S2 · Ep 7: Sleep And Mental Health — Why Rest Changes Everything | The MindSpa Podcast

In this episode of The MindSpa Podcast, Tina Wilston and Michelle Massunken explore the close relationship between sleep and mental health, and why sleep problems can make stress, anxiety, mood, and daily functioning feel much harder to manage.

They break down insomnia in plain language, including difficulty falling asleep, trouble staying asleep, and waking too early. Tina and Michelle also explain how sleep cycles work, why REM sleep matters, and why spending enough time in bed does not always mean you are getting restorative rest.

The conversation also covers practical, grounded strategies that can support better sleep, including consistent wake times, CBT-I approaches, wind-down routines, reducing stimulation before bed, journalling before sleep, and paying attention to caffeine timing. They also discuss recurring nightmares, how emotion shows up in dreams, and how Imaginal Rehearsal Therapy can help reduce nightmare distress.

Tina and Michelle also reflect on melatonin, the limits of sleep medication, and why teens often face unique sleep challenges because of circadian rhythm shifts and school schedules. This episode offers a thoughtful look at sleep as one of the most important foundations of emotional wellbeing.

What You’ll Hear In This Episode

• The three main types of insomnia

• How sleep stages and 90-minute cycles affect restoration

• Why CBT-I is often more effective than people expect

• How caffeine, blue light, and stress interfere with sleep quality

• How nightmare rescripting can help with recurring distressing dreams

• Why teen sleep patterns often differ from adult sleep patterns

The MindSpa Podcast

Thoughtful conversations about mental health, relationships, identity, healing, grounded in clinical expertise and steady human insight.

Hosts

Tina Wilston, M.Ed., Registered Psychotherapist 

Co-Owner, MindSpa Mental Health Centre

LinkedIn, Instagram, Facebook

Michelle Massunken, MSW, RSW

Co-Owner, MindSpa Mental Health Centre

LinkedIn, Instagram, Facebook

MindSpa Mental Health Centre

Ottawa - Kanata & Gloucester

themindspa.ca

LinkedIn, instagram

Listen on

Apple Podcasts | Spotify | Amazon Music | YouTube

Transcript

Why Sleep Matters For Mental Health

Michelle Massunken 0:03

All right, well, welcome back to The Mind Spa Podcast. Today we are talking about something that is so important. It affects every single person, but does not get talked about enough. And that is sleep. Sleep is a very important part of our mental health. Yes, it is. It's fundamental for our emotion regulation, for our mood, but yet we don't talk about it enough. We don't. Yeah. We take it for granted. We do take it for granted. So we're gonna talk a bit about sleep and what are the things that affect and impact our ability to get restful and restorative sleep. Yeah. Um and so why don't we start off with talking a bit about um about that?

Tina Wilston 0:42

Okay. So you have been uh a sort of specialist in sleep for quite a while. Um would you say that that is related to the fact that you've often worked with trauma and first responders and military and and such, which those jobs in and of themselves can impact sleep just in their role, not even what they've been through in their role, but their actual role. Would you say that's why you ended up just having to work with sleep so much?

The Three Faces Of Insomnia

Michelle Massunken 1:12

Yeah. I think um what I've seen in terms of the work that I've done around sleep is the folks that I've worked with often have experienced significant trauma and anxiety. And we've seen the correlation between anxiety and sleep. And so inevitably, many of the folks that I work with are also struggling with insomnia. Yeah. Because they're struggling with PTSD or anxiety. And so we've seen that correlation between being able to uh quiet the mind enough to be able to get that restful and restorative sleep. And that's been, I think, a thing that's come up quite a bit.

Tina Wilston 1:49

Can you define insomnia for me? Because I actually had insomnia for several years and had no idea because I had defined it as never sleeping.

Michelle Massunken 2:02

Okay.

Tina Wilston 2:04

I pass out sometimes. So I like I lose time. I look at the clock and I go, oh, three hours have passed. I must have fallen asleep. So I was like, I clearly don't have insomnia, but I definitely did. Yeah. So can you help us understand? Sure. So insomnia comes in, there are three types of insomnia. I didn't even know that.

Michelle Massunken 2:21

So there's the onset latency. So that's where I'm having a hard time falling asleep. On average, we want to be able to fall asleep within half an hour.

Tina Wilston 2:32

Okay.

