Cathy Cave: Hello and welcome everyone.
Today we have our webinar on Science of Sleep, it's out third in the series.
My name is Cathy Cave and I am the Co-Director of SAMHSA's Program to Achieve Wellness and
I am going get us started today.
The views expressed in this training do not necessarily represent the views, policies,
and positions of the Center for Mental Health Services, the Substance Abuse and Mental Health
Services Administration or the U.S. Department of Health and Human Services.
Again, this is our Science of Sleep webinar series, module 3, putting it all together,
sleep habits, rituals and routines for health and wellness.
Our presenters today are Dr. Peggy Swarbrick who's a Senior Consultant for SAMHSA's Program
to Achieve Wellness and we have contributions from Joshua Calarino.
I'll turn this over to our presenters.
Have a great workshop.
Peggy Swarbrick: Great, thanks Cathy.
I'm really excited to be back again today in this third module in this series, the science
of sleep.
Today, as Cathy mentioned, we're going be really looking at putting it all together
and today, Josh and I will really try to highlight some of the things that have been in the previous
modules and then we're going to introduce some ideas around sleep habits, rituals, routines
and really the importance of how we can look at in terms of our goal being to define aspects
of sleep and we're going to talk a lot about this idea of sleep preparation, something
you can have control over, as well as the habits and rituals that often can really help
us to get a good night sleep or look at the ones that maybe are getting in our way.
Really the big piece will be defining these aspects of sleep.
Really then also discussing, really essential, the importance of sleep for good mental health.
Just can't underscore that enough and hopefully by the end you'll at least see, at least two
strategies, if not hopefully more, for improving sleep patterns and routines.
As we go through this session one of the things we're going to highlight is that we're going
to be talking a little bit about some of these ideas but we're also going to be encouraging
you to use the chat function.
As Cathy mentioned, I am the senior consultant for SAMHSA's program to achieve wellness but
I also have many, many years' experience working in the field and in my life on this
issue of sleep.
Today where I'll bring some of the ideas, is from my work as an occupational therapist
in this kind of work, things that I helped people who were struggling with sleep challenges
but as well as things I have done for myself.
I'm going to direct us today to these additional materials.
We have really good materials here for you.
Now, this information, there's going be a link in the chat box that you can access this.
These two tools will be really, really good that you could go to and use that will really
maybe help you to pull some of what we're going talk about together.
There will be some materials and resources there from the National Sleep Foundation,
a really wonderful resource that where we did get a lot of information from the module
series as well as the place that you can go to
In this diary, this sleep diary and the sleep log are things that could take just a few
minutes to complete but they're really important tools that you can use to start to become
aware of, just like wellness is becoming aware of and making choices for our lifestyle, these
are tools that can help us become aware of aspects of our sleep habits, routines, rituals
and how we can start to make some change.
Use these tools for ourselves.
You can share these tools with other supporters.
They're great tools to bring to your medical providers and they really help us look at
the things you can think about, habits around sleep, these tools do.
They do say even on the website material, just changing one habit at a time is a path
to healthy sleep.
National Sleep Foundation is really ... The goal is to improve health and wellbeing through
education and these are great educational tools.
So we direct you to them as you want to think about, a tool that you can follow up with
as you leave this module training today.
So getting into the nuts and bolts, what is sleep?
We all know what it is because we spend so much time.
But there's a lot to think about dissecting sleep.
I think about it from my occupational therapy perspective and what we talk about in occupational
therapy is the activities that are related to sleep.
There's a series of activities that happen.
They're these habits and routines and rituals that we have as part of our lives or our day
or our hour in our day that really can help us to go to sleep and stay to sleep.
There are specific activities many of us do and really one of the things we know that
we've talked about in previous session was the idea about that health and safety through
participation in sleep involves looking at our physical and social environment.
So we had highlighted a lot about that, especially in the first module.
Really encourage you to go back to it but we'll bring some of it forward and really
we know what's been talked about over and over again.
Sleep is so important to our health and going to sleep and staying a sleep.
Getting that good night's sleep, getting into that REM, that stage of sleep as we've talked
previously, very, very important that can help our mental, physical, spiritual, social,
all the other dimensions of wellness can be affected significantly.
So we'd really think that this is an important area for mental health recovery and when we
move into today, one of the things we're going to be talking about as I mentioned was from
an occupational therapy approach to sleep.
As an occupational therapist, worked with people with a variety of health conditions,
particularly in mental health.
That's where I did a lot of my work, helping people with various mental health challenges.
The difficulties getting to sleep, staying asleep and how sleep interfered with people's
other valued roles, work, healthcare, being a partner, being part of the community, sleep
problems affected all other aspects of people's work, school, social community life.
So we as OTs take a look at this idea of sleep participation, that's that whole getting us
into sleep, staying asleep, getting that really good night sleep but there's this idea of
sleep preparation and I'm going to talk a lot about that today as well as the habits,
routines and rituals that we create for sleep.
