Friday 25 May 2018

Can't sleep, won't sleep: Overcoming insomnia

From irishexaminer.com

LACK of sleep brings with it an array of ill-effects — it’s been linked with everything from irritability, depression, and anxiety to poor memory and concentration, weight gain, obesity, and high blood pressure.
It can even lead to traffic accidents.
We’re familiar with the concept that lack of sleep is bad for us — yet research shows that just over 40% of Irish people notch up a bare six hours’ sleep or less on an average weeknight.
We continually subject ourselves to sleep deprivation, even though, according to the World Health Organisation, adults generally need between seven and nine hours’ sleep a night.
It’s a big issue, warns Peter Coss, head of the respiratory and sleep labs at St James’s Hospital in Dublin, who points to US research which found up to a third of people slept less than seven hours a night.
We’re simply not acknowledging the importance of sleep, says Dr Elaine Purcell, consultant in sleep disorder medicine in the Mater Private Hospital.
“People don’t put enough emphasis on the importance of getting enough sleep,” she says.
“In the western world today there is an epidemic of sleep deprivation across all age groups.
“This particularly worrying in children and teenagers because sleep deprivation can have a negative impact on the development of children for example, in terms of their physical growth,” says Dr Purcell, who explains that lack of sleep can disrupt a child’s production of crucial growth hormones which can seriously affect their growth.
Even though many people are conscious of the crucial role played by diet and exercise in their overall health, they will “often neglect sleep”, she says.
“We must emphasise the importance of sleep as a vital part of people’s health,” she says, adding that she believes anyone who has difficulty sleeping should discuss it with their GP.


As a nation we certainly have a problem. According to Awake, a recent RTÉ documentary on the issue, more than 40% of us notch up a bare six hours’ sleep or less on an average weeknight. Around 27% of people use alcohol to help them sleep, while 18% use sleeping tablets.
Insomnia is a particularly common problem with up to 15% of people suffering from the condition which leads to difficulty in falling asleep or staying asleep.
Meteorologist Joanna Donnelly has spoken openly about the debilitating effects of the condition while ITV political editor Tom Bradby recently took an extended break from work to address his chronic insomnia.
“Insomnia is the most common sleep disorder — research shows that it affects between 10% and 15% of people,” explains sleep physiologist Breege Leddy, manager of the sleep and clinical physiology department in the Mater Private.
Some people may be more vulnerable to insomnia as a result of genetics, family history, or the menopause, she explains.
For others, significant life events such as bereavement, illness, stress, or medication can be a factor, while insomnia can also be a problem for people who worry or ruminate excessively.
However, explains Leddy, there is hope. Cognitive behavioural therapy (which helps you understand that your thoughts and actions can affect the way you feel) has proven to be successful in treating the condition.
“It’s about changing the way people think about sleep, as well as about their behaviour and lifestyle,” she explains.
About 10% of people suffer from other sleep disturbance issues such as narcolepsy (excessive daytime sleepiness), restless legs syndrome (a strong urge to move one’s legs at night), or sleep apnea, a severe sleep disorder which occurs when a person’s breathing is interrupted during sleep. People with the condition may stop breathing repeatedly during sleep, which means the brain and the rest of the body may not get enough oxygen.
“If you’re sleeping under seven hours a night it can lead to psychological and neural deficits, but more and more people are reporting sleeping less than six hours a night,” says Coss.
“When you’re sleep deprived, your body tries to increase the drive to sleep in order to recover sleep, so you’ll be tired or sleepy, which can mean you are putting yourself at increased risk of an accident, for example, when driving.”
If you suffer from chronically insufficient sleep, you’re also at a higher risk of developing diabetes, obesity, high blood pressure, and stroke. “Irregular sleep patterns can affect mood and lead to depressive symptoms,” he says.
For those of us who don’t suffer from medical conditions like sleep apnea or narcolepsy, one of the biggest factors in achieving a good night’s rest is maintaining a good personal sleep regime.
According to Coss, what this means is we need to go to bed around the same time each night — preferably before midnight to allow for at least seven hours’ sleep — and not stay up ’til the early hours binge-watching the latest boxset.
It also means banning the TV and our beloved hand-held tech devices from the bedroom. They emit a blue light which can delay the onset of sleep.
“We are very concerned about excessive screen exposure in the lead-up to bedtime in all age groups. This delays people’s ability to fall asleep and reduces the overall amount of sleep they get because they are staying up late,” says Dr Purcell, who warns that the general advice is to shut off all screens two hours before bedtime.
In fact the American Academy of Paediatrics has identified electronic media use along with caffeine consumption as some of the main causes of sleep deprivation in teenagers. Coss advises people who have difficulty sleeping to avoid caffeine after midday.
“We need to have a national conversation about sleep and the importance of sleep — it’s seen as something that has to compete with work and social life, but we should view sleep in the same way as we do a good diet and exercise,” he says.
One of the main reasons why we’re not sleeping enough these days is that we’re ignoring the natural rhythms to which our bodies are attuned, believes Orlaith Donoghue, clinical lead for the Wellness Recovery Action Programme at St John of God’s Hospital.
“Sleep plays a major role in our health. It takes up one-third of our time,” she says, pointing out that, although many people understand why we need to sleep, nowadays they tend to ignore it.
Tempted by the many distractions and demands of modern life, we’re ignoring our body’s natural ‘off’ button, she warns.
And yes, there is a price to pay.
“The evidence is that too little sleep is associated with a decrease in concentration and creative thinking, and there’s an impact on mood — we become cranky and feel vulnerable,” she says.
“Our memory can be affected because during sleep we often process things, which helps us to remember. Therefore, when we don’t get sufficient sleep, it affects the processing of these memories and that affects our ability to recall things.”
If all of that wasn’t enough, our immune system can also be depleted by lack of sleep, says Donoghue, while our balance and co-ordination may be affected because of tired muscles.
So it’s worth paying attention to your body and getting the sleep it desperately needs.
“As a society we’re very driven,” says Donoghue. “We’re living in an age where the more you do the better you are. Therefore the more things you can say you are juggling and balancing the better,” she says, pointing out that the age-old traditions of Sunday as a rest-day for example, is almost extinct, while many people now don’t even take a lunch break.
Because so many of us keep pressing that ‘on’ button, the body can forget how the ‘off’ button works, which means we literally lose the knowledge of how to sleep. Many people are jumping into bed in fifth gear and then wondering why they cannot sleep, says Donoghue.
“It’s about forgetting how to wind down. To wind down you need to take breaks during the day. You have to be able to take rest breaks because they set the blueprint for having a good night’s sleep.”
We also need to know where we fit on the WHO-indicated range of seven to nine hours of sleep.
“Pay attention to your body. Remember, sleep is largely about habit and routine,” she says, adding that we not only need to go to bed at a regular time, but we also need to get up at the same time every morning.
“Lie-ins should not last for more than half an hour to an hour later than your normal rising time.”
And watch that caffeine intake — we’re often over-stimulated, warns Donoghue, pointing to students taking caffeine tablets and stressed employees drinking high-caffeine drinks to help them push through a long day.
Donoghue, who runs sleep workshops in the hospital, says the facilitators always ask people when is the time to start getting ready for bed.
“Most people will say about one hour before bed. However, the reality is you start getting ready for bed when you get out of bed in the morning, because you have to manage your energy, maintain your focus, and structure your day around work time, rest breaks, and physical exercise.
“Research shows that people who are rested are more productive and achieve more, not less.”

https://www.irishexaminer.com/breakingnews/lifestyle/healthandlife/cant-sleep-wont-sleep-overcoming-insomnia-844850.html

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