Michelle Massunken 2:33

And so if it's taking me a lot longer than that time to fall asleep, I'm tossing and turning for an hour and a half. I'm having a hard time resting and falling asleep. That's onset latency. So I'm having a hard time with the onset of sleep. And then there's the disruption of sleep. Okay. And so that's where I can't stay asleep. I'm awake, it's three o'clock in the morning. I toss over, turn back around, it's 3:45 in the morning. I'm up and I'm not able to fall back asleep. Okay. Or I do fall back asleep, but it's taken me a while to fall back asleep.

Tina Wilston 3:02

Like those, I know a lot of people will describe, let's say my alarm is set for 6 :30 and I fall asleep at 6:00. Yes. So I get another 30 minutes and then I am in a deep sleep at that time and then have a very jarring alarm. Exactly. Okay.

Michelle Massunken 3:15

So that's the third type of uh insomnia. So waking up before your alarm. Okay. And so if my alarm is set for 6:30, but I'm awake at six o'clock, that's where again I don't have the full uh the full experience of sleep where I'm waking up much earlier than my alarm clock. And so it's the onset, interruption, or waking up too early.

Tina Wilston 3:34

Okay.

Michelle Massunken 3:34

Those would be three different types of insomnia. Um I always say insomnia is essentially a busy mind. Okay. Having an overactive mind where you're going to be able to do it.

Tina Wilston 3:44

So shut my mind off, which is a lot of people will describe it.

Michelle Massunken 3:47

Yeah.

Tina Wilston 3:47

Okay. Right?

Michelle Massunken 3:48

And so we know that insomnia is very closely linked to stress and anxiety. And so most of the times, uh, whenever we experience moments of insomnia, we're usually under high levels of stress. Okay. Or anxiety. And our mind is really just going into survival mode of trying to figure out how do we fix this, how do we solve this.

Tina Wilston 4:04

Right.

Michelle Massunken 4:05

Um, but then those habits persist. Okay. Even after the stress has subsided. We maintain those habits, and then that's when it develops into insomnia. And some people might say, I've been I've been like this for years, and I just can't sleep. I can't fall asleep.

Tina Wilston 4:20

That's interesting because I thought that I that that reinforces why I thought I got in the first place, because I have four kids. Yeah. And I nursed most of them. And I co-slept. Yeah. And I thought this was my brain just getting used to being vigilant to the needs of the baby in the middle of the night. Then even when they transitioned to their own rooms, they often would wake in the night, probably till they were about three. So a few times that by four kids. I was like, I think my brain has just learned to stay really alert to any noise in the night. And also don't get too deep asleep because you could roll over and stuff like that. So I figured I probably trained my brain over time to not get and so I didn't notice it until my youngest was fully sleeping through the night for a lengthy period of time. And I was that's when I didn't I wouldn't have ever called it, I wouldn't have even said I had a problem with my sleep up till that point. And then I was like, why? I felt like a light sleeper.

Michelle Massunken 5:18

Yeah.

Tina Wilston 5:19

That was my experience of it, where it was like, I feel like it takes me forever to fall asleep. Then any little noise or movement wakes me up. Then I can't fall back to sleep. And then if I do fall back to sleep, it's like I only have a little bit of time left. Right.

Your Sleep Stages And 90 Minute Cycles

Michelle Massunken 5:35

So it's right before the alarm goes off, if anything. I think that's a that's a very common experience, right, with insomnia, whereas I can't get into that deep sleep. And so I might stay in like um a non-REM one or two, but not get into like this deep REM sleep where I'm like dreaming, or where we actually need to be in that REM sleep, right? For our bodies to be able to restore itself, for our bodies to be able to build on our immune system. And when we don't get into that deep sleep, it also becomes very difficult for us to feel rested in the morning. Right.

Tina Wilston 6:05

Um actually, can you explain to us beginning till end what a healthy sleep cycle is? Yeah. So when we like you know what I mean, in the sense of uh what stage of sleep you're in, how long you need to be in each stage of sleep, all that.

Michelle Massunken 6:22

Yeah. So there's four stages of sleep. There's an N1, right? So N1 is you're kind of dozing off. You're not fully asleep, you're dozing off, you're still with final show. Exactly. You're scrolling, the phone falls out of your head. That's when you're in the N1 stage of sleep. Okay. Um, when you get to N2, um you're you're still aware, right? You're sleeping, but you're lightly sleeping.

Tina Wilston 6:44

Okay.

