What is sleep counseling?

Since sleep is a basic human need, it strongly affects the quality of life. Therefore, it is important to pay special attention to sleep. We talked about sleep and sleep problems with Kene Vernik, who has worked in the field of sleep medicine for 12 years.

You work as a psychologist and sleep consultant. You have acquired the profession of a psychologist from the University of Tartu, but how did you find the path of sleep counseling?

When I was in the second year of my bachelor's degree in psychology, I wanted to get an internship at the psychiatry clinic of the University of Tartu. It turned out that they have a big shortage of sleep nurses. Although I had no nursing education, they agreed to train me. So, I went to the sleep department of the psychiatric clinic, where sleep doctor and psychiatrist Tuuliki Hion worked. In the beginning, I helped her with various tasks, including the technical side. I started doing polysomnographic sleep studies and soon started reviewing the results of the studies. This was followed by various trainings across Europe. After seven years of practice and attending trainings, I passed the exam of the European Sleep Medicine Committee and received a certificate.

Nurses and doctors work mainly as sleep technologists, there are very few psychologists. At the same time, insomniacs very often have anxiety disorders or depression, but such a person who could offer psychotherapy to an adult with a severe sleep disorder could not be found in Estonia. Because I really liked sleep counseling, I specialized in it.

What is sleep counseling like?

I advise everyone from mothers of newborns to the elderly. Since I know the diagnosis and clinical treatment of sleep disorders very well, I deal with different problems. First, we fill out the questionnaires, based on which I decide how to proceed: whether to send the client directly to the examination or to start ordinary or insomnia psychotherapy.

How aware are people in Estonia of the possibility of contacting a sleep consultant in case of sleep disorders?

Over the past ten years, we have worked hard to increase people's awareness, for example by giving lectures in kindergartens and schools. Thanks to this, people turn to a sleep consultant somewhat more often than before. At the same time, the first choice of Estonian people is still the tablet treatment prescribed by a family doctor. In the long run, sleeping pills will definitely not be beneficial. If, for example, you have a breathing disorder at night that you are not aware of, the pill will not help. Also, hypnosis is not helpful for restless legs syndrome - on the contrary, tablet therapy can make the situation worse.

Unfortunately, there are very few sleep counselors in Estonia. Apart from me, sleep doctors Tuuliki Hion and Heisl Vaher deal with sleep counseling. There are some sleep nurses working in hospitals who offer group therapy in addition to sleep counseling.

In recent years, the situation in the world has been anxious both because of the corona pandemic and the war in Ukraine. Have you noticed that what is happening in the world has increased the number of people who need the help of a professional sleep consultant

I think all psychologists who do psychotherapy have noticed an increase in health anxiety during the pandemic. Health anxiety is an anxiety disorder in which a person focuses excessively on health. On the other hand, generalized anxiety disorder has always had high statistical indicators, but it is definitely on the rise because of the fear of war. People can't stop thinking about if and how and what will happen. With these thoughts, they go to bed, and from there, a kind of life begins. People have many fearful thoughts.

I can't say how big the statistical change is, but when I think about my clients, I think 30% of anxiety cases are related to war and 60-70% to health. Every second or third client comes to my office because of health anxiety.

How frequent are sleep problems among Estonians? How well or badly do Estonians sleep?

The last major comparative study did not show anything good. In European terms, Estonians are not very good sleepers. You could even say that we are one of the worst, because the average sleep time of Estonian adults is around 7.2-7.5 hours. The average sleep time of children is 9.5 hours, which is catastrophically low. Behind this situation are long working hours, poor sleep hygiene, health problems (mainly mental health), as well as the climate. At the same time, you can't blame everything on the climate, because even in comparison with the Finns and Swedes, we are still in a worse position. Finland and Sweden have a different sleep culture and understanding of sleep health. At least on the basis of health indicators, it cannot be said that Estonia belongs to a welfare society.

In 2019, you published the book "Good sleep guide", where you discuss in detail how to deal with sleep disorders. What are the main recommendations to start with if it is difficult to fall asleep or sleep is interrupted?

First of all, you have to maintain a certain rhythm of sleep and wakefulness. Although sleep is affected by various external factors, it is important to focus on the internal rhythm, because otherwise the body starts to break down and becomes susceptible to diseases. In doing so, one must find out one's chronotype - the daily activity period from early to late - and take this into account when forming the rhythm. This means that a certain length of sleep is given to us at birth and we must be aware of our internal clock.

Another suggestion is to follow a daily schedule. Fixed feeding times are very important, because if you eat a large amount of food very late, it disturbs the system that activates sleep. Although the body signals that you are tired and should fall asleep, it may not succeed because the brain activity becomes more active and the body feels that it has to act.

Apart from nutrition, attention should be paid to physical activity. However, physical activity is poor in the Nordic countries, including Estonia. People are not outside for two hours, they don't move enough, although in fact they should move for two hours every day intensively. If the body is not physically tired, sleep will become shorter and more fragmented.

Therefore, if a certain sleep rhythm, specific feeding times and physical activity are ensured, nothing catastrophic can generally happen.

More information can be found on the website www.kenevernik.ee.

You can find practical advice on how to deal with sleep problems in our next blog post.