Still working from home? Dos and don'ts to avoid sleep disorders

From hindustantimes.com

Due to the pandemic related work from home (WFH) sleep disorders are becoming more common because of lack of activity, long work hours and loss of personal and professional boundary.(Pixabay) 

Considering Covid-19 is still very much around and waves come and go, many workplaces are still encouraging work from home for the safety of their employees. However, being at home most of the times can invite an array of health issues and one of them is insomnia. According to research, up to 30-40% of people suffer from some form of sleep disorder. Due to the pandemic related work from home (WFH) sleep disorders are becoming more common because of lack of activity, long work hours and loss of personal and professional boundary.

"Everyone needs a restful 7-8 hours of sleep for normal functioning of our body. The quality of sleep is of paramount importance. There is increased risk of mental and physical illnesses if there is reduced quality or quantity of sleep," says Dr Santosh Banger, Senior Consultant Psychiatrist, Global Hospital, Parel, Mumbai.

Dr Banger elaborates on the reasons how working from home can disrupt our sleep cycle.

The expert says the blue-ray emitted by laptop or smartphones can reduce sleep. He adds that sedentary lifestyle is also one of the culprits. "Sedentary lifestyle in the pandemic led to lack of exercise. Exercise release ‘endorphins’, a feel good hormone. Exercise also promotes sleep if taken early in the day," says Dr Banger.

He says that due to long work hours in WFH, the boundary between personal and professional gets blurred and this may lead to less family time, and add to stress. "Sleep is best once one is in a relaxed state of mind," he says.

Tips to cope with sleep problems

1. Maintain a strict sleep-wake routine.

2. Try to put blinds/blackout curtains in the room to darken it. A cooler (20-22 degree celsius) bedroom promotes sleep.

3. Caffeine, smoking and alcohol should be avoided.

4. Use bed only to sleep rather than using it as workspace.

5. Exercising early in the day can be effective for good sleep. Avoid exercising three hours before your bedtime.

6. Try and avoid taking naps after 3 pm.

7. If you can't fall asleep in 20 minutes, get yourself engaged in reading a book or listen to soothing music.

8. Keep your body relaxed before going to sleep by taking a warm bath or putting lavender oil on your pillow.

9. Avoid excessive use of gadgets which emit blue rays like smartphones or TV at least 2-3 hours before bedtime.

https://www.hindustantimes.com/lifestyle/health/still-working-from-home-dos-and-don-ts-to-avoid-sleep-disorders-101652271015717.html

Sunglasses can be bad for your health and sleep hormones; here's why

From hindustantimes.com

Wearing sunglasses all the time can mess with one's circadian rhythm which can lead to fatigue, insomnia and even depression 

Sunglasses are known to protect eyes from UV (ultraviolet) damage and harmful sun exposure at certain times of the day, but did you know they can they can also play havoc with your hormones and lead to insomnia and depression? Sunglasses are considered one of the coolest accessories among youth today and people tend to overuse them even when they aren't required. Wearing them all the time, however, can meddle with the body's circadian clock and cause several health issues.

Tim Gray, health optimising biohacker, psychology specialist, entrepreneur and global speaker says wearing sunglasses can starve the pineal gland and tricks the brain into thinking it's cloudy and stops the skin from preparing for skin exposure.

"On a sunny day, specific wavelengths of light from the sun filter into the eyes. This feeds the pituitary and pineal glands and lets the brain know it’s sunny. The skin then prepares for direct sunlight exposure and gets ready to make vitamin D," Tim Gray writes in his recent Instagram post.

Sunlight helps regulate the hormones by stimulating the hypothalamus in the brain, which is connected to the pineal gland (Pixabay)

The health expert says sunglasses can also mess with one's circadian rhythm which can lead to fatigue, insomnia and even depression (Seasonal Affective Disorder).

Talking about the importance of sunlight, Gray says it helps regulate your hormones by stimulating the hypothalamus in the brain, which is connected to your pineal gland. The expert says when your eyes aren’t absorbing sunlight naturally, your hormone cycles can be severely altered, messing with many different body systems and your moods.

"They can cause your eyes to become tired because they have to work harder to get natural light. This can lead to poorer vision over time," adds Gray.