Michelle Massunken 6:45

Um, and so you can still hear your name if I called you, right? You're sleeping, but I was like, Tina, Tina. I'm like, yes, what do you want? That's N2. Okay. Um N3 is you're sleeping deeply. And so if you were to wake up from N3 and um I open up the blinds or pulled the curtains, you'd be groggy, be a bit disoriented, kind of like what's going on right now. N4 is where we go into REM sleep. That's when we're dreaming. That's when we are um, it's our deepest sleep. Okay. So when we're in our N4 stage of sleep. And so that's where that whole cycle of sleep is what we go through, the four uh four stages of that. Um four stages sleep is usually about 20 to 25% of our sleep time. Okay. Because we don't spend a lot of time in REM, but it's the most important time that we have. Interesting. Right. And so when we are in our REM, sometimes we, again, we don't get a lot of REM sleep, but that's where we are able to dream. That's when our bodies can be able to repair, restore our hormone, uh, immune systems, all those things are being able to be restored in that stage of sleep. Um, and so that's usually what happens in that. Usually each sleep cycle is about 90 minutes. Okay. And so we go through a few sleep cycles throughout the duration of our sleep. So if we slept for eight hours, the beautiful thing is that we would have more room for REM sleep in our sleep cycle because it's a longer sleep. Whereas if we're sleeping for shorter periods of time, like four to six hours, there's less REM that we're getting in those moments, right? And so the idea is to be able to get as much of the four cycles in every set of sleep. Which tells us then that it's And you always have to go from one to the other.

Tina Wilston 8:25

You can't see through. Yeah, you don't skip the stages.

Michelle Massunken 8:28

Okay. Yeah. Um But that tells us though that it's really about the quality of sleep that we're getting, right? Versus like the quantity.

Tina Wilston 8:35

We want to make sure that we're getting if you're in bed for eight hours, that doesn't mean you went through eight cycles. Exactly. Okay. Exactly. Which is why you could get out of bed and be exhausted. Even though you were even lying in bed 10 hours.

Sleep Restriction Starts With Wake Time

Michelle Massunken 8:46

Exactly. Okay. So you want to be able to get those um those sets, right? You want to be able to go through the entire sleep cycle as many times as you need to. Um and that's where with insomnia, sometimes the treatment of that can look like sleep restriction.

Tina Wilston 9:02

Okay. I hear that's not a popular intervention. Would you agree? People kind of push back on that a little bit. Like, no, no, that can't be, that can't be the answer.

Michelle Massunken 9:12

I know, because it sounds so like counterintuitive. It does. Yeah. But I think once you explain it to them and they understand the education behind it in the sense of like, we want to be able to consolidate your sleep.

Tina Wilston 9:22

Okay.

Michelle Massunken 9:23

Right now it's very fragmented. Yeah. Right? You're you're going into N1, N2, N3, and four, and then you're going to N1 and 2, and then you're awake, and then you're going into we want to consolidate it so that you can at least have four or five hours of like solid cycles throughout all four cycles. But that's a great way for sleep to be more restorative and restful when you consolidate it.

Tina Wilston 9:46

Is it only ever restricted on the front end? Is it only ever like don't go to bed until 2 a.m., for example, versus restricted on the other end of wake up early?

Michelle Massunken 9:58

Yeah. So with treating insomnia, we always start by having a consistent wake-up time. Okay. So that's like just the number one.

Tina Wilston 10:06

Don't move that.

Michelle Massunken 10:07

Yes. And so what is the preferred wake -up time? If you're going to do anything to improve your sleep, it's have a consistent wake-up time. Okay. And so that's our starting point. So based on that, now we might we might now say we want you to get five hours or six hours of sleep. But if this is your consistent wake -up time, then we have to count backwards. Okay. And then that tells us what your new bedtime is.

Tina Wilston 10:29

And then do you have certain things that they have to do leading up to bedtime? So it's not like scroll on your phone until 2 a.m. Exactly.

Build A One Hour Wind Down

Michelle Massunken 10:37

Okay. And I was liking it to like, you know, when we're new when we have newborns or mothers, right? And the kids are getting ready to go to bed. They have a bedtime routine. Yes. Right? You take a warm bath, you read a book, you have a glass of milk, whatever the case is. But that tells your body and tells the kids that we're getting ready to go to sleep. Yeah. And the same as sure when we're adults. We don't want to lose sight of the cues that our body needs to know that we're starting to wind down, we're starting to get ready to go to sleep. And so we definitely encourage having a one-hour buffer zone before your bedtime.