With an OT perspective, we try to look at promoting optimal sleep performance, just
like you have optimal work performance, you can have optimal sleep performance.
Some of the things we're going to talk about is learning about how we can get that just
right amount of sleep that works for us or getting that deep sleep that helps.
There's a lot of things we can do around some of our habits, routines and rituals that can
really help that and we're going to look at that.
So really, a big piece of OT is helping people to establish that individual sleep hygiene
routines that really help you get to sleep.
So I encourage you, those of you who know about OT, this is really a big piece of where
we're highlighting today.
Occupational therapists are really very well skilled in this, but also peer providers can
do this.
It's a really self-care area.
So where we start off with the first idea of sleep preparation, thinking about sleep
preparation is taking care of those personal needs, those areas in our life that help us
to get to that point where we can then lay our head down and hopefully get into that
deep sleep that really as we said, it restores cells, it helps to get us recharged for the
next day to meet the demands of things in our life.
But really again on that cellular level, getting on a good night sleep.
So to be able to prepare, we want to be thinking about our environments, our physical environments,
our social environments, and taking care of our needs.
So thinking about those things that we do to take care of our personal needs to get
us into that habits and routines related to getting that, putting our head on that pillow
or wherever we put it down to feel well rested and get into that deep sleep.
It's taking care of our own needs and then again if we're working with other people in
our environment, it's negotiating the needs of others in our social environment.
So two things to think about, our own needs and those are a set of needs, the things that
we might do as well as other people's needs in our environment.
Again, it's not only the needs but what happens in that social environment around the interactions.
There's other people that might share the space or be in close proximity ... I'm thinking
of the word.
Close to our room.
They might be in another room.
They might be in the living room.
They might be somewhere around.
So it's being able to interact and negotiate those with people who are in shared spaces
or in spaces that are nearby the space that we're occupying to be working on our sleep
participation.
So really, be mindful of thinking of your needs, your own needs, the people around you.
How do we negotiate that and how do we figure out again getting to self-care, knowing what's
good for us and advocating for ourselves?
We might have to negotiate with people about things and the being able to know about monitoring
the comfort and safety of ourselves while sleeping and those things can sometimes can
relate to our needs or relate to those other things or put people or things in our environments
that might be influencing.
Again, we might be taking care of someone else, we might be a caretaker so that's going
to influence our sleep in certain ways because if someone's sick and we're taking care of,
we might have to be more of on alert and how do we negotiate that or figure out a way that
it doesn't get in the way of the sleep?
Habits that we need to get that optimal sleep.
So thinking about engaging in those routines that prepare for a comfortable sleep, there's
a lot of things related to grooming and undressing or getting the right kind of thing that we
wear.
Many of us have preference around what we wear.
It could pajamas or it could be sweat things or it could be nothing.
There's all different preferences around what's comfortable in our sleep.
So being aware of a knowing what that is and being able to do those activities that really
we know promote a good sleep.
For some people, it can be reading or listening to music or some kind of sound or some kind
of a thing that kind of gets us into that ability to get into that sleep.
It's like maybe having things around, saying something to someone, giving a kiss to someone.
There's lots of different things that people have that help get into that habit around
what they do to then really put them in that good physical and emotional state to be able
to fall asleep.
People sometimes have things related to prayers or meditations that they do.
So it's really knowing what those routines are and using them and doing them as much
as we can.
Sometimes it's having to negotiate with people to let them know what they are for us and
let them know what we're doing.
It's also preparing the environment for that time.
We want to prepare the environment.
We just don't think about that enough, making the bed or other sleep space.
We talked about that earlier.
Not having our computers and all the other stuff in there that might be related to our
work life or our school life or other kind of life.
Try to clear that stuff out of the way so we can make that space just right to meet
the needs that we have around getting into that sensory awareness that the sounds that
we need or that don't need and the things in those environments that might be triggering
for us.
So making sure the bed space or the sleep space is really in a way that it's going to
help prepare us for that period of unconsciousness and where our bodies can heal.
Again, looking at the temperature, the warmth and the coolness and that's also preferences.
Everyone has different preferences and as you age or your body changes, sometimes that
changes over time.
So knowing, having the right kind of sometimes that relates back to what we're wearing and
making sure or putting on the right kind of clothes to prepare for that so we don't wake
up in the middle of the night, we're too hot or we're not warm enough.
Getting that environment ready.
Then the safety concerns, depending on our situation.
There's security and safety concerns.
People many times who are dealing with certain trauma experience.
This is very, very important for helping people to think about that and getting their sleep
environment, that physical environment prepared for that period of time.
Things like, I've mentioned in previous, just looking at those electronic devices or lights
and related back to the previous slide, talked about the drawing the curtain.
I know for myself, the light was a big one that I really ... When I really use a lot
of these tools that we're talking about tracking and trying to figure out the right environments,
I really found it was really being in a hotel where that came to my ... That I really needed
to get the proper shades or blinds in my room to get me that room fully dark that enough
to be that right kind of sleep that I needed, in addition to a mask now, I use a lot to
help get out that stimuli because I'm very, very sensitive to that light, any kind of
light.
