mental health

How to Trick Your Brain Into Better Sleep

It’s recommended that adults get seven or more hours of sleep each night. Unfortunately we live busy lives and often do not get the sleep we need. How many times in the past week have you joked with your coworkers about being tired? Or griped about a case of the “Mondays”? Feeling tired or that we didn’t get enough sleep is a pretty common complaint.

Poor sleep quality can impact our mental and physical health. When we are sleep deprived our thinking is slower and less efficient. We are more likely to make mistakes, forget to complete tasks, become distracted, and have trouble coming up with words. Sleep deprivation increases the risk of obesity, heart disease, and type 2 diabetes.

The simplest way to increase the hours we sleep is to go to bed earlier or get up later. Easier said than done! There are also many ways to improve the quality of our sleep, but they require work like getting regular physical exercise, eating a healthy balanced diet, sticking to a regular sleep routine, and turning off electronics like the computer or phone for several hours before bed.

Researchers at Colorado College might have found a way to trick our brains into feeling like we had better sleep without much work!

This research relies on a concept called the placebo effect. You’ve probably all heard about placebos before. The placebo effect occurs when there is an outcome that is not attributed to a specific treatment, but rather to an individual’s mindset about the kind of treatment they are receiving. In other words it doesn’t matter what’s in the medication. What matters is what you believe the medication will do. For example research shows that people given placebo pills and told they contain caffeine (when in fact they do not) have more energy and perform better on cognitive tasks.

Like I said research on placebo effects has now been applied to sleep. Christina Draganich and Kristi Erdal published an article in the Journal of Experimental Psychology in 2014 that demonstrated this concept. Here’s what they did in this study:

  • They asked undergraduate students to rate how deeply they had slept the night before on a scale of 1 to 10 (with 10 being very deeply).

  • Next, all participants were told that on average normal adults spend between 20% and 25% of their sleep time in REM sleep and that individuals who spend less than 20% of their time in REM sleep perform worse on tests of learning and memory.

  • Participants were then hooked up to a machine that recorded EEG readings (their brain waves) for five minutes. They were told this machine would help estimate their REM sleep the night before (which wasn’t true, the researchers made this part up).

  • Participants could watch their brain waves being recorded and they were told that their data was being automatically downloaded to the database.

  • Students in the study were randomly assigned to an “above average” or “below average” sleep quality condition. This group assignment had nothing to do with how they reported their sleep the night before, and nothing to do with their brain wave ratings, it was random.

  • If they were in the “below average” condition they next watched the experimenter calculate that they had obtained 16.2% REM sleep on a fake spreadsheet. If they were in the “above average” group they watched the experimenter calculate that they obtained 28.7% REM sleep on the fake spreadsheet.

  • Next participants completed a number of tasks that look at their ability to maintain attention, quickly respond to information, and quickly come up with words.

What they found in this study was that self-reported sleep quality didn’t impact performance on the cognitive tests. In other words, participants that said they had a bad sleep the night before didn’t do any worse than participants is said they had a good night sleep before.

What did impact cognitive performance was what participants were told about their fake REM sleep quality data. Participants who were told that their brain waves suggested they had below average sleep quality did worse on the cognitive tests than participants who were told they had above average sleep quality. Remember, these REM sleep quality numbers were made up by the experimenters. They had nothing to do with their actual brain waves or sleep quality.

What this study showed was that our mindset can impact our performance. If we think we had a good quality of sleep we do better on tasks in daily life. The opposite is true as well. The more we complain about how tired we are or how bad our sleep was the night before the worse we will perform in daily life.

In this way we can trick our brain into feeling more alert and performing better simply by convincing ourselves that we had a good quality sleep.

Try this for the next few weeks. Every morning when you get up think to yourself “I had a great sleep I’m going to feel rested all day”. See how you feel at the end of the two weeks. I bet you will feel better than if you had woken up each day and told yourself “I had a crummy sleep today is going to suck”. Our minds are powerful tools and have great influence over our body. This means we can use our mind and our mental strength to perform better and feel better in our daily lives.

Check out this link from the Mayo Clinic if you are interested in more tips to improve sleep quality.

Pain and the Brain: Is It All In Our Heads Part 2

Last week I introduced the idea that the brain and the body are constantly interacting. Changes in our mental and emotional health can impact our physical health. Changes in physical health can impact how we feel mentally and emotionally. One interesting example of this mind-body connection is pain.

We’ve all experienced pain before. From small daily pains like stubbing your toe or bumping in to a table with your hip, to more noticeable pain like breaking a bone. Our body is constantly processing signals from our environment and perception of pain is one of those signals.