The health expert concludes that sunglasses have their role to play in shielding eyes when skiing, on the water or driving when the sunlight is bright but not all day and every day.

Sunglasses can be bad for your health and sleep hormones; here's why | Health - Hindustan Times

How to get improved sleep: Tips to get more shut eye and how to tell if you’re sleep deprived

From inews.co.uk

By Tom Bawden

Anxiety about Covid, the environment, war in Ukraine and the cost of living, mean sleep has deteriorated for Britons since 2020. And worries about insomnia are making the problem worse. But one scientist says we misunderstand how we sleep 

We’re not getting enough sleep and worrying about the problem is making it even worse.

Scientists agree that anxiety levels triggered by the pandemic, war, and insomnia itself – have led to a marked deterioration in sleep quality in the UK since 2020.

But there is hope – one expert says that if we understood sleep better we might become less worried about it.

Professor Russell Foster, director of Oxford University’s Sleep and Circadian Neuroscience Institute, thinks that some people who believe their sleep has got worse may actually be sleeping better.

This is because they are getting so much extra sleep they are unwittingly dividing it into two or more segments a day. The pattern is known as polyphasic sleep and is what used to happen before we had electric light.

“During Covid some people have slept longer and they’ve flipped back into polyphasic sleep,” Professor Foster tells i.

“This is making them extremely anxious because they’re interpreting the fact that they are waking at night as being worse.

“In fact, if you look at sleep patterns in the pre-industrial era, or in societies without electric light, that’s what it’s like. You have a slow winding down, a period of sleep, you wake up, interact with others, you go back to sleep again, you may have another period of waking up and going back to sleep. That is the normal state.”

However the academic, who has stopped watching the evening news to improve his own sleep, also agrees that “a significant number of people are sleeping worse at the moment”.

Are you getting enough sleep?

“You know if you’re getting a decent night’s sleep if you can function properly during the day,” says Oxford University’s bodyclock expert Professor Russell Foster.

“Do you need an alarm clock to wake you up? That indicates you haven’t had enough sleep.

“Other questions to ask include: Do you oversleep extensively on free days, particularly holidays? Does it take a long time to wake up? Do you feel groggy when you wake up in the morning? Do you feel sleepy and irritable and fatigued when you’re awake?

“Do you need a nap during the day? Do you find yourself doing stupid, unreflective, impulsive things? Do you need or crave caffeine drinks to sustain your daytime activities?”

“And do your friends and family comment that you are more irritable and have lost empathy?”

What to do if you’re not

If you answer “yes” to the above questions then here are Professor Foster’s tips for getting more sleep:

-You need to wind down: It could be yoga, mindfulness, anything that relaxes you and makes you less anxious.

-For many couples the end of the day is the only chance to talk about important issues but what surfaces in so many occasions is finances or worries about the kids or the parents that increase anxiety and keep them awake at night. In my household, we’ve banned talk of finances and other stuff and schedule a time, usually on a Saturday morning, when we go through the tough stuff, Professor Foster says.

-Exercise can be a good stress buster, as long as it’s not too close to bed time.

-Have a relaxing shower or bath, with candles.

-Read a few pages of a favourite novel or look through a wonderful old photograph. Anything that can promote gentleness and happiness of thought.

Aisling Traynor, Head of Advice and Training at Rethink Mental Illness, added: “There are plenty of strategies to help sleep but it can take time to find out what works for you. Anyone struggling to get some proper rest should try to find a routine that suits them, going to bed and waking at a similar time each day. Avoiding rigorous exercise, large meals and alcohol late in the evening and switching off screens for an hour before you go to bed and reading a book instead can help.”
“It may seem counterintuitive, but often a good solution is to get out of bed and do something relaxing until you feel sleepy.
“Rolling 24-hour coverage can make us feel anxious and powerless, so try to avoid doomscrolling and take regular breaks from the news to help you get some much-needed shut-eye. If you’re still struggling with your sleep, consider making an appointment with your GP to explore further options for support.”

The impact of the pandemic seems clear. A study by King’s College London, conducted in May 2020 as the first lockdown was being eased in the UK, found that sleep got worse for nearly two thirds of Britons after Covid restrictions were introduced.

