Author: CMHA BC and Anxiety Canada

What kinds of sleep problems can people have?

• Trouble falling asleep: lying in bed for more than 30 minutes without being able to fall asleep

• Trouble staying asleep: waking up frequently during the night

• Early morning waking: waking in the early hours of the morning before you need to get up but not being able to fall back asleep

• Behaviours that interfere with sleep: such as snoring, grinding your teeth, restless legs, sleep walking and breathing problems

• Sleeping too much or for too long

• Excessive sleepiness or urge to nap during the day

• Excessive fatigue or lack of energy

How much sleep do I really need?

The Public Health Agency of Canada recommends the following sleep times:

• Toddlers: 11-14 hours a night

• Preschoolers: 10-13 hours a night

• School-aged children: 9-11 hours a night

• Teens: 8-10 hours a night

• Adults: 7-9 hours a night

• Older adults: 7-8 hours a night

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Of course, different people have different needs. Some people naturally need less sleep or more sleep. However, for adults, consistently sleeping fewer than six hours a night or consistently sleeping for ten or more hours a night can have health risks or may be a sign of another health problem.

About two-thirds of Canadians say that they get at least seven hours of sleep most nights, but about half of adults report sleep problems at least some of the time. Only about 40% of adults report that they feel refreshed after sleep most of the time.

How do sleep problems affect mental health?

Sleep problems can have a negative effect on your mental health by influencing your emotions, thoughts, behaviours and body sensations.

• Emotions: If your sleep is disturbed, you might feel irritable, grumpy, numb, sad, anxious, worried or stressed.

• Thoughts: Sleep problems can make it difficult to concentrate, think clearly or make decisions the next day.

• Behaviours: You're more likely to avoid your usual activities when you are experiencing sleep problems.

• Body sensations: Sleep difficulties can leave you feeling tired, drowsy or worn out.

Tips for getting a good night's sleep

One of the most powerful ways to improve sleep is to make small changes in everyday behaviours that impact how fast you fall asleep and whether you stay asleep. The goal is to increase the behaviours that improve sleep while you reduce the behaviours that interfere with sleep.

Tip #1 Avoid caffeine close to bedtime

Some people have problems sleeping when they have consumed too much caffeine. This is especially true as you get older. Coffee, tea, soft drinks and chocolate are the main source of caffeine for most people. Some medications for colds, allergies, pain relief and appetite suppression also contain caffeine.

Tip #2 Avoid alcohol close to bedtime

It might feel like drinking alcohol helps you fall asleep faster, but alcohol can disrupt your sleep. Drinking alcohol before bedtime can also cause breathing problems and jerky arms and legs. People with alcohol problems often have chronic sleep problems.

If you are having problems reducing your use of alcohol, visit www.heretohelp.bc.ca or www.cisur.ca for more information and helpful resources.

Tip #3 Unwind

Stress has a big impact on sleep, so it's important to take time to relax before bed. Read a good book, do crosswords or Sudoku, take a bath or shower, listen to calming music or try a relaxation exercise. Screen time is stimulating and the blue light emitted by devices can affect sleep, so it's best to avoid watching TV, going online or using other electronic devices at least 30 minutes before bed.

Tip #4 Exercise a few hours before bedtime

Research shows that people who exercise regularly (30 to 60 minutes, three times a week) have deeper sleep. Exercising gives you a boost of energy, so it's best to exercise four to eight hours before bedtime.

Your local community centre is a great source of information about recreation and leisure options close to home.

Tip #5 Follow the same routine

Try to keep the same sleep and wake schedule every day—including weekends. Keeping a consistent schedule helps your body get into a routine. People who get up and go to bed at different times each day are more likely to have sleep problems.

Tip #6 Avoid naps if you experience sleep problems

Naps aren't necessarily a problem, but for some, naps may interfere with sleep at night. If you experience problems with sleep, consider cutting out naps to see if your sleep improves. In all cases, it's best to keep naps short, around 30 minutes at most, to minimize disruptions to your normal sleep patterns. If you often feel so tired that you can't get through the day without a nap, it's a good idea to talk to a doctor. It can be a sign of another health problem, including a sleep disorder.

Tip #7 Avoid going to bed too hungry or too full

Eating balanced, healthy meals and snacks at regular times throughout the day will help with a good night's sleep. Try to avoid eating a large meal in the two hours before bedtime. Consider a light, healthy snack if you’re still hungry just before going to bed.

Tip #8 Get up if you do not fall asleep within half an hour

Get up if you don't fall asleep within 30 minutes. Leave your bedroom and do something relaxing like listening to soft music, taking a bath, drinking a warm caffeine-free beverage or meditating. Avoid watching TV or going on a screen during this time. Go back to bed once you feel very drowsy. Don't try too hard to fall asleep—this usually doesn't work. At first, this strategy might feel like it's making things worse because you may have a few sleepless nights. However, after several nights, it will become easier to fall asleep and stay asleep. Be consistent in your use of this strategy. Studies show it is very effective in reversing sleep problems.

Tip #9 Make your bedroom comfortable and only use it for sleeping

A mattress with good support and comfortable bedding are both helpful. Make sure your room is not too hot or too cold—slightly cool is best. Don't use your bed for watching TV, working, studying or any other mentally stimulating activities, especially if you are already experiencing sleep problems.

Tip #10 Challenge the belief you can't function without a perfect night's sleep

When you can't sleep, you might check the clock and worry about getting through the upcoming day. This increases anxiety and makes it even harder to fall back asleep. Turn the clock away from your view. Remind yourself that you can likely do your daily activities even when you feel tired (unless this would pose a danger to yourself or others).

For more tips on managing difficult thoughts that can disturb sleep, see our Healthy Thinking Wellness Module at www.heretohelp.bc.ca.

