Addressing Sleep Issues

Introduction

Sleep is a very important part of life and is particularly important in a supported housing environment. Lack of sleep amongst residents can cause many issues, both personal and communal, so it is important to grasp some of the issues that might affect residents in their sleep patterns. There is a great deal of information out there, including advice from the NHS on insomnia. This document is intended to illustrate an introduction into some of the common issues that we encounter, but if you need any more support do let your Partnership Manager know.  

Causes of Sleep Issues

There are a number of reasons why a resident might have irregular sleep patterns, including, but not limited to:  

• Stress, anxiety, or depression
• Mental health conditions such as schizophrenia or bipolar disorder  
• Neurological disorders such as dementia, epilepsy or Parkinson’s disease  
• Long-term chronic pain or injury  
• Diet and eating just before going to sleep  
• Lack of exercise
• Allergies and respiratory problems  
• Alcohol, caffeine or nicotine consumption, including energy drink consumption  
• Recreational drugs such as cocaine or ecstasy  
• Noise issues  
• A room that’s too hot or cold  
• Uncomfortable beds
• Shift work  
• Video Gaming - Staying up all night on a gaming console, mobile phone or computer
• Phone calls - Staying up all night speaking on the phone  

Sleep disorders can be broadly categorised into:  

• Insomnia: The inability to fall asleep or to remain asleep. May be a symptom of another condition. Causes include many of those listed above. Tends to be classified as one of three types:
  • Chronic - Happens on a regular basis for at least 1 month
  • Intermittent - Occurs periodically
  • Transient - Lasts for a few nights at a time
• Sleep apnea: Characterised by pauses in breathing during sleep. This is a serious medical condition that causes the body to take in less oxygen and wake up during the night. There are two types:  
  • Obstructive sleep apnea: Where the flow of air stops because airway space is obstructed or too narrow
  • Central sleep apnea: Where there is a problem in the connection between the brain and the muscles that control your breath  
• Parasomnias: A class of sleep disorders that cause abnormal movements and behaviours during sleeping, including sleepwalking, sleep talking, groaning, nightmares and bedwetting  
• Restless Leg Syndrome: The overwhelming need to move the legs. Often associated with health conditions including ADHD, and Parkinson’s disease
• Narcolepsy: Characterised by “sleep attacks” that occur while awake. Individuals suddenly feel extremely tired and fall asleep without warning. This can cause sleep paralysis, which may cause the inability to physically move right after waking up. Often associated with certain neurological disorders, such as multiple sclerosis.  

Advice from Green Pastures

If you have a resident struggling with sleep, have them complete the Sleep self-assessment found on this webpage.  

Health Causes

If any of the causes of sleep issues in residents fall under medical conditions, mental health issues or chronic pain, of course encourage the resident to visit their local GP to get proper medical advice.  

Behavioural Causes

If a residents' sleep issues are  a consequence of behavioural choices, such as staying up late playing video games or on the phone, we encourage you to have a conversation with the resident seeking to understand why they make these decisions. Help them to consider the effect that a lack of sleep is having on their own personal mood as well as their interactions with others in the house. Encourage the resident not to sleep with their mobile phone or computer directly by their bed (although we advise you don’t encourage them to leave their personal property in communal areas). If it is helpful you can limit the hours that residents are able to access the Wi-Fi network in the property. For more information on this you will need to consult your Wi-Fi router’s manual. More information on what some of our Partner’s have done below.  

Ensure that the residents’ living conditions are comfortable and that the residents understand how to regulate the temperature of their bedrooms if they have control over this. Keep a good hand on the noise generated by other residents in the property - don’t be afraid to use warnings and have consequences for residents who are creating excessive noise.  

Encourage good lifestyle habits including plenty of exercise, good dietary choices and not snacking or consuming caffeine just before bed. You could organise a daily exercise program for your residents and help them prepare meal plans for the week, or perhaps have a house agreement to only consume one energy drink or cup of coffee per day.  

Help residents to manage their anxiety and depression. This could include providing them with more opportunities to engage in hobbies such as gardening, or offering them the opportunity to be part of a Social Enterprise. You might lead some bible studies centred around meditating on God. As always, and if necessary, encourage your residents to seek medical advice if these issues are particularly problematic.  

You will of course be providing ongoing support for any substance misuse issues related to alcohol and drugs. Encouraging residents to access support for these issues will likely help them with any sleep issues caused.  

Issues due to gaming

One of our Partners had issues with their house that were not attending workshops and counselling. This became a problem over a number of weeks and not just a one-off.  It became apparent during a house meeting and 1 to 1’s that the cause was gaming too much and the residents not getting enough sleep.  

The partner as a result deemed the internet to be a luxury and not an essential service, so they restricted times internet was on to 7am-11pm and also stated that if things did not improve the internet would be removed.  Attendance was improved and residents re-engaged.  

Another partner had issues with the residents gaming excessively affecting sleep patterns.  The partner was also getting complaints from the residents that the internet was not fast enough for gaming.  Again times were restricted and as the internet is deemed a luxury and not a necessity the request for providing better wifi was denied.  

If you can get access to the router you can restrict the time and also certain equipment can be blocked, the Xbox for example. The Internet must be looked at as a luxury and not an essential service like water, gas or electric.  

General Tips to pass onto Residents

• ‍‍Go to bed and wake up at the same time every day
• Relax at least one hour before bed - for example, read a book
• Make sure your bedroom is dark and quiet
• Exercise regularly throughout the day, but avoid exercise within two hours of sleep  
• Incorporate more vegetable and fish into your diet and reduce sugar intake  
• Limit your caffeine intake, especially in the afternoon or evening
• Decrease tobacco and alcohol consumption
• Maintain a health weight  
• Don’t eat a large meal just before sleeping  
• Don’t watch television or use devices just before sleeping  
• Don’t nap during the day
• Don’t sleep in after a bad night’s sleep - stick to your regular sleeping pattern  
• Visit a GP if changing your sleeping habits has not worked, if you’ve had trouble sleeping for months or if your insomnia is affecting your daily life. There are numerous medical treatments for lack of sleep.