And a second piece of Kings College sleep research published in November has since warned that persistent sleep problems “may continue long after the pandemic is over”.

“Covid, lockdowns and associated stress and anxiety around the pandemic have measurably impacted on sleeping patterns in the UK and communities around the world,” says Ivana Rosenzweig, head of the Sleep and Brain Plasticity Centre at King’s College London, who worked on both King’s College sleep studies.

“There has been a recognised change in sleeping patterns and a deterioration in sleep quality in the population over the last two years. And I would not be surprised if the horrors of the war in Ukraine have now further affected people.”

Professor Barbara Sahakian, of Cambridge University, who last week published a study saying seven hours was the optimal sleep duration, agrees. “Sleeplessness is a growing problem in the UK and I suspect this is due to chronic stress caused by concerns about the natural environment, Covid-19, the Russian conflict with Ukraine and the cost of living increases,” she said.

And, as Professor Foster points out, anxiety about a lack of sleep can be added to the list.

“Many people, particularly as we age, wake up in the middle of the night and think ‘Oh my God, this is it, I’m never going to get back to sleep’ and they start drinking coffee and doing their emails,” he says.

“But if we stay relaxed and calm and appreciate it’s perfectly normal, we’ll go back to sleep again.”

He also says that a minority are actually sleeping better than they used to – the 2020 King’s College study found that 27 per cent of men and 22 per cent of women – were sleeping longer hours and feeling more rested.

And people get far too hung-up on getting the seven or eight hours seen as optimal, according to Professor Foster who says this is highly variable from person to person.

“The healthy sleep range for adults is between 6 hours and 10 hours,” he says. “Sleep is like shoe size – one size does not fit all. We need to accept that and stop worrying about it.”

Life Time: The New Science of the Body Clock and How It Can Revolutionise Your Sleep and Health, by Russell Foster, is published by Penguin Books on 19 May

https://inews.co.uk/news/science/how-to-get-improved-sleep-tips-to-get-more-shut-eye-and-how-to-tell-if-youre-sleep-deprived-1612972

Insomnia, addiction, depression: The dark side of life trading crypto

From news.yahoo.com

When Joanna Garzilli was in Venice, Calif., for a holiday party in 2017, the bikini-clad dancers were on stilts, the drinks were flowing and the conversation was about one thing: cryptocurrency. It seemed so sexy, she remembered thinking. Lured by the glamorous crowd, she later invested and struck it big: an $85,000 profit from a crypto coin called GRT, bringing on dreams of life at the Ritz-Carlton Residences.

But soon, her trades became reckless, she said. Garzilli staked 90 percent of her life savings into a coin that lost her tens of thousands in days. She made risky investments into viral meme currency and constantly checked her trading apps to see how much money she'd made or lost. Her nights became sleepless, but Garzilli kept chasing the next big payday.

"Crypto is like going into Hades," she said. "Crypto can bring out the darkest parts of ourselves if we have an addictive personality; and I have a very addictive personality."

As the cryptocurrency boom has swollen the ranks of everyday investors chasing a life of mansions and yachts, mental health experts say it is sparking a rise in addiction. Price spikes and dips provide a level of excitement hard to replicate through the most volatile stocks and bonds. The highly unstable nature of cryptocurrency can reduce profits to zero in a flash, leaving investors with mountains of debt, fractured relationships and thoughts of suicide, addiction experts said.

Therapists, such as Aaron Sternlicht of New York, say they are seeing an influx of people seeking help for crypto addiction, though treatment is available for only a privileged few.

"A lot of people will not end up getting treatment who need treatment," he said.

Over the past decade, cryptocurrency has gone from an oddity to a core part of financial markets and popular culture, its market value skyrocketing from $5.4 billion to $1.8 trillion, according to Coin Market Cap, a site that tracks cryptocurrency statistics. Meanwhile, celebrity endorsements make for a lavish billboard for the lifestyle cryptocurrency can provide.

In recent months, Matt Damon has promoted Crypto.com, an app that can help you trade cryptocurrency. Tampa Bay Buccaneers quarterback Tom Brady and his wife, Gisele Bündchen, are advertising for the cryptocurrency exchange FTX. Influencers on YouTube, TikTok, Instagram and Twitter showcase lives filled with first-class flights and luxury rooftop pools, signifying that crypto is the best way to make it rich.

