A Good Night's Sleep

A GOOD NIGHT'S SLEEP

A GOOD NIGHT'S SLEEP

During sleep, we are not aware that anything is happening to us. However, a lot of important things happen to our body while we sleep. Sleep is essential to our health,normally there are two types of sleep. The most important type of sleep is called Rapid Eye Movement (REM) sleep. Everyone has about four or five cycles of REM and non-REM sleep a night. It comes and goes throughout the night and takes up around one fifth of our sleep time. During REM sleep, our brain is very active, our eyes move quickly from side to side and we dream. The rest of the time, during non-REM sleep, the brain is quiet, but hormones are released into the bloodstream and our body repairs itself after the wear and tear of the day.

What happens if we don’t sleep?

People normally tend to worry when they can't sleep, but the occasional night without sleep has very little effect on our physical or mental health. However, after several sleepless nights, you start to feel tired and may find yourself dropping off to sleep during the day. You will find difficulty to make decisions and may start to feel depressed. This can be extremely dangerous if you are driving or operating heavy machinery. Many deaths each year are caused by people falling asleep at the wheel while driving.

How much sleep do we need?

Babies sleep for about 17 hours each day but older children only need 9 or 10 hours a night. In adult life, most of us need between 7 and 8 hours sleep each night, but we need less as we get older. Many older people do not enjoy a good night’s sleep on a regular basis. They have trouble falling or staying asleep. For older people, the amount of time spent in the deepest stages of non-REM sleep decreases. This may explain why older people are thought of as light sleepers. There is a lot of difference between different people of the same age, and some people can manage for only three hours a night. Most of us can't do this. If we go without normal sleep for any length of time, we become drowsy and have difficulty in concentration and attention.

Sleeping too little (Insomnia)

Up to 40% of adults report at least occasional difficulty sleeping. Persistent and or severe insomnia affects about 10-15% of the adult population. More common among women and elderly

People often complain that they are having difficulty to sleep or not getting enough sleep, there are many reasons in everyday life that can make it difficult to sleep, your bedroom may be too noisy, the bed may be uncomfortable or too hot or too cold, you may not have regular routine or you may not be getting enough exercise. If you eat too much you may find it difficult to get off to sleep, if you are hungry you may find yourself waking too early, alcohol and drinks containing caffeine, such as tea and coffee, will also disturb your sleep.

At any age, insomnia is the most common sleep complaint, Insomnia means:

Taking a long time to fall asleep (more than 30 to 45 minutes)
Waking up many times each night
Waking up early and being unable to get back to sleep
Waking up feeling tired

If, however, your sleeping difficulty persists, it may be caused by serious problem such as physical, family problems, stress at work or psychological, such as anxiety or depression.

Insomnia can be linked with other sleep disorders such as sleep apnea, a common problem that causes breathing to stop for periods of up to 2 minutes, many times each night. The common type is obstructive sleep apnea which is an involuntary pause breathing- air can not flow in or out of the person’s nose or mouth, the sleeper is totally unaware of his or her struggle to breathe. Daytime sleepiness coupled with loud snoring at night is clues that you may have sleep apnea.

Sleeping too much

Sometimes people may fall asleep during the day, although they want to stay awake, the commonest reason is lack of sleep at night or as a way of escaping from pressure of everyday life. However, if this goes on for more than a few days, it is more likely due to physical illness of some sort. Such as diabetes, thyroid, etc... An unusual condition which also can cause excessive sleep is called narcolepsy, where the person suffers sudden and uncontrolled attacks of sleepiness sometimes in public, which may be preceded by excitement, laughing or anger.

Suggestions for a good Night’s Sleep:

In general, sleep is helped by two factors-beings tired at bedtime and being in tune with your own internal clock. Sleep may be difficult or less satisfying if it occurs at a time when the biological clock says” it ‘s time to be awake”.

