Better sleep toolkit

Why are we offering it?

The results from our first ever national police wellbeing survey in 2019, told us very clearly that fatigue is a big issue within policing. It identified that 45% of police officers and 30% of police staff reported sleeping less than six hours per night very often or all of the time and that people working shifts experience poor sleep quality more frequently with 27% of police officers and 25% of police staff reporting disturbed sleep.

We do a tough job, and working for the police – especially if you are a shift worker – means that your sleep patterns are vulnerable to all sorts of challenges. These webinars will help you to learn and practice strategies to improve the quality of your rest, no matter how much, or how little, you get.

Dr Sophie Bostock with an introduction to the better sleep toolkit

Video transcript

Would you like to wake up with more energy?

Be more focused and productive or simply worry less about your sleep?

My name is Dr Sophie Bostock sleep scientist turned sleep evangelist, over the last year I've worked with police officers and staff and the team at Oscar Kilo to deliver the better sleep webinar series.

We had some great feedback after the webinars but many of you asked for more bite-sized content that you could access in your own time, you also asked for tips and reminders to help you stick to new sleep habits and more opportunities for Q&As.

The better sleep toolkit is an online course which aims to help you learn and practice the habits you need to wake up with more energy be more productive and worry less. The course is designed not only to help explain what to do but also how to make it easy and why it's important.

This is a toolkit for everyone who wants to know more about sleep whether you're already sleeping well but you want to go from 80 to 90 or you've really been struggling and you're looking for a step change in your sleep patterns.

All recommendations are based on rigorous evidence and tried and tested with the police family.

We've taken questions from hundreds of officers and staff and put everything together in a series of short videos quizzes and downloads to give you the answers you need how can I get my mind to switch off; what's the best way to prepare for night shifts? how can I sleep through the night?

The main course is split into four one week modules the course will take just five to ten minutes a day but you can move at your own pace and just choose the bits that feel most relevant to you. There's an extra module to help you manage night shifts and information about the most common sleep disorders, if you want help to fall asleep right now the toolkit includes a series of breathing and relaxation techniques which you can download and listen to in bed.

Every month there will also be a live Q&A session, with me, over zoom to answer any questions that you might still need help with. By the end of the course, you will be an expert in your own sleep,  you'll know what you can do to feel sleepy at the right time and how to naturally boost your energy during the day, you'll recognise what triggers sleep problems and how to cope with them.

To launch the better sleep toolkit please click on the link below. If you want to sleep better,  worry less, and get more energy during the day - let's get started I'll see you on the inside.

How do I access the better sleep toolkit?

If you are a serving officer or member of staff within a UK Police Force with a .police.uk email address and you would like to access this content, please go to the login page (at the top right hand side of your screen) and set up an account. You will then be automatically able to access this material. If you already have an account and are logged in, please use the button below to take you to the sign up page.

Go to online course

If you do not have a .police.uk email address but are a serving member of a police force or other policing organisation - then please email contact@oscarkilo.org.uk to request access.

If you have already registered a login for the Oscar Kilo website with a .police.uk email address, but you cannot gain access, please contact us using the email above.

Better sleep webinars

In December 2020, we held our first better sleep webinar: Banish the winter blues, hosted by Dr Sophie Bostock.

The series continued with four more live sessions covering: Sleep strategies for shift workers; solving stubborn sleep problems, nightmares, snoring and other challenges and sleepless parents survival guide.

Series two has sessions on: Fighting fatigue, sleeping with anxiety, women's sleep and the dream completion technique.

Access the better sleep webinar recordings

As with the better sleep course the recordings are only available for people who work in UK policing. If you are a serving officer or member of staff within a UK Police Force with a .police.uk email address and you would like to watch these webinars, please go to the login page (at the top right hand side of your screen) and set up an account. You will then be automatically able to access this material. If you already have an account and are logged in, please use the button below to take you to the better sleep webinar recordings.

Watch the recordings

Quick tips and bite-sized information

Below are some quick fixes that you can start straight away to improve your sleep.

How can breath work help you sleep?

Video transcript

Do you ever feel as though you're always on and have difficulty switching off?

