Sleep is not just ‘time out' from our busy routine. Most of us need to sleep well to help our bodies recover from the day and to allow healing to take place. But with increasingly busy lives it's estimated that we now sleep around 90 minutes less each night than we did in the 1920's. If you add to this the large numbers who are known to have problems sleeping, it's obvious that many people are now functioning in a permanently sleep-deprived state.
Lack of sleep can make us feel physically unwell as well as stressed and anxious, and scientists also believe that it contributes to heart disease, premature ageing and death on the roads.
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There are more than 80 different sleep problems listed in the medical textbooks, ranging from the inability to get to sleep (insomnia) to the inability to stay awake (narcolepsy). Many sleep problems are temporary, and you may find the self-help measures below help get you back to more normal sleeping pattern. But sleep problems can also be a symptom of other conditions such as a problem with your thyroid gland or depression - so it's worth seeing your GP if your sleeping problems continue.
Insomnia
Insomnia is the most common sleep disorder, affecting an estimated 20 per cent of the world's population. Typical symptoms are:
- Problems falling asleep
- Problems staying asleep (so that you to wake up several times each night)
- Waking up too early
- Daytime symptoms include sleepiness, anxiety, impaired concentration and memory and irritability.
Short-term insomnia, lasting for a few nights or a few weeks, generally affects people who are temporarily experiencing one or more of the following:
- Stress
- Change in environmental noise levels
- Extreme change in temperature
- A different routine, perhaps due to jet lag
- Side effects from medicines
Chronic insomnia, lasting for a month or longer, often results from a combination of factors - which sometimes include underlying physical or mental problems. But it can also be due to behavioural factors such as too much caffeine or alcohol or a long-term disruption to your routine - as with shift work.
Narcolepsy
Narcolepsy is a brain disorder which upsets how the body regulates whether it should be asleep or awake. One of the main symptoms is excessive sleepiness - sufferers can fall asleep at work, talking or driving a car - and these ‘sleep attacks can last from 30 seconds to more than 30 minutes, regardless of how much sleep they are getting at night.
Sleep apnoea
Sleep apnoea is a breathing disorder during sleep, typically accompanied by loud snoring. Apnoea during sleep consists of brief periods throughout the night when breathing stops. People with sleep apnoea wake up to breathe hundreds of times during the night, making them very sleepy during the day. Usually there is no memory of these brief awakenings. In one form of sleep apnoea, called Obstructive Sleep Apnoea, the upper airway is restricted - making this a potentially life-threatening condition needing urgent medical attention.
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There are many things you can try to help you sleep well:
- Exercise regularly, but at least three hours before bedtime.
- Avoid tea and coffee and don't drink a lot of alcohol before bed.
- Try to go to sleep and wake up at the same time each day.
- Don't use your bed for anything other than sleep or sex. Your bed should be associated with sleep.
- Establish a regular, relaxing bedtime routine which lets you unwind and send a signal to your brain that it's time to sleep.
- If you can't sleep, don't worry about it, but get up and do something relaxing like listening to music or reading until you feel sleepy.
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If sleep problems don't respond to the life-style changes or behavioural approaches suggested above, you need to see your doctor. It may be worth keeping a sleep diary for the 10 days before your visit so you can explain the problem. Doctors will generally look for any underlying medical or psychological reason for the problem and may suggest further changes to your routine or lifestyle to help improve your sleep.
If these don't work, a doctor may suggest sleeping pills for insomnia-type problems. Sleeping tablets can help in the short term but quickly become less effective and can even make your sleeping problems worse. They can also be very addictive. For all these reasons, sleeping pills are generally prescribed at the lowest dose and for a short period of time until you are back in a better sleeping pattern. If your problems persist, your doctor may want to refer you to a specialist sleep disorder clinic.
There is no cure for narcolepsy, but the symptoms can be controlled by medication and by lifestyle adjustments such as changing your sleeping routine, improving your diet and more exercise.
Losing weight and sleeping on your side can usually help mild sleep apnoea, as can devices you put in your mouth to help keep the airway open during sleep. Sufferers with more severe sleep apnoea may need to use a special machine at night, which blows air into your nose to keep the airway open.
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A good night's sleep is also important for childrens' physical and emotional health. Children need periods of uninterrupted sleep for optimal growth and development, but sleep problems are very common - especially among younger children. Sustained periods of disturbed sleep have enormous impact on the whole family - both on parents' ability to function during the day and on other children. Problems with sleep may include a reluctance to go to sleep, waking up in the middle of the night, nightmares and sleep walking. Some children with special needs, such as those with autism seem to have particular difficulties establishing consistent sleep patterns.
Some of the self-help measures suggested above can also be adapted for children, and it may also be a good idea to keep a sleep diary for children to show your doctor. Medication is generally seen as a last resort in treating children's sleep disorders because it can be habit-forming and doesn't treat the root cause of the problem. Excessive sleeping or a child's continued reluctance to get up also needs to be investigated as this could suggest depression or other psychological problems.
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Written in 2001
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