SLEEP DISORDERS AND PROBLEMS WITH SLEEPING

Most of us have had problems with sleeping at points in our life which is a normal temporary experience but if sleep problems happen on a regular basis this needs to be dealt with.

The lack of quality sleep has negative effects on our energy levels, our emotional balance and general physical as well as mental health.

Understanding Sleep Problems

Sleep can be a barometer of our overall health so those in good health normally sleep OK but people suffering from repeated problems either getting off to sleep or staying alseep may have underlying medical or psychological problem.

Lack of sleep affects our mood, energy levels, efficiency and also our ability to handle stress. The roll on effect can influence our job performance, our relationships and can also lead to accidents.

How can you tell whether your sleeping problem is minor or a sign of more sleep disorders or an underlying medical condition?

First lets begin by examining your symptoms:

Do you :

Feel irritable or sleepy during the day?

Have difficulty staying awake when sitting still, watching television or reading?

Often get told by others how tired you look?

Notice how your reactions have slowed down including physical and mental responses?

Have trouble controlling your emotions?

Drink a lot of coffee to keep yourself going?

If you answered yes to any of these questions then you may have a sleep problem. Now let us take a look at some of different reasons for difficulty in relaxing and regenerating sleep.

Insomnia which is the most common type of sleep disorder

Insomnia is the inability to get the right amount of sleep required to wake feeling rested and refreshed. Insomnia is often a symptom of other problems such as stress, anxiety, depression or, in some cases, an underlying health condition. It can also be caused by our lifestyle, certain medication being taken, lack of exercise, jet lag or in some cases simply the amount of coffee a person drinks.

It is important to see how insomnia is a symptom of other problems and most cases can be cured with changes you can make without having to always rely on prescription or over the counter medication.

Symptoms include:

Difficulty falling asleep despite being tired.

Waking up frequently during the night.

Trouble getting back to sleep when you are awake.

Exhausting sleep and feeling tired on waking.

Relying on sleeping pills or alcohol to fall asleep.

Waking up too early in the morning.

Feeling drowsy, tired or irritable during the day.

Difficulty concentrating during the day.

Common Causes

Are you under a lot of stress?

Are you depressed or feeling emotionally flat and feel the future appears hopeless?

Do you struggle with chronic feelings of anxiety and worry?

Have you recently gone through a very traumatic experience?

Are you taking medication which may affect your sleep pattern?

Do you have health problems which interrupt your normal sleep pattern such as chest conditions, chronic or acute pain?

Is the place where you sleep quiet and comfortable?

Are you spending enough time in the sunlight during the day which can relate also to Seasonal Affective Disorder (light therapy may be of significant help if this is the case and you can read more by following this link)

Do you have a regular sleep pattern such as going to bed and getting up at the time of day?

Common mental and physical causes:

Psychological problems such as depression, anxiety, chronic stress, post traumatic disorder.

Medications that can cause insomnia such as antidepressants, cold and flu mediations, pain relievers, diuretics, coritcosterioids, thyroid hormones and high blood pressure medication.

Medical problems such as asthma, allergies, Parkinson disease, hyperthyroidism, acid reflux, kidney disease, cancer and chronic pain.

Sleep disorders such as sleep apnea, narcolepsy, restless leg syndrome (see below for more information)

Anxiety and Depression : two of the most common causes of chronic insomnia

Most people suffering from anxiety and depression have problems sleeping. What is more the sleep deprivation an make the symptoms of anxiety and depression worse and so clearly treating the underlying psychological issues is the key to curing the insomnia.

Changing habits that disrupt sleep

Some of the things we do to cope with insomnia may actually make the problem worse. For example if you are using sleeping pills or alcohol to get yourself off t sleep this can disrupt your sleep even more in the long term. Again, if you drink too much coffee during the day this will interrupt your normal sleep so cut this out of your daytime pattern. Also we need to cut out the alcohol and cutting back on nightly use of sleeping tablets to using once every other night.

It may take a few days for your body to respond but once it does you will notice how you are now sleeping better.

Using a sleep diary to identify insomnia inducing habits

Sometimes habits are so ingrained that we may overlook them when trying to stop insomnia. Sometimes a clear connection with late night television to internet surfing are contributing to your insomnia and so keeping a sleep diary can pinpoint important habits and behaviours.