Many of us fill our days to the brim with work, sport, family, friends, social media, DIY, shopping, hobbies, it's all good stuff but it can mean that we rarely make time to pause and just be.

The problem with this always-on approach is that our brains learn to rely on our fight or flight stress response powered by the energising hormones adrenaline and cortisol to keep our energy levels high all day.

If your stress response gets stuck in the on position it can make it very difficult to get into a deep restorative sleep, the stress response is balanced by an opposing rest or digest or relaxation response which promotes digestion, repair, sexual arousal and sleep.

To flip the switch from stress to relaxation we have to convince the brain that we are safe and in control. When we're in danger our breathing tends to either get faster as we prepare to fight or flee from a threat or occasionally it might pause completely as we freeze while we make up our minds.

Maintaining a slow steady breathing rate, therefore, helps to signal to the brain that we're not under threat and helps to drive the relaxation response. There are many different breathing techniques you can try and it's worth experimenting with a few different exercises until you find an approach which you find it easy to focus on and which has a calming effect on you.

Relaxation is a skill, the more often you practice the more quickly and deeply you'll be able to relax. It's a good idea to practice for a few minutes during the day as well as part of your wind-down routine before bed for example box breathing involves breathing in for a count of four holding that breath for a count of four breathing all the way out for a count of four and holding for a count of four as you complete the exercise.

It can be helpful to picture a dot traveling around the outline of a square each side is the same length so it should take the same amount of time to breathe in hold breathe out and hold.

So we're going to try a couple of cycles of box breathing together now.

If you're sitting have your feet flat on the floor back straight head balanced on top of your spine when you breathe in focus on keeping your shoulders relaxed and breathing deeply down into your belly. If you're lying down it can be helpful to keep one hand on your belly one hand on your chest.

Focus on making your belly rise and fall rather than your chest. This means you're more likely to be using your diaphragm to pull the air all the way deep into your lungs which provokes the relaxation response.

I recommend closing your eyes to avoid distractions and I'll talk you through it.

Let yourself breathe all the way out now breathe all the way in through your nose and into your belly for a count of one, two, three, four, and now hold that breath for one, two, three, four and now slowly release your breath all the way out through your nose for one, two, three, four, and hold that breath for one, two, three, four.

Now let yourself breathe in deep in through your nose and into the belly for a count of one, two, three, four, and hold on to that breath for one, two, three, four, and slowly release your breath all the way out for one, two, three, four, and hold for one, two, three, four you can carry on at your own pace.

Sometimes I find that if I wake up in the middle of the night holding my breath for a count of four can be quite difficult so I'll just start by counting to two and then when that feels easy I'll work my way up to three and four.

If you wake up feeling panicky or you feel yourself getting worked up during the day a few cycles of box breathing can help to calm you down and help you feel in control.

If you'd like to learn more about evidence-based techniques to help you relax and prepare for a restorative sleep please sign up to the Better Sleep Toolkit below, you'll get access to a selection of different relaxation strategies you can download and listen to at any time of day or night.

What controls when and how well we sleep?

Video transcript

Instructions for sleep are hardwired into our DNA. We don't have to teach a newborn baby to sleep, their innate sleep system has been programmed to do the work.

The problem is that as we get older we're sometimes exposed to things which disrupt this programming, stress, health or relationship problems, pain, technology, children or shift work. These things can trigger a period of poor sleep. After a while, we can start to feel afraid that we'll never sleep well again and getting anxious about not sleeping can make things even worse.

No matter what your circumstances research shows that you can improve your sleep by practicing simple habits to strengthen your natural sleep systems and by learning to cope with the unhelpful thoughts that can sabotage your sleep. That's the premise behind the Better Sleep Toolkit, it's an online programme that teaches you how sleep works and gives you simple strategies you can practice to reset your sleep patterns.

So how does your sleep system work?

There are three main components and we can improve any one of these to optimise your sleep.

The first component is your circadian rhythm or body clocks.

Every cell in your body contains a tiny molecular clock which is programmed to operate on a 24-hour cycle of action during daylight hours and recovery at night.

If you wake up at the same time every day of the week this anchors all of your body clocks so they can work together efficiently.