Cryptocurrency has characteristics that make it more prone to addiction than sports betting, gambling and traditional financial investing, according to addiction scholars. Crypto can be traded around-the-clock, unlike most stocks. People don't need to drive to a casino to invest in a coin. The volatility in crypto prices, especially alternative currencies like meme coins, can be quick and provide the brain quick feelings of reward. And given crypto's decentralized nature, it can be easier to hide the financial impacts of addiction.

Lia Nower, director of gambling studies at Rutgers University, said sleek investing apps fuel rates of addiction. With colourful, real-time charts, trading apps like Robinhood make buying cryptocurrency seem like a video game.

"They know what it is to get people more engrossed in something - that high action, that quick turnover with that positive reward," she said. "It's why people like lottery scratch-off tickets, because they can scratch madly and they get their reward in that second and that gives you a burst of dopamine. These people are doing a similar thing."

Though research is still developing, several recent studies document links between cryptocurrency trading and addiction. In April, a team of Finnish researchers found that cryptocurrency traders also had high rates of gambling, video game and Internet addiction. Crypto traders, who were more likely to be immigrants, also had higher levels of psychological distress and loneliness compared with stock traders, they found.

                                                                     Bitcoin (Washington Post illustration/iStock)

Ashwin Manicka, a spokesman for Robinhood, strongly disagreed that the app plays any role in crypto addiction.

"It is our view that such allegations are an elitist attack on ordinary people who have been empowered by intuitively designed financial products to participate in the equities and cryptocurrency markets for the first time," he said in a statement. "We have yet to see any hard evidence to support these anecdotal claims, and the data paints a different picture."

Sternlicht and his wife, Lin, a husband-and-wife therapist team in New York who treat cryptocurrency addiction, said they have seen a roughly 40 percent rise in people from all over the world calling to get their crypto-tailored therapy services. Their services cost $2,500 for a consultation and $25,000 for a 45-day therapy treatment plan that is more intensive than traditional forms of talk therapy. To treat the addiction, they meet with family members, have access to bank accounts and meet with patients multiple times a week.

Most of their clients come for help when they are over six figures in debt, have ruined their relationships, face significant bouts of depression and carry other addictions, particularly to alcohol, cocaine and Adderall. Aaron Sternlicht added that people who come to their practice usually have significant wealth, but for those without much means, seeking treatment can be difficult.

The American Psychological Association has not classified cryptocurrency addiction as a subset of gambling addiction, Sternlicht said, which creates a grey area that allows many insurance companies to decline coverage for crypto-related addiction therapy.

"There's not enough research in it to really have it be diagnosable yet," he said.

Despite that, Nower said, people suffering from crypto addiction do not need to seek out specifically tailored services and can get treatment with a gambling addiction counsellor. "What you're really addicted to is the action of taking the risk," she said. "Anybody who's a good treatment provider for gambling can treat crypto addiction."

Drew Vosk, a 30-year-old cryptocurrency investor who lives near northern Virginia, got hooked on cryptocurrency investing around 2017, when he started putting money into Ethereum. From there, he got interested in mining crypto currency, maxing out his credit cards to buy the equipment needed for it. "I spent all the money I had on buying cryptocurrency and building out crypto mining rigs," he said. "I was addicted. I was obsessed."

At multiple points, he has turned a $1,000 investment into $100,000, only to see those profits evaporate. When the swings happen, the impacts are significant. "I wake up, I'm depressed," he said. "I'm like, 'Wow, I can't believe this. Like, that's just gone.'"

And for Garzilli, 49, living with cryptocurrency addiction is a daily battle. When a new investment opportunity comes on her radar, the urge to invest and chase the high of another payday is strong. So is the fear of missing out. "It's like a pulling feeling in my stomach," she said. "It's like my whole body is being dragged toward 'Go do it. Go do the trade.'"

