Do you suffer from insomnia, how are you sleeping? Depression is common in many with those with sleeping issues, some who are constantly fatigued or tired during the day, others may find they may have sleep apnoea, (known as apnoea to some) others yet will snore every night and some may be very irritable on waking in the morning due to inadequate sleep.
Do you suffer from insomnia, how are you sleeping? Depression is common in many with those with sleeping issues, some who are constantly fatigued or tired during the day, others may find they may have sleep apnoea, (known as apnoea to some) others yet will snore every night and some may be very irritable on waking in the morning due to inadequate sleep.
Many patients I see in my clinic have a sleeping issue; in fact I would say it would be a third and ranging up to a half of all people. Most people at some stage during their lives will suffer from insomnia particularly during the rough times, but when it happens for weeks, months or years on end, it needs sorting out!. Working and thinking too much, stress and sleeplessness feed on each other. When you suffer from stress and fatigue, anxiety or depression, you will have more difficulty in getting a good night’s sleep.
Insomnia is a sleep condition characterised by difficulty falling and/or staying asleep. The disorder can be acute (short-term) or chronic (long-term). It may also appear and disappear. Acute insomnia can persist anywhere from a single night to several weeks. Insomnia is considered chronic when it occurs at least three times a week for three months or longer.
When A person comes to my clinic and tells me they have difficulty in sleeping, it’s important to find out what kind of insomnia they have. Did you know there are several types of insomnia?
It’s natural to have difficulties sleeping during pregnancy, but many expectant mothers endure sleeplessness in the second and third trimesters, as other pregnancy symptoms worsen and a growing baby belly makes getting comfortable in bed more difficult than ever!
Insomnia, like many other common pregnancy symptoms, can be traced back to hormonal shifts. But, in addition to the traditional suspect, there are a number of other factors that could keep you awake at night, including:
Insomnia symptoms can include:
The more tired you become, the less you are capable of coping with stress and the more stressful life seems and more you have a problem going to sleep. Many patients we see in the clinic are victims of the wear and tear of modern 21st century lifestyles, and appear to be caught in this “no-win, no-rest cycle, yet they are probably blissfully unaware that simply doing too much and stress is actually sabotaging their efforts to get a good night’s sleep. Research in the 1970’s revealed that stress decreases the time spent in the deepest, most restorative sleep stages and disrupts dream or “rapid-eye-movement” (REM) sleep. In one study, chronic insomniacs reported that during the time their sleep problems began, they also experienced a greater number of stressful life events than in previous years. These problems include marital problems, financial worries, and the death of a close person or losing their job.
Many patients I have seen have cited causes such as “I have not had a regular sleeping pattern since having my children” or “since my separation” , “since my husband died”, etc. These sleeping patterns can be changed, you do not have to be plagued with insomnia all your life and having to stay reliant on sleeping pills. It is so true that you don’t really appreciate good health until you have a lack of it, what bliss it is to sleep deeply and soundly night after night!
OK, so you are tough and think you can get away with little sleep, night after night? Think again, it will soon catch up on you. But what if you don’t sleep for many hours on end? You’ll go mad, in 1959, a New York DJ called Peter Tripp embarked on a marathon 200 hours without sleep. Within a few days, he became irrational, moody and paranoid, and even began to see imaginary spiders spinning cobwebs on his shoes. When a neurologist arrived to examine him on the final day of his challenge, Tripp imagined the doctor was “an undertaker coming to bury him alive”. Screaming with fear, he actually ran for the door and took off down a hallway with doctors and psychologists in pursuit. Tripp conducted his experiment at a time when little was known about the consequences of sleep deprivation. The stunt started out as a joke to raise money for a charity and pull in more listeners, but Tripp’s family said the DJ was never quite the same again. Since Tripp’s experiment, researchers have associated lack of sleep with a range of damaging physical and psychological conditions. Not getting enough sleep can increase your risk of diabetes, heart problems, depression, substance abuse and anxiety. It can also make you fat, reduce your sex drive, impair your immune system and make it harder for you to pay attention or remember any new information. You need sleep, good quality deep sleep on a very regular basis, if not you will soon get sick and will even die. Could you imagine if you had a poor sleep pattern for years?
