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Insomnia – Why the Drugs Don’t Work
I have several episodes a year where I struggle to get a decent nights sleep and these episodes may last from a couple of nights to a couple of weeks lost sleep. I generally am more aware now of the reasons behind my inability to sleep and this has helped me resolve my lack of sleep sooner, whilst leaving me feeling more in control of my insomnia too.
When we suffer from bouts of sleeplessness the usual term for this is insomnia. Insomnia is the inability to sleep well and can happen to anyone at any point in their lives and is one of the most common of complaints that people suffer from. There are three main types of insomnia. 1. An individual may have problems going to sleep initially; 2. they may have intermediate difficulties where they sleep initially but wake during the night 3. and lastly the individual sleeps during the night but wakes too early in the morning.
All three types can be short term or they can develop, if left untreated, into a habit – a faulty sleep pattern – which leaves the individual exhausted. I have been lucky that my insomnia has not developed into a long term problem. Once a poor sleeping habit is established, it can be incredibly hard to overcome, however not impossible.
So what causes insomnia?
There are numerous causes of insomnia and these may vary from episode to episode. Furthermore, there may be more than one cause too. However the causes of sleep problems may be categorized into three areas:
Physical causes – as the name suggests these causes are purely physical in nature and affect our body is some way. Examples include pain, hormonal imbalance in women, medical issues such as asthma, arthritis, high blood pressure etc
Psychological causes – these causes are linked to our emotions and our mental well being and include anxiety, stress (both good and bad stress) and depression. A fear of death is a common cause of insomnia too.
Temporary events – these are things that affect us on a temporary basis and are not a permanent fixture in our lives. Examples include jetlag; an increase/excessive caffeine or alcohol intake; poor sleep habits (getting into the habit of staying up too late); a poor sleep environment (a warm room etc)
So how can we overcome or rectify insomnia?
Many sufferers turn to sleeping pills or barbiturates to overcome their sleep problem as it appears to be a quick and ‘painless’ solution, however these are not natural methods and involve taking drugs. Furthermore, these drugs may get you to sleep but they don’t cure the condition. The cause of your insomnia has not been located and dealt with which could mean that when you stop taking the drugs, your insomnia returns. So obviously the cause of the insomnia must be treated to remove the symptom and knowing what has caused the condition is a huge step in overcoming the condition.
So before we even consider what plan of action to take, it is important to determine the reasons behind your sleeplessness first. Once you know what has caused your insomnia then you can take the most suitable positive action to get you back into a regular sleeping pattern.
How do you determine what is keeping you awake?
We ultimately know the reasons for our poor sleeping habits – however if you are struggling to find the reason for yours, then ask yourself some simple questions such as:
o What was happening in your life when the insomnia first started? To check if there is a trigger to your insomnia and to check if it is still relevant at present. For example if you have just lost your job, then this could well impact on your sleeping pattern.
o Did you eat a large meal close to bedtime? Ideally you should not eat 2-3 hours before bedtime as digestion may interfere with sleep.
o Are you getting too much sleep? Are you sleeping during the day? Sleeping during the day will cut down on the amount of sleep needed during the night. Also you may need fewer hours at night than they think. An average nights sleep for an adult is 7 or 8 hours. A teenager requires an average of 10 hours a night. Over 65’s require around 6 hours a night.
o Do you drink caffeine/alcohol before sleep? Caffeine is a stimulant and can keep you awake and still has an impact up to ten hours before sleep. Alcohol, in smaller doses, also acts as a stimulant keeping you awake initially. Alcohol (excessive) induced sleep is not ‘good’ sleep leaving you tired when you wake.
o Do you use your bedroom for any other purpose, such as work? If you do work in your bedroom you may well be creating the wrong association for your bedroom and this will need to be altered. You have to have a positive sleep related association to your bedroom and bed.
o Have you built up poor bedtime habits? Do you fall asleep in front of the television? Do you have very irregular bed times? If your problems are purely poor bed time habits, then you will need to change them and incorporate good bedtime practice.
o Have you developed an expectation of not going to sleep? If we expect not to sleep then it is pretty certain we won’t! We need to be more positive in our approach to sleep.
o Is the insomnia serving a purpose? Do you dread going to work in the mornings? Insomnia may be an unconscious way to keep you from the pain caused by your work. o Are you tense or anxious before bed? Tension and stress will keep you from sleep and you need to find some form of relaxation to overcome this.
o Are you afraid of dying/having nightmares/something awful happening during sleep? If this is the case then you will need some help to identify the cause of these fears and finding a good psychotherapist/hypnotherapist can help you resolve these issues.
Hopefully by now you will now have some idea as to the cause of your insomnia and this insight itself can have a great impact on improving your sleeping patterns. Once you become aware of the cause or your sleeplessness, you may be able to move on to help yourself in the most appropriate manner.
Psychological or medical causes
Some individuals may well be completely at a loss as to why they are experiencing problems sleeping well and if this is the case then they may need some advice or help. Insomnia can be due to many things but you must always be aware that it can be a sign that you may have unresolved medical or psychological issues, and it could be necessary to check with your doctor first before thinking about treatment.
