Some form of sleep disturbance will affect the majority of us at some point in our lives. In most cases we’ll get over it, but for some people ongoing sleep problems persist. In this fact sheet we outline some of the common causes of poor sleep and offer some simple tips to help improve sleep.
About insomnia
Insomnia is the name given to the inability to go to sleep or to stay asleep. There are several types of insomnia. It’s more common in older people who, fortunately, need less sleep.
Primary insomnia
Most adults need about seven and a half to eight hours sleep each night; however some people simply need less sleep. About two per cent of the population needs less than five hours a night. They can be highly productive and quite happy. These are not the people who visit a sleep disorder clinic; however not everyone in this group wants to live this way. Many would rather go to bed at the same time as their partner or simply don’t want to lie there until 1.30am. These are the people who seek help and who may say, “Oh, I’ve never been a good sleeper”. But they still manage to function well and are generally not tired.
It’s interesting to note that other family members will often have the same complaints. They’re tricky to treat as they are very resistant to non-drug strategies. Basically, it is recommended they go to bed for fewer hours – while listening to their own body clock for clues. Some simple lifestyle changes may also have an impact. See tips to improve your sleep.
Insomnia stimulated by an incident
Have you always been a good sleeper but something has triggered a change in your sleep patterns? Often the trigger is a period of emotional trauma; perhaps your shifts at work have altered or you’ve had a baby. Bad habits persist beyond the trigger period because your body has now learned that this is the norm. Patients visit sleep clinics feeling frustrated and anxious. This emotional state only makes the problem worse.
With this group a range of psychological techniques aimed at ‘unlearning’ the conditioned sleep pattern may be suggested. Sleep clinics offer strategies to overcome anxiety or frustration and will also recommend changing lifestyle habits. See tips to improve your sleep.
Disorders of the body clock
These people cannot be described as having insomnia, but instead, have problems with their timing rather than quality or duration of sleep. Usually people with disorders of the body clock have trouble getting to sleep and are then unable to get up in the morning. This can pose a real problem for those of us who have to get up early to go to work. When the body clock is unhappy, the person carrying it around is bound to feel sleepy during the day and will crave recovery sleep on the weekend.
The body clock can be manipulated with carefully timed exposure to bright light. In the same way that our body clocks adjust to differing time zones when traveling, we can shift body clocks with light exposure, best managed with a sleep specialist or sleep psychologist.
Some other causes of sleep disturbance
Menopause
Menopause symptoms, particularly hot flushes and night sweats, can disturb sleep.
Sleep apnoea
Sleep apnoea is when the airways are blocked, causing airflow and breathing to stop for a short time during sleep.
Depression and anxiety
Depression and anxiety can affect sleep, or be caused by lack of sleep. Counseling may be helpful.
Shift work
Working when your body thinks you should be sleeping can impair sleep and lead to chronic sleep disturbance.
Pain
Pre-existing and chronic conditions can impair sleep. Addressing the pain may be helpful.
Tips to improve your sleep
Ask yourself whether you need to change a few of your habits to get a good night’s sleep. Sometimes a change in routine is all it takes.
Caffeine
Cut your caffeine intake to two a day – including cola, as well as tea and coffee.
Alcohol
Too much alcohol reduces sleep quality. Limit yourself to two standard drinks a day.
Exercise
Here’s a secret tip: your body temperature will drop nicely, which is necessary for a good sleep, if you do some rigorous exercise four to six hours before going to bed.
Regular timing of bed and wake times
This is important for those with body clock disorders. Important: try to get out of bed at the same time each day.
Total time in bed
Restrict the amount of time you spend in bed in an attempt to train yourself to sleep when you get there. Restrict bed time for sex and sleep – not eating, reading or watching TV
If not sleeping, get out of bed
Frustration at your inability to sleep makes the problem worse. Regain control. Get out of bed and do a quiet, relaxing task in another room.
Hide the clock
Do not clock gaze during the night. This accentuates the sense of frustration. Turn you clock away from view.
Relaxation techniques
Mediation and relaxation may help some people to relax and get to sleep.
Medications for sleep disturbance
Sleep medications (e.g. benzodiazepines, stilnox) may be prescribed for short-term use; however these medications may cause dependence and should be taken with care.