You'll start to wake up refreshed, before your alarm, thanks to the morning peak in the hormone cortisol.

You'll be focused during daylight hours and hungry at meal times.

When it gets dark the hormone melatonin will kick in at the same time each night to signal the body that it's time to prepare for sleep.

If you're a shift worker things are a bit more challenging and the toolkit explains some more detailed strategies to help your body clocks adapt.

The very short version is that our body clocks are sensitive to light, food, and movement.

So by avoiding an excess of those things for a few hours before you get into bed it will help you drift off to sleep.

The second component of your sleep system is called sleep pressure. The longer we've been awake the more of a sleep-inducing chemical called adenosine builds up making us feel drowsy. After about 17 hours awake sleep pressure slows our reaction time and makes us less alert. After a long sleep the adenosine is broken down and sleep pressure resets.

Have you ever found it harder to fall asleep on a Sunday night after a lengthy morning lie in?

Sometimes we struggle to fall asleep if we don't have enough sleep pressure to help us drift off.

If you're really not sleepy try getting into bed 15 minutes later and only switch out the light when your eyelids are feeling heavy.

Every 24 hours your alertness follows a pattern a bit like this increasing through the morning, taking a dip after lunch, picking up in the evening, and then dipping down again when it gets dark and you fall asleep.

Your body clocks provide the alerting signal which keeps you awake during the day and sleep pressure builds up to make you fall asleep and then resets overnight.

But there is a third component of your sleep system which can derail the other two and that's the stress system.

Most people know that if they feel stressed they're less likely to sleep well and we'll talk a lot more about that and how to cope in week two of the toolkit.

But for now, I'll finish with one simple tactic for banishing stressful thoughts in bed. Before I switch out the light I think about three things I'm grateful for.

They could be big things like a member of my family or one of my best friends or little things like a really good chocolate brownie.

Try to picture an image of your three good things in your mind and focus for a few moments on what's special about them and why they make you feel so good.

Savouring positive emotions can help us diffuse stress and allow us to relax into the right mood for sleep.

If you're a member of the police family and you'd like to learn more about how your sleep systems work and how to optimise your sleep you can sign up for the better sleep tool kit, at no cost thanks to Oscar Kilo.

I really hope you find it useful thanks for listening and sleep well.

How much sleep do you really need?

Video transcript

How much sleep do we really need?

A few years ago sleep scientists reviewed hundreds of studies looking at the relationship between hours of sleep and things like mood, alertness, memory and problem solving, plus long-term health outcomes like diabetes, heart disease and cognitive decline.

They concluded that on average adults need seven to nine hours sleep for optimal health and functioning over the age of 65 the recommendation narrows to seven to eight hours sleep.

It's best thought of as a bell-shaped curve with the majority of adults needing seven to nine hours sleep to feel at their best, but with a minority managing well on a little less, while some need a little more.

Some people carry a short sleep gene which means they can wake up after five hours and feel refreshed, but they are pretty unusual.

Teenagers are recommended to get between eight and ten hours of sleep but few of them do and of course, it's not just about how many hours of sleep you get - quality is important too.

So how do you know if you're getting enough sleep?

The most important thing is how you feel during the day ask yourself do you fall asleep within five minutes of your head hitting the pillow, do you rely on an alarm clock to wake up most days, do you need caffeine or sugar to keep you going through the day, do you sleep longer at the weekends to catch up?

These are all indicators of sleep deprivation.

One of the main reasons people try and cut back on sleep is to try and get more done and be more successful in their careers and, to be honest, I used to do the same, but research into the consequences of sleep deprivation and a rather nasty climbing accident have made me change my ways.

For example, did you know that sleep also interferes with your leadership potential?

One of the most important characteristics looked for promotion to senior leadership is integrity or honesty and having strong moral principles and let's face it in the police this is pretty fundamental.

In a rather sneaky study in a manufacturing firm 300 workers were asked to record their sleep over 90 days whilst unbeknownst to them their managers counted the number of deviant behaviours they observed, turning up late, taking credit for someone else's work, being rude or shirking their responsibilities, researchers found that there was a direct correlation. The fewer hours of sleep workers got the more likely they were to engage in unethical behaviour.

