Meet the Speaker: 

Stephen is a physiotherapist with a clinical interest in sleep and how it affects health and athletic performance. He runs a physiotherapy clinic in Essex and is also the strength and conditioning/physiotherapy lead for England Para-Swimming (many of our para-swimming medallists have progressed via Steve’s performance programmes). 

Alongside his clinical and sports performance work, Stephen also provides a sleep therapy service focussed on providing simple science-based solutions to help people optimise their sleep. 

In his presentation at Therapy Expo 2024, Stephen shared insights into the crucial role sleep plays in health and performance. His interest in studying sleep developed after noticing how commonly it affected his patients coupled with a realisation that he didn’t have the adequate tools to address it clinically. 

Stephen outlined that approximately one in three people in the UK report sleep issues. He emphasised that sleep is a habit-based, active process influenced primarily by light and routine, and disrupted by factors such as stimulation and sedation. Common sleep problems fall into three categories: difficulty initiating sleep, maintaining sleep, or both. 

He highlighted the importance of sleep cycles, typically lasting 90 minutes and comprising of both non-REM and REM stages. REM (rapid eye movement) sleep, crucial for stress recovery, is particularly vulnerable to sedatives such as alcohol and sleep medications, which often disrupt natural sleep patterns and have limited effectiveness compared to behavioural approaches. 

Key components of sleep therapy include four pillars: physiology, routine, environment, and thought processes.  

• Physiology 

Melatonin, the sleep hormone, is driven by exposure to natural daylight (not artificial or through windows). 

Morning light helps initiate melatonin production later in the day. 

Cortisol, the "wake-up" hormone, should peak in the morning and drop at night. Caffeine, exercise, and food intake influence cortisol levels and should be timed carefully. 

• Routine 

A consistent waking time is more important than a consistent bedtime and should be maintained every day. 

Getting outside shortly after waking helps regulate circadian rhythm and melatonin production. 

Sleep cycles are 90 minutes long; most people need 4–6 cycles (6–9 hours total). 

• Environment 

Key factors include light, noise, temperature, and room layout. 

People often self-adjust their sleep environments, but considerations like avoiding home offices in bedrooms may help. 

• Thought Processes 

Busy minds at bedtime are a common barrier to sleep. 

“Worry time” is used to offload thoughts before bed: journaling worries around two hours before sleep. 

Use a "worry tree" to categorise concerns into hypothetical (let go) or practical (schedule action). 

NSDR (non-sleep deep rest) audio recordings are recommended to calm the brain before lights out. 

Finally, Stephen advised against relying too heavily on wearable sleep trackers due to their potential inaccuracy and the anxiety this can then provoke. His message was clear: consistent routines, daylight exposure, behavioural adjustments, and stress management form the foundation of better sleep. Perfection isn’t required, but forming consistently good habits can be life changing.