Sleep

SleepMost people have trouble sleeping at one time or another, and it is thought that athird of people in the UK have bouts of insomnia – sustained difficulty getting tosleep or staying asleep for long enough to feel refreshed in the morning.Types of sleep problem• Falling asleep: this is the most common problem. Some people take hours tofall asleep, but then sleep well• Maintaining sleep: waking up in the night and having difficulty falling asleepagain• Waking up too early• Poor quality sleep: light, disturbed sleep which does not leave people feelingrefreshedHow much sleep do we need?The amount of sleep we need varies from one individual to another; school agechildren need around 10 hours while healthy adults need an average of 7-9 hours anight. People tend to sleep less, and be light sleepers, as they get older.What stops us sleeping?There are many possible causes of insomnia:Stressful events: Some people’s insomnia starts in response to a stressful eventand continues even after the stress has been resolved. Sleep is easily affected byhow we feel.• Worry about work, money, health etc.• Death or illness of a loved one• Environmental factors – noise, sleeping in a room that is too hot/cold orlight/dark, working away from home and having to sleep in hotels, anuncomfortable bedShift work: Working changing shifts prevents a regular sleep pattern.Psychiatric problems: Sleep can be affected by underlying mental healthproblems, including:• Mood disorders, such as depression or bipolar disorder• Anxiety disorders, such as generalised anxiety, panic disorders, or posttraumaticstress disorder• Psychotic disorders, such as schizophreniaPhysical conditions: Insomnia may be caused by an underlying physical conditionsuch as:• Heart disease, such as angina or heart failure• Respiratory disease, such as asthma• Neurological disease, such as Alzheimer’s or Parkinson’s disease• Hormone problems, such as an overactive thyroid• Gastrointestinal disease, such as irritable bowel syndrome• Joint/muscle problems and chronic pain• Sleep disorders, such as sleep apnoea, narcolepsy or restless leg syndromeDrug and substance misuse: Including the misuse of alcohol, recreational drugs,caffeine and nicotine.Medication: Some prescribed or over-the-counter medication can also causeinsomnia, including:• Antidepressants• Epilepsy medication• High blood pressure medication• Hormone treatment• Non-steroidal anti-inflammatory drugs (NSAIDs)• Some medicines for asthma, such as salbutamol, salmeterol, theophylline

Consequences of insomniaSleep is important – it helps to build up our immune systems, stabilise mood,lowers the risk of obesity, enhances attention and alertness and helps our ability tohandle stress. An occasional bad night will only result in feeling tired the next day,but several sleepless nights may results in:-Difficulty concentratingFeeling tired all the timeMorning headachesAn inability to function normally, e.g.being clumsy, groggy or forgetfulMore vulnerability to health problemsStress and worryingBeing irritableFalling asleep during the dayTips for a good nights sleep• Try to stick to a regular sleep schedule - set a regular bedtime and wake upat the same time every day• Don’t nap – a nap can be a great way to recharge but it can make insomniaworse. If insomnia is a problem for you and you feel tired during the day, take awalk, get some fresh air, or do a puzzle for a short time. If you must nap, do itin the early afternoon and limit it to 30 minutes.• Make your bedroom more sleep-friendly – If you can’t avoid or eliminatenoise, try masking it with a fan, soothing music/sounds or white noise, or tryearplugs. Even dim lights – especially those from TV or computer screens – canconfuse the body clock, so use heavy shades/curtains to block light fromwindows or try an eye mask.• Sleep in a comfortable bed - If you often wake up with a sore back or achingneck, you may need to invest in a new mattress or try a different pillow.• Try to relax before going to bed - Many people use TV to fall asleep or relaxat the end of the day, but TV actually stimulates the mind rather than relaxingit. If your favourite show is on at night, record it to watch earlier the next day.Instead of watching TV before bed, try reading a light book/magazine, take abath, listen to soft music, do some easy stretches or make simple preparationsfor the next day.• Food and drink – Avoid eating a heavy meal late at night, though eating alight snack (such as a turkey sandwich or a small bowl of whole grain cereal)can calm the brain and help you sleep. Avoid alcohol before bed as it reducesyour sleep quality, and drink less caffeine – it can cause sleep problems up to10-12 hours after drinking it!HypersomniaHypersomnia is excessive daytime sleepiness or/and prolonged night time sleep. Itcan result from a physical problem, medication or medication withdrawal, anothersleep disorder or drug/alcohol abuse. If you think you have hypersomnia see yourGP.Seeking further helpIf you have long-term trouble sleeping, see your GP. They will first diagnose andtreat any underlying health condition, and advise you on changes you can make tosleep better. They may then prescribe a short course of sleeping tablets, orcognitive behavioural treatments.Useful websitesNHS insomnia information -www.nhs.uk/conditions/insomnia/Pages/Introduction.aspxThe Mental Health Foundation Guide to a Better Sleep -http://mentalhealth.org.uk/content/assets/PDF/publications/MHF-Sleep-Pocket-Guide-2011.pdf