So again, sometimes it's a trial and error to figure out what's the right type of stimuli
or lack of stimuli we need to get us into that way of preparing to get to that good
night sleep.
But it's really, really important that we think about these things.
Again, those other factors.
Animals is one.
Not only partners but if we have animals, sometimes they're great for sleep too but
sometimes they can have their own rhythms that don't match with our rhythm and we have
to kind of figure out how to negotiate that as well.
So we think about them also in terms of sleep.
There's the preparation so that preparing what we do to prepare our self, prepare the
environment, dealing with people that's in it, that's really important.
Then there's things that relate to our sleep habits.
Habits sometimes are more automatic behaviors that are really often integrated into these
complex patterns.
We all have habits.
We have good ones.
We maybe have ones that we don't think are so good.
But there are really some sleep habits that many people have or can develop that can help
people to really engage in that sleep preparation process and then hopefully getting into our
deep sleep on a daily basis.
The one that we see hear, brushing teeth for many people, that's one that definitely is
part of a habit that people will do that really gets them into fresh space, that space in
their mouths or other things that they do related to that that makes them really feel
good that they can go to sleep or start to lay their head down and really feel fresh.
There's other things related to even just that one habit of brushing your teeth.
There's probably different ways people do brush their teeth.
There's different lengths of time people do, different things that people do.
They're all things that can actually foster some good night's sleep for us.
Again, sleep habits are so important to be thinking about especially the good ones and
there's probably a lot of them.
Some people have to have ... I just talked into someone this morning and she said about
she has to have a little snack before going to bed and that's part of her habit, whereas
for me, that's not one that's going to work but that works for her and gets her into that
good night sleep so she can get up and go to work.
There's also what we've talked about, sleep habits that can support our sleep, taking
a warm bath, having that snack.
Myself, it's getting that bath.
Going through a whole piece of the brushing the teeth but also a whole host of things
in the bedroom to do to prepare the bedding.
But then there's also things that can interfere with that.
Many people do report texting in bed or having the TV in the room, things like that, or habits
that sometimes interfere with their good night sleep or getting to sleep, keeping asleep.
There's also a whole bunch of other habits that we have in our, maybe in our evening
routine.
Sometimes you want to think about those habits that even start the minute you got in the
door, whether that's 5:00, 8:00, 9:00, that often can lead up to a good night sleep.
Sometimes, there's habits related to what we are reading or what we are drinking or
what we are drinking and chemicals that can influence our sleep.
So again, as you start to use these sleep diaries, sleep log tools, you might start
to see some of those patterns.
So we have talked already now about sleep habits, sleep participation and sleep preparation.
Now, what we're going to do is I'm going to turn it over to Josh who's going to really
give us some really good examples of some of the things that he's done and some of the
challenges he's had.
Joshua Calarino: Hello everyone.
My name is Joshua Calarino.
Thank you for that introduction, Peggy.
So within my own personal experience, a lot of sleep took a major, major toll on my mood
but more so on my mental health and that in turn took a tool in school and the classes
I was taking and friendships I had and things like that which only added to the toll on
my mental health.
The lack of sleep was, it just was not working.
I just could not function properly during the day.
I could not interact socially.
I couldn't work.
It was very, very bad.
So I needed to definitely find a way to get rid of that.
I took some time to really think about and it was that I was taking a lot of my stress
to bed.
Taking things like the friendships I had, all the schooling that I was not excelling
in due to my lack of sleep and everything, I was taking all of that to bed and I was
just tossing and turning all night and I couldn't do it.
It was just impossible for me at that time.
So what I decided to start doing was really take the time to sit down and figure out what
was going on.
I was trying to overcome my challenges and one of the ways that I started doing that
was making sure to block off time to sleep.
I would specifically set a time, whether that was 10:00, 11:00, anytime of your choosing,
I was able to set it for 10:00pm and I said, "At this time, I'm going to shut down and
I am going to bed and I'm going to stay in bed all the way up until say 7am."
It was always that time.
I needed to do that because before, I didn't have a shutoff button.
I will just keep going and going and going and I knew that I needed some way to slow
that down.
So I made sure that in my mind, in my body and my spirit that from 10pm to 7am, I was
off.
I was on off mode.
That also allowed me to make a ritual so that I knew that before 10pm that all the things
that I needed to do to be able to go to bed so my sleep preparation, my sleep habits,
everything like that was done and finished before 10pm.
So for me specifically, I would do a small workout.
I would then shower.
I would brush my teeth or I would drink water actually.
Water is very big for me.
Then I would brush my teeth and I would switch into my very, very comfortable pajamas and
I would go straight to sleep right after that and it worked every time.
But unfortunately for me, that just wasn't enough.
It's one thing to be able to block off your time and it's one thing to be prepared for
bed, but I still sat up at night and I would toss and turn due to all of the stress and
the anxiety that I was seeing for the upcoming day.
So what I started to do was using stress release tactics.
