Exercise, diet and sleep

Exercise

There are no specific physical exercises that will help with your DPAFU, but there is a vast body of research that indicates that any physical, oxygen-burning exercise (i.e. anything that gets you out of breath) helps improve low mood, anxiety and stress. Exercise need not be expensive and you don’t need to join a gym. You can cycle, walk and run almost anywhere and they’re either free or relatively cheap. Local authority leisure facilities often offer reduced rates for off-peak times and/or concessionary rates. Many GPs prescribe physical exercise as a treatment for anxiety or depression, and these ‘exercise referral schemes’ also offer discounted rates. Many people who suffer with DPAFU report feeling better following a good workout and find swimming very relaxing. Sports where you need to concentrate hard (e.g. racquet or ball sports) will also be helpful in keeping your focus on your environment and giving your mind a break from worry and rumination. Try a variety of forms of exercise to see what works best for you.

Diet

People with DPAFU sensations don’t need to follow any specific diet or avoid any particular foods. In fact, people who suffer with DPAFU are like most other people; they report that when they’re feeling less than 100 per cent they have a greater need to eat a healthy diet including more fresh fruit, vegetables and fibre and to reduce the amount of sugar, salt and fats they consume. Of the 400 people who have participated in research at our Unit, there is no general consensus regarding diet. However, caffeine is a stimulant and in excess can mimic symptoms of anxiety. So if you experience anxiety in any form, reducing your caffeine intake may be helpful. Remember that caffeine comes in many guises; it’s in cola-type soft drinks and many ‘energy boosting’ drinks, as well as the more obvious coffee and non-herbal tea.

Sleep

As we all know, poor sleep can leave you feeling exhausted the next day. In turn, you’re more likely to feel ‘spaced out’ and/or ‘disconnected’. You may also find that your ability to concentrate is diminished. All of these sensations are very similar to DPAFU and you may have noticed that when you’re tired your DPAFU seems worse. Poor sleep patterns can lead to negative cycles of behavior. You wake up feeling tired so you have an afternoon nap; then you find it difficult to go to sleep at night. You lie in bed worrying about not getting to sleep, eventually dropping off in the early hours of the morning, only to get up again feeling tired – and so the problem continues.

Although the use of prescribed sleeping pills can work well in the short term for most people, their effectiveness can diminish very quickly. All too often in the past the dose was increased and increased until soon people were unable to sleep without taking a pill. Today GPs are less likely to prescribe them for the longer term because a vast amount of research has shown the risks of dependence with this type of medication. Generally people are encouraged to seek out more natural methods to improve their sleep. Luckily, there has been a lot of research in this area and some very effective techniques are around. There are self-help guides too that specifically address this problem, for example Overcoming Insomnia and Sleep Problems by Colin Espie.

If you’re having problems sleeping, you may find the following suggestions useful. However, you may need to put these into practice over a number of weeks before you see the benefits. Please don’t feel too disheartened if your sleep pattern does not right itself immediately. The key to success is not to give up and to give it at least two to four weeks to reset your sleep pattern. The only long-term remedy for poor sleep is to get into a positive cycle through a process of sleep hygiene. Here are some of the golden rules:

 

•   Don’t go to bed until you feel sleepy. Don’t go to bed just because it’s ‘bedtime’ or you’re bored. Stay up until you’re tired, no matter how late this may be. Prepare yourself for sleep by having a warm bath or reading a relaxing book. Don’t do anything remotely stimulating for at least an hour before bed, and don’t have any caffeine-based drinks (tea, coffee, chocolate, Coca-Cola) for at least two hours before bed. Over a few weeks, gradually limit your caffeine intake during the day. Avoid alcohol and nicotine for several hours before bed. Alcohol may make you feel that you can get to sleep quicker, but that sleep is likely to be of poor quality. You’ll wake up feeling tired and suffering the side effects of alcohol!

•   Your bedroom is for sleeping only. Don’t associate the bedroom with anything else. Try not to use your bedroom during the day. Don’t lie in bed and watch TV, listen to the radio or read, no matter how relaxing these things are. It’s okay to do these things if you don’t have a sleep problem, but when you suffer from insomnia you need to be strict about the activities you do in the bedroom. Instead, do these activities downstairs or in another room to help induce sleepiness. Sex is the only exception. Sex may help you to feel sleepy – especially if it’s at night.

•   If you’re not asleep within 15 minutes, get back up. You don’t want to associate your bedroom and your bed with lying awake. When we lie in bed awake, we often find our mind becomes preoccupied with all sorts of thoughts and worries. This can often leave us feeling more anxious, depressed or stressed. So when you get into bed to sleep, turn out all the lights. If you’re not asleep within 15 minutes, get up again and go somewhere else. Keep warm and do something quiet and not stimulating. This is a good time to try your relaxation, mindfulness or grounding image exercises. Or you could do something very boring instead such as the ironing or doing a job you’ve been putting off. Don’t drink, eat or smoke (smoking is a mild stimulant). Avoid associating this time with anything meaningful or pleasant. Only go back to bed when you feel sleepy. If you’re not asleep within 15 minutes, get up and repeat this sequence – all through the night if you have to. It might seem better to just keep lying in bed, rather than getting up every 15 minutes. However, research shows that the 15 minute rule will work if you stick with it – and normally within a few nights.

•   Get up at the same time each morning. This applies even if you only managed one hour’s sleep. Set an alarm and get up when it goes off. It’s important to establish a routine. You shouldn’t get up later than 9 a.m., even if you don’t have anything to do that day. Don’t make any exceptions – even for the weekend – when you first start.

•   Don’t sleep during the day. Stick to this rule no matter how tired you are. Don’t try to catch up on sleep; this will spoil all your hard work. If you find yourself feeling sleepy during the afternoons, go out for a walk, do some housework, or phone a friend instead. Don’t go to bed or nap on the sofa. If you need to re-energize yourself during the day, try taking several deep breaths of fresh air.

•   If you sleep too much, gradually bring the time that you usually get up forward by one hour per week. If, say, you’re sleeping until 1 p.m., then in week one set your alarm for 12 noon, and in week two set it for 11 a.m. Do this until you’re getting up no later than 9 a.m.

A word of warning! Be aware that you may feel worse and more tired when you first use these strategies. But don’t give up. Rest assured that it may take a couple of weeks to break many years of poor sleep habits but it is definitely worth persevering.