Many patients come to me with the following questions: How much sleep do I need? Why do I wake up feeling worse than before I went to sleep? With my night-time schedule, how can I get to sleep? I'm always tired, yet I don't seem to be able to sleep?
How important is sleep? We spend a third of our lives sleeping. Yet, how many of us even think about the all-important link between sleep, health, and wellbeing? Till recently, we knew nothing about the eight hours we spend in “active” sleep each night — when our entire immune system is revitalised, hormones are balanced, brain patterns fluctuate, and our body is given the opportunity to repair and heal itself. Sleep disorders, according to experts, may be linked to everything from Chronic Fatigue Dysfunction Syndrome [CFIDS] - a debilitating illness where the individual feels "bone tired" - headaches, muscle and memory problems, and depression, to even early death.
In fact, if you sleep less than six hours a night, you have a 70 per cent chance of early mortality. What's more, since the body is literally starved of oxygen, in certain sleep disorders — heart disease and asthma — we should evaluate them as part of routine medical treatment.
The good news is there has been exciting progress in the diagnosis and treatment of sleep disorders. You no longer have to haul your overnight bag to a clinic where you lie down in a laboratory with wires and electrodes taped to your entire body, and spend the night being videotaped and monitored.
Yes, millions of people worldwide report that they have some kind of sleep difficulty - from trouble falling asleep at night to waking too early. The interesting fact is - even though sleep disorders can take many different forms, they usually fall into a couple of common categories.
Watch the block
The two most common sleep disorders are -
- Insomnia [when you can't fall asleep]
- Sleep adjustment disorder [when you can't synchronise your sleep to your work schedule].
Insomnia is terribly common, and can persist for months, and even years, leaving the person fatigued and depressed. Physicians may prescribe sleeping pills. These pills and sedatives deeply alter your sleep cycle, and actually shorten the amount of time spent in deep sleep. We should remember that it is during deep sleep that the body releases immune-boosting substances, while it gets detoxified and repaired. An occasional sleeping pill may be the answer for sporadic insomnia, but after years of dependence on sleeping pills, health can be subtly, but seriously damaged.
To diagnose and treat insomnia, I first isolate the underlying causes of the disorder in my practice. Some common causes are medications, stress, chronic fatigue, allergies, dietary problems, and hormone imbalances. Caffeine and alcohol can also be the culprits, since they are both potent nervous system stimulators. In other words, they can interfere with sleep. You should also watch out for vitamins, which, at times, act as stimulants, and certain herbs.
Did you know that your morning cup of coffee might be keeping you awake at night? Caffeine can disturb sleep up to twenty hours after consumption. Alcohol can be even more powerful disrupter of sleep. Some insomniacs complain that a few drinks put them to sleep, but that hours later they are wide awake. This is because alcohol relaxes the nervous system only temporarily. When consumed, it is metabolised; it causes a strong rebound effect, a few hours later. The solution? Don't use alcohol to fall asleep. Your diet may also contribute to your lack of sleep. Food allergies, for example, sometimes lead to excessive histamine production in the body, leading to a strange combination of fatigue, anxiety, and poor sleep.
Sleep apnoea: Danger signals
Sleep apnoea causes people to literally stop breathing in their sleep. It also robs their heart, brain and lungs of precious oxygen. The sleeper stops breathing as many as 200 times a night, waking for an instant when his/her oxygen-starved brain rings the alarm bell. The problem is that most people don't have an idea that they are being deprived of restful sleep.
The most common symptom of sleep apnoea is snoring. Typically, it is the spouse - or, someone else - that notices the other person's nosey bugle.
Some studies suggest women need up to an hour's extra sleep a night compared to men, and not getting it may be one reason why women are much more susceptible to depression than men.
- Source: National Sleep Research Project, US.
Sleep apnoea affects many people. It can cause prolonged daytime fatigue, sudden death from night-time heart problems, including headaches, depression, memory loss, and severe mood swings. In addition, many people who suffer from sleep apnoea tend to be overweight.
Diet too can be a contributing factor to sleep apnoea. Carbohydrates, for instance, worsen apnoea since they produce carbon dioxide when metabolised. This increases the amount of air expelled. This, in turn, increases the amount of air breathed in. The outcome is snoring, especially after a large meal.
Insomnia can be treated through a combined approach. For example, supplements such as L-phenylalanine, and herbs such as chamomile, valerian and Passiflora incarnata [passion flower], are known to relax the nervous system. These, along with a proper diet and relaxation, which I prescribe, for other underlying causes - such as mental anguish and stress - can all be part of a customised treatment plan for insomnia.
Travellers and people who work night shifts often experience sleep adjustment disorders. If you are one of those folks, your sleep clock may be off the block. But, don't despair. Science now has a solution for you. When daylight disappears, the brain secretes a chemical substance called melatonin. Recent studies have shown that people who take melatonin pills, during daylight hours, experience a shift in their internal sleep clock, and are able to sleep restfully. However, before you rush to your nearest store to get your magic lullaby, be aware that there have been incidents of dizziness due to improper dosages. This can be a problem, especially in the elderly.
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