Over three months sleepless leaders have been shown to be more likely to engage in bullying behaviour in the workplace and are rated by their peers as having lower charisma, but one of the curve balls of sleep deprivation is that when we're sleep deprived we're less likely to notice the impact on other people, we become less sensitive to others facial cues and less able to empathise.

We're also more likely to interpret neutral faces as threatening and this can lead to more defensive or even aggressive behaviour. Everyone has the odd poor night's sleep but if you're routinely getting fewer than six hours sleep during the week you're probably accumulating a sleep debt during the week. So by Friday your mood and concentration start to suffer, your alertness and reaction time will slow.

Limiting your sleep to six hours for two weeks has a similar effect on your alertness as not sleeping at all for 24 hours and will put your reaction time on a par with someone over the drink driving limit.

I'd go as far as saying that whatever is the most important goal in your life right now whether that's to do with your work, your relationships, your health, or happiness prioritising sleep could help to give you the energy, positivity and determination to achieve your goals.

If you are struggling with sleep perhaps you're having difficulty falling asleep or staying asleep through the night or you just wake up feeling unrefreshed the Better Sleep Toolkit has been designed to help you.

There are bite-sized videos to help you become an expert in your own sleep tactics to ease the racing mind and tips to get your sleep patterns back on track.

Thanks for listening I hope to see you on the inside.

Snoring 101 - what it is and what you can do about it

Video transcript

Snoring may sound like a tractor, a strangled cat or foghorn but is simply the sound made by the vibration of soft tissue as air is forced through a narrowing in the upper airways.

This usually happens when the muscles in your tongue or soft palate collapse towards the back wall of your throat making the space smaller, congestion in the nasal passages can also cause snoring. According to a recent survey 38 of men and 30 percent of women in the UK say that they snore, this may be an underestimate since it's often only a bed partner who complains about snoring.

During the day we have plenty of tone in our muscles but during sleep our muscles deeply relax when we lie flat gravity encourages the tongue and soft tissues to fall back on the airway if you sleep on your back with the mouth open the jaw moves down and back and can further compress the airway.

Snoring itself is usually harmless but can cause serious problems for a partner's sleep and put relationships under strain. If you often wake up with a dry mouth or headaches this can also be a sign that you're breathing through your mouth during sleep rather than through your nose which is a less efficient way to breathe and may be associated with fatigue.

Around one in eight snorers also suffers from obstructive sleep apnea or OSA, where the airways temporarily become blocked and this causes frequent pauses in breathing or gasping for breath during sleep.

Firstly weight loss - if you've gained weight and your snoring has got worse losing weight could be the most effective strategy.

Secondly regular exercise - this can improve circulation and overall muscular tone which can reduce fluid retention strengthen the muscles around the airways and help to prevent collapse.

Thirdly sleeping on your side - if your snoring is worse when you lie on your back try using a line of pillows to stop you from rolling onto your back or use a wedge pillow designed to help you sleep on your side.

Fourthly limit alcohol - go easy on alcohol this will also help your sleep quality, if you're going to have a drink stop a few hours before bed.

Number five is to practice nasal breathing - do you ever wake up with a dry mouth?

Does your partner complain that you snore with an open mouth?

The nasal cavity plays an important role in filtering warming and humidifying inhaled air, nasal breathing ensures that you get more oxygen to your lungs and a healthier oral microbiome.

Mouth breathing at night has been linked to bad breath, dental cavities, headaches, and fatigue.

On waking practice breathing more through your nose during the day some people find that a small piece of micropore or surgical tape on the lips can be helpful to remind them to breathe through the nose and this can also be worn at night. This can help to reduce and even eliminate snoring.

Number six is to keep the jaw forwards - one of the best ways to prevent the tongue from collapsing backwards is to ensure that the jaw or mandible stays forward you can wear a device that looks like a gum shield called a mandibular advancement device which helps to keep the airway open.

These devices have been shown to reduce snoring and may also help to reduce OSA for some patients, they can feel a bit uncomfortable to begin with so it's worth asking your dentist to find a device that fits you.