There are no hard or fast rules really in terms of exactly how much sleep you need, and it is unfair to say that you need 8 hours each and every night no exception. Thomas Edison, the famous inventor who invented the light bulb amongst other things, slept apparently only a few hours a night yet was one of the most prolific inventors ever. Albert Einstein, on the other hand, said that he needed eleven hours a night and was at his most creative when he slept from eleven to twelve hours. Winston Churchill would always have his afternoon or midday nap for one hour even during the war years. Each of these famous men was highly successful in their individual endeavours, yet the amount of sleep they each required varied greatly. They would have worked out their individual requirements and throughout their lives maintained similar sleep patterns. Have you worked out your individual needs?
A survey of 1.1 million residents found that those that reported sleeping about 7 hours per night had the lowest rates of mortality, whereas those that slept for fewer than 6 hours or more than 8 hours had higher mortality rates. (American Cancer Society) Getting 8.5 or more hours of sleep per night increased the mortality rate by 15%. Severe insomnia – sleeping less than 3.5 hours in women and 4.5 hours in men – also led to a 15% increase in mortality. However, most of the increase in mortality from severe insomnia was discounted after controlling for co-morbid disorders. After controlling for sleep duration and insomnia, use of sleeping pills was also found to be associated with an increased mortality rate.
The lowest mortality was seen in individuals who slept between six and a half and seven and a half hours per night. Even sleeping only 4.5 hours per night is associated with very little increase in mortality. Thus, mild to moderate insomnia for most people is associated with increased longevity and severe insomnia is associated only with a very small effect on mortality.
Sleepiness And Car AccidentsI’m sure there will be some who can relate to being drowsy behind the wheel, the sad thing is that many car crashes happen due to driver fatigue. The best thing you can do is to pull into a rest area and relax for awhile.
Drivers who get six hours of sleep or less are 33 percent more likely to have an accident on the road, compared to those who get seven or eight hours of sleep. Driving while sleep-deprived has the same or worse impact as driving with a blood alcohol concentration (BAC) of 0.05%.
The CDC reports that 35% of Americans get less than the necessary seven hours. Insufficient sleep is one major cause of excessive daytime sleepiness, which is thought to affect up to 18% of the U.S. population
When I was in clinical practice and a patient would mention insomnia, these are the seven questions I would ask. Let’s work through them one at a time. Please read the question first, then scroll down and look at the answer.
1. A healthy person takes about 10 – 20 minutes before they are really asleep.
You don’t get into a healthy deep-sleep pattern by sleeping “as soon as your head hits the pillow”. This is because your mind will first go from the beta brain wave (busy thinking & conscious thought patterns) into the alpha brain wave pattern (relaxed, dreamy, “floating”, half-asleep/half-awake pattern) Later on in the night your brain will move into the refreshing theta brain wave state, called the “rapid eye movement” or REM state. This is the important phase as far as feeling great when you awake is concerned.
The delta state is even deeper, and a healthy person could be in this deep state for up to 60 minutes. Those who say: “a bomb can go off and I don’t wake” are generally in the deeper states such as the delta, because arousal is much more difficult in this state than it is in the alpha.
Healthy sleep consists of a combination and repetitive phase of the four above mentioned brain wave states. Interrupting a cycle can have negative consequences. Remember sometimes just as you dose that you remember something important? This is because the alpha state allows your mind to be more creative and think “peripherally” about minor trivial problem-solving issues, and you are less focused on the main problems in your life.
2. A good indication that you are getting enough sleep is the ability for you to wake most mornings without an alarm clock.
This generally means you are getting enough sleep. In my experience, most people simply don’t get enough rest, they tell me they sleep fine, but do they really get the quality of sleep they need?. If during the week the alarm wakes you and you turn over, you need more sleep. Using your alarm clock is a good measure for this.
3. Waking up close to the same time each morning, and not waking early (from midnight to 5.00am) and then having a disturbed sleep pattern thereon, tells me that your hormone patterns are well balanced. If you have a problem with energy, and suffer from adrenal fatigue then you may well have a sleeping problem. This is a typical presentation in my clinic, and I have seen many patients like this.
