The benefits of sleep. Or, how your Mother was right.
The benefits of good sleeping habits are more than just
wives tales, they’re well documented. Deep, optimal sleep has been proven to
provide countless benefits to daily life - including a strengthened immune
system, increased memory and improved reaction time.
Simply put, there is just no substitute for the benefits
of sleep.
The National Sleep Foundation estimates that the effects
of lack of sleep cost more than $100 Billion a year in lost productivity.
According to the National Highway Traffic Safety Administration, each year more
than 100,000 traffic accidents are caused by the effects of lack of sleep on
drivers. And many industrial accidents, from Three Mile Island to the Exxon
Valdez, have been blamed at least in part on human error caused by a sleep
deficit.
Benefits of sleep
Research by Cornell psychology professor James B. Maas
shows that if you get less than eight hours of sleep a night, you are operating
impaired; your alertness, productivity and creativity, and general health are
all affected.
Hoping to reach those who missed his award-winning
documentaries on public television, the sleep seminars and keynote addresses for
corporations or his introductory psychology class at Cornell, Maas has compiled
his findings and advice in a new book, Power Sleep: The Revolutionary Program
that Prepares Your Mind for Peak Performance (Villard, 1998). The book
details the enormous costs to individuals and society of sleep deprivation, then
explains the "architecture and functions" of sleep and offers a practical guide
to balancing a personal sleep budget while coping with those who can't.
One-third of all Americans get six hours of sleep a night or less when they
should be getting nine or 10.
"If we can get people sleeping eight hours, that would be
wonderful, although still not optimal," Maas said and explained the
significance of that number. "Between the seventh and eighth hour is when we
get almost an hour of REM (rapid eye movement) sleep, the time when the mind
repairs itself, grows new connections and puts it all together. REM sleep
occurs about every 90 minutes, and the periods of REM sleep get longer as the
night progresses. If you’re a six-hour sleeper, you’re missing that last,
important opportunity to repair and to prepare for the coming day."
We don't usually need to think very much about our sleep -
it's just a part of life that we take for granted. When we can't sleep,
though, it can be a real problem. In fact, most of us will find it hard to
sleep at some point in our lives. We have a word for it - insomnia. It's often
just for a short time, perhaps when we're worried or excited. After a few
days, things settle down and we get back to sleeping normally. However, we
need sleep to keep our minds and bodies healthy. If we carry on sleeping
badly, we start to notice the effects.
What is sleep?
Sleep is the regular period in every 24 hours when we are
unconscious and unaware of our surroundings. There are two main types of
sleep:
-
Rapid Eye Movement (REM) sleep
It comes and goes throughout the night, and makes up about
one fifth of our sleep time. During REM sleep, our brain is very active, our
muscles are very relaxed, our eyes move quickly from side to side and we dream.
The brain is quiet, but the body may move around. Hormones
are released into the bloodstream and our body repairs itself after the wear and
tear of the day. There are 4 stages of non-REM sleep:
- The muscles relax, the heart beats slower and body
temperature falls - "pre-sleep".
- Light sleep - we can still be woken easily without
feeling confused.
- "Slow wave" sleep - our blood pressure falls, we may
talk in our sleep or sleep walk.
- Deep "slow wave" sleep - we become very hard to wake.
If we are woken, we feel confused.
We move between REM and non-REM sleep about five times
throughout the night, dreaming more as we get toward the morning.
During a normal night, we will also have short periods of
waking. These last 1 or 2 minutes and happen every 2 hours or so. We aren't
usually aware of them. We are more likely to remember them if we feel anxious
or there is something else going on - noises outside, our partner snoring etc.
How much sleep do we need?
This depends mainly on how old we are.
- Babies sleep for about 17 hours each day.
- Older children only need 9 or 10 hours a night.
- Most adults need around 7-8 hours sleep each night.
