WEBVTT - Sleep in Uncertain Times

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<v Voiceover>Welcome to sleep talk. The podcast about all things sleep

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<v Voiceover>brought to you by sleephub.com.au. Here are your hosts Dr.

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<v Voiceover>David Cunnington and Dr. Moira Junge.

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<v Dr Moira Junge>So welcome to this special episode of the Sleep Talk podcast.

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<v Dr Moira Junge>Welcome Moira.

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<v Dr Moira Junge>Hello Dave. A really good idea to just have this quick one off episode to

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<v Dr Moira Junge>get some messages out there about those that aren't sleeping

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<v Dr Moira Junge>well which is probably the most of the world at

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<v Dr Moira Junge>the moment.

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<v Dr David Cunnington>So the circumstances we find ourselves in are unfortunate but

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<v Dr David Cunnington>we thought it was important to try and give people

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<v Dr David Cunnington>some strategies to help with sleep during these difficult times.

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<v Dr David Cunnington>One of the key points we wanted to emphasize is

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<v Dr David Cunnington>that our daytime lives are markedly different. It's been totally

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<v Dr David Cunnington>thrown upside down in what we're allowed to do during

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<v Dr David Cunnington>the day. So really we should expect that nighttime and

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<v Dr David Cunnington>sleep is also going to be different. It's a very

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<v Dr David Cunnington>stressful time. So it's also important to make sure we

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<v Dr David Cunnington>look after ourselves both physically and mentally. We've experienced this

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<v Dr David Cunnington>personally over the last week feeling anxious and finding sleep's

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<v Dr David Cunnington>changed but have been able to manage our symptoms. I've

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<v Dr David Cunnington>been waking up a bit earlier. It's a natural tendency

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<v Dr David Cunnington>of mine anyway but it does get earlier again when

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<v Dr David Cunnington>I'm a bit stressed or anxious. Cycling's my thing. If I'm

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<v Dr David Cunnington>feeling a bit stressed or anxious spending some time on

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<v Dr David Cunnington>a bike and fortunately I've got an indoor bike set

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<v Dr David Cunnington>up so I can do that whilst maintaining social distancing.

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<v Dr David Cunnington>It's been helpful. So although I've been waking early I've been

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<v Dr David Cunnington>fitting in a cycling session before work and I found

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<v Dr David Cunnington>that pretty helpful. I've also selected a couple of books

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<v Dr David Cunnington>to read that deliberately aren't work or virus related. What about

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<v Dr David Cunnington>you Moira?

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<v Dr Moira Junge>It's a devastating time. There's the worry about the virus.

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<v Dr Moira Junge>There's also that fear of keeping yourself safe and your

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<v Dr Moira Junge>family safe. Am I being cautious enough? Those sorts of fears.

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<v Dr Moira Junge>But of course there's the worry and the sadness about

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<v Dr Moira Junge>the deadly economic and social consequences. The change is so rapid.

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<v Dr Moira Junge>There's so much uncertainty. So I haven't actually been sleeping

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<v Dr Moira Junge>very well. In the first maybe say a week ago and

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<v Dr Moira Junge>I've managed to get things back on track.

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<v Dr David Cunnington>So what did you do?

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<v Dr Moira Junge>Isn't it great that a physician, not that I'm a physician,

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<v Dr Moira Junge>but physician heal thyself. I actually just had to take

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<v Dr Moira Junge>my medicine and put into practice the CBT-I principles that

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<v Dr Moira Junge>I've taught for many many many years now. We've actually

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<v Dr Moira Junge>just developed a new Sleep Health Foundation fact sheet that's

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<v Dr Moira Junge>available now. We'll put the link to that in our

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<v Dr Moira Junge>show notes that outlines basically what I did. Do you want me to tell you what I did?

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<v Dr David Cunnington>Absolutely.

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<v Dr Moira Junge>One of the most important things for me was to

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<v Dr Moira Junge>limit my media exposure because I'm just devouring the media exposure about COVID-19.

