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.
Challenging
self-defeating thoughts that fuel insomnia
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Self
defeating thought
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Sleep
promoting thought
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Unrealistic
expectations - I should be able to sleep well every night
like a normal person.
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Lots
of people struggle at certain times in the life with getting
the right amount of sleep and I will be able to change this.
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Exaggeration
- It is the same every single night and another night of
sleepless misery.
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Not
every night is actually the same and so what is happening
is that some nights I sleep better than others.
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Catastrophizing
- If I don't get some sleep I wont be able to do my job
and loose my career.
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I
can get through work tomorrow even if I am tired and at
least I can still rest and relax even though I cant get
off to sleep immediately.
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Hopelessness
- I am never going to be able to sleep well ever again and
it is clearly out of my control.
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Insomnia
can be cured if I stop worrying so much about it and focus
instead on positive solutions which will end this insomnia.
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Fortune
telling - It is going to take me at least over an hour to
go to sleep tonight.
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I
don't know what will happen tonight but I can go to sleep
more easily if I start to use the strategies which I have
learned.
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Remember,
replacing self defeating thoughts takes time and also practice.
So, you might find it helpful to jot down your own list
whilst taking note of the negative thoughts that come into
your mind so you can actively challenge and dispute them.
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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.
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