forms part of my good sleep behaviour prescription.
Numerous studies have shown regular exercise is associated with longer and deeper sleep. Moderateintensity exercise in the afternoon or early evening is associated with getting off to sleep quicker and increased overall amounts of sleep for people with insomnia.
But don’t leave your exercise session too late in the day. If you work out in the two hours before you go to bed, the hike in metabolism could make it more difficult for you to fall asleep. Last time I had a caffeinated drink: Aim for no coffee after lunch and cut back on tea after noon. Last time I ate: Avoid eating a heavy meal within two hours of bedtime. eating too late forces your body to achieve two opposing biological processes, digestion and sleep, at the same time.
It is equally important not to go to bed hungry (which can wake you up), so a night-time snack is fine. Units of alcohol: Alcohol is a sedative, which sounds appealing if you are having difficulties getting off to sleep, but the effects wear off quite quickly, and typically leads to light, unrefreshing sleep in the second half of the night.
As alcohol is a diuretic, you are more likely to be dehydrated which increases sleep fragmentation. So, avoid alcohol close to bedtime and don’t use it as a sleep aid. How tired I feel: this gives you a quick measure of whether you drifted through the day in an exhausted daze or you felt reasonably fresh and perky.
As you go through your diary, this will provide a picture of your sleep quality and its capacity to rejuvenate you. Tomorrow’s important tasks:
If you are likely to wake up in the night worrying about everything you have to do the next day, this is your chance to jot down your to-do list, getting it out of your head so you don’t have to worry about forgetting anything. What have I done to prepare for tomorrow: tackle any impending anxiety about your plans for the next day by jotting down the steps you might have taken to prepare for them.
Notes such as ‘my smart suit is dry cleaned and ready’ can help ease anxious thoughts about the following day. For more insight on making this section really work for you, see Wednesday’s paper.
If you forget to fill in your diary within one hour of waking up, skip your entry for that day — a hazy memory may affect the accuracy