How to fall asleep if adrenaline is keeping you awake

Strategies to Sleep in Extremes

It’s hard to sleep when we’re stressed. 

Most of us know this all too well, but the stresses we face are rarely life threatening. Even minor anxieties can lead to physical tension, and a cocktail of stress hormones which activate the brain, and banish the precious melatonin which ensures a deep slumber.

If my own sleep has a wobble, I remind myself I’ve coped with much less sleep before, take some deep breaths and try to relax, and if I really can’t sleep after 15 minutes, I'll get out of bed and read on the sofa until I feel sleepy again.

But what if your brain is screaming at you to BE ALERT, and there is no sofa to retreat to?

• What if you’re camped under canvas in 30C heat and hear the whistling and crash of mortal shells just a few miles away? Or you only have 20 minutes to rest on frozen ground before lacing up your boots for your next stint of 200 mile ultra marathon? Or all you have to make you comfortable is a creaking, rocking, 60 foot boat careering into the iceberg-infested darkness at 20 knots.. and you’re all alone?

Every year I get to live adventures vicariously at the World Extreme Medicine conference (WEM). This is a hub for real explorers (and wannabe adventurers) who share a love of the great outdoors, and an interest in keeping people healthy, and saving lives. Here are some of the insights from some extraordinarily inspiring people I’ve chatted to recently about sleep in the extremes...

How can you make it easier to fall sleep in extreme environments?

1. Daily debrief: if your day is high octane and you haven’t had a moment to pause, take a few moments to reflect before you switch gears towards sleep. If you work with a team, this can be a quick verbal download, but writing in a journal (or blog) can also be hugely helpful for processing and defusing the excitement of the day. Once you’ve committed it to paper, or spoken it out loud, let it go. If you need a gentle distraction, focus on 3 things you’re grateful for before you close your eyes. 
2. Familiarisation before you set out: Novelty makes us uneasy, and makes sleep lighter. If the first time you unroll your sleeping bag is when you’re desperately tired - not only may it not fit, but the unfamiliar feel will only add to your discontent. Practice with the same mattress (if you have one), pillow, eye mask or ear plugs. One ocean rower I spoke to got used to the scent of lavender for a few months before leaving home, then gave a quick spritz on board to mask the damp sweat aroma, and make it feel more like home. Even NASA allows astronauts to pack a (small) cuddly toy. Get as familiar as you can with your sleep environment, before you pile on the pressure.
3. Control the controllable: Your environment may unstable, but you can still control small things.. which pockets to pack things in at the end of the shift, the order in which you wash, brush your teeth or unpack your bedding. Creating a wind down ritual is an abbreviated version of the kids’ bedtime routine. The objective is the same: separate wake from sleep with a routine set of behaviours which act like a dimmer switch on the day, allowing arousal levels to gradually dip. You don’t need to think, you just follow the pattern, which your body knows usually ends in sleep. 

Pip Hare aims to beat Ellen MacArthur's Vendee Globe record when she sets out around the world, 8 Nov. Pip is unlikely to be able to sleep for more than 30 min at a time.

4. Visualisation: when you’re full of adrenaline, it’s very hard to switch the mind completely off, so it may be helpful to redirect your attention away from the urgency of the moment, and into a dream-like scene. Picturing yourself at favourite beach, or dream home, may not work if you’re surfing 30 foot waves or it’s minus 12C. Instead, focus on an image which is positive and calming in your mind, but not totally incongruous with the setting. Relocate your mind to the peak or finale of a previous successful expedition. Focus on the sense of wellbeing you had then - the sense of accomplishment, mastery, camaraderie and gratitude for your team. Gratitude is a wonderful antidote for stress.

5. Rest is OK too: It’s hard not to panic if sleep just won’t come, but making more effort doesn’t help. Adopt the mindset that quiet wakefulness is useful too. Even if you don’t sleep, you will still be allowing your muscles to relax, for blood pressure to come down, and for some neurons in your brain to take a breather. Resting can still reduce stress, improve your mood and motivation. The more you can accept not sleeping, the more likely sleep is to come to you. 

Tori Evans will be attempting to break the world record for an Atlantic ocean rowing crossing in February 2021, in aid of Women in Sport.

Ocean rowers typically follow a 2hr on, 2hr off schedule, 24 hours a day. In her 'down time', Tori will have to prepare food, eat, check on navigation, make repairs, manage personal hygiene, communicate with her team... sleep will be a precious commodity.

6. Ultra short sleep: When sleep deprived, even a 10 minute nap, which includes just 3 minutes of stage 2 sleep, can help to restore vigilance and reduce fatigue. Fewer than 10 minutes sleep seems to have relatively little recovery power - so pressing 'snooze' is a poor replacement for unbroken sleep! The most physically restorative stage of sleep is stage 3, or deep sleep. It usually takes about 40 minutes to enter this lush slumber, but when you’re sleep deprived, you may slip into it more quickly. When you're woken from deep sleep, you risk a dangerous 30-60 minute period of ‘sleep inertia’ where your mental faculties need time to warm up. Because of this, a 20-30 minute nap appears to be the sweet spot for ultra short sleepers. Alternatively, if you can protect a full 90-120 minutes, you could benefit from a full sleep cycle with a stint of both deep sleep, and emotion-regulating REM sleep.

7. Breathe: Slowing your breathing down is a simple way to signal the brain that you’re safe, and it’s OK to relax. A simple counting technique can be all you need: slow breath all the way into the belly for 2, pause, then breathe out for a slow count of 3. Next, all the way in for a count of 3, and all the way out for 4. Keep concentrating! Next it's all the way into the depths of your belly for 4, and all the way out for 5. Repeat. There are lots of recipes for breath work you can try, but the common ingredient is paying attention to the simple act of breathing, into the belly and out again. Mindfulness meditation is another tool you can use anywhere to create mental space from what is going on around you.

My not so 'extreme' adventures this summer have been limited to a caving trip to Wales, but many of these techniques still came in handy!

If you have more strategies for sleeping in the extremes to share, or a challenge you're preparing for, please check out WEM, comment here, or drop me a line [email protected].

With immense thanks to Pip Hare, Alex Thomson, Sarah Tingey, and Tori Evans, and other intrepid adventurers.