4. This is similar to question 1, if you fall asleep rapidly when you lie down in the day you need more sleep. But only when the tiredness is not in relation to meals, i.e.; well away from meals, because if you get tired after eating a meal containing carbs like bread or pasta, it could mean you are a bit low in blood sugar and you may naturally feel a bit tired, Try sleeping for 8 hours a night for 1 week, and if wake up feeling refreshed then try these afternoon naps and you will find that it takes generally much longer to easily sleep in the afternoon after a 5 minute lie down.
5. If you don’t get quite enough sleep, your brain will want a catch-up in the weekend generally. If these “catch-ups” continually occur, you may find it harder to function on a Monday morning, because you are starting to shift you waking and sleeping patterns and are pushing them ahead by an hour or two. It is important to get to bed by 9.30pm – 10.00pm at the latest for most people. Get to bed when you feel naturally tired, don’t have a nap at 8 or 9.00pm and then stay up until 12.00pm – 1.00am. This is very common today, as we try to squeeze every last drop out of our day due to our increasing workloads. And we prop these habits up with coffee and tea to keep us “topped up” with energy. Are you starting to “droop” at 9 – 9.30? Then go to bed.
6. If you find that you need more sleep whilst you are on holidays, you are over-working yourself, end of story. If you are away from the stressors and go “phew” when you are away, it would be best to create a sanctuary at your home, a place where you can escape and relax away from phones, kids, computers, and stop always saying “yes” to people. How much “you” time do you set aside each day or week? Sleeping more on holidays and weekends indicates an underlying problem with “sleep debt”, your sleep back account is going into the red fast and you will soon be bankrupt (burn-out) unless you service this debt.
7. If your husband and you are fine in your relationship but he snores and it drives you crazy, it could be really be affecting the quality of your sleep cycles. Your brain needs to be in a combination and repetitive pattern of the four above mentioned brain-wave patterns to allow sleep to be refreshing and restorative. If his snoring has bumped you out of a deep delta sleep state, it could have severely interrupted your sleep cycles. Remember, deep sleep improves your daytime serotonin (feel good hormone) cycles, which allows you to wake up feeling positive, happy and motivated. Try separate beds for a week or two to see how the quality of your sleep improves. If there is a marked change for the better, consider him getting his snoring sorted, there is help available and by speaking with your doctor you will be able to get a referral for appropriate help.
Poor sleep in turn makes coping with a stressful lifestyle more challenging. In a UK study, volunteers deprived of a good night’s sleep couldn’t think of creative solutions to a stressful challenge and often fell back on rigid approaches that weren’t as effective. In time, trying to get by despite sleeplessness can lead to depression, anxiety and other psychological problems.
Try to get into the habit of regular sleep to keep your biological clock in sync. By going to bed at the same time, and getting up at the same time you will soon see that your body starts to fall into the pattern of regularity. Travel can really throw you out, and here again, keep to regular times with eating and sleeping. Learn to understand how important a good night’s sleep is to your health, it is one of the most important foundations apart from good nutrition and good emotional health.
1. Exercise will help your body deal with tension and stress more effectively, allowing your body and mind a chance to unwind. It could be something as simple as a twenty minute walk, swim or bike ride at least three times weekly. What’s the big deal? And you tell me that you “haven’t got the time”? There is an old saying that “those who don’t make the time for good health now, will find plenty of time for ill health in time”.
If you get stressed and tensed at work, the ideal time to exercise is later in the day like late afternoon. Exercise when it suits your lifestyle – either early morning or late afternoon. Exercise is a classic example of investing your time in an activity which is guaranteed to give you rewards later on. A one hour exercise session makes your other 23 hours so much more effective and the spin off is that you will sleep much more deeply and soundly. Just do it.
2. Never go to bed completely worn out or very hungry. Going to bed too tired will mean that you are not going to get a good night’s sleep. Eating a big meal too late will interfere with your sleep as well. Your digestive system may well play up too, giving you plenty of gas, flatus and tummy rumblings.