To manage, Garzilli has enrolled in a 12-step program, similar to Alcoholics Anonymous. She forces herself to unplug from her screen throughout the day. She takes walks, meditates and goes for drives in the car if the urge to invest in a coin becomes too great. Nowadays, she invests in less-risky cryptocurrency, and she tells herself that she needs to build her portfolio with an eye toward retirement.

Even still, Garzilli said that government action is required to rein in the scammers who prey on cryptocurrency investors and curtail projects that provide little value.

"People are still going to get murdered," she said. "Until we have stronger regulation come in."

https://news.yahoo.com/insomnia-addiction-depression-dark-side-121507696.html 

How to sleep better and beat insomnia

From which.co.uk

Can't sleep? We ask the experts what works, and whether sleep aids are worth spending your money on 

Struggling to get to sleep or sleep through the night?  You're not alone - the National Institute for Health and Care Excellence (NICE) says that around one-third of adults experience sleep problems at least once a week, with up to one in ten permanently plagued by chronic insomnia (which is defined as difficulty getting to or staying asleep most nights for longer than four weeks). 

Covid and its related worries hasn't exactly helped matters either. A 2021 review of studies showed that around 40% of people suffered from sleep problems during the pandemic. 

We ask Professor Guy Leschziner, professor of neurology and sleep medicine at Guy's Hospital Sleep Disorders Centre, and author of The Secret World of Sleep, about the science behind getting a better kip. 

Get the lowdown on free ways to improve your sleep habits, and if any sleep aids really work.

Why can't I sleep? 

Many factors can hamper your ability to get a good night's sleep, and both biological and psychological influences are at play. Professor Leschziner says: 'Daytime stress causes causes physical and psychological 'activation' or disruption which will make sleep more difficult or of a poorer quality.'  

Over time, positive conditioned responses (such as 'bed is a restful place') may get displaced by negative ones (such as 'bed is somewhere I now associate with not being able to sleep'), creating a vicious cycle. 

6 tips to help you sleep better 

In most instances, disturbed sleep can be helped by addressing 'sleep hygiene' and establishing good practices, such as: 

1. Change poor sleep patterns: sleep less to sleep more 

Professor Leschinzer says: 'It might sound counter-intuitive but depriving yourself of sleep can enable your brain to re-establish a proper sleep schedule.' 

Note down how much time you actually spend asleep on a typical night - as opposed to tossing and turning - then allow yourself to sleep for this amount of time plus 30 minutes. 

For example, if you are trying to sleep for eight hours but only managing five, spend five hours and 30 minutes in bed - based on the time you want to get up and altering your bedtime accordingly - and gradually increasing it once you're spending the majority of time in bed sleeping. 

If you have a smartwatch or fitness tracker the sleep tracking function may help you understand aspects of your sleep, but Professor Leschziner suggests using them with caution as the information could be inaccurate and could even fuel your anxiety - causing further sleep issues. 

2.Get your bedroom temperature right 

Our body temperature drops by a couple of degrees when we are sleeping to help conserve energy for vital functions such as breathing. 

If it's too cold (under about 12°C) it can be difficult to drop off, and if it's too hot (24°C or more) this can lead to a restless sleep. We typically sleep better when the room is cooler - ideally around 16-18°C. 

A 2012 study reported in the Journal of Physiological Anthropology found that room temperature is one of the most important factors when it comes to achieving a good quality sleep. A fan, air conditioner or heater can help you to help achieve a suitable bedroom temperature, but opening a window, or if its cold piling on the blankets, can also help. Bed socks can also make a big difference if you're feeling chilly. 

3. Pick the right mattress - and pillow 

A 2021 Italian Journal of Trauma and Orthopaedics literature review on sleep quality and back pain found that a medium-firm mattress helps with sleep quality, comfort and keeping the spine in the best position. 

The type matters too. When we surveyed Which? members about mattresses, those who have an open coil mattress were less likely to say it helps them get a good night's sleep than those with other types of mattress. 

Lie for around five to ten minutes on several mattresses when you're trying them out, remembering to try turning on them to see how comfortable this is, too. If you sleep with a partner, bear in mind any differences in weight and size between you both, as this affects what type of mattress will suit you best. 

Choosing the right pillow can help, too - for example, a memory foam pillow is a great option for those looking for neck pain relief, as it contours to your body. 

