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Sleepless in Seattle

Sleepless in Seattle

Dr Ross Walker
9 October 2013

by Ross Walker

When writing a weekly column it is important to make it relevant, preferably on a topic that affects all of us in some way. Therefore, this week’s topic is absolutely relevant because we all do it, we all need it and without it we would not survive for too long.

Probably the most important point about sleep is that the quality of your day depends on the quality of your sleep the night before. Have a bad night’s sleep, you’ll have a bad day.

So, lets examine sleep and the first question here is how much do we need? The answer is, although this is variable, most adults need somewhere between 6-8 hours. Of course, there are people who can function with less and others need more, but most of us fit within this timeframe.

Interestingly from newborn to old age, the actual time needed to sleep becomes less. A newborn needs about 23 hours of sleep while an elderly person may only need 4.

When you sleep, you actually go through 4-5 cycles, each lasting on average around 90 minutes. The two most publicised components of these sleep phases are REM (Rapid Eye Movement) sleep where you do most of your dreaming and non-REM or deep sleep which is vital to rejuvenate your body to restore your cells for the next day’s activities.

If you have too little sleep for your body’s needs, then you will probably suffer chronic sleep deprivation. Basically, missing out adequate amounts of non-REM, deep sleep means you are not experiencing that vital repair and rejuvenation which allows you to function normally.

So, people who go to bed late and wake up early on a regular basis will experience constant fatigue, difficulty concentrating, memory disturbance and if this becomes extreme, irritability and even hallucinations.

Other serious consequences of sleep deprivation include high blood pressure and palpitations (a sense of an abnormal heart beat).

Common sleep problems

The number one sleep problem for all of us is insomnia. There are not too many people who haven’t experienced insomnia at some stage in their life. Insomnia is defined as taking more than 30 minutes to fall asleep either at the beginning of the night or, if you awaken during the night.

Another major sleep problem experienced by men of all ages is sleep apnoea. Sleep apnoea is the “Snorer’s disease” and is characterised by loud snoring that keeps your partner awake (and often makes your neighbours think someone is using a chainsaw in your house during the night). It is also manifested by restless sleeping, your partner noticing that you stop breathing during the night because let’s face it, they can’t sleep because of the noise, so they might as well amuse themselves by monitoring your nocturnal breathing habits.

When you wake in the morning, you feel as if you have not slept a wink (along with your partner) and you drag yourself throughout the day often falling asleep at the most inopportune moments.

When it becomes severe, you may fall asleep at the wheel of your car, killing yourself, your passengers or passengers in oncoming traffic. You may also develop high blood pressure, have strokes or heart attacks.

What I am basically inferring is that if you or your partner suspects you are a sleep apnoea sufferer, you better have it checked out sooner rather than later.

Many other chronic illnesses can affect your sleep patterns. Chronic pain syndromes disrupt sleep, as pain is often worse while you are not experiencing the distractions of the day. Long-standing heart problems or lung disease may also affect your breathing, especially when you lie down at night. Hiatus hernia, peptic ulcers and associated reflux are often worse when you lay flat.

So, after that lot, how can you sleep better? When considering a program to improve your sleep habits, it is important not to focus on just one issue. I like to approach better sleeping with the following approach:

  • Improve the quality of your waking hours;
  • Preparation for sleep;
  • Sleeping environment;
  • Quality of sleep;
  • 24-hour cycle.

The quality of your waking hours very much depends on your ability to manage your life. The major determinants of your waking hours (apart from sleep quality itself) are:

  • The quality of your nutrition
  • Your personal fitness and exercise program
  • Work habits
  • Underlying illnesses
  • Inner sense of peace and contentment

Preparing for sleep is very important, just as it is important to plan other aspects of your life. In preparing for sleep, there are two major considerations – the activities that you should avoid and the activities that are helpful.

Avoid:

  • Family/emotional problems (including phone calls) - 1 hour before sleep
  • Exercise – 2 hours before sleep
  • Eating – 2 hours before sleep
  • Alcohol/stimulants (including caffeine based drinks)/other drugs - 3 hours before sleep
  • Falling asleep in front of the television, listening to the radio or with the light on

Activities to encourage:

  • Reading a magazine/novel (not a thriller) - 1/2 hour before bed
  • Warm bath/shower - one hour before sleep
  • Warm non-caffeine based drink - one hour before sleep
  • Relaxation tapes/CD just before sleep
  • Lovemaking

Your sleeping environment is very important. Feng Shui practitioners are always very interested in this aspect of our physical surroundings. I will make some comments now that might seem heretical. I believe that the bedroom is for sleeping and lovemaking and for little else. I believe the television should be banned from the bedroom. There should not be other electronic gadgets such as computers/fax machines and so on. Try to make your bedroom as comforting and enticing an environment as possible.  A vital part of good sleep is a comfortable bed with comfortable pillows. Beds that are too firm or too soft can cause problems, depending on the individual’s needs. Another vital aspect of the sleeping environment is the person next to you, if indeed you sleep with someone. A poor relationship, a restless sleeper, a snorer or someone with a chronic illness who is either coughing, endlessly waking up to pass urine (hopefully not in the bed), or some other concerning complaint, can also disrupt your sleep. What is going on outside the bedroom can be just as disrupting as inside the bedroom. A barking dog, noisy neighbours or traffic noise can create enormous disturbances. Other disruptions that are in many ways necessary and unavoidable, such as crying or sick children, are great sleep killers.

Quality of sleep itself is important. Try following the five ‘R’s of sleep:

  1. Routine – going to sleep around the same time each night is important for quality of sleep.
  2. Relaxed – probably the strongest sleep killer is going to bed stressed. Try sleeping after a screaming argument with a family member or during an intense period of work disruption. It just won’t happen.
  3. Reducing temperature- the function of the warm bath or shower or warm drink is the after effect of reducing temperature. It is much harder to sleep if your body temperature is rising.
  4. Relationship – poor relationships often equate with poor sleep. In my medical practice, the greatest complaints of poor sleep come from people involved in long term domestic problems or work stress.
  5. Ready – your body knows when it needs sleep. Don’t go to bed and try to sleep if you are wide awake.

The 24 hour cycle is always a factor. Our body clocks ate constantly ticking away. These clocks give us our circadian rhythms and time our cellular mechanisms (if we let them), to perfection. Sleep is a key component of this 24 hour cycle. Most studies suggest that somewhere between six to eight hours is the ideal amount of sleep for most adults, certainly decreasing as you age.

Many people wake in the early hours of the morning with their mind racing at a million miles an hour worrying about many aspects of their life. This is not a sleep problem; this is a symptom of a disordered, messy life. Sleep is a vital part of our lives. If you treat your sleep with the respect it deserves, it will become a wonderful friend that will definitely enhance the quality of your life.

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