- Older people need the same amount of sleep, but will
often only have one period of deep sleep during the night, usually in the
first 3 or 4 hours, after which they wake more easily. We also tend to dream
less as we get older.
There are also differences between people of the same age.
Most of us need 7-8 hours a night, but some (a few) people can get by with
only 3 hours a night. It's not helpful to regularly sleep more than 7-8 hours
each night.
The short periods of being awake feel much longer than they
really are. So it's easy to feel that we are not sleeping as much as we
actually are.
What if I don't sleep?
It's easy to worry when you can't sleep. The occasional
night without sleep will make you feel tired the next day, but it won't harm
your physical or mental health.
However, after several sleepless nights, you will start to
find that:
- you are tired all the time
- you drop off during the day
- you find it difficult to concentrate
- you find it hard to make decisions
- you start to feel depressed.
This can be very dangerous if you are driving or operating
heavy machinery. Many deaths are caused each year by people falling asleep at
the wheel while driving.
Lack of sleep may also make us more vulnerable to high
blood pressure, obesity and diabetes.
Sleep problems in adult life
Sleeping too little (Insomnia)
You may feel that you aren't getting enough sleep or that, even if you do get
the hours, you don't get a good night's rest.
There are many everyday reasons for not sleeping well:
- the bedroom may be too noisy, too hot or too cold
- the bed may be uncomfortable or too small
- you partner may have a different pattern of sleep from
yourself
- you may not have a regular routine, or may not be
getting enough exercise
- eating too much can make it difficult to get off to
sleep
- going to bed hungry can make you wake too early
- cigarettes, alcohol and drinks containing caffeine,
such as tea and coffee
- illness, pain or a high temperature.
Some more serious causes include:
- emotional problems
- difficulties at work
- anxiety and worry
- depression - you may wake very early in the morning and
not be able to get back to sleep
- thinking over and over about day to day problems.
Can medication help?
People have used sleeping tablets for many years, but we
now know that they:
- don't work for very long.
- Leave you tired and irritable the next day.
- lose their effect quite quickly, so you have to take
more and more to get the same effect.
- some people become addicted to them. The longer you
take sleeping tablets, the more likely you are to become physically or
psychologically dependent on them.
- there are some newer sleeping tablets (Zolpidem,
Zalpelon and Zopiclone), but these seem to have many of the same drawbacks as
the older drugs, such as Nitrazepam, Temazepam and Diazepam.
Sleeping tablets should only be used for short periods
(less than 2 weeks) - for instance if you are so distressed that you cannot
sleep at all.
If you have been on sleeping tablets for a long time, it is
best to cut down the dose slowly after discussing it with your doctor.
In some cases, antidepressant tablets may be helpful.
Over the counter medication
You can buy several remedies at your chemist, without the need for a
prescription. These products will often contain an anti-histamine, like you find
in medicines for hay-fever, coughs and colds. These do work but they can make
you sleepy well into the next morning. If you do use them, take the warnings
seriously and don't drive or operate heavy machinery the next day. Another
problem is tolerance - as your body gets used to the substance, you need to take
more and more to get the same effect. It is best not to take anti-histamines for
a long time.
Herbal alternatives are usually based on a herb called
Valerian. It probably works best if you take it nightly for 2-3 weeks or more.
It doesn't seem to work so well if you take it occasionally. As with the
anti-histamines, you need to be careful about the effects lasting into the
following morning. If you are taking any medication for your blood pressure
(or any other sleeping tablets or tranquillisers), have a chat with your
doctor before using an over the counter remedy.
Psychological Treatments
A technique called cognitive behavioural therapy has been shown to be helpful.
It involves looking at unhelpful ways of thinking that can make you more
anxious, and so interfere with your sleep.
Things to avoid
- Alcohol. Everybody knows that alcohol can help you to
fall asleep. The problem is that you will usually wake up half-way through the
night. If you drink alcohol regularly to help you sleep, you will find that
you need to drink more and more to get the same effect. If you drink regularly
and you stop drinking suddenly, you may find it hard to sleep for a week or
two.
