By Richard Shane, Ph.D., and Stephen James, Ph.D.
First responders experience enormous stress, from being in life-threatening situations to trying to meet society’s demands and expectations, in addition to working long hours and addressing organizational pressures and more.
It’s remarkable EMS providers get any sleep at night. And yet, good sleep is probably the single most important thing you can do to improve your job performance and increase your quality of life.
The effects of poor sleep
Research shows that poor sleep leads to increased risk of sickness, weight gain, obesity, diabetes, high blood pressure and heart disease. There is also the impact on our psychological health, which can lead to anxiety, depression, anger and irritability. Poor sleep impairs our ability to think clearly and causes increased reaction time and decreased energy and productivity; impairs personal relationships; and increases the possibilities of errors and accidents. The positive news is that good sleep can reverse almost all these damaging effects.
The impact of stress on sleep
Research shows that the danger and stressors of first responder work, combined with shift work, have a negative effect on the amount and quality of sleep. [1,2]
The many stressors of first responder work can make it difficult to shut off your mind when it’s time to sleep. This may make it difficult to fall asleep, or you may wake up too early and have difficulty falling back to sleep. Or you may not sleep deeply, so you don’t feel refreshed when it is time to start your day. When you don’t sleep well, you are then more prone to stress and the negative cycle spirals downward.
How to sleep better in the midst of stress
While lots of people talk about the importance of sleep, they often do not address how to get to sleep.
There are several body sensations that are like neurological switches for sleep. When you engage these body sensations in a simple way, this establishes a neurophysiological pathway that calms the mind, emotions and body, and sleep occurs naturally. Calming these specific body sensations associated with sleep is more effective and easier than trying to calm your entire body.
When people are stressed or anxious or their mind is very active, they usually try to deal with that in their mind and emotions. But mind and emotions don’t have a physical form, so trying to calm them can be like trying to chase a cloud – and that makes the process of change more difficult.
When you are stressed or anxious or your mind is active, there is almost always a corresponding tension in your body. You may have tension in various areas of your body, but we are selecting just a few specific body sensations that are like switches in your nervous system, that when you calm them, it calms your mind and emotions.
An important factor in this approach is you don’t have to try to initially calm your mind or emotions because that is the struggle that makes sleep more difficult. With this method, instead, in the midst of whatever is going on in your mind and emotions, you feel these few body sensations of sleep that create the body feeling of falling asleep and your mind naturally becomes quiet by itself.
For relaxation, people commonly use visualizing being in a peaceful place. However, a lot of times visualization is just another form of thinking. We need something easier. When your head is on your pillow, you don’t need to visualize your pillow – you just gently feel it. Similarly, with any of these simple steps, you don’t have to visualize – just gently feel the comfortable body sensations. If images come to mind by themselves, that’s fine. You just don’t have to create images.
If your mind wonders, “Am I doing this right?” realize just like there is no right way to drink a glass of water, there is no right way to do any of this. That can help relax any part of you that is perfectionistic. There is no right way to do any of this – your body will settle into its own natural way of feeling this.
You don’t need to concentrate. This is not meditation. If your mind drifts, gently bring it back to any of the comfortable body sensations of this process, but please do that without adding self-criticism about having drifted. For many people, when their mind drifts, they criticize themselves. With the steps below, gently bring your mind back to any of the comfortable body sensations without adding self-criticism.
If you need to swallow, or your mind drifts, or you are distracted in any way, simply bring your awareness back to the sleep process.
The first time you use these steps, you don’t need to have a deep experience. Even if you feel this just a little, as you continue to use these simple steps, they gradually lead to easier sleep.
Read the steps listed below a few times. Then close your eyes and feel the steps. Do this during the day without the intention of falling asleep. You will then be familiar with the steps and easily use them when you want to sleep.
Simple steps and hacks for improved sleep
There is no need to initially try to quiet your mind. In the midst of your mind being busy, feel any of the following elements:
- If your tongue is pressed against the roof of your mouth or your teeth, allow your tongue to relax and feel softer. If your tongue is not pressing, allow it to relax a little more. It can rest anywhere in your mouth, even lightly touching the roof of your mouth or your upper or lower teeth, just not pressing. Don’t make your tongue relax – allow it to relax.
- Allow your throat to have the feeling that happens when you yawn. Your throat can begin to feel more open. The inside of your lower throat can begin to feel softer. If your tongue or throat gets tense again, allow them to relax. Relaxing your tongue and throat helps your jaw and neck begin to relax.
- As you exhale, feel your chest move inward toward deep in your chest. That happens naturally every time you exhale. You don’t need to make that happen – you are feeling something that happens naturally. As you exhale, your chest moves inward toward deep in your chest. As you gently feel that, it flows a feeling of comfort to deep inside your chest, the area of your heart.
- As you exhale, your chest also moves a little downward toward your abdomen, softly flowing comfort down into your abdomen, gradually soothing and calming your abdomen.
- Your mind likes that feeling of calmness deep in your chest and abdomen and can rest in that feeling, like resting on a soft pillow inside you. It is like having a secret hiding place to go to inside yourself. Your mind becomes quiet because it’s resting inside you, not outside of you “flying around,” thinking about things in life. This feeling of comfort deep inside your chest begins to spread through your nervous system, calming your body, mind and emotions. When you use this for a longer time, you gradually ease closer to sleep. You can let go of the pressure to fall asleep or back to sleep very quickly because even if you are not yet all the way to sleep, you feel comfort deep in your chest and abdomen and rest in that. That feels good and healing, easing toward sleep. That reduces anxiety about not yet being asleep, which then makes sleep easier.
Using these steps, your intent should be not to achieve a great improvement in your sleep, but to enjoy the tiniest improvement in your sleep, as that removes any pressure.
References
- Neylan T, et al. (2002). Critical Incident Exposure and Sleep Quality in Police Officers. Psychosomatic Medicine, 64:2(345-352).
- Vila B. (2010). The Effects of Officer Fatigue on Accountability and the Exercise of Police Discretion in Candace McCoy (ed.) Holding Police Accountable. Washington, D.C.: Urban Institute Press.
This article was originally posted November 2, 2021. It has been updated.
About the authors
Richard Shane, Ph.D., is a world-renowned sleep expert with over 25 years treating serious sleep disorders and working with medical groups serving hundreds of thousands of patients, including police, firefighters and first responders, with whom sleep is more than a matter of health, it is a matter of sometimes life or death safety. His work led him to co-found Sleep Easy, which delivers digital and telehealth sleep solutions utilizing his Neurosomatic Patterning for Sleep (NSP-S). Learn more at sleepeasymethod.com.
Stephen James, Ph.D., is an assistant professor in the College of Nursing at Washington State University Health Sciences Spokane. His research focus includes the interaction between physical stressors such as sleep-related fatigue, law, policy, training, and practice relating to operational performance for military and law enforcement personnel. Dr. James strives to better understand the dynamics of performance in a wide variety of military and policing tasks, driving, citizen encounters, crisis intervention and deadly force encounters.