Another tip is not to go to bed on an empty tummy; you may well wake up due to low blood sugar levels, especially if you suffer from adrenal fatigue. Sometimes eating a small snack, even a little piece of cheese can do the trick.
3. Watch the caffeine. No coffee at least 6 – 8 hours before bedtime if you have sleeping problems and like coffee. Coffee, tea or chocolate may stimulate you for several hours after, causing a disturbed or a restless sleep. Be aware that caffeine containing foods or drinks may in addition clash with certain prescription drugs causing sleep issues, so check in with your doctor here.
Are your teens up at all hours? I’ll bet they have developed a taste for those caffeinated soda energy drinks. They were unheard of when I was a teen, I was told I had to be 15 before I could have a cup of coffee, and now we let kids as young as 7 or 8 have cans with as much caffeine as two cups of coffee. And you wonder why they are bouncing off the walls with their energy!
4. Sleep on a good bed. This is a BIG one. You are less likely to get a good night’s sleep on a worn out old bed, or one that is too hard or soft or too small. I know from experience, I replaced my bed recently and what a huge difference it has made. Do you wake up regularly with a sore neck or back, is your bed sagging or creaking?
Time to replace it, and remember, you spend so much time sleeping why do you put up with a crappy bed? If you go to bed tonight and say to yourself” I hate my bed” then I don’t think it is a crazy idea to invest in a nice new bed. You will wonder why you didn’t get a good bed few years ago. It could mean the difference between a great night’s sleep and a feeling like you woke up after sleeping all night in a tent. Forget the two week cruise this winter, buy the new bed instead.
5. Are you a sleeping-pill taker? Get your stress sorted sooner rather than later, because stress leads to sleeping issues, which in turn stimulate stress. A real catch twenty two situation. See your naturopath for non-drug options to help you sleep at night; I use herbal medicines like passiflora, avena sativa, valerian, and various others depending on the person’s requirements. Try 400mg of Magnesium citrate about half an hour before bed instead of the popular sleeping pill Immovane® (Zopiclone). Magnesium works well, especially if you drop the coffee and chocolate and alcohol from lunch time onwards.
6. Smokers don’t sleep as deep as non-smokers. Research has shown that those who smoke heavy take longer to fall asleep, awaken more often and spend less time in the REM (deep) sleep phase. Because nicotine withdrawal can last two to three hours after their last puff, smokers may actually wake in the middle of the night craving a cigarette. Ask a reformed smoker, and most will tell you how much their sleep has improved since they kicked the habit.
7. Drink in moderation. Many people think that a drink will help them get to sleep and stay asleep, but drinkers don’t sleep as well as those who drink in moderation or not at all. According to many different studies, even moderate drinking can suppress REM sleep, the deep sleep we need in order to wake up refreshed. Ever noticed that the nights you drink moderately heavy you wake up feeling “groggy”? Too much booze with dinner can make it hard to fall asleep, and too much later at night can harder to stay asleep. You end up sleeping in fragments and often wake in the early hours in the morning. If I have more than one glass of red wine, I never seem to sleep all that well and wake up at one or two and sleep lightly the rest of the evening, almost guaranteed.
Pot smokers will certainly find that sleep improves, the hormone melatonin increases substantially in regular cannabis smokers. But yes, there is a downside – the next day dope smokers will find that they are more tired in afternoon as a consequence and will also crave more sweet foods, the “munchies”, which will create fatigue, lethargy and low blood sugar levels.
8. Go for quality of sleep, not quantity. It is the quality that really counts, and six good solid hours is better than eight or even ten hours of light or disturbed sleeping patterns. Don’t feel that you need eight solid hours every night anymore than you need to drink “eight glasses of water every day”! If five hours does the trick several times a week, you may well find that a nap here or there for twenty minutes may be all you need. Quality counts, so experiment what is right for you. But, studies do show that those who sleep seven hours a day live longer. Sleep on it.
9. Become a napper. Some people, like my wife, actually feel worse for naps. Not me, I have a chill-out session at least three times weekly for twenty minutes in my office on a carpeted floor. I call it my TPM sessions, or twenty peaceful minutes, you have heard me mention this before and find that it really does the trick for me. Try it yourself; these sessions involve lying down on the floor anywhere between the 2.00pm – 3.00 pm. This time slot is probably the best, due to the naturally lower level of cortisol your body produces at this time.