- Slimming tablets make it hard to sleep, as do street
drugs like Ecstasy, cocaine and amphetamines.
Helping yourself
Here are some simple tips that many people have found
helpful.
Do's...
- Make sure that your bed and bedroom are comfortable -
not too hot, not too cold, not too noisy.
- Make sure that your mattress supports you properly. It
should not be so firm that your hips and shoulders are under pressure or so
soft that your body sags. Generally, you should replace your mattress every 10
years to get the best support and comfort.
- Get some exercise. Don't overdo it, but try some
regular swimming or walking. The best time to exercise is in the daytime -
particularly late afternoon or early evening. Exercising later than this may
disturb your sleep.
- Take some time to relax properly before going to bed.
Some people find aromatherapy helpful.
- If something is troubling you, and there is nothing you
can do about it right away, try writing it down before going to bed and then
tell yourself to deal with it tomorrow.
- If you can't sleep, get up and do something you find
relaxing. Read, watch television or listen to quiet music. After a while you
should feel tired enough to go to bed again.
Don'ts...
- Don't go without sleep for a long time - go to bed when
you are tired and stick to a routine of getting up at the same time every day,
whether you still feel tired or not.
- Caffeine hangs around in your body for many hours after
your last drink of tea or coffee. Stop drinking tea or coffee by
mid-afternoon. If you want a hot drink in the evening, try something milky or
herbal (but check there's no caffeine in it).
- Don't drink a lot of alcohol. It may help you fall
asleep, but you will almost certainly wake up during the night.
- Don't eat or drink a lot late at night. Try to have
your supper early in the evening rather than late.
- If you've had a bad night, don't sleep in the next day
- it will make it harder to get off to sleep the following night.
If you try these tips and you still can't sleep, go and see
your doctor. You can talk over any problems that may be stopping you from
sleeping. Your doctor can make sure that your sleeplessness is not being
caused by a physical illness, a prescribed medicine, or emotional problems.
There is some evidence that cognitive behavioural therapy (see above), can be
helpful if your sleeplessness has gone on for a long time.
Sleeping at the wrong time - Shift Work and
Parenthood
You may have to work at night and to stay awake when you would normally be
asleep. If you only have to do this from time to time, it's quite easy to
adjust. It is much more difficult if you have to do this more often. Shift
workers, doctors and nurses working all night, or nursing mothers may all have
this problem. They find themselves sleeping at times when they ought to be
awake. This is similar to jet lag, where rapid travel between time zones means
that you find yourself awake when everybody else is asleep.
A good way to get back to normal is to make sure that you
wake up quite early, at the same time every morning. It doesn't matter how
late you fell asleep the night before. Use an alarm clock to help you. Make
sure that you don't go to bed again before about 10 pm that night. If you do
this for a few nights, you should soon start to fall asleep naturally at the
right time.
Sleeping too much
You may find that you often fall asleep during the day at times when you want
to stay awake. The commonest reason is not getting enough sleep at night.
However, you may find that you are still falling asleep in
the daytime even after a week or two of getting enough sleep at night.
Sometimes, a physical illness can be responsible - diabetes, a viral
infection, or a thyroid problem.
There are other conditions which make people sleep too
much:
Narcolepsy (Daytime sleepiness)
This is uncommon condition that has often not been recognised by doctors.
There are two main symptoms:
- you feel sleepy in the daytime, with sudden
uncontrollable attacks of sleepiness even when you are with other people
- you suddenly lose control of your muscles and collapse
when you are angry, laughing or excited - this is called cataplexy.
You may also find that you:
- can't speak or move when falling asleep or waking up -
(Sleep Paralysis)
- hear odd sounds or see dream-like images
(Hallucinations)
- "run on auto-pilot" - you have done things, but can't
remember doing them, as if you had been asleep
- wake with hot flushes during the night.