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<v Dr Moira Junge>Because as a business owner, as a parent, as a

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<v Dr Moira Junge>concerned citizen, I really want to be up to date

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<v Dr Moira Junge>but I realize that I have to really limit that

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<v Dr Moira Junge>and only go to the official sites. So I actually

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<v Dr Moira Junge>recommend the www.health.gov.au because the rest of the media reports

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<v Dr Moira Junge>are just too conflicting. Have you noticed, it's just too conflicting and there's just too

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<v Dr Moira Junge>much uncertainty. So for me I just have to go

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<v Dr Moira Junge>with what the actual requirements and guidelines are right now today.

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<v Dr Moira Junge>The other thing I found really important that I've taught

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<v Dr Moira Junge>all my life and realize how much I needed to

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<v Dr Moira Junge>do it myself is unwinding. So spending that time relaxing

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<v Dr Moira Junge>doing other things other than looking at COVID-19 reports. Also

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<v Dr Moira Junge>I thought was super important to keep up my fitness

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<v Dr Moira Junge>and I've got my whole family onto that too that

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<v Dr Moira Junge>we are really clear about our exercise every day and

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<v Dr Moira Junge>eating sensibly. There's nothing open anyway so there's no need

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<v Dr Moira Junge>to be drinking too much, so we're actually just really really

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<v Dr Moira Junge>white hot onto the three pillars of health of exercise,

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<v Dr Moira Junge>our diet our sleep. Just prioritizing those three things to

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<v Dr Moira Junge>keep our immune system healthy but also to keep our mental

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<v Dr Moira Junge>health functioning well because there's a lot of angst in

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<v Dr Moira Junge>our household like around the world. I also have really

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<v Dr Moira Junge>got into making myself remind myself of the importance of

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<v Dr Moira Junge>meditation and I can't stress that enough. To me it's

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<v Dr Moira Junge>like the insulin for the diabetic at this time. I

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<v Dr Moira Junge>just have to fall back and lean into my meditation

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<v Dr Moira Junge>to actually make sure that I keep my levels of

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<v Dr Moira Junge>hyper arousal reasonable and make sure that I don't go

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<v Dr Moira Junge>over that threshold to sleep poorly. I really need my

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<v Dr Moira Junge>sleep more than ever.

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<v Dr David Cunnington>It's a really good point about the meditation and I've

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<v Dr David Cunnington>been a bit more proactive about that as well because

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<v Dr David Cunnington>often if people aren't sleeping well they'll conceptualize it as

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<v Dr David Cunnington>'the answer is I'm going to fix this by doing

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<v Dr David Cunnington>something about sleep' but in stressful times like this the

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<v Dr David Cunnington>answer is more about self care and managing worries during

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<v Dr David Cunnington>the day. So really important to be proactive about managing

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<v Dr David Cunnington>worries throughout the day and there's a lot to worry about.

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<v Dr David Cunnington>People are also going to sleep shorter because that's actually

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<v Dr David Cunnington>pretty common when we're uncertain of things for adrenaline levels

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<v Dr David Cunnington>to be higher.

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<v Dr Moira Junge>Bed restriction and sleep restriction are core components of CBT-I that we've talked

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<v Dr Moira Junge>about a lot. I made sure that I practice it myself.

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<v Dr Moira Junge>I had to be realistic about just staying up as

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<v Dr Moira Junge>late as possible with my unwinding period mind you and in

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<v Dr Moira Junge>dim light to make sure that I could actually have

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<v Dr Moira Junge>that higher level of sleep pressure to make sure I

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<v Dr Moira Junge>could initiate and then maintain my sleep better. And if I wasn't

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<v Dr Moira Junge>sleeping well that I did go to another room, waited to be

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<v Dr Moira Junge>tired and sleepy. Did some reading. All the stuff I've taught.

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<v Dr Moira Junge>So glad I actually know how to do this stuff. It turned back

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<v Dr Moira Junge>very quickly within a matter of just a day or two.

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<v Dr David Cunnington>And that's what the research shows. Those two techniques sleep

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<v Dr David Cunnington>restriction stimulus control are really powerful strategies for getting sleep back

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<v Dr David Cunnington>on track by changing behavior around sleep.