Our experience of pain is a combination of neurological (brain) and psychological (mind) factors. At a basic level, there are specialized nerve endings called nociceptors in our tissues (e.g. skin, organs, bones, and joints) that are alerted when there is damage to the tissue that our brain perceives as pain. For example if you place your hand on a hot stove these nociceptors will perceive the damaged tissue and send the signal alerting your brain to danger. The signals travel from the site of the injury to your spinal cord, then up to your brain.

There are many parts of the brain involved in processing pain including sensory areas of the brain (to identify where the pain is in your body), motor areas of the brain (to respond to the pain), and the areas of the brain that process emotion and memory. Because these higher cortical areas involved in memory, emotion, and complex thought are involved in experiencing pain, our past experiences will impact our perception of pain. For example if you have touched a hot stove before and felt pain, the next time you see a hot stove you are going to react faster and maybe even before you touch the stove because your brain has learned to avoid the stove and the associated pain.

Touching a hot surface is an example of acute pain. Our brain is really efficient at reacting to acute pain so that we get away from the source of the pain (take our hand off the stove) and start to heal. This type of acute pain reaction is our brain’s response to danger and helps us survive.

Another type of pain is chronic pain. Chronic pain is pain that lasts beyond normal injury recovery time. For example say I fall and sprain my knee. The sprain heals in 6-8 weeks, but six months later I still have pain. The injury has healed but my brain is still reacting as if I am experiencing acute pain. This pain is an example of chronic pain. Sometimes the original cause of the chronic pain is known like in this example but often it is not. Chronic pain can develop gradually over time such as chronic back pain, or chronic headaches.

Like I said from an evolutionary perspective pain is beneficial. It helps us avoid danger and protect our bodies. However, in chronic pain this normal brain response goes awry. Because pain is partly a learned process, sometimes our brains can overreact to situations and interpret pain as more severe or more dangerous than it should be. Rather than becoming less bothered by pain over time as the injury heals, individuals prone to chronic pain can become very alert for pain, they start to avoid activities that will trigger the pain, and this results in the brain becoming less tolerant and less able to cope with pain. Just like my example from last week of the individual who starts avoiding bright lights because they are aggravating, individuals who start avoiding situations that might cause pain lose physical and mental tolerance/stamina/strength to tolerate pain. I feel pain, so I stop the activity that causes pain, so my body and my brain have less strength and tolerance to cope with pain, so next time I go into the situation my brain is going to perceive it as more painful and I will further limit my activities. Think about if you had broken your arm and it had to be in a cast for several months. When I take my cast off my arm is going to be weak. When I start using the arm again it is going to hurt because my muscles are weak. If I avoid exercising my arm, it’s going to get even weaker over time, and I’m going to be in even more pain when I try and use it again. This is how chronic pain can develop.

So why do some people have more tolerance for pain? When a pain signal reaches the brain it passes through brain regions involved in emotion, decision-making, and physical sensation. How we react to pain is determined by a number of individual factors. In this way pain is all in your head because it’s impacted by her past experiences and her brains perception.

Psychological factors impact our perception of pain. We know that chronic stress, anxiety, low mood, and poor sleep can increase perceived pain. We feel pain as more severe when we are stressed. Experiences we had in childhood or throughout our lives can also impact how we perceive pain. For example, if our family members struggle with pain management we are more likely to struggle with managing pain. As well if we’ve had past negative experiences in situations associated with pain we are more likely to have a stronger pain reaction. For instance if you’ve had a bad experience at the dentist before with lots of pain even a minor dental procedure can be perceived as more painful. Again, our brain learns to react to situations that might cause discomfort or pain from our past experiences.

The good news is we have many strategies that can help us retrain our brains to have higher tolerance for pain. Again it can be helpful to think of the brain like a muscle. We slowly increase our exposure to activities that cause pain and our brain learns that it can handle situations, the pain is not a signal of something horribly wrong with our body, and over time our brains get stronger at managing pain. Think back to my example of elite athletes last week. While we can’t all be professional athletes, we can develop mental strength like an athlete to help manage pain. I would encourage you to check out the Canadian Psychological Association fact sheet on chronic pain for more information.

There are also some strategies that can trick our brain into managing acute pain better. Here are some strategies for helping with acute pain:

  1. Rub the area - If you stub your toe or bump into your desk, rub the area. This will help the pain go away faster. According to gate control theory of pain by rubbing the area around where the injury occurred we stimulate the nerve fibers that recognize touch and this inhibits the pain receptors. So the pain becomes less intense.

  2. Swear like a sailor - Next time you stub your toe let the profanities fly. Research suggests that uttering curse words helps with acute pain management. This is because of how pain signals pass through the parts of brain that are involved in preventing us from doing socially inappropriate things (like swearing). You have to use profanities though, just yelling random words doesn’t work.

  3. Distract yourself - Another option to manage pain is distraction. If we are able to find another task we like doing it helps manage pain.