4. Get outside in the morning, and off your phone at night 

If you're not sleeping properly, exposing yourself to natural light in the morning can help reset your 'body clock' so you'll sleep more easily at bedtime. 

Daylight in direct sunlight has up to 10,000 lux (bright office lighting is generally less than 500 lux) which is why daylight is so powerful at helping to reset the sleep-wake cycle. 

Conversely, blue light emitted by many devices including smartphones and laptops has been found in multiple studies to contribute to poor sleep and excessive daytime sleepiness. 

Stop using screens an hour before bedtime - even if they are in night mode, to avoid overstimulation preventing good sleep. 

5. Take a warm bath or shower 

A 2019 study published in the journal Sleep Medicine Reviews found that taking a warm bath or shower of 40-42.5 °C one to two hours before bedtime improved sleep quality and sleep efficiency (the time spent asleep when you're in bed), and reduced by an average of 10 minutes the amount of time it takes to drop off to sleep. 

During the night our temperature drops and this aids better sleep, so although it sounds counter-intuitive, warming ourselves up by immersing ourselves in warm or hot water a little while before we go to bed actually helps to aid this natural drop. 

The way it does this is by taking heat away from the body's core and to the hands and feet from where it is dispersed. 

6. Try a sleep app 

If sleep hygiene doesn't seem to be helping, online self-help apps offering cognitive behavioural therapy for insomnia (CBT-I) can be an effective insomnia solution - and in some cases even better than face-to-face therapy. 

Research carried out in 2020 by the Oxford Academic Health Science Network found that Sleepio - a six-week digital treatment for insomnia - helped those with insomnia gain almost six hours more sleep a week, as well as reducing sleeping pill use, time off sick and the number of GP visits. 

CBT-I helps you to identify thoughts and behaviours that are causing your sleep problems and replace them with more constructive ones to promote healthy sleep through better habits. 

https://www.which.co.uk/news/article/how-to-sleep-better-and-beat-insomnia-adkTs0w409oF

Ten practical ways to relieve insomnia

From spokesman-recorder.com

No sleep, no wellness!

Great sleep is the foundation for great health. During sleep our physical and mental selves get a chance to relax, rejuvenate and restore themselves so that we can continue to carry out our daily obligations. 

We all know that sleep is important on many levels. We have all heard that we need to sleep in order to grow, or when we are sick we need to sleep in order to get better. We have long recognized even in our children that if they are not sleeping well their behaviour becomes unreasonable. That is demonstrated by watching any toddler who has missed their nap! 

Great sleep is recognized as important even in our workplace with the sound advice to sleep on a big decision before making it. 

Photo by Anna Shvets on Pexels.com

Sleep is by definition a state of reversible, often supine, decreased muscular activity with specific brain wave patterns, often with eyes closed and a decreased level of consciousness. Sleep is what we want at the end of a stressful day or when we are not feeling well just to tune out and go off the grid for a little while. 

How incredibly stressful it becomes, then, when we want to sleep but it eludes us! Insomnia by definition means that we are taking more than half an hour to get to sleep. While there are many causes of insomnia, such as racing mind, pain, sleep apnoea,  and medications, I will focus on providing some practical solutions to help decrease your chances of ongoing insomnia.

1.  Keep a routine bedtime and wake-up schedule. This means trying to go to bed about the same time and getting up about the same time each day. This will help your body’s hormones and circadian rhythm to sync, and this in turn will help you get to sleep and feel more refreshed when you wake up.

2.  Do not look at the alarm clock! Be sure that the alarm clock is facing away from you so you are not seeing the time that is passing as you try to fall asleep. Remind yourself that what time it is is not important and the more you see what time it is, the more likely you are to have further delay getting to sleep. The light emitted from the numbers on the clock can also impair your ability to get to sleep.  

3. Set the alarm for the time that does not allow you to snooze. Snoozing more often than not makes you feel more tired, as you are not able to get into as deep a sleep again. This adds to sleep disruption. Hearing the alarm should tell you that you must get up immediately or you will be late.

4. Try to not eat within a couple hours of bedtime. Eating close to bedtime leads to ongoing production of stomach acids and GI irritation, which add to sleep disruption.