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<v Dr Moira Junge>It really helps build that empathy as well. You really

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<v Dr Moira Junge>need to understand how bad it can be for people

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<v Dr Moira Junge>and just to really understand t his is the strategy

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<v Dr Moira Junge>I'm going to do. It's so important when you are

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<v Dr Moira Junge>out of the bed waiting to be sleepy and tired that you are in dim light and you

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<v Dr Moira Junge>don't monitor the clock. It's very important. Just do not

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<v Dr Moira Junge>even buy into what time it might be and what

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<v Dr Moira Junge>you what you are missing or calculating all that sort of stuff. The final

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<v Dr Moira Junge>point I wanted to make was that it's really important

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<v Dr Moira Junge>to manage your fatigue. Even I didn't get much sleep it

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<v Dr Moira Junge>doesn't mean that it is the end of the world or mean I wouldn't be able to function well the next day.

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<v Dr Moira Junge>I've been making the use of having little naps if

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<v Dr Moira Junge>I needed to and even though I had a coffee,

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<v Dr Moira Junge>actually having appropriately timed caffeine to help manage my sleepiness

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<v Dr Moira Junge>and my energy levels. So that was really important. I

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<v Dr Moira Junge>also have been right on to following my psychological society's

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<v Dr Moira Junge>fact sheets on things like how to manage distress in

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<v Dr Moira Junge>the time of coronavirus and also Beyond Blue which is our

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<v Dr Moira Junge>leading national advocate on mental health. They've got good resources on mental health and we'll put

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<v Dr Moira Junge>both those resources in the show notes.

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<v Dr David Cunnington>Thanks for that discussion Moira. Just to try and tie

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<v Dr David Cunnington>things together. The key points for people who are having

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<v Dr David Cunnington>trouble with sleep for me is expect sleep to be

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<v Dr David Cunnington>different. Our day times are very different. This is a very

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<v Dr David Cunnington>uncertain time and we're all going to be feeling somewhat anxious.

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<v Dr David Cunnington>So in those circumstances expect sleep to be shorter, to

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<v Dr David Cunnington>be waking more, for sleep to be lighter and change

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<v Dr David Cunnington>your behavior accordingly maybe by going to bed later. Not

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<v Dr David Cunnington>be so concerned if you wait during the night and

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<v Dr David Cunnington>if you do wait during the night don't be afraid

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<v Dr David Cunnington>of getting up doing something else until you feel sleepy

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<v Dr David Cunnington>before you go back to bed. What about for you Moira?

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<v Dr Moira Junge>I think the overall management of your self care, your

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<v Dr Moira Junge>stress management is really important and I think that the

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<v Dr Moira Junge>keeping the three pillars in check making sure you do

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<v Dr Moira Junge>have plenty of exercise and that you're eating well and

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<v Dr Moira Junge>that you are prioritizing sleep at least allowing time for

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<v Dr Moira Junge>sleep and rest in this sort of uncertain time. I

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<v Dr Moira Junge>think these are the key things that will help bring

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<v Dr Moira Junge>people back on track to actually just improve their sleep.

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<v Dr David Cunnington>If you are having trouble with sleep despite accessing the

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<v Dr David Cunnington>good resources like the Sleep Health Foundation fact sheet that

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<v Dr David Cunnington>we'll link to, remember that healthcare providers are still working

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<v Dr David Cunnington>during this time and are available. Providers like myself and

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<v Dr David Cunnington>Moira have worked very hard to shift our consultation services

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<v Dr David Cunnington>online so that we're available for people throughout this period,

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<v Dr David Cunnington>which is going to be a challenging period and cause

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<v Dr David Cunnington>changes with sleep for many people. Thanks very much for

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<v Dr David Cunnington>your insights Moira and for contributing to this episode.

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<v Dr Moira Junge>Thank you very much Dave. Thanks for organizing it so

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<v Dr Moira Junge>promptly and I just want to say just best wishes

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<v Dr Moira Junge>to everyone.

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<v Dr David Cunnington>Thanks a lot.

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<v Voiceover>This podcast is not intended as a substitute for your

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<v Voiceover>own independent health professionals advice, diagnosis or treatment. Always seek

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<v Voiceover>the advice of your physician or other qualified health provider

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<v Voiceover>within your country or place of residency with any questions

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<v Voiceover>you may have regarding a medical condition.