Remember pain is an experience that combines the mind and the body. This means that we can learn to have more control over our pain and improve our quality of life.

Is it all in our heads? How mental and physical health interact.

Have you ever been in a situation where you started to feel physical symptoms in your body in response to stress? We all have. It’s pretty common actually. Think about the last time you were stuck in rush hour traffic. Did you notice your shoulders were getting closer to your ears? Or your neck got sore? Or your stomach got upset? Physical symptoms that our body develops in response to stressors are called somatic symptoms.  

There are strong interactions between our mental and physical health. Changes in physical health can impact our mental or emotional health. Think about the last time you had a cold, or had an injury and were in pain, your mood probably felt a bit down right? It is also very common to experience sadness, stress, and worry after receiving a major health diagnosis like cancer. The opposite also happens where changes in our emotional health impact our physical health. Stress, anxiety, and depression can increase the risk of heart disease and stroke for example. Stress also changes our immune functioning and can make us more prone to catching a cold or flu.  

Like I said these somatic symptoms are really common. We all have them from time to time. Other common examples are stress headaches, stomach upset when public speaking, or hands trembling when you are nervous. These are normal signals that our body sends us to tell us we are under stress or pressure.

Some people are more prone to developing somatic symptoms and experience them more often, or experience more severe symptoms. For example somatic symptoms can include convulsions, blindness, paralysis, abnormal walking, or severe tremors.

Significant somatic symptoms that interfere with our daily lives are also very common. Up to 40% of individuals who come to a neurology clinic have somatic symptoms (often referred to as functional neurological disorders).

Rather than these symptoms being due to a physiologically based medical condition (like epilepsy, or a movement disorder), they are psychologically produced. This does not mean these symptoms “aren’t real” or are “all in your head”. Rather we generally think of these symptoms as the body’s learned response to coping with stress.

For example one type of personality that is prone to developing somatic symptoms are individuals who are described by others as “the go-to person” in the family, or “the one we can all count on”, or “the one that keeps the rest of us sane”. While this can be a very admirable trait, helping others, often what happens when we are the caretaker in the family is we take on all of the stress and worry of those around us. That stress can be internalized or pushed down deep inside. This can work for a while, and can help us be very successful in some situations. We are able to push through hard times by ignoring the stress. However, they body can only take this for so long. Eventually the body send up the white flag, says enough is enough, and develops physical symptoms.

Another way that our brain learns to be prone to developing physical symptoms in response to stress is through our early experiences. For instance sometimes we are taught when we are young that mental health (e.g. stress, worry, sadness) are not appropriate topics, but physical symptoms are okay to experience. These individuals learn that physical health concerns are acceptable, but stress is not, and so their brains are more likely to develop somatic symptoms.

A third common pattern occurs where there is some triggering event for the development of somatic symptoms. For example someone might have an acute episode of dizziness (maybe due to an ear infection or other illness) but when the reason for the initial symptoms resolves, the dizziness persists. Individuals prone to somatic symptoms tend to be more alert for physical symptoms. Therefore rather than the brain becoming less concerned with these symptoms over time as whatever caused the initial symptoms resolves, individuals become more focused on symptoms and begin avoiding situations that make their symptoms worse. This results in the brain having reduced tolerance for symptoms and symptoms get worse rather than better. Think about this example. Say my dizziness gets worse when I’m in a bright room. So I start avoiding bright lights. Then my eyes get more sensitive to light, and my brain has less strength to tolerate bright lights. Therefore each time I go into a bright room my symptoms get worse, and I avoid lights more. Even though my brain is trying to protect me by avoiding lights, this avoidance is actually making my brain weaker and my symptoms worse.

The good news is that we can build our mental strength to help overcome physical symptoms. I have talked about people who are more prone to somatic symptoms, but there are also people who have remarkable tolerance for physical symptoms. Athletes are a great example. My favorite example of this mental strength to overcome physical symptoms comes from the 1996 Olympics. An American gymnast named Kerri Strug was the last up for her team on an event called vault where the gymnast runs down a runway, flips over an apparatus like a sawhorse (the vault), then lands on the other side. Kerri Strug landed her first attempt somewhat crooked and hurt her ankle. We learned later that she actually broke her ankle in this first attempt. But she needed to finish her second attempt to win gold for the American team. She was able to run down the runway, flip over the vault, and land essentially on one leg to win gold before collapsing. Marathon runners are another great example. They are able to push themselves past what should be physically possible to complete the race, before collapsing just past the finish line when their bodies give out.

Athletes build this mental strength and resilience through practice. Just like learning any new habit, it takes a lot of practice, repetition, and hard work to change our brain’s learned behaviours. Psychologists are great resources to learn how to implement some of these strategies in daily life. Check out the Canadian Psychological Association website for some great resources regarding the role of psychologists.