So what I did is that did deep breathing exercises.
The exercising beforehand would also help me release my stress as it has some stress
relief capabilities when you do physical exercise.
I would deep breathing exercises.
I would do prayer.
I would pray personally, some mild meditation and would be just going over and reviewing
my entire day and just really thinking about all of the things that I can try and do better
tomorrow.
That gave me a very good sense of relief and it really calmed my anxiety and really toned
down my mental health struggles and things like that and really, really allowed me to
be able to sleep more soundly at night.
That was my personal experience.
Peggy Swarbrick: Josh, we're going to hear a lot more from Josh as we go along, as well
as we're going to hear from you guys.
We've heard a lot of some amazing experiences, just really using these tools and really doing
that self-introspection and starting to take a look at what you would ... Josh, what was
going for you.
I think that what we wanted to encourage our participants is to think about the question
and Josh, you can highlight any of these things because you have many of them.
But as we are going to have in the chat box, we want to hear from the group what sleep
habits helped you to get a good night sleep and which ones are getting in the way.
So let's hear in our box.
Maybe we could start to hear what people are saying.
We'll from them.
Josh, do you want to just highlight what you have just said or anything else you wanted
to say about the sleep habits that have helped you get a good night's sleep or any that you
might want to mention about that got in the way of a restful sleep?
Joshua Calarino: I know that just to ahead and expand on that, one of the things that
got in the way was I've stated before that I live with my mom.
You had to share that space of sleep and wellness and having her in such near proximity and
having to plan around that as stated before was just really something that was in the
way.
Peggy Swarbrick: Can everyone start using the chat box and we'll see ... Okay, we've
had drinking night time tea and reading a book before bed.
We have there's glasses that screen out the blue light of a technology which can really
impact people's sleep as we mentioned and the person mentioned they can get to sleep,
making sure my bed is made before I get into the bed to sleep is a sleep habit they use.
So there's the tea, the reading, really preparing the bed, avoiding looking at the cellphone
or laptop.
Yeah, that's one that's definitely one that really again, some of the things in the first
webinar we went over, really highlighted some of the problems with that, using that technology
in the room where we sleep.
Anyone else want to share anything that gets in the way or something that's really helping
to get into good night sleep?
Prayer and a gratitude list is another one.
A cup of protein tea milk or turmeric milk helps.
Lavender spray.
So again, getting back to the other one, the sensory modalities, that lavender, some type
of smell sometimes that people talk about.
When I do the laundry and I put that down and that day that you do it, it really feels
good to go to a real clean, good smelling sheet.
Again, related to what Josh talked about, this one is essential.
Keeping that same bedtime and wake time on ... This one says one weekends as I do during
the week.
That's one, definitely the same time is so important and then for some people it's keeping
that consistent across seven days.
Some people can change it up to the Saturday and Sunday but I found that one also was really,
really important.
So we've got some great things coming in so keep ... We also asked you to think about
what are new habits you can adapt to get satisfying sleep.
So you might not be doing it but you may have done it in the past.
You want to be thinking about those things as well.
Joshua Calarino: If I can just mention for a moment, Peggy.
I know one of those for me, a new one that I've sort of adapted since the one that, since
the sleep habits I've described before was that I like the sound of rain calms me.
So I'll add maybe some small background noise of just some rain falling, some audio or things
like that or if it's raining outside, I'll take deep listen.
Peggy Swarbrick: Yeah, that noise.
That's really ... So again, as the habits that are helping us to get a good night sleep,
we have some really good ones.
Taking a shower before I go to bed.
A lot of people really talking about that, that technology being a challenge, some of
the things that are coming through.
Then you get these new things.
That's the one thing I love about working with people who in recovery and sleep in such
a big area, it's an area I've worked a lot for myself for other people.
I'm always amazed at some of the new things that people are saying that they trying or
really ... That you can learn so much from people.
Someone else is saying listening to a podcast Sleep With Me.
There's some really good mindfulness things.
I know a couple of peers who use a lot of the mindfulness tapes to help them to really
settle in that night routine.
So using that kind of technology can really help.
So great, we're really appreciative.
As we go along, just keep yourself, those of you, a lot of people only listening, we
will want to hear from you as well if you can share some of your ideas so keep yourself
attentive to the chat box because we'll be moving along as we go through.
So thank you so much for everyone.
Before we go, anything else you want to say, Josh, before we move into the next piece?
Joshua Calarino: Yeah, one quick it that I see here is someone said that exercising too
close to bedtime negatively impacts their sleep practices.
I think it's important to highlight and you said it earlier that there are differences
in everyone's sleep habits and their sleep preparation.
It's completely individual where exercise for me help me, for them, negatively impacts
it.
Peggy Swarbrick: Yeah.
Excellent point.
All of these things are so self-defined just like wellness is a self-defined process of
becoming aware and making choices for our lifestyle.
This is all self-defined.
It's all going to be personal preferences and our needs, our sensory needs, our biology's
are so different.
Again, the last one before we move is the great relaxation apps.
