The secret to a great night’s sleep
A lack of quality sleep is not only bad for your health, it can be life-threatening. Professor Kerryn Phelps reveals how to sleep soundly.
When I take a medical history, I ask about sleep. How much sleep do you get? Do you sleep through or wake during the night? What time do you usually wake up? Do you wake feeling refreshed? If you don’t get enough quality sleep, sooner or later it will impact on your health. Some sleep disturbances are clues to an underlying medical diagnosis and certain sleep disturbances can be life-threatening. So how much sleep is the right amount? Some people need very little, but most of us need six to eight hours, uninterrupted.
You have a sleep problem if:
It takes longer than half an hour to get to sleep. You wake frequently during the night.
You have difficulty staying asleep.
You wake up in the early hours of the morning and have trouble getting back to sleep.
You wake feeling unrefreshed.
How lack of sleep affects your health
Insomnia and other sleep disturbances cause more than bags under your eyes and the desperate need for an afternoon nap. It can also cause: Impaired memory.
Impaired alertness and co-ordination.
Irritability and depressed mood.
High blood pressure and increased risk of stroke.
Type 2 diabetes.
Heart, immune system and hormone disruption. Increased tendency to accidents.
Sleep disorders that need medical attention
More serious sleep disorders call for medical diagnosis and intervention, initially with your GP, and some cases will need specialist referral.
Obstructive Sleep Apnoea
The signs of Obstructive Sleep Apnoea (OSA) are snoring with breathing pausing for up to a minute, then restarting with a gasping or choking sound. Obesity, smoking and alcohol increase the risk.
In childhood, the most common cause of snoring and OSA is enlarged tonsils and/or adenoids. This can make children tired or irritable during the day and their school performance can also suffer.
Some people need very little, but most need six to eight hours.
Disturbed sleep This causes daytime sleepiness and fatigue. It can start to affect mood and personality and your ability to concentrate, it puts strain on your heart, and can lead to an increased rate of accidents, morning headaches and high blood pressure. Treatment starts with losing weight and cutting out alcohol and smoking.
Restless legs This is a condition where you feel jumpy and restless at night and you just can’t keep still. It is more common in women than in men. There may be an underlying medical problem, such as iron or magnesium deficiency. It can be treated with exercise early in the day, hot baths and magnesium or iron supplements.
Teeth grinding and clenching These conditions might be seen by a dentist or doctor as headaches, jaw pain or worndown teeth, and teeth grinding and jaw clenching can disturb the deeper stages of sleep. Teeth may need to be protected with a night splint worn in the mouth between the upper and lower teeth. Treatment involves removing stimulants, reducing alcohol and managing stress.
Sleep terrors and sleepwalking usually happen between one and three hours after going to sleep, and occur during non-REM (rapid eye movement) sleep stages. The events usually aren’t remembered once awake. They are both associated with a lack of sleep, erratic sleep schedules and life stresses.
Nightmares These often occur during REM sleep. Treatment involves reducing life stresses, treating anxiety, avoiding excess alcohol and not using night sedatives.
Habits for a better night’s sleep
Sometimes all you need for a good night’s sleep is to improve some of your sleep habits.
Check that you have a comfortable, supportive mattress and pillows that are not too old.
Make sure the bedding is suitable for the weather conditions.
Make sure your room is not too light or too noisy. Heavier curtains and earplugs are possible solutions.
Medical problems can affect sleep, such as frequent trips to the toilet or pain.
Check if any of your medications or supplements can contribute to sleep problems.
Exercise helps to relieve stress, improve daytime alertness and night-time sleep quality. It is best to exercise early in the day. Afternoons are fine, too, but make sure you finish exercising several hours before bedtime.
Set up a bedtime ritual to help you wind down. Dim the lights in your home about an hour before you go to bed. Turn off computers, electronic devices, televisions and other sources of light and stimulation.
Have a warm bath.
Head to bed when you feel sleepy and set a regular time for getting up. Go outside soon after waking to expose yourself to morning sunlight. Make sure you give yourself enough bedtime to get the amount of sleep you need.
Maintain a healthy weight. Limit how many fatty foods, spicy foods and refined carbohydrates you eat. Avoid large meals too close to bedtime.
Alcohol may make you sleepy, but it disrupts normal sleep patterns and worsens snoring and obstructive sleep apnoea.
Cut out all sources of caffeine (medicinal, coffee, tea, cola drinks, chocolate) after about 3pm, then work backwards in the day from there, down to an average of zero to two coffees or the equivalent early in the day.
Nicotine is a stimulant and smoking also makes snoring worse because it inflames the soft tissues in the nose and back of your throat.
If something is on your mind, try to talk it through with a family member, a friend or a work colleague early in the evening and then put it on the “to do” list for tomorrow.
Life events such as job loss, financial problems or relationship difficulties cause stress. Anxiety and depression can also show up as sleep problems. Counselling may help you to resolve these issues.
Melatonin is the hormone secreted at night by a gland near the brain that gives the signal to sleep. Doses of it are sometimes used for a few weeks to regulate the sleep rhythm. Ask for medical advice about timing and correct doses.
Tryptophan is a precursor of melatonin, so tryptophan-rich foods, such as warm milk, can boost melatonin levels.
Medication may be prescribed by your doctor after you have been fully assessed.
Common herbal treatments for insomnia include valerian, lavender, camomile and lemon balm.
Getting a good night’s sleep is an essential part of ensuring your long-term health.
Cutting out caffeine drinks after 3pm and waking up at a regular time can help you to sleep better.