If it becomes clear that there are no medical reasons for your insomnia it may be wise to seek some psychotherapy or hypnotherapy to see if you have unresolved psychological issues. A good therapist can help you resolve any issues you may have at an unconscious level and also get you back into a good sleep time routine. (If you do choose to see a therapist ensure that they are fully trained and regulated).
Examples of psychological causes of insomnia
As parents we tend to say and do things sometimes without too much thought for the impact they may have on our children. I remember being told as a child that I must not get out of bed because the ‘bogey man’ might get me and I remember being petrified some nights and not surprisingly this fear remained with me into early adulthood. My parents may well have thought that it kept me in bed, hence aiding a good nights sleep, however, unfortunately is had quite the reverse affect.
As mentioned earlier, the fear of dying during sleep factors in some cases of insomnia either on a conscious level (which could involve panic attacks in bed) or at an unconscious level, where the cause has long since been forgotten. Children are often told that a dead relative/pet went to ‘sleep’ rather than being told that they died. Some of you may well remember the childhood prayer below and when you read it – it becomes very apparent why some children and adults developed sleep related problems!
Now I lay me down to sleep
I pray dear Lord my soul to keep
If I should die before I wake
I pray dear Lord my soul to take
Some individuals may suffer from frequent nightmares or night terrors and these can obviously keep an individual from sleep in order to avoid such distressing dreams. Dream analysis or therapy can help uncover the ‘message’ of the dream, which are usually unresolved psychological issues.
Once the cause of the psychological conflict has been resolved then the cause of the insomnia has been dealt with and the insomnia cured. However some individuals may need to adopt a more positive sleeping habit too and the steps below, can assist them to get on the right path.
Some suggestions to assist in a setting up a regular sleep pattern to create a positive sleep habit. Some of these will be more relevant to you and some less depending on the underlying cause of your insomnia.
o You must in the short term ban anything other than sleep from the bedroom (even sex!) in order to re-associate sleep with bed. The mind will associate bed with sleep and this will encourage a good bed time habit. Once a good habit is formed, then the client can introduce other pursuits into the bed!
o Ensure you have the right environment for sleep – make sure your mattress, pillows etc assist in a good night sleep. Ensure that your room is at an optimum temperature – if the room is too hot or too cold this will interfere with sleep.
o Keep your room dark during sleep hours. Your body clock could be disrupted with early morning light/street lights so use black out blinds or curtains to keep the room dark.
o Ensure that you have a regular bed time – this creates a good habit. Also your unconscious mind will associate a certain time with bed and it will prepare your mind and body for sleep before bedtime – it will be literally be ‘winding down
o Build up a relaxing and comforting night time routine. Your body needs to prepare for sleep and wind down – so too much stimulation can keep you awake. Do something relaxing such as having a warm bath, reading, yoga, meditation and ensure you keep to this routine.
o Take up some form of daily exercise – this is good to release stress and toxins from the body which interfere with healthy sleep. (However refrain from strenuous exercising just before bed).
o Try yoga or gentle exercise before bedtime which can be relaxing and de-stressing – especially good if you feel tense and anxious before bed.
o Do something to help you unwind – a relaxing bath, yoga, meditation.
o Ensure that you do not eat a heavy meal or drink caffeine or alcohol 2-3hrs before bed time. (If you smoke then no cigarettes either!)
o A light snack before bed such as a piece of toast or banana can help along with a milky drink (no caffeine).
o It you wake or can’t sleep then try externalizing your thoughts worries etc as this can help clear and calm your mind helping it to focus on sleep.
o If you cannot sleep then get out of bed and do something else until you are sleepy – again this just reaffirms the association between bed and sleep.
o Use self hypnosis or a hypnosis CD. Relaxation CDs, visualization and meditation work very well too in helping the body and mind relax and prepare for sleep.
o The Law of Reversed Effort ensures that the more desperate you are to sleep the less likely you are to manage to get to sleep i.e. the more effort you put into it the less likely you are to succeed. So if you cannot sleep don’t try to get to sleep – it won’t work. Try reverse psychology. Tell yourself that you are going to stay awake and the harder you try to stay awake the sleepier you will become. (use self hypnosis here to give yourself suggestions such as ‘you will try to stay awake and the harder you try to stay awake the sleepier you will become and the harder you try to keep your eyes open the heavier and heavier your eyes will become’.
The more we worry about lack of sleep the more we will suffer from lack of sleep, so it is important to remain relaxed and positive about our approach to sleeplessness. We can all overcome our insomnia, by taking some simple but proactive steps to set up and maintain a regular and relaxing bed time routine. Being aware of the cause of our insomnia can help us treat it effectively by finding the right solution, even if that means seeking outside help or support to get you back on track.
Whatever the cause of your insomnia – the earlier you deal with it the easier it will be to resolve. So take control today and get the sleep you need.
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