A lot of people again, say these things really help, those rain as you were mentioning Josh
or the waves and sounds can really help people quite a bit.
So a lot of great things that really help.
I know myself I got into a yoga routine now and I know the day and I know the yoga also
helps and the days I don't get to the yoga, I actually have ... I make sure I set aside
time at the evening to just do a couple of poses because it's definitely one that helps
with that winding piece.
So again, personally defined, building them into our routines.
But some really great practical ideas we have heard about in terms of people's sleep habits.
We'll move into this idea of rituals.
So when we speak about rituals, all of us probably have so many different rituals if
we really look at it.
I think it sometimes it seems better when you're younger, you can almost more identify
it rather than now, do I really have a ritual, you might think.
Is that just more of a habit or routine?
But rituals are things that really have a symbolic connection to ... It could be connected
to our spiritual side or cultural side or some aspects of social.
So there's symbolic action that's connected to this activity or this set of activities
that we do.
Again, rituals also become hard to break as well.
So they're good to get when you get a ritual in down, but if we have ones that are challenging
rituals, they're hard to break.
But they really oft can have a very strong component to it.
So we want you to think about many cultures have different rituals that may relate to
sleep.
So you may have that from your upbringing and you may have continued to do it or you've
maybe gotten away from it.
It would be important to think about, "Did I have something when I was younger that connected
to my culture, my spiritual, my side that I'm connected that really helped me?"
So we really want you to be mindful of that or was there something in the past or is there
something currently?
Again, a lot, a cultural or a ritual that many people have and I know probably, I know
myself, was like reading a child a book before, like so many people, that's part of what they've
done in their upbringing or they've had that happen for them or they do it now with their
children or their grandchildren or nieces or nephews, it's a ritual that often many
people who are ... Really helps with that whole preparation.
It's a whole part of that sleep preparation process.
So we want you to be thinking about that and thinking about putting into the chat box what
rituals have been important for you to get quality restful sleep.
Again, thinking about having that symbolic connection to the spiritual, cultural, social
meaning.
Joshua, did you want to say anything about that for you?
Joshua Calarino: Yeah, like I said earlier, one of my sleep rituals was actually both
prayer and some meditation.
I would pray and then I would meditate right after it and that was ritual that helped me
out tremendously.
Peggy Swarbrick: Yeah.
So for other attendees, we encourage you.
We have another routine here that someone put in I'll mention about washing face with
warm cloth and then doing a body scan when I get into bed and listening to the radio
or speaker tape that's playing softly, softly playing.
So that sounds like another ritual, a routine that someone identified that looks really
a good one.
The prayer, the meditation as you've been mentioning.
I encourage everyone else to kind ... Let's hear what your rituals, sleep rituals that
you have that's important for your quality sleep.
Again, reading some of them.
Some of them are still on the habit, on the habits that we had before.
Warm showers.
Spray sheet with lavender spray, read a book.
Really excellent habits people use as part of their sleep preparation and warm bath,
yeah, those are really ones that many people say are really important, like really cleaning,
that temperature really help into lying down the body.
Someone wrote that they have a prayer they do every night and they've done the same one
for over 10 years.
When I don't, it makes me feel weird and that's the first thing they'll do in the morning.
So really, yeah, having prayer, meditation, something that you read, sleeping, it really,
really be something that could be really helpful and especially when it's really connected
into some kind of a cultural or spiritual or social meaning.
It often has a very strong impact for us and so that's one of the reasons why we're encouraging
you to think about these things and just write them in the ... Into the box and we'll kind
of read them as we go along.
I'm reading again, someone talking about the comfort in the house and the thing about the
mattress too.
That was one of the thing that I wanted to mention that I forgot earlier is thinking
about your bedding.
So not only that preparing your environment and scanning the environment as you do your
sleep preparation things but also being mindful of the linen, sometimes finances can get in
the way but the quality of the bedding we have, as well as the mattress.
Many people on my work as an OT, we find sleep ... We help sleep aids and help props for
people to get a good sleep and sometimes the bedding, you have to be very mindful of the
type of the mattress because that sometimes could be contributing to some people's poor
sleep because the mattress is not being hard enough or being too firm and again that different
preferences.
So we have a lot of different things that have been coming through and again some different
routines that people are highlighting.
It's great to see that people are writing in the box so we encourage you to keep doing
that.
We'll move it along and we'll probably go back and maybe even Cathy at the end might
take up on a couple of them but I'm going to move it along a little bit to the routines.
So when we think about the habits and rituals, how to get strung into a routine and they
become that pattern, that's really going to be really, really something as you start
looking at this clearly and start to think about the ones that you really want to keep
or the ones you want to get rid of or you want to eliminate.
Seeing how they come together to help support our good night sleep.
Really important again, I think one of the things just as great when you told the story
and we'll show it at the end is you start to think about the time to get there and the
time to end it.
So always having that bookends on the timing around.
I'm going to get to sleep by this time and I'm going to get up by that time.
That becomes two markers.