The cause for this has recently been found - a lack of a
substance called orexin, or hypocretin.
Treatment consists of taking regular exercise and having a
regular night time routine. Depending on the pattern of your symptoms,
medication may be helpful - an antidepressant or a drug which increases
wakefulness, such as Modafinil.
Sleep Apnoea (Interrupted Sleep)
- You snore loudly and stop breathing for short periods
during the night. This happens because the upper part of your airway closes.
- Every time you stop breathing, you wake suddenly and
your body or arms and legs may jerk.
- You are awake just for a short time before falling off
to sleep again.
- This often happens several times during the night. So,
you feel tired the next day, often with an irresistible urge to go to sleep.
You may also have a dry mouth and a headache when you wake up in the morning.
It is more common in:
- older people
- the overweight
- smokers
- those who drink a lot of alcohol.
Sometimes, the problem is noticed more by their partner
than by the sufferer. Treatment usually involves correcting the parts of your
lifestyle that may be making the problem worse - cutting down smoking and
drinking, losing weight, and sleeping in a different position. If your apnoea
is very bad, it may be necessary to wear a Continuous Positive Airway Pressure
(CPAP) mask. This fits over your nose and supplies high pressure air to keep
your airway open.
Other problems with sleeping
At some point in their life, about 1 in 20 adults have
night terrors, and 1 in 100 report that they sleep-walk. Both these conditions
are more common in children.
Sleepwalking
If you sleepwalk, you will appear (to other people) to wake from a deep sleep.
You will then get up and do things. These may be quite complicated, like
walking around or going up and down stairs. This can land you in embarrassing
(and occasionally dangerous) situations. Unless someone else wakes you up, you
will remember nothing about it the next day. Sleepwalking may sometimes happen
after a night terror (see below).
A sleepwalker should be guided gently back to bed and
should not be woken up. It may be necessary to take precautions to protect
them or others from injury. You may need to lock doors and windows, or lock
away sharp objects, like knives and tools.
Night terrors can occur on their own,
without leading to sleepwalking. Like a sleepwalker, a person with night
terrors will appear to wake suddenly from a deep sleep. They look half-awake
and very frightened, but will usually settle back down to sleep without waking
up completely. All you can do is sit with them until they fall asleep again.
Night terrors are different from vivid dreams or nightmares
as people don't seem to remember anything about them the next morning.
Nightmares
Most of us have had frightening dreams or nightmares. They usually happen
during the later part of the night, when we have our most vivid and memorable
dreams. They do not normally cause problems unless they happen regularly,
usually because of an emotional upset. Nightmares often follow a distressing
or life-threatening event, such as a death, a disaster, an accident or a
violent attack. Counselling may be helpful.
Restless Legs Syndrome (RLS)
- You feel you have to move your legs (but also,
sometimes, other parts of the body ).
- You may have uncomfortable painful or burning feelings
in your legs.
- These feelings only bother you when you are resting.
- They are generally worse at night.
- They are relieved by movement, such as walking or
stretching, for as long as you carry on doing it.
You may not be able to sit still in the daytime, making it
difficult to work, and may be unable to sleep properly.
Sufferers usually first seek help in middle age, although
they may have had symptoms since childhood. It seems to run in families.
RLS usually occurs on its own. It can occasionally be
caused by a physical illness, such as iron and vitamin deficiencies, diabetes
or kidney problems. It can also happen in pregnancy.
If it is not caused by another physical illness, treatment
depends on how bad it is. In mild RLS, the symptoms can usually be controlled
by simple steps designed to help you sleep better (see section on 'Helping
Yourself').
In more severe RLS, medications may help. These include
medications used in Parkinson's disease, anti-epileptic medications,
benzodiazepine tranquillisers and painkillers.
If simple measures do not help, you can be referred to a
sleep or movement disorders specialist.
Related Links:
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