Number seven is to prevent nasal collapse - if you know that you suffer from nasal congestion using an adhesive nasal dilator strip can help you to improve the airflow through your nose, some people also find that decongestants or antihistamines can be helpful if the nose is blocked due to allergies. A warm bath or shower before bed can also help to clear the nostrils and get the body ready for sleep.

Number eight is exercises to improve muscle tone - recently a few small trials have shown that practicing exercises for your tongue can help to strengthen the muscles and prevent airway collapse these are called oropharyngeal and tongue exercises or myofunctional therapy.

For example, according to LATO and colleagues, volunteers who used exercises like these three times a day for three months had a marked improvement in snoring; the first one is to push the tip of your tongue up against the hard palate and slide the tongue backwards 20 times; number two is to suck the tongue upwards so it presses all against that hard palate at the top of your mouth 20 times; number three is to force the back of the tongue against the floor of the mouth while keeping the tip of the tongue in contact with the front incisor teeth 20 times say it slowly so that you can do it at the same time and the final one is to elevate the soft palate that's a bit at the back of your throat while saying the vowel a 20 times like this.

That's my functional therapy, if none of these methods help speak with your GP who might refer you to an ear nose, and throat specialist.

What causes insomnia and how can we solve it?

Video transcript

We all have the occasional poor night of sleep, perhaps we're a bit stressed or we go to bed too late or we're nervous about something happening the next day, but as soon as the stress has passed sleep patterns usually go back to normal within a few nights.

In insomnia disorder sleep patterns don't get back under control, even months after that initial trigger has passed, sometimes you might sleep quite well but on other nights you might not sleep at all and it gets increasingly difficult to know what sort of night you're going to have.

Insomnia disorder is defined as difficulty falling asleep, staying asleep, or waking up feeling unrefreshed, for three nights a week or more, for three months or more, which has a negative impact on daytime function despite adequate opportunity for sleep.

If you've ever had one sleepless night it's not hard to imagine what some of those negative daytime impacts might be after weeks or months at a time, difficulties concentrating, irritability, fatigue, memory problems, poor performance at work, relationship problems, not being able to fulfil family responsibilities or just feeling downright miserable.

Insomnia sufferers are at more than double the risk of anxiety and depression compared with good sleepers, over time they're also at greater risk of accidents, weight gain, diabetes, infections and heart disease.

One thing I find extraordinary about insomnia is that it affects so many people, at least one in ten adults and closer to one in four shift workers.

International research within police officers specifically, found that 51% experienced poor sleep quality with those with more years of service at higher risk.

Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events.

There are literally millions of people across the UK coping with a chronic sleep problem on a daily basis and yet remarkably few of them ever ask for help, it can feel like a very lonely condition, all that time wide awake in the middle of the night when the people around you are sleeping soundly.

I think it's really important to know that you are not alone and even more importantly the ability to solve it is within your reach, in fact you're already well on the way.

Often the first and hardest step is recognising that you need help. There's a model called the three Ps which helps to explain how persistent sleep problems develop, absolutely anyone can experience insomnia but statistically some people are at greater risk than others.

There are predisposing or risk factors which you can't change; you're more vulnerable if you are a woman, if you're over 50, if you work shifts, if you have a family history of poor sleep or more of a worrying personality. I've met plenty of young men with insomnia though, so don't let the predisposing factors put you off.

On their own these things aren't enough to cause insomnia for that we usually need another P a precipitating factor or trigger, this is usually some sort of stress, work stress, relationship strain, a health problem or even a global pandemic, all of these can push you into fight or flight mode increase your levels of arousal and make it harder to sleep.

Humans are very adaptable and usually the stress passes or we get used to it, the things which make sleep problems stick around and shift from an acute insomnia to a chronic insomnia disorder are the perpetuating factors the unhelpful ways that we react to sleep loss.

Unhelpful habits like drinking too much caffeine, or alcohol or eating junk food before bed, haphazard sleep and wake times or simply starting to worry too much about sleep, the more anxious you feel about it the worse it gets. Over time insomnia sufferers often believe they'll never sleep well again and even the thoughts of getting into bed can fill them with dread the solution with the most evidence for treating insomnia is called cognitive behavioural therapy for insomnia or CBTI.