Keep track of when you go to sleep and when you wake up along with where you fall asleep and what you eat and drink as well as any stressful events that have occurred during the day.

Adopting new habits to help you sleep

Make sure your bedroom is quiet, dark and cool. Noise, light and heat can interfere with sleep. Try using a sound machine or earplugs to cut out noise, open a window or switch on a fan to keep the room cool and also consider installing a blackout curtain or using a sleep mask to block out light.

Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up around the same time each day, including weekends, even if you feel tired.

Avoid napping during the day as it can make it hard for you to get off to sleep at night. If you do feel a power nap helps then back sure it is no longer than a maximum of 30 minutes and before 3pm.

Avoid stimulating activity and stressful situations before bedtime. This includes rigorous exercise, important discussions or arguments, sitting in front of the television, computer or playing video games. Instead focus on quiet, soothing activities, such as reading, knitting or listening to soft music whilst also keeping the lights down low.

Do not read with a back lit device such as an iPad and you wish to read an ebook then choose a device which is not backlit i.e. one that requires an additional light source.

Limit the amount of caffeine, alcohol and nicotine. No caffinated beverages at least eight hours before bed and avoid drinking or keep alcohol down to a minimum for whilst it can make you feel sleepy it has been shown to interfere with the quality of your sleep. If you smoke cut down at night as nicotine is a stimulant.

Preparing your brain for sleep

Your brain produces an important sleep hormone called melatonin to regulate the sleep - waking cycle. As melatonin is directly controlled by light exposure not enough natural daylight can make your brain feel sleepy while too much artificial light at night can surpress the all important production of melatonin and thereby make it hard to get to sleep. To help regulate your sleep - wake cycle and prepare your brain for sleep:

Increase light exposure during the day. Take breaks outside in the sunlight and remove sunglasses when safe to do so and open blinds and curtains during the day. See more about light therapy to help with Seasonal Affective disorder by following this link.

Limit artificial light at night. To boost melatonin production use low wattage bulbs, cover windows and electrical displays in your bedroom, avoid bright light and turn off the television, smartphone and computer screens one hour before you go to bed.

Coping with Shift Work

Working nights and irregular shifts can disrupt your sleep schedule. You may be able to limit the adverse effects by practicing healthy bedtime habits detailed above and following these ideas:

Adjust your sleep - wake cycle by exposing yourself to bring light when you wake up at night' use bright lights or daylight stimulation devices in your work place (read more about light therapy) and then wear dark glasses on your journey home to encourage sleep.

Limit the number of night or irregular shifts you work in a row to prevent the effects of sleep deprivation mounting up.

Avoid frequently rotating shifts so you can maintain the same sleep schedule.

Avoid a long commute that cuts into your sleep time. The more time you spend travelling home in daylight, the more awake you will become and so find it hard to get to sleep.

Eliminate noise and light from your bedroom during the day by blackout curtains or a sleep mask. Turn off your phone and if necessary use ear plugs or a soothing sound machine to block out daytime noise.

Insomnia cures and treatments - Neutralising anxiety when you can't sleep

The more trouble we have with sleep then naturally the more worries about sleeping start to invade our thinking especially when we go to bed. Many people tell me how they dreaded going to sleep because the just knew that they were going to toss and turn in bed and be up at 2am.

Or maybe it is because you worry because you have an important day tomorrow and if you don't get a solid eight hours of sleep you will blow the important meeting. Clearly worry and expecting sleep difficulties only makes the insomnia worse because your body floods with adrenaline and before you know it - yes you are wide awake.

Learning to associate your bed with sleeping and not sleeplessness

If worry about sleeping stops your ability to unwind at night then the following may be of help. The goal is to train your body and mind to associate your bed with only sleep or sex and not frustration and anxiety.

Use the bedroom only for sleep and sex. Don't work, watch television, use your computer or your smartphone. To goal is to associate your bedroom with sleep and sex so that when you get into bed you have trained both your brain and your body to receive a strong signal that it is either time to nod off or be romantic.

Get out of bed when you can't sleep. Don't try to force yourself to sleep. Tossing and turning only increases your anxiety. Get up, leave the bedroom and do something relaxing such as reading, drinking a warm cup of tea, taking a bath or listening to some soothing music. Now, when you are sleepy, simply go back to bed.

