 |
Sleep Problems
Sleep is normal, something we take for granted most of the time. However, lack of sleep, or insomnia, is a common and distressing symptom and often leads people to consult their doctor. It may be due to ordinary, everyday causes or it may be a symptom of more serious underlying problems.
What is sleep?
While sleeping, we are not aware of the world around us. However, while we sleep, a lot of things happen that are essential for us to stay healthy. We sleep in different ways at different times of night. One of the most important of these types of sleep is called Rapid Eye Movement (REM) sleep. It comes and goes throughout the night and takes up about one fifth of our sleep time. During REM sleep, the brain is particularly active, our eyes move quickly from side to side and we dream. During the other type of sleep (non-REM sleep), the brain is inactive, but there is a great deal of bodily activity. Hormones are released into the bloodstream and the body tissues are repaired after the wear and tear of the previous day
How much sleep do we need?
This depends mainly on our age, but varies a lot between people of the same age. Babies sleep for about 17 hours a day, but this reduces to 9 or 10 hours per day for older children. Most adults need between 7 and 8 hours sleep each night, less as they get older. There is a lot of difference between individuals and some people can manage on only 3 hours a night. The elderly need less sleep and so often find their sleep at night is broken, particularly if they take naps during the daytime.
What happens if I don't sleep?
It must be remembered that no-one has died through lack of sleep. The occasional night without sleep has very little effect on either our physical or mental health. However, after several sleepless nights, people find themselves dropping off to sleep during the day. They find it more difficult to make decisions and their mood may be affected. This can be extrememly dangerous if somebody is operating heavy machinery or driving - many deaths each year are caused by people falling asleep at the wheel on motorways.
Sleep problems in adult life
People often complain that they are not getting enough sleep or that their sleep is not satisfying. Quite often, people actually sleep much more than they imagine, short periods of being awake feeling much longer than they really are. Sleeping too little is most commonly due to simple things that can be sorted out without going to see a doctor - too much noise, uncomfortable temperature or bed, irregular routines or too little physical activity. Eating too much may make it difficult to get off to sleep, eating too little may lead to early waking. Cigarettes,, alcohol and drinks containing caffeine, such as tea of coffee, will also disturb sleep. We sleep badly if we are in pain or running a high temperature. However, if lack of sleep continues, it may be due to emotional problems, difficulties in everyday life or sometimes more serious psychological problems. People with severe anxiety find it very difficult to get off to sleep. In severe depression, people may wake early, or even in the middle of the night, and then be unable to get back to sleep.
Can Drugs Help?
Sleeping tablets have been used for many years, but we now know that they are not a permanent answer. They tend to make you tired and irritable the next day and lose their effect quite quickly, so people take increasing doses, which may lead to addiction. The only place for sleeping tablets is their use for short periods when someone is so distressed they cannot sleep.
Substances To Avoid
Alcohol has similar effects to sleeping tablets and tranquillesers and so should be avoided. Slimming tablets make it hard to sleep, as do "street drugs" like Ecstacy and amphemtamines.
Helping Yourself
If you have trouble sleeping, here are some simple tips that will help you get a good night's rest.
Don't go without sleep for a long time - keep to a regular pattern of going to sleep and waking up at the same time every day whether you are tired or not.
Make sure that your bed and bedroom are comfortable - not too hot, not too cold, not too noisy.
Take moderate amounts of exercise such as swimming or walking.
Cut down or stop drinking tea or coffee in the evening. Try a milky drink before going to bed.
Don't drink a lot of alcohol. It may help you fall asleep, but will almost certainly make you wake up through the night.
Don't eat or drink a lot late at night. Try to have your evening meal early rather than late.
If you've had a bad night, resist the temptation to sleep the next day - it will make it harder to go to sleep the following night.
Try to relax properly before going to bed. Your doctor may be able to recommend a helpful relaxation tape.
If something is troubling you and there is nothing you can do about it there and then, try writing it down before you go to bed and then tell yourself to deal with it tomorrow.
If you can't sleep, don't lie there worrying about it, get up and do something you find relaxing like reading, watching television or listening to quiet music. After a while you should feel tired enough to go to bed again.
If none of these approaches help, it may be necessary to see your doctor for advice, either to talk over any problems that may be stopping you from sleeping or to make sure that your sleeplessness is not caused by a physical illness, prescribed medicine, or emotional problems of some sort.
Sleeping At The Wrong Time
Sometimes we have to stay awake when we would normally be asleep. If it happens occasionally we adjust quite easily. However, it is more difficult when this disturbance of our sleep pattern continues, as it does for shift workers or doctors working all night, or nursing mothers. People in these situations often find themselves sleeping at time when they ought to be awake. This is similar to jet lag, where rapid travel between time zones means that you find yourself awake when everybody else is asleep. A good way of readjusting is to make sure you wake at the same time every morning, relatively early, with the help of an alarm, no matter what time you have fallen asleep the previous night. You should not go to bed again before about ten o'clock the next night and will soon start to fall asleep naturally at the right time.
Sleeping Too Much
Some people find that they fall asleep during the day despite wanting to stay awake. Of course, the commonest reason is lack of sleep at night. Some people fall asleep as a way of escaping from the pressures of day to day life. However, if this continues, it may be caused by a physical illness such as diabetes, viral infections or thyroid problems. There are also two unusual conditions which make people sleep too much -
Narcolepsy
This consists of sudden, uncontrollable attacks of sleepiness during the day, sometimes in public. There is a sensation of not being able to move one's body and the sufferer may see or hear strange things as they are falling asleep. Narcolepsy may sometimes be associated with sudden collapses due to loss of muscle strength when the sufferer is angry, laughing or excited.
Sleep Apnoea
Loud snoring may be more of a problem for the person sharing the bed than for the person snoring!. However, Sleep Apnoea is a potentially serious condition in which the loud snoring is associated with stopping breathing for short periods of time during the night. Every time this happens, the person wakes briefly and understandably feels tired the following day. It is more common in those who are overweight and with increasing age.
Other Problems With Sleeping
Sleepwalking and Night Terror
A person will apparently wake from the deepest stage of sleep and then do some quite complicated things like walking around or going up and down stairs. This may land the individual in embarrassing (and occasionally dangerous) situations. Unless woken at the time, the person will remember nothing about it the next day. Such episodes may be heralded by night terrors. In these, the individual appears only half awake, is obviously frightened but without the kind of vivid ideas that characterise nightmares. Night terror can also occur on their own, without leading to sleep walking. Sleep walkers should be guided gently back to bed and should not be woken up. It may be necessary to take precautions to protect the sleepwalker or others from injury - locking doors and windows and locking away any sharp objects like tools. People with night terrors on their own often settle down to sleep again without fully waking. Both these conditions are more common in children but about 1 in 20 adults experience night terrors at some stage and 1 in 100 report sleep walking.
Nightmares
Most of us have had frightening dreams or nightmares. They take place usually during the later part of the night when we have our most vivid and memorable dreams. They do not normally cause problems unless they occur regularly, which usually reflects emotional difficulties. Nightmares often follow a traumatic event such as a bereavement, a disaster or a violent attack. Counselling may help.
|
|