To find out how much sleep you need, try to determine your own sleep pattern. You should feel sleepy at about the same time every evening. If you frequently have trouble staying awake in the daytime, you may not be sleeping long enough or perhaps you are not sleeping well enough. Both the quantity and quality of sleep and wakefulness are important. You are sleeping as much as you need if, during your waking hours, you are alert and have a sense of well-being.

A good night’s sleep can make a big difference in how you feel. Here are some suggestions to help you:

Consistent wake times are recommended, regardless of the quality and quantity of sleep.
Excessive time in bed or daytime napping is a counterproductive coping strategy used by some people with insomnia.
Eliminate pre-sleep activities that heighten arousal; (e.g. exercising, working, socialising, discussing family or marital conflicts)
Prepare bed with relaxing rituals such as warm bath reading or other non stressful activities.
Avoid excessive caffeine throughout the day and any caffeine within several hours of bedtime
Alcohol close to bedtime may be relaxing but sleep may be disturbed later in the night, nicotine is also a stimulant.
Eliminate bedroom “clock watching” which can frustrate and stimulate the person who has trouble falling asleep or staying asleep
Reading or watching TV in bed unless sleep producing, is generally inappropriate
Established a sleep environment that is comfortable, quiet dark and cool.
Exercise in the late afternoon (at least three hours before bedtime) may improve sleep.

Why treat insomnia?

If you are so tired during the day that you cannot function normally and if this lasts for more than 2 to 3 weeks, you should see a specialist.

Untreated insomnia has a significant associated ill health. Those with chronic insomnia often state that it affects every aspect of their lives. People with insomnia have poorer overall health, greater work absenteeism. Lower job performance more negative mood and greater use of health care services. Those reporting chronic insomnia also report two and one-half times the frequency of accidents related to fatigue.

It is also clear that insomnia increases the risk of development of the first occurrence of psychiatric disorder, including depression, anxiety, alcohol or/and sleeping tablets dependency, the presence of insomnia may also exacerbate associated medical and psychiatric disorders.

OUTLOOK

There are several approaches to help a person with insomnia. The role of sleep habits and life-style issues needs to be considered when treating insomnia, whether or not medication is used. Relaxation techniques or Behavioural therapy such as cognitive therapy have shown beneficial results.

Cognitive therapy generally require multiple training sessions conducted by a specialist. Follow-up sessions chart progress and necessary adjustments or corrections are made. Improvements in sleep are likely to occur only after a few weeks, but there is some evidence that benefits with behaviorual treatments last months beyond the actual treatment sessions. The person who succeeds with behavioural treatment gains confidence and feels more in control of their sleep.

A persons’ quality of life and perception of happiness and productivity is often linked closely to a good night’s sleep. Indeed, mood, job performance and other measures of a quality lifestyle are remarkably improved when sleep problems are efficiently treated. With the availability of safe and effective treatment approaches, can help people improve their overall health and wellbeing.

Cognitive therapy generally require multiple training sessions conducted by a specialist. Follow-up sessions chart progress and necessary adjustments or corrections are made. Improvements in sleep are likely to occur only after few weeks, but there is some evidence that benefits with behaviorual treatments last months beyond the actual treatment sessions. The person who succeeds with behavioural treatment gains confidence and feels more in control of their sleep.

A persons’ quality of life and perception of happiness and productivity is often linked closely to a good night’s sleep. Indeed, mood, job performance and other measures of a quality life style are remarkably improved when sleep problems efficiently treated. With the availability of safe and effective treatment approaches, can help people improve their overall health and wellbeing.

Dr. Akeel. A.Abdul Wahab

Fellow & Member of The Royal College of Psychiatrists (UK)

FRCPsych. (UK), MRCPsych. (UK), Board NeuroPsych. (London University ,UK), Dip.Psych. (London University, UK), MB.ChB.(Basra University , Iraq )

Formerly Senior Consultant Psychiatrist & Clinical professor

Metal Health Public awareness/A good night sleep Published June 2004 Revised /AAW/2021

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