But then it's those things before that period where you get, okay, so it's the 10:00 time,
those routines before then that we want to be mindful of.
Then again, it doesn't just end when you wake up.
There's probably a series of things that when we get our foot on the floor that we want
to be thinking about as routines that are really going to help prepare us for a good
day.
So really want to be thinking more about these habits, routines, rituals, again, how they
really help us with putting into sleep participation activities that we ... Preparation activities
that can help us to get a good night sleep.
So again, we're just going to come back to that we've been highlighting, so important.
So the need for sleep routines, the sleep preparations for people who have identified
with mental, serious mental illness is so essential.
As you can see, a lot of the literature shows the significant challenges.
There's a lot of literature and there's so much of our lived experience that we know
from peers that will work in such an important area that we can help people.
So we want to note that establishing routines can really help people.
Helping people to really find ways to start to develop and putting in some of these strategies
into the light is really going to be helpful and there's a lot of evidence that does work.
We have lots of researches that we are sharing about the literature that's been looking at
these studies, that has been looking at this, but we know from lived experience, you've
heard from Josh.
I have some experiences and a number of people working with through many long years, this
does really work when people take a look at these.
There's a lot of studies that show that many people living with many different illnesses
can really improve functioning, functioning in school, work, social life, all of the areas
of our life when you develop daily habits, routines for sleeping.
Really focusing on the sleep.
We have also studies that show that when we help people with health stuff management,
when especially around sleep can help empower people who are discharged from in-patient
facilities to get that sense of normality, helping people to get those routines and help
people to take them into their life.
That's one of the things that happens is when people go into the hospital, they might get
to sleep.
We don't spend enough time helping the person figure out, okay, what's happened in this
hospital that might help you and translating that into the home environment.
So a big area for our own personal education, our own advocacy, our own recovery, as well
as the field.
How are we helping to have these dialogs with people and not just go into pharmacological
way to answer the problem because as mentioned previously, that becomes even a bigger problem.
So there are significant studies that are showing.
Another piece of a study because people want to know, okay, what's the evidence of those.
We know we are evidence that these experiences are really valuable and a lot of the things
we saw on the chat box, these are working for people.
Sleep quality is really a cornerstone in promoting wellness and self-management.
There's a really, really, really good study that we referenced here by some folks at Yale
that really is highlighting about improved sleep, diet and exercise in adults with serious
mental illness.
It was a pilot self-management intervention there's a very ... The variety of these interventions
or programs that are being developed that are really looking at this as an area that
can help people's mental health recovery and help people to do deal with symptoms and manage
their life and getting to the recovery that they want.
So this is just an example of a study by Timothy Schmutte, Larry Davidson and Maria O'Connell
that really just shows that teaching people sleep and self-management around sleep, because
all we're talking about today is self-management strategies, can really, really help people.
So that's some more of the evidence.
So we want to just get back to hearing a little more about you guys who are listening here.
What sleep routines are helping you get a satisfying quality sleep?
We've had a couple of them come in already that we've heard.
One person answered a really good one, I like this one too because I tried it sometimes,
is getting it all set on Sunday, like really thinking it ahead, not only the night before
but the week before, getting on Sunday, preparing a lot of these things out for yourself, meals,
planning exercise based on what that week looks like and then starting to manage them
along the day.
That's what the person has mapped out, a great, great strategy.
Looking at some more.
Oh, a really good one for routines again.
People highlighted that hasn't been mentioned yet.
But alarm, that alarm, sending that alarm maybe to remind you to get to bed or to wake
up on both ends.
It can really help.
Someone wrote, I am struggling to stay asleep at night.
Maybe Josh, you had talked about that.
Maybe you want to mention something about that.
Joshua Calarino: About my sleep routine?
Yeah, I mean-
Peggy Swarbrick: Someone asked, I struggle staying asleep at night and you mentioned
that in your story so maybe you want to highlight some things from that.
Joshua Calarino: Yeah.
I was incredibly introspective with myself when it came to having trouble staying asleep
and the whole tossing and turning and the amount of stress.
Again, this is very individual.
But one thing that I did was really, really sat down with myself, I mean, really thought
about, like what is going on with me and looked into all aspects.
I'm trying to figure out what is causing me to wake up at night, right, asking myself
those questions and really digging for an answer and then finding it and being able
to address it that way.
You can also try and just adjust what it is you're ... Or either make a sleep routine
if you don't have one and if that still doesn't work then try and adjust till you find something
that really fits your bill.
Then if that doesn't work, then again, you can really try and take some time to be introspective
and really figure out what it is that is keeping you up at night or waking you up at night.
Peggy Swarbrick: At the end, we'll highlight about the dairy as a log.
You might want to start to use that a little bit and track yourself over seven or 14 days.
That might also help.
It's using those tools yourself but sharing them with people as well.
So thanks Josh for putting that.
People, want to send your comments to all participants because a lot of them are coming
directly to Deanna and folks.
I'm just so wonderful to see these stuff.
I can't even keep up with reading it, some of these.