To improve the quality of your sleep, follow these strategies on as many days as you can

• Use our sleep skills diary below to track your progress.

• Be consistent in your use of the strategies.

• Remind yourself that it takes time to change sleep behaviours and see positive results.

Still having sleep problems?

If you continue to experience difficulties with your sleeping patterns, talk to your doctor or mental health professional. Sleep problems can be a sign of a sleep disorder, mental illness, substance use problem, or other health problem. Health problems like asthma and chronic pain can also affect the way you sleep. The quality of your sleep often improves once these illnesses or conditions are identified and managed.

Some medications may cause sleep problems. Talk to your doctor if you think that your medication is affecting your sleep.

For more information about sleep disorders, visit the Canadian Sleep Society at www.css-scs.ca.

Author: Anxiety Canada

Anxiety can really impact our appetite. Some people crave more food when anxious or stressed. They can eat too much, chasing some temporary feeling of comfort or relief. Others experience less hunger and thirst. Some may feel slightly nauseous, or simply have too much on their mind to remember to eat or drink.

If this sounds like you, try to eat more 'by the clock' at regular times every 2-3 hours, rather than waiting for feelings of hunger to kick in. And don't forget to keep hydrated! Keep a reusable water bottle handy.

Yeah, Yeah...eating healthy is good for you...but I manage OK. Does it really matter that much?

Yes. Your diet does matter. What and how often you eat affects how you feel, including how well you deal with anxiety. Dehydration, caffeine or sugar crashes, and lack of nutrition can contribute to many NOT fun things like jitters, light-headedness, weakness, lack of focus, and racing heart. Sound familiar?

And do you feel run down a lot? Sure one obvious reason is lack of sleep, but you may be surprised how much your diet is slowing you down too.

Think of your body like a car and food like fuel. Good fuel in = a car that runs smooth on a flat road and goes the distance (rather than a car that sputters to a stop or revs out of control and runs off a cliff).

But eating healthy is so much EFFORT, and I'm in school or at practice all day. I'm not even that hungry at lunch anyway.

Try packing some high protein snacks for on the go or keeping a 'snack stash' in your locker*, like:

• Almonds or other nuts

• Edamame

• Cheese and whole-wheat crackers

• Protein bars or shakes

• Granola or trail mix

• Fruit (bananas, apple)

• Cottage cheese

• Greek yoghurt

• Thick cut (or steel cut) oatmeal

• Hard boiled egg

*Some of these snacks can be kept around in your locker or bag for when you really need them, but some you definitely don't want to forget about. Trust us.

But I think more clearly after a coffee or an energy drink...and I really like my little treats.

Yep, us too. Just be aware that the quick boost from a coffee or energy drink comes at a cost. Anything that goes up must come down...with a CRASH.

If you aren't ready to give up your caffeine or sugary snack try pairing it WITH something with protein to help you go the distance. And sure, treats are OK once in a while—but not as your daily 'go to' for a boost of energy or to chase your hunger away.

Caleb Leduc, Hons BA, BEd, MHK, PhD Student

Reprinted from the "Mind-Body Connection" issue of Visions Journal, 2014, 10 (2), p. 34

The mental health benefits of physical activity appear to be equally available to both boys and girls. Engaging in physical activity has a protective effect on body image. And, importantly, this occurs regardless of noticeable physical changes or weight loss.

Engagement in physical activity for children and youth with a disability is critically important. Being physically active has been shown to reduce the incidence of depression and isolation, and prevent the development of secondary disabling conditions in these children and youth.9 Further, participation in physical activity promotes independence, and challenges and improves physical skills, self-esteem and feelings of self-worth in children and youth with a disability.9

Physical activity influences two underlying contributors to positive mental health. The first is “working memory.” Working memory is our ability to retain and manipulate information in the short-term and is critical for focusing and making sense of the world. Increasing physical activity and exercise levels in children and youth during after-school programs has been shown to improve working memory and increase cognitive processing and performance.10,11

The second underlying contributor is sleep. Being active physically decreases the amount of time it takes children to fall asleep and increases their total sleep time

Article: https://www.lhsfna.org/index.cfm/lifelines/september-2016/spiritual-wellness-what-is-your-meaning-and-purpose/

Finding meaning and purpose may be a lifelong process that evolves based on unique circumstances, individual experiences and global events. Along with the other dimensions of wellness, a person’s level of spiritual wellness often fluctuates throughout their life. It is natural to experience a variety of emotions along the path to spiritual wellness – both positive (hope, forgiveness, acceptance, joy) and negative (doubt, fear, disappointment, conflict).

Spiritual wellness has the power and capability to make our decisions and choices easier, ground us during periods of change and give us the resiliency to survive with grace and inner peace in the face of adversity. Having a spiritual element in our lives may even help us heal when suffering from a physical or mental condition.

Personal Reflection

Take a moment to assess your own spiritual wellness by asking yourself the following questions.

1. What gives my life meaning and purpose?

2. What gives me hope?

3. How do I get through tough times? Where do I find comfort?

4. Am I tolerant of other people’s views about life issues?

5. Do I make attempts to expand my awareness of different ethnic, racial and religious groups?

6. Do I make time for relaxation in my day?

7. Do my values guide my decisions and actions?

Practice Spiritual Wellness

When striving to develop and practice your own spiritual wellness, it is best to find the technique and approach that works for you; similar to the other dimensions of wellness, there is no “one size fits all” approach.

Your journey to spiritual wellness may involve the following:

• Practicing meditation or yoga

• Praying or taking part in organized religion

• Spending quiet time alone pondering the meaning of life

• Building awareness through journaling

• Serving your community, spending time in nature, appreciating music and the arts