This is a talking therapy approach including cognitive techniques to address unhelpful thoughts and behavioural strategies to retrain your sleep patterns to help you fall asleep naturally and get good quality sleep. CBTI is usually delivered over four to eight sessions, the nice thing is that research shows that self-help strategies using books and digital programs can be as effective as in-person therapy and the effects last. Most people who recover using CBTI will still be sleeping well a year later.

The better sleep toolkit is based on the principles of CBTI this course is a sleep education program and it's not the same as treatment but it will help you to understand and practice the main skills and techniques of CBTI at a time and pace that suits you.

Night shifts - how to sleep better during the day

Video transcript

Our DNA contains instructions in every cell in the body which tell us to follow a 24-hour rhythm of activity and recovery. Over hundreds of thousands of years we've evolved to move, interact and eat during daylight hours and to rest at night, these 24-hour rhythms are called circadian rhythms circa meaning about and dian day.

So if our internal clocks run on a 24 and a half hour timeline how do we make sure that they don't get out of sync with the outside world and the rising and setting of the sun.

Light, light lands on special photosensitive cells in the retina at the back of the eye which signal a master clock in the brain which helps to coordinate our rhythms in temperature, hormones, and alertness, and so on.

The photosensitive cells which influence the timing of our body clocks are different to the cells we use for vision, they are particularly sensitive to bright light in the blue wavelengths of the visible spectrum, the sort of light you naturally get exposed to outside on a cloudless sunny day. In general artificial indoor lighting is much less intense and contains less blue light than natural daylight which can make working in poorly lit environments a real struggle, especially when you're feeling sleepy on a night shift.

In darkness, the master clock triggers the release of melatonin which signals the body to get ready for sleep and makes us feel sleepier. One of the most important principles for night shift workers is to try and gradually shift the timing or phase of your sleep wake rhythm so that you're not trying to sleep when you feel most alert and not trying to work when you feel most sleepy.

For an average adult, on a day shift, who goes to sleep around 11pm and wakes up at 7 am they are most alert at around 4 to 5 pm in the afternoon which is when their body temperature is highest. Their most sleepy time is around 4 am in the morning, between 3 and 5 am is their drowsiest phase which coincides with their lowest body temperature.

In an ideal world when working nights we'd shift the timing of our sleep weight rhythm so that the sleepiest phase falls within our new sleep time. For most people this means delaying the sleepiest phase by about six hours to help them fall asleep at around 9 am soon after returning home from their night shift.

It's usually easier to delay the body clock than to advance it since the clocks are naturally running on a schedule slightly longer than 24 hours but it's still tough for anyone to change their body clocks by more than one to two hours a day.

The master clock in the brain is particularly sensitive to light in the few hours before and after the sleepiest phase, we can see this if we look at the phase response curve for light.

This graph shows what happens to our body clocks if they're exposed to light at different times and it all pivots on the TMIN the time of your lowest body temperature.
Bright light just before the sleepiest phase from about 12.30 to 3.30am has the effect of delaying the body clock by up to two hours which is usually what night shift workers want in order to sleep when they get home.

In contrast bright light directly after the sleepiest phase from about 4.30 to 7.30 am will have the opposite effect it can advance the body clock and make you sleepy earlier in the evening. This is the opposite of what you want for your next night shift. Where the line is flat light won't change the timing of your body clock forward or backwards but light can still make you feel more alert and improve your mood.

The general principles to remember about light are get plenty of bright light in the first part of the shift and seek out well-lit areas. If you really struggle to stay awake during night shifts research also suggests that sitting by a bright light box for 40 minutes before your shift or if you sit at a desk getting three 15-minute exposures in the first part of the shift can help with your alertness.

Think about limiting blue light and bright light after sunrise by using blue light blocking glasses or sunglasses to travel home after a night shift and make your bedroom as dark as possible. The easiest way is with blackout curtains but you can also get stick on blackout blinds or even use pieces of cardboard, an eye mask will also help. If you get up during the day to go to the bathroom try to avoid exposure to daylight.

If you'd like to learn more about how to combat a racing mind how to manage your caffeine intake or detailed examples to show how to shed your light, food, and movement please sign up for the better sleep toolkit and I'll see you on the inside.