Tina Wilston 11:08

Okay.

Michelle Massunken 11:09

Where you're unplugging, you're disconnecting, you're doing things that help your body recognize that we're getting ready to go to sleep. Yeah. And so what does that look like for you? If it's a skincare routine or if it's a book that you're reading, or if it's having a light conversation with your loved ones, but something needs to be that cue that tells you that, okay, I'm winding down now, I'm getting ready to go to sleep.

Tina Wilston 11:39

So if I understand correctly, if what you do is not as important as doing it consistently, so that your brain associates the routine with bedtime.

Michelle Massunken 11:49

Yeah, but you also don't want to do anything that's overly stimulating either. So as long as so there are a few to-do list items, right? Things like packing your lunch, working on a puzzle, reading a book, going through old photos, like things that are mundane, boring, not overly stimulating, um, but that can allow you to now get into this restful state. Yeah. Right, where you can find yourself, where sleep can find itself, its way to you. Right. Um, versus it's being stimulating and exciting that you just don't want to fall asleep.

Tina Wilston 12:20

That reminds me of like I should have kept my first year law textbook because I feel like that used to put me to sleep. There you go. That would have been a good thing for me.

Michelle Massunken 12:29

Yes, exactly. So reading some heavy duty textbooks or things of that nature are great ways um to do that. Even just like organizing certain things, or if it's like reading a book or uh listening to relaxing music, or doing some deep breathing, things of that nature that just really tell your body that, okay, I'm okay to produce a melatonin now and I can write, get ready to go to sleep.

Tina Wilston 12:52

Yeah. Something that always helped me was actually a sleep hypnosis audio. Because one of the things about hypnosis is hypnosis can only be, you can only actually get hypnotized under a theta dominant brainwave. And that is the meditative sort of brainwave and hypnotists, they specialize in getting your brain in a theta state. So they know what voice to use, what music to use to encourage your brain to get into a theta state. And if I understand correctly, because on the neurofeedback side to things, when we're looking at brainwave activity, high beta is associated with feeling anxious. So that's that's not conducive to falling asleep from an anxious state. Yeah. Right. And what you're describing in your routine is how do we bring it from high beta to beta, which is more conversational brainwave activity, to alpha, which is a bit more daydreamy brainwave activity, to theta, which is much more meditative, then to delta, which is the sleep brainwave. That you always want to kind of bring your mind down. So what you're describing is that these are activities that will actually affect your brainwave activity to slow it down to make it more gentle into that sleep.

Michelle Massunken 14:06

Exactly. So yeah, so think about that progression, right? How do I bring it downwards versus upwards and increasing that, which makes it hard for me to fall asleep?

Tina Wilston 14:14

Yeah.

Michelle Massunken 14:14

Um, and sometimes it's even just writing things down. If you find that, you know, what keeps you awake are stressors or thoughts or your to-do list, writing those down, externalizing it. Yeah, right.

Tina Wilston 14:26

Having a list of things that Oh my gosh, yeah, when your brain won't shut off of the yeah, especially on because it's like don't forget. Don't forget. It's 3 a.m. in the morning, don't forget. Don't forget. Yeah, all day the next day, you will forget all the said things. Exactly. Until it's bedtime again. And it's like, damn it, I forgot.

Michelle Massunken 14:44

Yeah, yeah. And that's the thing too. I think it's it's so important to realize that like our brains at 2 a.m. are not in its problem-solving state of mind. Right. And so to try to process your to-do list and to try to unpack it at that time of day, it's not gonna be productive or effective in any way. You know, and so having some pre-bed writing is helpful where you write down what are my concerns? Yeah. But then also taking it a step further, what are some solutions?

Tina Wilston 15:12

Yeah.

Michelle Massunken 15:13

And having yourself think about those things. And that way, when you go to bed, you're able to look at that piece of paper and say, like, I've already thought about this. Yeah. Right. I've already gone there. And so it makes it easier for your brain to now quiet itself instead of it now feeling as if it has to intrude and tell you all the things that you have to do that you haven't gone to doing. So having that time where you move down in terms of like levels of intensity or levels of stimulation, but then also writing things down can be very helpful just to be able to get yourself to sleep.

Tina Wilston 15:41

Amazing. Can you talk a bit about caffeine and or substances that interfere with sleep? Yes.

Michelle Massunken 15:50

So we know that caffeine, we typically encourage folks to not have caffeine eight hours before their bedtime because of the half-life. Right. Because it stays in your system for that duration of time.