5.  Control pain. If you have a chronic pain condition, give yourself time to find a comfortable position. If medications are needed, take them as directed so that chronic pain is not preventing you from getting to sleep and staying asleep.

6.  Make sure the room you are sleeping in is darkened so that the sun rising earlier than your desired wakeup time does not cause you to wake up sooner than you would like to. You may need to wear an eye mask.

7.  Wear earplugs. Keeping your sleep environment as quiet as possible is helpful in maintaining sleep. Having earplugs in if needed helps to block out distracting noises that can cause you to wake up prematurely. For example, if you know that on Tuesday mornings your recycle truck comes for pickup and it is loud, you may choose to wear an ear plug that night at minimum in the ear that is not on the pillow.

8.   If you take a medication for sleep, take it as directed and see your prescribing provider if you desire any dosage change. Many of the medications that are prescribed to help with sleep have adverse effects if stopped abruptly.

9.  If you have a difficult time getting to sleep or staying asleep, consider setting the mood:  

• Use blue and green light filters on cell phones and on any backlit electronics and computer screens. This will help to keep your own melatonin level as high as possible, which leads to better sleep.
• Take a bath at night. Feeling and smelling clean, especially using bath salts such as eucalyptus, is relaxing. 
• Meditate. Browse the many apps that are available, many of which are free! Mediation will help you to slow down your mind and not relive, rewrite and replay the past or perceived future.
• Do something relaxing at night such as read a book as opposed to watching a show or another activity that might get you upset.
• Turn off social media and notifications when getting ready for bed.

10.  Limit your activities in the bedroom to do those that are sleep-promoting. Consider consulting with a sleep specialist to discuss the details of your sleep problem. They can discuss and, if need be, prescribe cognitive behavioural therapy and medications.

https://spokesman-recorder.com/2022/04/15/ten-practical-ways-to-relieve-insomnia/?utm_source=rss&utm_medium=rss&utm_campaign=ten-practical-ways-to-relieve-insomnia

The elderly and insomnia

From bereamail.co.za

Sleep problems in the elderly are often mistakenly considered a normal part of ageing. Insomnia, the most common sleep disorder, is a subjective report of insufficient or non-restorative sleep despite adequate opportunity to sleep

INSOMNIA

Insomnia is a prevalent problem in late life and Pharmacists and Doctors are often approached with elderly patients looking for an instant cure. Sleep problems in the elderly are often mistakenly considered a normal part of ageing. Insomnia, the most common sleep disorder, is a subjective report of insufficient or non-restorative sleep despite adequate opportunity to sleep. Even though more than 50% of elderly people have insomnia, it is typically undertreated, and non-pharmacologic interventions are underused by health care practitioners. The latter very often solves the problem and is as important as proper sleep hygiene.

CAUSES OF SLEEPLESSNESS

Two primary factors control the physiologic need for sleep: the total quantity of sleep (average of ∼8 hours of sleep each 24-hour period) and the daily circadian rhythm of sleepiness and alertness. Sleep requirements and patterns change throughout life, but sleep problems in the elderly are not a normal part of ageing. The progression of sleep across the night is called sleep architecture, and it is displayed as a sleep histogram or hypnogram. Sleep architecture is composed of 3 segments. The first segment includes light sleep (stages 1 and 2), and the second segment includes deep sleep (stages 3 and 4). Taken together, stages 3 and 4 are referred to as delta sleep or slow wave sleep (SWS). SWS is believed to be the most restorative part of sleep. Stages 1 to 4 constitute nonrapid eye movement (non-REM) sleep.

Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common factors that may interfere with sleeping. Psychiatric disorders are often associated with persistent insomnia. Depression is usually associated with fragmented sleep, decreased total sleep time, earlier onset of REM sleep, a shift of REM activity to the first half of the night and a loss of slow-wave sleep. In manic disorders, a reduced total sleep time and a decreased need for sleep are cardinal features of the condition. Sleep related panic disorders occur in the transition from stage 2 to stage 3. Abuse of alcohol may cause or be secondary to the sleep disturbance. Heavy smoking (more than a pack a day) causes difficulty falling asleep. Excess intake near bedtime of caffeine and other stimulants as found in over-the-counter medicines and  remedies causes decreased total sleep time – mostly non-REM sleep. Some medical conditions, like chronic pain, respiratory conditions like asthma, uremia, thyroid disorders and nocturia could be causes of insomnia.

