SLEEPING IS CHEATING – BUT WHAT IF YOU CAN’T SLEEP!!

Sleep habits are one of the most important determinants of sleep quality. The more maladaptive sleep practices an individual employs, the more sleep disruptions he or she may experience.

Bootzin & Epstein (2011)[1] also found that along with sleep habits, sleep disturbance is intricately entwined with our sense of well-being, health, emotion regulation, performance and productivity, memory and cognitive functioning, as well as social interaction.

However these associations are more applicable to mild sleep disturbances, than for those with more serious insomnia.

The most commonly used values on sleep variables to characterize insomnia are;

  • taking more than 30 mins to fall asleep,
  • more than 30 minutes of wake after sleep onset,
  • total sleep time of less than 6 hours a night,
  • for three nights or more per week,
  • for at least 3 months,
  • causing significant distress or problems in work, school or other functioning
  • with symptoms such as fatigue, moodiness, sleepiness or reduced energy

Sleep problems can occur at any age but most commonly start in young adulthood. The type of insomnia problems often vary with age. Problems getting to sleep are more common among young adults. Problems staying asleep are more common among middle-age and older adults.

The symptoms of insomnia can be

  • Episodic (with an episode of symptoms lasting one to three months)
  • Persistent (with symptoms lasting three months or more)
  • Recurrent (with two or more episodes within a year)

Symptoms of insomnia can also be very complex and associated with an injury or other medical condition, or brought on by a specific life event or situation.

If focusing on simple sleep habits does not improve insomnia, there is a strong evidence base that supports the efficacy and durability of psychological and behavioural treatments for insomnia.

Many individuals have many faulty sleep hygiene habits and beliefs (with younger adults having more), as well as wrongly believing and expecting that all sleep is deep and uninterrupted across the night.  Normal sleep is sporadic with periods of lighter sleep, which may include restlessness or wakefulness, and so these should not be considered abnormal.  Incorrectly labelling these normal sleep patterns as insomnia, ironically can cause insomnia.

Good Sleep Habits

  1. DO NOT take daytime naps lasting two or more hours.
  2. TRY TO go to bed at similar times from day to day
  3. TRY TO get out of bed at similar times from day to day.
  4. DO NOT exercise to the point of sweating within 1 hour of going to bed.
  5. DO NOT stay in bed longer than you should more than two or three times a week.
  6. DO NOT use alcohol, tobacco, or caffeine within 4 hours of going to bed, or after going to bed.
  7. DO NOT do something that may wake you up before bedtime (for example: play video games, use the internet, or clean the house).
  8. DO NOT go to bed feeling stressed, angry, upset, or nervous.
  9. DO NOT use your bed for things other than sleeping or sex (for example: watch television, read, eat, or study).
  10. DO NOT sleep on an uncomfortable bed (for example: poor mattress or pillow, too much or not enough blankets).
  11. DO NOT sleep in an uncomfortable bedroom (for example: too bright, too stuffy, too hot, too cold, or too noisy).
  12. DO NOT do important work before bedtime (for example: pay bills, schedule, or study).
  13. DO NOT think, plan, or worry when you are in bed.

 

Many people turn to complementary health approaches to help with sleep problems. According to the National Institutes of Health some may be safe and effective, others lack evidence about effectiveness, and some raise safety concerns.

  • Relaxation techniques, used before bedtime, can be helpful for insomnia.
  • Melatonin supplements may be helpful for people with some types of insomnia. Long-term safety has not been investigated.
  • Mind and body approaches, such as mindfulness/meditation, yoga, massage therapy and acupuncture lack evidence to show their usefulness, but are generally considered safe.
  • Herbs and dietary supplements have not been shown to be effective for insomnia. There are safety concerns about some, including L-tryptophan and Kava.

Please try these things and improve your sleep.

If you still have difficulties with your sleep, and you feel it may be related to an injury, please visit a physiotherapist to assess your problem.

Your Physiotherapist will also be able to recommend an appropriate plan or arrange a referral to another medical professional as necessary.

SLEEP TIGHT

[1] Bootzin, R. R., & Epstein, D. R. (2011). Understanding and treating insomnia. Annual Review of Clinical Psychology7, 435-458.

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