Getting better sleep

SLEEP

A sleep history is medically important because if you do not get enough quality sleep, sooner or later it will have an impact on your health. Some sleep disturbances are clues to an underlying medical diagnosis, and certain sleep disturbances can themselves even be life threatening.

So how much sleep is the right amount? Some people need very little sleep, but most of us need six to eight hours uninterrupted.

YOU HAVE A SLEEP PROBLEM IF:

• It takes you longer than half an hour to get to sleep
• You wake frequently during the night
• You have difficulty staying asleep
• You wake up in the early hours of the morning and have trouble getting back to sleep
• You wake feeling unrefreshed

HOW SLEEP CAN AFFECT YOUR HEALTH

Insomnia and other sleep disturbances cause more than bags under your eyes and the desperate need for an afternoon nap. It can also cause:

• Impaired memory

• Impaired alertness and co-ordination

• Irritability and depressed mood

• High blood pressure and increased risk of stroke

• Obesity

• Type 2 diabetes

• Heart, immune system and hormone disruption

• Increased tendency to accidents

SLEEP DISORDERS NEEDING MEDICAL ATTENTION

More serious sleep disorders call for medical diagnosis and intervention, initially with your GP and some cases will need specialist referral.

OBSTRUCTIVE SLEEP APNOEA (OSA)

The signs of OSA are snoring with breathing pausing for up to a minute then restarting with a gasping or choking sound. Obesity, smoking and alcohol increase the risk.

In childhood the most common cause of snoring and OSA is enlarged tonsils and/or adenoids. This can make them tired or irritable during the day and their school performance suffers.

Disturbed sleep causes daytime sleepiness and fatigue. It can start to affect mood and personality, your ability to concentrate, strain on the heart, an increased rate of accidents, morning headache and high blood pressure. Treatment starts with losing weight and cutting out alcohol and smoking.

RESTLESS LEGS

This is a condition where you feel jumpy and restless at night and you just can’t keep still. It is more common in women than in men. There may be an underlying medical problem such as iron or magnesium deficiency. It can be treated with exercise early in the day, hot baths, and magnesium or iron supplements.

TEETH GRINDING AND CLENCHING

Teeth grinding and jaw clenching might be seen by a dentist or doctor as headaches, jaw pain or worn down teeth. It can disturb the deeper stages of sleep. Your teeth may need to be protected with a night splint worn in your mouth between the upper and lower teeth. Treatment involves removing stimulants, reducing alcohol and managing stress.

SLEEP TERRORS AND SLEEPWALKING

Sleep terrors and sleepwalking usually happen between one and three hours after going to sleep, and happen during non REM sleep stages. The events usually cannot be remembered. They are both associated with lack of sleep, erratic sleep schedules, and life stresses.

NIGHTMARES

Nightmares usually happen during REM sleep. Treatment involves reducing life stresses, treating anxiety, avoiding excess alcohol, and avoiding the use of night sedatives.

HABITS FOR A BETTER NIGHT’S SLEEP

Sometimes all you need for a good night’s sleep is to improve some of your sleep habits.

• Check that you have a comfortable, supportive mattress and pillow that are not too old.
• Make sure the bedding is suitable for the weather conditions.
• Make sure your room is not too light or too noisy. Heavier curtains and ear-plugs are possible solutions.
• Medical problems can affect sleep such as frequent trips to the toilet or pain.
• Check if any of your medications or supplements can contribute to sleep problems.
• Exercise helps to relieve stress, improve daytime alertness and night-time sleep quality. Exercise early in the day. Afternoons are fine, but finish exercising several hours before your scheduled bedtime.
• Set up a bedtime ritual to help you to wind down. Dim the lights in your home about an hour before you go to bed. Turn off computers, electronic devices, televisions and other sources of light and stimulation.
• Have a warm bath, head to bed when you feel sleepy and set a regular time for getting up. Go outside soon after waking to expose yourself to morning sunlight. Make sure you give yourself enough bed time to get the amount of sleep you need.
• Maintain a healthy weight. Limit fatty foods, spicy foods and refined carbohydrates. Avoid eating large meals too close to bedtime.
• Alcohol may make you sleepy but it disrupts normal sleep patterns and worsens snoring and obstructive sleep apnoea.
• Cut out all sources of caffeine (medicinal, coffee, tea, cola drinks, chocolate) after about 3 pm then work backwards in the day from there, down to an average of zero to two coffees or the equivalent a day (early in the day).
• Nicotine is a stimulant and smoking also makes snoring worse because it inflames the soft tissues in the nose and back of your throat.
• If something is on your mind, try to talk it through with a family member, a friend or a work colleague early in the evening and then put it on the “to do list” for tomorrow.
• Stressful life events such as job loss, financial problems or relationship difficulties cause stress. Anxiety and depression can also show up as sleep problems. Counselling may help you to resolve these issues.
• Melatonin is the hormone secreted at night by a gland near the brain, which gives the signal to sleep. It is sometimes used for a few weeks to rest the sleep rhythm. Ask for medical advice about the timing and doses of melatonin.
• Tryptophan is a precursor of melatonin, so tryptophan-rich foods such as warm milk can boost melatonin levels.
• Medication may be prescribed by your doctor after you have been fully assessed.

HERBAL THERAPIES

Common herbal treatments for insomnia include valerian, lavender, camomile and lemon balm. You can find out more about a better night’s sleep in the book.

ULTIMATE WELLNESS by Prof Kerryn Phelps AM