What we're going to try to do is put them together and share them with you because I'm
just amazed with some of these wonderful things people are saying.
Some of the things are similar but some of them are very specific and really people highlighting
things around meal prep, things like that, so we really want to hear more.
The temperature things.
One person I did want to mention before I move is the idea about, someone mentioned
there, a diabetic, so again when you have another medical issue, making sure I don't
forget my insulin at dinner and bedtime and not drinking a lot of water after 7pm.
When you have something else, making sure those other things start to come into your
sleep preparation routines and habits.
So making sure think about that and building that because it definitely can really affect
our sleep.
So again, bringing it in, I'm going to move to a few things and then we're going to start
to wrap down.
But establishing that bedtime habits, routines and rituals, this can start again as I mentioned
from the time you walk in the door from wherever you are, if you're in a program, school or
work, volunteering, whatever it is you're doing, trying to start that, you start to
really think about those things because they can really have a very positive and or negative.
Again, you're having fights with people, you're bringing your stress home from work, things
are going wrong in the house, the house is not in the way that you want it, they can
all affect that and we can take ... Start to chip away on it slowly by slowly and it
really can make a positive effect on your getting that good night sleep.
I do want to highlight something here that might ... Again, this kind of really summarizes
a majority of what we've talked about here today, to start to help you think about this
for yourself.
You've done some great job with what you've been writing out there.
Start to think now for yourself, what is that and we did break it out, weekday versus weekend
because that can differ for people.
Some people mentioned they want to keep it consistent, someone like myself.
But other people break it out.
I know earlier in my life, I broke it differently.
I gave myself a lot more sleep on the weekend but as I get older, I don't seem to need as
much sleep.
I don't know why.
But that's just, I have to accept that for myself.
But knowing when it is and start to figure out when it is that works for you and I'm
going to go to bed by this time and I'm going to wake up by this time, you start to set
that natural body clock and our body clock affects our whole other parts of our body
system.
So real important to think about what's that good amount of sleep and then start to map
out here for yourself what are some of the habits, what are some of routines, some of
the rituals, even if you just after the webinar just start to map this out for yourself, look
at it, see what's going well or what you want to improve.
You can start to make that small step since that's what it says on the sleep foundation,
just one habit at a time can really influence people's getting a good night sleep.
So this is just a resource we have here that we wanted to mention.
I did want to highlight rest.
Now, resting is important.
I'm usually someone who I don't want to start to rest because then my body is going to slow
down but then when I started to meditate or rest or just take that little, two, three,
five, seven, 10 minutes to rest has a really important effect.
So rest can help sleep even though we think we shouldn't stop and you see someone ... Like
their father use to just shut his eyes and they say, "What are you doing?"
"I'm getting my eyes a little break."
Well they had to rest.
Quiet and effortless action that can interrupt physical and mental activity.
Just think about the value of that when we're really stressed.
Can we stop it and get into a relaxed state just for a few minutes?
So finding ways to rest or build in rest and basically there was an interesting ... There
was a Dr. Bill Anthony who was a very, very noted person in the field of psychiatric rehabilitation.
He was a wonderful man.
He is a wonderful man.
He wrote some books on the art of napping and really good books and just wanted to mention
that, because it's rest.
Take that rest.
Take a nap.
We do it as children.
It helps our development.
Maybe as we get older, we can take that rest or we can take that nap and we knew that it
does ... Just thinking about adding a few minutes of rest into our day how that can
help.
A couple of people, people can't do it at work.
But I think even just having that rest, breaking away, getting out, going under a tree somewhere
and resting could be something we might think about trying to do.
So we've done a lot of information today.
I'm going to hand it to Cathy to help us with the Q&A.
Cathy Cave: Can you hear me all okay?
Joshua Calarino: Yeah.
Peggy Swarbrick: Yeah, great.
Cathy Cave: Thanks.
Thank you for that information.
Josh, so great hearing from you as well.
Just wanted to comment on one of the things that came up around kind of knowing ... Having
someone comment on knowing that the TV is bad for me but that the background noise is
really important to kind of help manage anxiety.
So I really wanted to offer a couple of thoughts around that in response to that.
Many of us have survived some really harsh experiences and due to trauma reminders may
have a hard time going to sleep and staying asleep.
The television for many of us can be comforting.
So a couple of thoughts around that.
Just to lower it as much as you can so that if commercials come on while you're sleeping
because often commercials can be louder than a television show.
They can wake you up once you've gotten to sleep.
So adjust the volume as much as it best supports your sleep.
Then to also think about other sounds that might be useful and trying out ... Peggy,
there was something you said about chipping away at it, trying a new thing and then a
new thing and a new thing.
So it may take a while to find kinds of sounds that are soothing and comfortable.
For many of us who have sound machines, they have many different kinds of sounds.
So trying what might work and testing that out.
Peggy, there was something that you also spoke to around having pets that sleep with us and
pets can be great.
We had to train our dog to sleep with us at the foot of the bed because in her ... She's
great.