Tina Wilston 16:03

Okay.

Michelle Massunken 16:04

And so for it to be able to be out of your system and have metabolized, you want to give yourself that time period. Yeah. And so if you know that you're going to bed at 10 p.m., your last coffee should be at 2 p.m. latest. Um otherwise, again, that's adding to that level of stimulation that we're having, that we're trying to be able to fall asleep. And sometimes people don't think that, you know, I often hear folks say, especially in the CBTI group, that well, caffeine doesn't really affect me. And I find I'm able to fall asleep with caffeine.

Tina Wilston 16:33

Especially the highly anxious people like it.

Michelle Massunken 16:36

How would you know you never give it an opportunity? So I think that's one thing where realizing that sometimes you might not, again, because insomnia looks three different ways. Yeah. So I might still be able to fall asleep. Right. But am I waking up in the middle of the night?

Tina Wilston 16:52

Right?

Michelle Massunken 16:53

Caffeine has affected me.

Tina Wilston 16:54

I understand why that would be counterintuitive, though, of like if I drink lots of caffeine and I pass out every night, as soon as my head hits the pillow, I clearly don't have a caffeine issue. Exactly. Which is not true whatsoever. Exactly.

Michelle Massunken 17:06

But I can understand why you'd conclude that. Yeah. But what you're not realizing, I guess, in that is that you're not allowing yourself to get into as many sleep cycles.

Tina Wilston 17:14

Right.

Michelle Massunken 17:15

And so you might have gotten into one cycle and then you're awake. Yeah. Right? But then your body's like not able to get into another set of sleep cycles. And so it affects you in different ways, especially it affects the quality of your sleep. It may not affect the onset of your sleep or the duration of your sleep.

Tina Wilston 17:29

It affects your ability to get into stage four sleep.

Michelle Massunken 17:32

Exactly. Yeah. And that's exactly it, right? And so it keeps you from getting into that REM stage of sleep because of that arousal, the stimulation that it provides. And so that's where people don't realize they're like I'm sleeping, anyways, but you're not getting that deep sleep. You're not getting the restful, restorative sleep that we want to be able to get.

Tina Wilston 17:48

Yeah.

Michelle Massunken 17:49

And so it affects people differently, but it definitely affects folks more than they realize.

Tina Wilston 17:54

Okay.

Michelle Massunken 17:55

Yeah.

Tina Wilston 17:56

I am so curious about dreams specifically. Um, because there's a lot of people out there that say they don't dream, which we know is probably more factually they don't remember their dreams. It doesn't mean they're not getting into stage four sleep, if I understand correctly. Right. Um, and so because am I am I right? And I've always thought that if you remember your dream, it's probably because you were woken up from stage four sleep. Is that correct?

Michelle Massunken 18:23

Or do you know? Sometimes I don't know fully. I know that sometimes, especially especially when it comes to like nightmares. Okay. I know that sometimes it's more you're recalling it more because you were woken up by it, right? Like you woke up. It was so distressing. Exactly. Okay. So you remember it differently in that way. Um, but sometimes it could be the other way around where you're remembering it because of whether it's the emotional pull that it had on you. And I think one thing that I've noticed with the folks I work with around like dreams or nightmares is we want to always focus on like the content, right? Like what is the emotion that I had in the dream? Okay. Or when I woke up from the dream. Right. Because that's often telling versus like what was the dream about and who was that person?

Tina Wilston 19:02

And that might be scared or was I sad? Exactly like those are feeling trapped. Exactly. I feel like that one is a common theme.

Michelle Massunken 19:10

Feeling trapped, feeling powerless, yeah, feeling helpless.

