Adequate sleep is necessary for the proper functioning of all the body’s systems and allows the body to repair itself, remove toxins and the general maintenance of normal body functions. It is known that inadequate sleep can contribute to cardio-vascular disease, diabetes and obesity. Lack of sleep disrupts neuronal function which may be expressed as cognitive disfunction such as concentration, memory and learning. It is also closely implicated in exacerbating anxiety, mood and many neurological disorders. Researchers have discovered that pro-inflammatory pathways are activated by diminished sleep.
Sleep problems are not uncommon with over 6% of all Australians have some difficulty during sleep time. This may be going to sleep, staying asleep, early waking or non-restorative sleep. Sleep disorders can include sleep apnoea, chronic pain during rest or daytime fatigue to name three.
Causation of sleeplessness may include:
- a new environment
- heat and cold
- movement disorders such as restless leg syndrome
- noise disruption and disturbances
- acute and chronic pain
- fear of not sleeping
- worry and anxiety
Other reasons for a disturbed sleep routine can be:
- poor sleep hygiene such as computer use or blue light at bedtime
- stimulants such as caffeine and nicotine at bedtime
- medication such as antidepressants (SSRI), sinus medication, some lipid lowering agents and β blockers
Anxiety and worry are the highest percentage reason for interrupted sleep.
How much sleep do you need?
- infants (ages 0-3 months) require 14-17 hours a day
- Infants (ages 4-11 months) require 12-15 hours a day
- Toddlers (ages 1-2 years) require about 11-14 hours a day
- Pre-school children (ages 3-5) require 10-13 hours a day
- School-age children (ages 6-13) require 9-11 hours a day
- Teenagers (ages 14-17) need about 8-10 hours each day
- Most adults need 7 to 9 hours a night for the best amount of sleep although some people may need as few as 6 hours or as many as 10 hours of sleep each day
- Older adults (ages 65 and older) need 7-8 hours of sleep each day
- Women in the first trimester of pregnancy often need several more hours of sleep than usual.
If this is a recent onset then looking at the cause can be relatively easy. Look to when it started and then identify the problem and formulate an intervention.
Often it is more challenging to discover and may require one of the many tests available to find a definitive reason. Sleep clinics are established to look at these more intractable problems. Sleep apnoea once identified is another relatively easy problem to improve. Sometimes the cause can be disconnected from sleep such as at iron and ferritin levels in those with nocturnal restless leg or movement disorders preventing sleep.
Your practitioner can look at saliva/blood tests to check melatonin, cortisol, hormones, amino acid and neurotransmitter profiles.
Conventional medicine practitioners may use tricyclic antidepressants for night time sedation but now are more frequently using the hormone derived from serotonin; melatonin.
The complementary medicine approach is to identify any causes that can be rectified and if necessary, address depleted states. Herbs, homeopathy, TCM and acupuncture, minerals and vitamins and neurotransmitters may all have a role to play in restoring the person to a good sleep pattern.
What can be done to help correct the problem?
- Keep a sleep diary – this helps both you and your practitioner.
- Get some sunlight first thing in the morning (helps circadian rhythms)
- Exercise – a brisk 20 minutes a day
- Avoid caffeine after mid-afternoon (tea, coffee, chocolate, energy drinks)
- Avoid alcohol before bed
- Stop smoking
- Have a 30-minute nap mid-afternoon (we are made for two sleeps a day)
- Limit drinks so you don’t have to get up to go to the toilet
- Check with your doctor if any of your medication could be interfering with sleep.
- Go to bed and get up at the same time. Don’t forget children need 10-12 hours per night.
- Encourage teenagers to read a book rather than look at a screen. Use blue light blocking glasses.
- Before bed relax (read a book, take a bath, meditate) and empty your bladder.
- If you need to eat a light snack (no sugary foods) do so an hour before bed. No fluids in the last 90 minutes before bed.
- Make sure light in your bedroom is removed or reduced as much as possible (it may confuse your brain as to what time it is). Keep your clock turned away from you.
- Keep your room cool, no more than 18C
- Make sure you bed is used only for sleep purpose. (association with sleep not games)
- On retiring take some slow deep breaths and empty your mind and relax.
If you think you need supplements to help you get off to sleep then speak to your health practitioner.