Panic and Sleep

If you want to catch up you can find the pre-session, week one, week two, week three and week four posts in the links

Welcome to week five - dealing with panic and getting a better night's sleep.  Instead of covering these with the usual 'theory/practice' approach, I'm going to talk about them as two separate topics as that's really how we went through them in the session.  We were down to 10 (plus three people observing) yesterday which is a far cry from our 20 we started with, and I was a little surprised as I'd expected sleep to be a big draw.  One of the facilitators actually said that many people book onto StressControl explicitly for the sleep info as it's something that a lot of people want to know more about.  But first - panic:

Panic

We talked about what panic is and how those extreme feelings linked to fight or flight can, in some circumstances make us feel like we're dying.  A lot of the symptoms of panic are (unsurpisingly) similar to those of stress or anxiety - sweating, dizziness, heart palpatations, clammy hands, shortness of breath etc... Some regular readers may also notice that these are also symptoms some people experience when having a hypo (happy Hypo Awareness Week by the way...) so understanding the cause is really important.

We also talked about panic can be a response to a particular situation (confined spaces and having bloods taken from my arm), or can also be 'out of the blue' panic.  If you've never had a panic attack, it's not something I'd recommend.

In terms of management, a lot of techniques we've covered over the last few weeks came in to play.  Focusing on breathing is key as it helps us regulate our internal biology. We talked quite a bit about hyperventilating and how this adds to feelings of panic as you're upsetting the oxygen/carbon dioxide balance whichcan fuel some of the symptoms.  It's not something I have a lot of personal experience with though.

Aside from breathing, remembering to engage our rational voice helps - you might feel like you're going to faint, but if you never have, is that a likely outcome or is the fear fuelling the problem?  We didn't cover avoidance in relation to panic so based on my own experience, I can tell you I actively do avoid situations that involve confined spaces where I can.  I can't avoid blood taking though so it was reassuring that my own personal brand of coping (deep breaths, play some music, focus on something else) is largely in line with proper advice.  I think it's helpful to add in the rational thinking bit too though (although I very nearly did genuinely faint once...)

Sleep

It did feel like sleep was the thing with the biggest build up, so it may be disappointing to here how it was nearly all grounded in the most mundane, common sense approach imaginable.  As with most things throughout the course, it's reassuring that there's nothing too complicated to learn that's brand new, but also makes you wonder why you can't always see the easy common sense stuff for yourself.

We covered difficulty getting to sleep as well as difficulty staying asleep - I guess the difference between quantity and quality of sleep.  Very few silver bullets here, but some of the things worth remembering are:

1. Avoid caffeine before bed (and bear in mind it can stay in your system for up to eight hours)
2. Reduce hot drinks closer to bed time (although the benefits of an Ovaltine are the exception there)
3. Alcohol might help you get to sleep but it can affect the quality of your sleep and you shouldn't end up being dependent on it
4. Eating a big meal before bed means your body will be digesting if after you've gone to sleep which again can affect the quality of sleep you get
5. Cool (but not cold) temperature is best - around 18 degrees.  I felt particularly vindicated by this point as I'm a fan of sleeping with the window open
6. Reduce noise and light where you can (ear plugs, blackout blinds) but playing white noise can reduce the affects of environmental noise
7. Reduce screen time before bed (even where there are blue light filters)
8. Keep your bedroom for sleeping and not working, emails etc

We also covered how even small changes can have an impact so if you're struggling with sleep then some of these may be for you.

I think what I found frustrating here was the X factor that diabetes can chuck into the mix.  I didn't have a decaf coffee after about 5pm yesterday, cooled the spare room (early start means I get the spare room) and had ambient noise that I know helps me get to sleep.  And then I had a hypo at 2am and was up for about 40 mins before getting up at 4:40am...  

I guess you can only control what you can control, but the impact that diabetes can have on sleep is catastrophic sometimes.  I also know that weeks like this where I'll be sleeping in four different beds in seven days means I'll struggle.

So we're nearly at the end - next week is the final week of the course where we'll link all these bits together in an attempt to have a more concrete plan about improving our wellbeing and thinking about how we continue the work after the course has finished.  All the hard work is still to come I think as it's the ability to stay focused on these techniques away from a weekly structure.

Hopefully this has been helpful - see you next week.

Diabetes UK are running a hugely important campaign about improving the provision of and access to a variety of emotional support services. People with diabetes are twice as likely to suffer from burnout or difficulties with their own mental health compared to those without the condition. Some estimates suggest that one in ten people with diabetes are clinically depressed. You can read more about the vital It's Missing campaign by following the link. My story is just my story. If you need to talk to someone about how diabetes is making you feel, you can ring the Diabetes UK Helpline on 0345 123 2399 or you can ring Samaritans 24 hours a day on 116 123