She's a great comfort but we have two cats and everybody likes to be in the bed.
Once we trained her to stay at the bottom of the bed, I actually got more sleep because
she wasn't waking me up trying to get to the pillow or trying to ... I might turn over
and I can't move the covers so I end up being more awake.
So it's really thinking about, I like the way you said it, the pet's routines often
don't match with ours.
So trying to figure that out.
But with a little bit of training, it really did change things.
As someone who has survived childhood trauma, having my pet in bed really does help.
Routines that folks talk about in terms of habits and the routines that would ... They
get to be regular practice and can enhance what we do.
So as, again, someone who has had some adverse experiences, walking around my house at night,
there's the routines I have that are about taking care of my pets, do they have water,
have they all been out, that kind of stuff.
Then there's making sure that the blinds are drawn and the doors are locked and windows
are secure.
There's a window that I like to have open a little bit, I might open that.
Make sure that I feel okay about that.
Then to put that together with a thought or a meditation or a text to a friend that says,
"I'm in for the night and thank you."
So it's wanting to put together the ways that the routines and the habits and our rituals
really can come together in a way that supports sleep better.
Thank you for covering all that ground today.
Peggy Swarbrick: Any other questions from anyone or any other thoughts that people in
the last couple of minutes?
Cathy Cave: A couple of folks asked for copies of the PowerPoint.
Absolutely, materials will be made available for download.
Peggy Swarbrick: It looks like it's mostly people just giving fantastic ideas.
I mean, I'm seeing a lot of not necessarily questions but things that people are responding
to the questions we asked along the way that are wonderful strategies that people are using
for the sleep preparation, the sleep participation kind of activities are just wonderful.
Again, we have highlighted, this is such an important area for our like I said, as you
work, its part of one of our occupations.
Occupations we think about is work but sleep is an occupation that is such an important
one for all of those other areas in our life.
Again, it's going to help us so much if we could just kind of start to think about some
of these things and as we talked about many of these resources we have, I'm going to move
to that in a minute, but we have references at the end.
I thought they were there but we have some really good references you can go to as well
as the resources.
So do it for yourself.
You can use some of these diaries and exercises for yourself but then also get some feedback
for people to share, to process it with people, other people, whether it's a peer supporter,
an occupational therapist, a therapist, a family member, share it with people and again
they could also help us to empower us to make some of the changes we want and or maybe get
some of the resources we might need.
Sometimes it means just getting a resource or making that alteration off the blinds or
stuff.
These things do cost money and might cost having someone come and fix that for us.
But I think that once we get some of these things that we know for us just can really
go a long way to really feeling much better and having a better quality of life.
Someone also highlighted a big area working with moms, new moms and sleep is just such
interrupted area of their life, when people have a child, they have a wonderful new addition
to their life but then the sleep habits of the child become ... Or such that the mother,
the new mother and again that's definitely an area ... If someone ask for ideas, we don't
have one definitely for but a lot of times the respite for them is going to be critical
because sustained sleep interruption is going to be very challenging for a new mother and
you see a lot connections to postpartum depression and stuff.
So there's some interplays there that might want to work within ... Maybe for the person
who's asking the questions that they work with new moms not getting normal sleep, there's
a lot of good postpartum depression resources perhaps in your local community that maybe
you could access.
I know in New Jersey we have quite a bit and it's a big area to help train, educate mothers
and train them.
So definitely in the area.
But yeah, we really want to thank everyone for coming on the webinar.
Before we end, I just want to see if Cathy or Josh want to say something before we close?
Cathy Cave: Thanks.
So just quickly, there is a comment about pain.
We talked a little bit about that in our last webinar.
But wanted to just touch base around acupuncture as something that help with both pain management
and with getting better sleep.
So just to offer that.
Someone had mentioned it in the chat box as a struggle that can sometimes challenge sleep.
Thank you all very much for your comments and thoughts.
Josh, anything for you?
Joshua Calarino: Yeah, well, one thing earlier I was talking about how that someone likes
to have the TV on and how it could also be distracting at the same time.
So one suggestion that we've talked about earlier that might help supplement that without
having the added distraction is maybe to do a podcast, right, so you still have the voice
but you don't have the blue light and all of that disrupting the circadian rhythm.
Also on top of that, someone had mentioned how they have issues staying asleep.
One of my, for a while, a sleep ritual of mine was ... My preparation for sleep started
essentially as soon as I'd wake.
I would wake up and I would do work on the morning, very deep ones so that by the time
that had already rolled around to 10pm, I was pretty much physically drained and so
tired that my body would just fall asleep for the entire not as well.
Outside of that, thank you very much for having me.
I hope we were a great resource for some of you.
Peggy Swarbrick: Great.
Thanks everyone.
We want to encourage you to complete the survey upon exiting the webinar.
We always use the feedback to improve the things that we're offering.
So we really appreciate any feedback and we definitely want to encourage everybody to
keep thinking about these ideas and writing them down; using the tools; and we hope everyone
has a really good night sleep tonight.
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