Ask a Mental Health Professional No. 10

By Earle Irwin

Question: I don’t sleep. It’s been so long since I had a good night’s sleep, I’ve pretty much accepted that I won’t ever have one again. But my spouse stays on my case about it, saying that there is help for my problem. Yeah, I’d probably be easier to live with if I could get some rest, but is sleep really THAT big a deal?

Response: Yes—restorative sleep is a basic biological need. Our bodies cannot effectively function without it. Complicating matters, we live within a culture that places more value on time and productivity than sleep.

Sleeping Girl circa 1620-1622, by Domenico Fetti.

Not enough hours in the day? Just go to the time bank and borrow from the hours our bodies have designated for sleeping.

A problem: that loan cannot be repaid in full. There’s no catching up on lost sleep.

Information from the National Institutes of Health:

Sleep is important to a number of brain functions, including how nerve cells (neurons) communicate with each other.  In fact, your brain and body stay remarkably active while you sleep.  Recent findings suggest that sleep plays a housekeeping role that removes toxins in your brain that build up while you are awake… 

Sleep affects almost every type of tissue and system in the body – from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance.  Research shows that a chronic lack of sleep, or getting poor quality sleep, increases the risk of disorders including high blood pressure, cardiovascular disease, diabetes, depression and obesity. (

The good news: the quality of your sleep can be improved, and it can start with changes that you can make at home, some of them in the comfort of your own bedroom.  We call these healthy sleep habits “sleep hygiene.”

Practicing good sleep hygiene involves these measures: set and keep a regular bedtime and wake up time; limit exposure to “screens” (television, electronic devices) for two hours prior to bedtime; provide a clean, quiet, dark, cool sleeping space; limit caffeine and alcohol intake during the day, especially during the six hours prior to bedtime; engage in bedtime rituals that aid relaxation, such as a hot bath or shower or listening to music; and avoid checking the time if awakened during the night.

For information about these measures and more, the American Sleep Association maintains a helpful site:

Sometimes sleep troubles are related to medical issues. According to the Mayo Clinic, one such problem is sleep apnea “a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.”

A reasonable approach to personal sleep problems including lack of restorative sleep is to try to clean up your sleep act yourself by practicing sleep hygiene measures. If you try this at home without significant improvement, talking to your medical practitioner about your sleep issues is a next step. The medical professional will be better able to evaluate your problem after hearing what approaches you’ve already tried.

Many island residents have reported that they have not slept well since Hurricane Dorian. Sleep disruptions after dealing with a major life disruption such as Dorian are a common component of post-traumatic stress.

In addition to making sleep hygiene adjustments, additional measures may be needed. If you were awakened from sleep on Sept. 6, 2019, by the storm your brain may not yet have registered that going to sleep at night is a safe practice.

Our brains process traumas as lessons to be learned about what to avoid in the future. While this pattern assists our survival, when our brains too broadly generalize, we can have problems.

Additional efforts may be needed to convince our brains that going to sleep does not mean we will awaken to a disaster. Part of your new bedtime routine may be to find ways to reassure yourself that you are safe.

Do you have dreams or nightmares that replay components of the disturbing event? You may want to talk to a mental health professional abouts ways to reprogram your nightmares by retraining your brain to play positive alternatives.

If you are an island resident dealing with sleep issues or other stressors, let’s talk!

Please call, text or email me at 252-385-2172 or

Earle Irwin, a retired clinical nurse specialist, is on Ocracoke through March to help islanders cope with Dorian aftermath and any other issues they may be dealing with. The Ocracoke Interfaith Relief & Recovery Team received funding from the Outer Banks Community Foundation for Earle’s return.

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