Dreams Nightmares And What They Signal

Tina Wilston 19:13

We had something called Montana Mares back in the day. Because when you work in the restaurant, anybody who's ever worked in the restaurant industry, those listening right now can relate to this. When you work in the restaurant industry, you have nightmares about not being able to get to this one table. And you keep messing up their order, or you're you keep trying to like get them their water, but things keep getting in the way. The other one is like, I'm trying to punch in their order, but it's like I can't get to the screen to like go punch it in. And I I always equated it to if I didn't take a shower before I went to bed, then my hair still smelled, okay, like the restaurant, and then my brain was like, You're there. Okay. So you're still processing. You're still processing. And it's a stressful job. No matter what, even when you're doing it one minute, it's demanding. So we we called it because I worked at Montana, so they were Montana mares, but I think most people could relate to that. Yeah. But there is something, there is something to that. Now, do you know much about because I remember learning about how different parts of the brain shut down during different stages and light back up? And I know I just don't know. I know the emotional center of the brain does actually shut down during certain stages of sleep, but lights right back up at the REM sleep, which is why we have such big emotional experiences during dream sleep. But it's also why if we're afraid of having a nightmare, the fear of having the nightmare can actually be the emotional fuel to the nightmare. And one of the strategies that I've worked on with people is going, if I have a nightmare, I have a nightmare. If I don't, I don't. How can we embody that? Not just say it to ourselves, but embody the like it's okay if I have one. Yeah. And then I know you do nightmare rescripting, right? Can you tell me? Because I feel like that's that that helps with it does.

Michelle Massunken 20:56

Yeah. So it's called IRT, so imaginal rehearsal therapy. Um, and it's designed specifically to treat nightmares. And so there's lots of research around it, which uh speaks to the evidence of nightmares being a combination of our reality and our imagination. Okay. Right. And so sometimes the reality piece might be the emotion, helpless, powerless, right? That was real. I very much felt that in a real life experience. However, the imaginative piece might be the who and the where and the what. And so what IRT does is it takes the dream in its original form, right? So you're gonna tell me how the dream starts and how it ends in your mind. Because you never really get to the end of a nightmare.

Tina Wilston 21:42

Okay.

Michelle Massunken 21:42

You always wake up at the climax. Ah. You always wake up like just before the cliff or just before they pull like whatever it is, right? Like before they pull the trigger or whatever it is, but you wake up at the climax. And so you never really get to play the tape to the end. Right. And so what ends up happening is that same dream, especially if it's a recurring nightmare, yeah. It comes back the next morning and or the next night rather, and say, Well, we didn't finish.

Tina Wilston 22:07

It's time to replay it. Time to replay it.

Michelle Massunken 22:11

And so it replays it. Okay. And then it becomes a recurring nightmare, right? Because you never get to the end. You always wake up right at the climax of it. And so what IRT does is it helps you to rewrite the ending.

Tina Wilston 22:21

Okay.

Michelle Massunken 22:22

So now we're going to write the script as we know it, and we're also going to end it. But the beautiful thing is we're going to use our imagination to our advantage. Yeah. And so we want to be able to make this as creative as we want it to be, as funny as we want it to be, whether someone is a superhero or there's a superpower in there or something happening. It does need to be reality. It does need to be reality. Okay. And so we rescript it. Being as creative as we need to be, as we want to be, and we have an ending now, which we've never had before. Okay. And so in some of the dreams, you know, I've seen people write, and whether it's um somebody comes in, right? Whether it's their spouse comes in now and helps to save the day, or now they have the superpower, they're able to like fight off in the ways that they weren't able to fight off before, so they're no longer feeling powerless or helpless, or they're able to kind of like charge themselves up and and fly off, or whatever the case might be. But you want it to be as imaginative as possible because it's part of our imagination. Yeah. And then what you end up doing now that you have this rewritten script is you rehearse it. And so you read it before you go to bed. You work on it with the client, or you work on occasionally taking it. Exposure there too. For sure.

Tina Wilston 23:34

Yeah. Because normally it's like I try not to think about that nightmare I keep having. Yeah. So we get in that war.

Michelle Massunken 23:42

Exactly. And so I always remind them like the nightmare piece is part of our imagination and it's part of our real experience, right? But keep in mind that there's an imaginative component to it. And that's what we're focusing on. And it's hard to do IRT when they haven't done the trauma work though. Because then they start to they kind of bounce back and forth between, but this actually did happen and this part happened.

Tina Wilston 24:01

Right.

Michelle Massunken 24:02

And so you often have to refocus on okay, what happens in the dream though? Yeah. What's the nightmare about? Okay. Um so once they've rewritten that, you read it over again, they rehearse it. Usually they're feeling good about the re-ed the rescripted version of it. You know, they're smiling about it because it's different than what they've experienced before.

Tina Wilston 24:20

Yeah.

Michelle Massunken 24:21

Um, and then you encourage them to read it before they go to bed.

Tina Wilston 24:23

Okay.