I used to tell my receptionist to hold all calls for this time and relax, do some deep breathing and can feel my mind “slipping away”. By the time I get up, I feel very refreshed and relaxed. It’s what I call a defrag of the mind. It is not that I lack the sleep; I need these sessions to help me re-focus and get my mind from the busy beta into the relaxed alpha state.
Try it, you may find that irritability levels drop off and you become more humane around people if you are a bit anxious, easily stressed or simply try to squeeze too much into your busy life. I make it a habit of going to bed between 10 – 10.30pm every night. I wake at 6.30 every morning feeling refreshed, unless I drink wine which I know affects my sleep.
10. Time outs. Here is a simple way to break out of the stress-sleeplessness cycle. Take regular time-out sessions during the day. It could be something as simple as closing your eyes. Several times a day close your eyes, take a few deep and relaxed breaths and meditate on a relaxing scene. It can work wonders.
11. Don’t worry & be more organised. Some folk lie in bed thinking of what they should have done during the day, or about tasks they have to perform the following day. Try to deal with work related distractions before you hit the sack. Make a list of tasks before you go to bed may help. Write out anxieties or worries and possible solutions, this will save your mind having to do this whilst you are supposed to be resting. Tell yourself that you will sort it the next day. I tell my patients this: “when you lie down, don’t think about any problem that requires a solution”, it is easier said than done, but with a little practice it is easily achievable.
Try not to go to bed until you resolve disagreements with those you care about. It is true; we all have disagreements or arguments with our partners or loved ones from time to time. The trick is in resolving the matter before bed so your mind can rest. Do you go to bed after an argument and lie there churning things over in your mind?
Relax before you go to bed to get yourself in the right frame of mind, and if you do have indifference it is important to resolve the issue as much as possible in order to have a “clear head”.
12. Is Melatonin the answer for insomnia? Melatonin is a hormone produced in the brain which facilitates sleep, it is available freely on the Internet and I have found that many insomniacs have tried melatonin at some stage. Melatonin is very safe, I have fond no evidence of adverse effects even in those who use it for extended periods of time.
When you are asleep, melatonin, which is made from the “feel good” hormone called serotonin, is released from the pineal gland in the brain. When you are awake, serotonin aids in many different functions including muscular contractions. Restless and fidgeting at night are often the result of a confused sleep-wake cycle and can point to a serotonin (too much) or melatonin (not enough) imbalance. Although Melatonin supplements appear to help with better sleep, it is not necessarily better quality or longer sleep.
A recent study demonstrated that the differences between 0.01 and 10mg dosages were not significant. In comparison, the average adult human produces 1mg of melatonin in a 24hr period whereas most tablets available on-line come in 2, 3mg or more. Melatonin is still a controversial subject, and my advice before you take melatonin is to try other things first such as the suggestions above.
13. Are Insomnia Cookies the answer to Insomnia? Apparently, “Insomnia Cookies” was created out of a dislike of heavier foods late at night and a sweet craving”. Insomnia Cookies was founded in 2003 by Seth Berkowitz, who was in college at the time and realised that there was a demand for more late-night delivery options. Their Facebook page says “specializes in delivering warm, delicious cookies right to your door – daily until 3 AM”. Well, this isn’t exactly the kind of food I would recommend somebody at 3 am, how about some sleep? The last thing you need is a load of sugar, flour, fat and ice cream at this time of day.
Work on getting to bed on time, having regular breaks during the day and thereby improving the quality and quantity of your sleep you will be amazed at how your health can improve. Isn’t it funny how we always want to “take” things to improve our sleep, when what we really need to be looking at is improving the simple things first like going to bed when we are actually physically or mentally tired, avoiding stimulants (and alcohol) if we have regular sleeping issues, and also trying to exercise regularly? Poor sleeping patterns affect so many people in this country, is your poor sleep affecting you? By following the above mentioned self help tips you will be surprised how much the quality of your life can improve. Sleep on it.
Insomnia References