Move bedroom clocks out of view. Yes you have guessed it anxiously watching the minutes tick by when you can't sleep and knowing that you are going to be exhausted when the alarm goes off is going to increase tension and insomnia. Use the alarm but make sure that you cannot see the time when you are in bed.

Self-help strategies for chronic worriers

Do you try to get to sleep but then find yourself laying awake worrying about what if and worst case scenarios? Follow this link to explore chronic worrying as a mental habit and what you can do to learn to break it.

Insomnia Cures and Treatment - harnessing your body's relaxation response

Relaxation techniques such as deep breathing, meditation, yoga, and tai chi can help quieten your mind and relieve tension. They can also help you to fall asleep faster and get back to sleep more quickly if you wake in the middle of the night.

Relaxation techniques which can help you sleep

Here are a series of podcast recording which you can listen to here on line or download to help with relaxation.

SLEEP DISORDERS

Sleep Apnea

Is a common sleep disorder where your breathing temporarily stops during sleep due to a blockage in the upper airway. These pauses in breathing naturally interrupt your sleep leading to a slight shock to your system. The result is that you may spend several hours awake. Whilst most people don't remember the initial shock that caused them to wake the lack of sleep results in their feeling tired and exhausted during the day.

If sleep apnea is happening on a regular basis then it is important to seek medical help.

Symptoms include:

• Loud, chronic snoring
• Frequent pauses in breathing during sleep
• Gasping, snorting, or choking during sleep
• Feeling exhausted after waking and remaining sleepy during the day no matter how much time you have spent apparently asleep in bed.
• Waking up with a shortness of breath, chest pains, headaches, nasal congestion or a dry throat.

Restless Leg Syndrome (RLS)

This sleep disorder causes an almost irresistible urge to move your legs or arms. The urge to move occurs when you are resting or lying down and is usually due to uncomfortable, tingly, aching or creeping sensations.

Common signs and symptoms are:

• Uncomfortable sensations deep within the legs, accompanied by a strong urge to move the legs.
• The leg sensations are triggered by rest and appear to get worse at night.
• The uncomfortable sensations temporarily get better when you move about and stretch the legs or when you physically massage your legs.
• An experience of repetitive cramping or a jerking sensation in the legs during sleep.

Narcolepsy

This is a sleep disorder that involves excessive and often uncontrollable daytime sleepiness. It is caused by a dysfunction of the part of our brain which controls being asleep and waking. Common symptoms are having what are termed 'sleep attacks' whilst in the middle of talking, working or even when driving.

Common signs include:

• Seeing or hearing things when you feel drowsy or starting to dream before you are fully asleep.
• Suddenly feeling weak or losing control of your body muscles when you laugh, are angry or when you are experiencing strong emotions.
• Dreaming right away after you fall asleep or having very intense dreams whilst alseep on a regular basis.
• Feeling paralyzed and unable to move when you are either waking from sleep or when you are dozing off to go to sleep.

Change in the Circadian (Biological Time Clock) Rhythm

Our internal biological time clock regulates the 24 hour sleep cycle which is known as our circadian rhythm. It is light which is the primary cue that regulates this natural chemical process. So when the sun comes up in the morning the brain tells the body that it is now time to wake. Then at night when there is less light the brain triggers the release of melatonin which is the hormone which makes us sleepy.

There are times when the circadian rhythm or our biological time clock are disrupted leading to certain sleep disorders such as insomnia, jet lag and shift work sleep problems.

It is relatively easy to reset our biological time clock as a result of jet lag and with all of the international lectures I have had to complete over the last twenty years I have become an expert in this field.

If you are travelling through several time zones you can gradually adjust your sleep. For example three days before you plan to travel go to bed half an hour earlier than usual and then get up half an hour earlier in the morning. The day before you planned travel go to bed 90 minutes earlier and you will find that on the day of travel you will find it easier to adjust to the new time zone.

Switch to the new time zone and so do not wait until it is bedtime in the new time zone. For the first day or two spend as much time outdoors as can to let the light switch your biological time clock and so to wake earlier go out in the morning sun and to wake later go out in the afternoon sun.