DO YOU STRUG­GLE WITH IN­SOM­NIA?

Great Health Guide - - CONTENTS - Dr Tammra Warby

Seven new so­lu­tions to beat in­som­nia & get a re­fresh­ing nights sleep

Have you ever wo­ken at 3am and started to toss and turn, frus­trated that you aren’t able to fall back to sleep quickly? Then you start think­ing about all that you must do to­mor­row and all you didn’t get done today. Af­ter an­other hour, you think about how tired you will feel the next day and end up pro­gres­sively an­noyed about be­ing awake? Or per­haps you’re a busy work­ing mum and af­ter ev­ery­thing you’ve done all day, you stay up a lit­tle later just to try to have some time to your­self. De­spite be­ing ex­hausted while you stay up, when you fi­nally go to bed, you sud­denly find your­self wide awake and un­able to sleep. Both sce­nar­ios are forms of in­som­nia, which is the in­abil­ity to ini­ti­ate or main­tain a full and re­fresh­ing night’s sleep. This type of in­som­nia, when it is not as­so­ci­ated with an­other problem such as a men­tal health dis­or­der (anx­i­ety or de­pres­sion), can be amenable to some tips to help pro­mote a good night’s sleep.

1. LIMIT THE USE OF SMART­PHONES, TABLETS AND COM­PUT­ERS FOR AN HOUR BE­FORE BED.

For the sleep process to be en­abled, sev­eral things need to come to­gether, in­clud­ing the hor­monal reg­u­la­tion of our body and our be­hav­iours lead­ing up to sleep and as we go to bed. As the sun goes down, our body pro­duces the hor­mone mela­tonin. This keeps us in our nat­u­ral rhythm and pro­motes the sleepy feel­ing, pre­par­ing us for bed. The re­lease of mela­tonin can be in­hib­ited by bright lights, smart­phones, tablets and com­put­ers, which is why the first tip is to limit the use of th­ese de­vices in the hour be­fore bed and dim the lights if pos­si­ble.

2. HAVE SOME WIND DOWN TIME, TO BE­COME SLEEPY BE­FORE AT­TEMPT­ING TO SLEEP.

It is not help­ful in the late evening to rush from one thing to an­other and an­other and then go straight to bed, if you’re not al­ready sleepy. You will sim­ply be awake and stressed in bed. So, it’s im­por­tant to have some wind down time, to clear your head and to be­come sleepy be­fore at­tempt­ing to sleep. This can be helped by hav­ing ‘the worry list’ sorted be­fore bed, so that as you go to bed, you can tell your­self ‘that has al­ready been dealt with’ when your mind starts rac­ing again. Cog­ni­tive be­havioural ther­apy (CBT) can help to lessen th­ese thoughts, as well as re­duc­ing neg­a­tive thoughts as­so­ci­ated with in­som­nia it­self.

3. REG­U­LATE BODY TEM­PER­A­TURE IN READI­NESS FOR SLEEP.

Our body reg­u­lates its tem­per­a­ture very care­fully dur­ing the 24-hour pe­riod, cool­ing down in pre­pared­ness for sleep. Thus, if the room is too hot or too cold, it makes it very dif­fi­cult to sleep. One thing that can help lower our tem­per­a­ture a lit­tle in readi­ness for sleep, is the warmth of a bath or shower, af­ter which the body cools down. So, to reg­u­late tem­per­a­ture,

have a warm bath, don’t ex­er­cise too close to bed (within three hours) as it heats up the body. Play close at­ten­tion to lay­er­ing of cloth­ing and en­vi­ron­men­tal con­trol so that you are not too hot or too cold.

4. KEEP A CON­SIS­TENT BED­TIME AND BED­TIME ROU­TINE.

Apart from our hor­monal reg­u­la­tion to en­able sleep, there is also the be­havioural el­e­ment that is the learned mind­set to sleep. This is learn­ing and recog­nis­ing that the bed is a re­lax­ing place where only sleep oc­curs. For some in­som­ni­acs, the bed be­comes their bat­tle­ground, one of end­less frus­tra­tion and even dread. So, for a start, re-es­tab­lish­ing this re­la­tion­ship in­volves keep­ing a con­sis­tent bed­time and bed­time rou­tine as well as hav­ing no TV or com­puter in the bed­room.

For those who lay awake un­able to ini­ti­ate sleep, limit this time to 30 min­utes be­fore get­ting back out of bed and un­der­tak­ing a non-stim­u­lat­ing ac­tiv­ity (e.g. read­ing else­where or med­i­ta­tion/quiet time) un­til feel­ing sleepy again. Then go back to bed to try to sleep when you are re­laxed, yawn­ing and sleepy again. This cy­cle can be re­peated as of­ten as nec­es­sary to reestab­lish this re­la­tion­ship of sleep to bed.

5. STOP CHECK­ING THE CLOCK.

Other things to change would be to stop any check­ing on the time if you re­main awake or wake in the night and thus re­move any vig­i­lant at­ten­tion given to the sleep­less­ness it­self.

6. LIMIT CAF­FEINE AND AL­CO­HOL.

There are other life­style fac­tors that can con­trib­ute to in­som­nia. The stim­u­lat­ing ef­fect of cof­fee in the evening can last up to five to six hours and can de­lay the body clock which re­duces the amount of deep sleep. Al­co­hol may make you drowsy and help you fall asleep but it in­ter­rupts the rapid eye move­ment (REM) sleep. Dis­rup­tions in REM sleep may cause day­time drowsi­ness and poor con­cen­tra­tion. It can also sup­press breath­ing and con­trib­ute to sleep ap­noea.

In­som­nia is the in­abil­ity to ini­ti­ate or main­tain a full & re­fresh­ing night,s sleep

7. DON’T SAC­RI­FICE YOUR SLEEP.

When sleep is ab­sent, it has a global ef­fect on one’s health and pro­duc­tiv­ity. But it is also some­thing that is of­ten sac­ri­ficed in pur­suit of work, fam­ily or leisure time. Try to put your­self and your sleep at the top of the list, rather than the bot­tom. Re­mem­ber any per­sis­tent in­som­nia, es­pe­cially that as­so­ci­ated with anx­i­ety or a low mood, should be dis­cussed with your lo­cal doc­tor.

Dr Tammra Warby is a Gen­eral Prac­ti­tioner with a PhD in Vi­rol­ogy. She has worked in emer­gency medicine and gen­eral prac­tice in chronic dis­ease man­age­ment in­clud­ing di­a­betes, pae­di­atrics, men­tal health, pre­ven­ta­tive medicine, skin cancer checks and surgery. Tammra works at Foxwell Med­i­cal, and can also be con­tactable via Twit­ter.

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