Michelle Massunken 24:24

And so you read this before you go to bed. And this way, now your brain says, Well, I don't have to bring it up anymore because you've already gone there. And that becomes the new version of the dream. And I've seen it work wonders in many of my folks who have nightmares, just being able to re-script that and rewrite that. Um, and I often use that in conjunction with the CBTI for insomnia treatment. Okay. If that's what's causing the disruption in the middle of the night, then I would do some rescripting with their sleep around that.

Tina Wilston 24:54

Amazing.

Rewrite Recurring Nightmares With IRT

Michelle Massunken 24:55

But sometimes it's about turning our attention to the things that we're fearful of and sort of just giving it attention just to minimize the intensity that it has and to help quiet it down and then being able to kind of go from there.

Tina Wilston 25:06

Yeah. When you were talking, it was making me realize just how almost normalized it's become to not sleep well in today's society. You know, the conversation, there's so many things actually I find in our line of work that have been so normalized then they become discounted when they should be amplified. Like the power of the breath, for example. We talk about all the time. People are like, yeah, yeah, I know, but give me some other strategies. It's like, no, no, can we master this one? This one's really powerful. But also, and and I know there's a lot of times people will come in and we have to start with sleep, right? If you're coming in with anxiety, if you're coming in with depression, we have to start with getting your sleep back on track for sure. It's been a good thing. Or work. Yeah, we're we're spinning our wheels. We're not gonna actually get a lot of traction moving forward. And people are like, no, no, but let me tell you about this thing. Like, we can definitely talk about that. Yeah, but that from an intervention, like where we need to start perspective is often like we need to get that sleep back on track.

Michelle Massunken 26:02

It's so underestimated the power of sleep. I think people don't recognize a they go to fixing the anxiety or trying to fix their depressive symptoms. But that's difficult to do when you're not sleeping. Yeah. It's hard to get to those places when the sleep is what it is is is fundamental, you know. And so I think it's one of the first interventions that many people, I see at least, start off with, you know, if they're doing group, it's often their first exposure to anything in the mental health world is they came in because they're sleep, and then they find out later on that there's actually anxiety or there's PTSD there.

Tina Wilston 26:38

That's the bonus. There's less stigma on I can't sleep.

Michelle Massunken 26:41

Exactly.

Tina Wilston 26:42

So people are more open. But I don't know that everybody always thinks of mental health professional as the person to go to if they're struggling with sleep. But it definitely because I would say talking to a therapist before trying a sleep med is a good idea because a sleep med will work, but it will it has first of all. I personally have tried melatonin before and I'm like, I'd actually rather feel the exhaustion feeling of not sleeping than the exhaustion feeling of a melatonin hangover. Like being groggy in the mornings I hear. It's like my brain doesn't turn on.

Michelle Massunken 27:13

I'm like, at least my brain turns on after I didn't sleep. Yeah. And I feel like melatonin is almost like it doesn't even get you to that deep level of sleep either, right? It's sort of just like is that bullhorn that says, okay, we're gonna try to sleeping now. Okay. Right? We're gonna do what we need to do. It's more of an initiator. Exactly. Yes, versus like getting you that deep, restful sleep that you're needing. And so people talk about that all the time where it's like, well, that didn't work as well for me. Because it's not, it's going to set you on the right path, but it's not going to make you sleep.

Tina Wilston 27:40

And I just realized, because there is talk about how melatonin makes your dreams more vivid. Not necessarily bad, but if they are bad, now they're bad and vivid, which isn't necessarily good. But I'm kind of curious now, just in the sense of how it's affecting that level of sleep, and if it's more that it's interrupting, like it's not actually allowing a good stage four sleep. Right. So then you're waking up and remembering it more clearly as opposed to getting back into stage one.

Michelle Massunken 28:08

I wonder. Yeah, there's there's there's so many possibilities with that. And that's why I always say to folks, like, you could go the medication route, that works. Yeah, but only when you take it.

Tina Wilston 28:18

Yeah.

Michelle Massunken 28:18

Whereas if you work on what are the underlying factors that are contributing to my inability to sleep, and I do it from like a CBT insomnia perspective, you know that that's going to work and have longer-term effects. Right. And so most of the time folks will start off uh with medications, do CBTI and then recognize they actually don't need to take medication or medicinal marijuana or melatonin or whatever they were taking to initiate their sleep because they've identified the causes, the habits, right, the anxious thoughts, the stressors that are contributing to their sleep.

Tina Wilston 28:49

Yeah.

Medication Limits And Why CBT-I Works

Michelle Massunken 28:49

And have this, whether it's a wind-out routine or a buffer activity that helps them to actually get the sleep that they're needing.

