Sleep is part of our everyday life and functioning and it is often taken for granted — until it is a problem. Unfortunately, life stresses and emotional issues such as grief, anxiety and mood disorders can upset sleep patterns. At certain points in our lives we may find that we are having trouble falling asleep or develop a tendency to wake up in the early hours of the morning and then struggle to get back to sleep. Conversely, we may find that we are sleeping too much and as a result are feeling lethargic and lack energy.
Why is Sleep Important?
Sufficient sleep is vital to maintaining physical and mental health. The length of sleep deemed sufficient will depend on your age and individual variations, but 8 hours is a general recommendation. (1) Our sleep patterns are regulated by our circadian rhythm, which is based on light. In the evening, when the sun goes down, our brain releases hormones that make us sleepy. In the morning, daylight triggers the release of different hormones that will keep us awake. (2) Normally, our circadian rhythm and sleep balance are aligned, but travel or shift work can disrupt these. (3) Prolonged disruption of these systems is detrimental to health. (4)
Types of sleep:
There are two types of sleep: non-rapid eye movement (NREM) and rapid eye movement (REM). During sleep, our body cycles through five stages of sleep, each different and with varied levels of brain activity. (5) Most people experience four to six cycles per night. (6) The following table looks at the two different types of sleep and what happens to our bodies when we are asleep:
|Type of sleep||Cycle||What happens during this cycle?|
|NREM sleep||1||Dozing or drowsiness|
|2||Light sleep. Body temperature drops, breathing and heart rate slow|
|3 &4||Deep sleep. Low blood pressure, slow heart rate and breathing. Muscles relaxed. Important stage for body growth/repair. Slow brain waves.|
|REM sleep||5||Eyes jerk under lids. Brain activity similar to waking. Heart rate, blood pressure and breathing rate rise. Limbs paralyzed. Most dreaming occurs in REM sleep.|
- Lasts 90 to 120 minutes and contributes to restoration and growth of the body, and this will vary with age
- Plays a key role in learning and memory
- Occurs three to five times per night, taking up 90 to 120 minutes (mostly during morning hours) (7)
- Older adults spend less time in REM sleep than younger people (8)
Factors That Contribute To Poor Sleeping Patterns:
Poor sleep is common and can be caused by a number of different factors that include:
- Shift work or travel
- Stress, anxiety or depression
- Drug or alcohol misuse/withdrawl
- Too much caffeine or nicotine
- Sleep apnoea
- Poor sleeping habits (e.g. being on the Internet late into the night/too much rest during the day
- Trying too hard to sleep (tossing and turning)
- Going to bed at irregular hours/ sleeping in too late
Short-term sleep deprivation effects:
- Lack of concentration
- Poor memory
- Low mood
- Poor judgment as well as decision-making, reaction time and physical coordination – therefore an increased risk of accidents (9)
Long term sleep deprivation effects:
- Sleep deprivation correlates with obesity, diabetes, mood disorders, cardiovascular disease and even early mortality (10)
Tips For a Better Nights Sleep:
The following table looks at the factors that contribute to poor sleep and offers suggestions to help combat these factors.
|Daytime naps||Restrict sleep to the evenings.|
|Too much rest during day||Try to keep physically and mentally active through the day.|
|Worry, stress||Deal with worries before bed, use relaxation techniques and mental distractions. The client might need to get up and repeat their sleep wind down, or do a calming activity until they feel ready for sleep.|
|Medication misuse or withdrawal||It might take a few days to a week for various medications to be out of the body. These effects will pass in time. It is advisable to work with a GP when withdrawing from medication.|
|Stimulants before bed||Stop drinking tea/coffee in the evening. Replace with warm, caffeine-free drinks such as herbal teas or milk.|
|Pain/discomfort||Pace activities during the day. Pain can be worse at night because there are fewer distractions — use relaxation techniques and distracting imagery.|
|Alcohol in the evening||Avoid or limit the amount.|
|Depression, anxiety||Appropriate psychological treatment and/or medication.|
|Trying too hard to sleep — tossing and turning||Relaxation techniques. Get up and do something calming. Might need to repeat several times.|
|Late-night activities that get your brain racing||Avoid these activities in the evening. Plan for more relaxing, pleasant tasks before bed.|
|Going to bed at irregular hours or often sleeping late in the mornings||Establish a regular routine, and avoid TV, computers or reading in bed. Get up at the same time each day.|
Note that a range of information on sleep issues can be found at www.tuck.com and in particular see the sections on sleep and health, also sleep and depression and anxiety.
1 – Headspace 2015, ‘Tips for a healthy headspace’, retrieved from http:// headspace.org.au/get-info/tips-for-a- healthy-headspace.
2 – Better Health Channel 2015a, ‘Sleep’, retrieved from http://www.betterhealth. vic.gov.au/bhcv2/bhcarticles.nsf/pages/ Sleep?open.
3 – Division of Sleep Medicine 2008, ‘You and your biological clock’, retrieved from http://healthysleep.med.harvard.edu/ healthy/getting/bio-clock.
4 – Sleepdex 2014, ‘Circadian cycles and sleep’, retrieved from http://www.sleepdex.
5 – Better Health Channel 2015a, ‘Sleep’, retrieved from http://www.betterhealth. vic.gov.au/bhcv2/bhcarticles.nsf/pages/ Sleep?open.
6 – Smith, M., Robinson, L. and Segal, R.
2015, ‘The importance of deep sleep and REM sleep’, retrieved from http://www. helpguide.org/articles/sleep/how-much- sleep-do-you-need.htm.
7 – ibid.
8 – Better Health Channel 2015a, ‘Sleep’, retrieved from http://www.betterhealth. vic.gov.au/bhcv2/bhcarticles.nsf/pages/ Sleep?open.
9 – ibid.
10 – Division of Sleep Medicine 2008a, ‘Why
sleep matters: Consequences of insufficient sleep’, retrieved from http://healthysleep. med.harvard.edu/healthy/matters.