Sleep & Insomnia

Insufficient sleep is a global public health problem. In the great British Sleep Survey 2012 a total of 20,814 people from across the UK took part. The average sleep score was 5.1/10. The top 5 physical factors (19%-67%) for sleep problems were bodily discomfort, noise, partner, and room temperature and light levels. However this was dominated by persistent mental thoughts bothering people at night (71%-82%). The impact of poor sleep affects us physically but also emotionally. Long-term poor sleepers are 7 times more likely to feel helpless and 5 times more likely to feel alone, but also twice as likely to suffer from fatigue, relationship problems and lack of concentration.  People in Scotland and Londoners had the highest average sleep scores. Women tend to have 10% lower average sleep score, and more likely to be long-term poor sleepers. The quality of sleep decreases as we get older. People taking sleeping pills are associated with poorer general well-being, with 42% of those on sleeping pills have been taking it for more than 10 yrs, which suggests that they do not help to resolve long-term sleep problems.  This highlights the need for alternative non-drug sleep solutions. peacefully sleeping

Sleep is a pleasurable shift in our consciousness that our body needs every day. During sleep our body relaxes causing our heart rate to slow down; body temperature to fall and most importantly there are significant changes in our brain activity. In the sleep cycle we enter a state of ‘non-rapid eye movement’ (NREM) sleep, which with longer sleep patterns we are able to complete the three NREM stages progressively entering deeper sleep states. Finally, in stage 4 we enter a rapid eye movement (REM) sleep when we start to dream.  The cycle lasts around 1 ½ hours long. To feel rested when we wake up, we need to complete all four stages.

Sleep Debt
Sleep Debt is the result of not getting enough sleep. Adults require between 6-9hrs of sleep daily. In toddlers (1-3yrs) it is around 12-14hrs, which gradually reduces to 11-13hrs (3-5yrs), 10-11hrs (5-12yrs), and between 8-9hrs for teenagers.  A significant debt causes detrimental effects on our mental, emotional and physical abilities. Overall, there is fatigue and causes us to have diminished ability for higher level cognitive functions.

How to improve your sleep
The key is to develop a sleep routine that works for you. A regular sleeping pattern teaches the brain and body to become familiar with waking and sleeping periods, and programs the brain to set an automated internal body clock. By working out what time you need to wake up for the next day you can calculate the time you need to go to bed. Winding down is an important part of preparation for bed. Depending on the individual this can be a warm bath, relaxation exercise, relaxing music or reading a book.  Some of the ways to get a good night’s sleep are;

  • Have a bedtime routine to maintain a regular sleep pattern.
  • Make your bedroom a relaxing environment. Bedrooms need to be dark, quiet and a comfortable temperature and bed to sleep in.
  • Empty your bladder before going to bed.
  • Avoid drinking alcohol.
  • Avoid using technology in the hours just before bedtime.
Integrative & Complementary medicine

Complementary and alternative therapies may be helpful adjuncts to the above.  One can use simple techniques to alleviate stress and enhance relaxation, or see a qualified practitioner for other more complex treatments.

Acupuncture has been shown to be more  effective in the treatment of insomnia, when compared to conventional medication. When used in conjunction with medication and herbs it continued to show better effects than without it. Acupuncture increases the levels of serotonin and encephalins in the central nervous system and plasma. Thus, effecting  psycho-emotional states and reducing anxiety and depression that may be associated with sleep problems.

Nutrition supplements will help improve overall health. In one German trial magnesium supplement helped to improve sleep. Foods rich in magnesium include; nuts, whole grains, beans, dark vegetables, fish and lean meat. Poor nutrition can affect the brain chemistry particularly three hormones; tryptophan, serotonin, melatonin which help induce sleep. A nutrition diet combined with avoiding stimulants such as caffeine and cigarettes, as well as sleeping pills will optimize the production of the body’s sleep inducing chemicals.

Aromatherapy & Massage can help improve sleep. Lavender or chamomile essential oil has shown in limited studies to be as effective as sleeping pills. It influences the increase of slow-wave, deep and restorative sleep.   A few drops of essential oil burner or on a tissue paper can be placed on the radiator in the room. Massage helps to break the cycle of stress, and most people feel relaxed and possibly drowsy after a massage. In clinical trials lavender has been found to be effective as a nocturnal sedative in elderly patients with sleeping disorders. Through observations the quality  and length of the sleep was much visibly improved.

Other therapies such as acupressure, meditation, relaxation therapies or breathing techniques to quieten the mind and body will assist in reducing physical tension but also stress related thoughts. Regular exercise will help you to enjoy sleep better, but also enhance fitness. Amongst them Tai Chi, Chi Qong and yoga. Relaxing herbal teas can be helpful, including chamomile tea. Herbal supplements such as melatonin, valerian and various sleep formulas may be used but only after seeking professional advice.

References:

  1. Thomas Y. The Good-Night Guide. The Sleep Council. [accessed: 10 April 2014] http://www.sleepcouncil.org.uk/wp-content/uploads/2013/01/The-Good-Night-Guide.pdf
  2. NCCAM (2009). Sleep disorders and CAM: At a Glance. NIH. [accessed: 10 April 2014www.nccam.nih.gov/health/sleep/ataglance.htm
  3. National Sleep Foundation (2013). [accessed: 10 April 2014] www.sleepfoundation.org
  4. Sleepio, The great British sleep survey 2012. www.greatbritishsleepsurvey.com/2012report/
  5. NHS Choices (2012). How to get to sleep. NHS. www.nhs.uk/Livewell/insomnia/Pages/bedtimeritual.aspx

Revised: Dec 2014