                  

SIGNS AND SYMPTOMS:  

Persons having sleep problems may typically complain of difficulty getting to sleep or staying asleep, intermittent wakefulness during the night, early morning awakening, or a combination of these. Difficulty in falling asleep may suggest delayed sleep phase syndrome, chronic psychophysiological insomnia, inadequate sleep hygiene, restless leg syndrome, or childhood phobias. Difficulty in maintaining sleep suggest advanced sleep phase syndrome, major depression, central sleep apnoea syndrome, periodic limb movement disorder, or ageing.

The Epworth Sleepiness scale can be used to determine excessive daytime sleeping.

Situation

Sitting and Reading

Watching TV

Sitting inactive in a public place

Riding as a car passenger for one hour continuously

Lying down to rest in the afternoon

Sitting and talking to someone

Sitting quietly after lunch (no alcohol)

Sitting in a car stopped for a few minutes in traffic For each situation, probability of dozing is self-rated as none (0), slight (1), moderate (2), or high (3). A score of ≥ 10 suggests abnormal daytime sleepiness. TREATMENT In general, there are two broad classes of treatment for insomnia and the two may be combined: psychological (cognitive-behavioural) treated by practitioners with expertise in CBTI and pharmacologic. The latter may be treated with over-the-counter medicines from your local pharmacy with sedating antihistamines which might induce sleep, but it might not treat the intermittent wakefulness during the night which means a visit to your medical doctor is necessary. The possibility of drug dependence should always be kept in mind, and one should be aware of that possibility when using prescribed treatment for insomnia. Newer generations of hypnotics have a much smaller chance of a patient becoming dependent on them and causes less of a “groggy” feeling the next morning although one soon becomes desensitised towards these unwelcome side-effects should they occur. Good sleep hygiene is very important. Go to bed only when feeling sleepy. Use the bedroom only for sleeping and sex. If still awake after 20 minutes, leave the bedroom, pursue a restful activity (such as a bath or meditation) and only return when sleepy. Get up at the same time every morning regardless of the amount of sleep during the night. Discontinue caffeine and nicotine, at least in the evening if not totally. Establish a daily exercise programme. Avoid alcohol as it may disrupt continuity of sleep. Limit fluids in the evening. Learn and practice relaxation techniques. Establish a bedtime ritual and a routine for going to sleep. Research suggests that cognitive behavioural therapy for insomnia is as effective as prescribed medication with benefits sustained 1 year after treatment.          WHEN DO YOU KNOW IT IS TIME TO VISIT YOUR DOCTOR? Persistent insomnias that do not respond to sleep hygiene practice or over-the-counter treatment should warrant a visit to the doctor. Also, if psychiatric disorders like depression or delirium, pain, respiratory distress syndromes, uremia, asthma, thyroid disorders, and bedwetting due to benign prostatic hyperplasia seems to be likely, a visit is necessary.       ADVICE Before looking at medication as a relief for insomnia, proper “sleep hygiene” should be looked at as a point of departure. Compile a sleep diary for at least two weeks and show it to your doctor or pharmacist and give them a proper history of all your chronic conditions i.e. pain, diabetes, hypertension, anxiety, depression. Try lifestyle modification at first and re-evaluate after two weeks. Only then start with a sedating antihistamine obtainable from your pharmacist as a first option, and if insomnia persists, visit your doctor.     REFLECTION Sleep requirements and patterns change throughout life, but sleep problems in the elderly are not a normal part of ageing. Whether older people need less sleep or cannot get the sleep they need, requires ongoing research. There is currently no gold standard for how much sleep is normal in the elderly. Good night! Johann Kruger M.Pharm., M.Phil., PhD., FPS is a Director at Medwell SA – The Home Health Care Specialists and the Head of EDNA Medical Distributors, an incorporated company at Medwell SA.  For more information visit www.edna.co.za or www.medwell.co.za https://bereamail.co.za/284142/the-elderly-and-insomnia/