Tina Wilston 28:55

And that's something we do here now. We do the CBTI groups for military right now, and we are going to be looking to expand that out for people because it is such a great intervention to help get back on track.

Michelle Massunken 29:06

Yeah, and I don't think people offer it enough. And so definitely, if insomniaism that folks are struggling with, I would encourage you to seek out CBT for insomnia treatment. Yeah. Uh just to be able to get yourself sleep because we need it. It's so important.

Teens Sleep Needs Circadian Rhythm Light

Tina Wilston 29:19

So it's cognitive behavioral therapy for insomnia, isn't it? Yeah, it's is how you find it. But um, yeah, I thank you so much. You're, I mean, this is it is a very important topic, and something we haven't, I don't know, maybe we'll take a couple minutes to talk a little bit about teens in sleep because I think that that's quite an issue that most people, if you have lived with a teenager, you recognize that sleep is a bit of an issue for them. And I think it boils down to the fact that our school system is actually not designed for how teenagers sleep, the level sleep that they need. Yeah.

Michelle Massunken 29:53

And there's also research that talks about the need for teenagers in terms of even their the way that their circadian rhythm is regulated, right? Where it's not on the same wake cycle as ours as adults. And so they do need longer periods of sleep, even if it's the sun is out, even if it's wakeful moments, but they do need longer periods of sleep. But like you said, when school starts at a certain time, or they even I think because of the way that their circadian rhythm is set up, they often go to sleep a lot later too. Uh, because the onset of sleep is later for them. Yeah. But I I don't think that our system is set up to take that into consideration. Um so a lot of them nap after school.

Tina Wilston 30:33

Which I think i is how they cope with it, is they nap after school, but then it really feeds the cycle of not being able to fall asleep um in the evening. And then again, you throw in the fact that our sun sets at 4 p.m. Right in the winter. I always the thing that I'm always concerned about is more you're losing these daytime sun hours and exposure to the light that we need and stuff if you sleep till noon and then the sun sets at four.

Michelle Massunken 30:59

Yeah.

Tina Wilston 30:59

But it is kind of the reality.

Michelle Massunken 31:00

Yeah. And that's a thing too, because the sun does help us to regulate our circadian rhythm. And so if we're not getting that exposure to it, then uh it does become a little bit confusing in so many ways.

Tina Wilston 31:10

But that's why the the blackout blinds are good on the nighttime side of things, but not good on the morning side of things. You need that light to actually start triggering your brain, right? Because melatonin is actually associated with light levels. Exactly. That's why blue light is a bit of an issue because it stops your brain from creating the natural melatonin to encourage yourself to get sleepy and go to bed.

Sleep As The Foundation For Mental Health

Michelle Massunken 31:34

Yeah, yeah. So there's definitely work that needs to be done. I know that there's lots of research that's happening, which is great. Yeah. And hopefully that translates into something that helps. Because otherwise it just becomes this ongoing issue, right? Where we again become a society where sleep or insomnia is just a part of how we operate.

Tina Wilston 31:52

Yeah. Um and we'd actually talk about the interaction of stress and that, right? Because, you know, we were previously talking about burnout and how that chronic stress will interfere with your ability to fall asleep. Yeah. And then interfere with your sleep cycles and that type of stuff. So again, I think that if the biggest takeaway from this conversation is if you are not feeling like you're doing well emotionally or stress-wise, sleep would be a good starting point. Absolutely. Absolutely. Work on that alone. You should be able to actually see a certain percentage improvement just on that.

Michelle Massunken 32:28

Brain function, body function, your hormone levels, your digestive system, like all of these things are dependent on our sleep.

Tina Wilston 32:36

Yeah.

Michelle Massunken 32:37

And if our sleep is not well regulated, if it's not restful, if it's not restorative, if it's not the quality that we need it to be, everything else kind of falls in doesn't fall into place that we don't need it to fall into place. Yeah. So it's huge. Huge. Yeah. Number one. Definitely. Number one. Yeah. It is. Yeah. It's like foundational. Like the basic, basic essence of our mental health. Yeah. Is getting good sleep. Absolutely. So we'll have to talk about this again some at some point. I'm sure we will.

Key Takeaways And Goodbye

Tina Wilston 33:07

I'm sure we will. Thank you so much for tuning in. I hope you enjoyed this episode of The Mind Spa Podcast.