Adults & Sleep

Adults & Sleep

Getting the restful sleep you need is a lot easier when you know how to get it.

Sleep problems happen. Everyone, men and women, experience them. When you do experience them, other problems occur. Like stress and lack of productivity. But, there's no reason you have to live with sleep problems.

Help is here. Our range of articles and resources covers an assortment of prevalent sleep-related issues many adults encounter. So please take some time to peruse this section - you'll find expert guidance behind every "click."

Helpful articles - developed in conjunction with the National Sleep Foundation.

• Sleep debt can cost you

What is sleep debt? It's the result of not getting the sleep you need to perform at your best the next day. Fortunately, there are effective methods for preventing sleep debt.

• Sleep & Travel

What are the best ways to prepare of a long trip in your car? How can you minimize jet lag? Get the facts about travel before you travel again.

• Pregnancy & Sleep

For most, pregnancy is a time of great joy. But, it can also be a time of sleep disturbances. The good news is you can take care of these disturbances fairly easily.

• Stress & Insomnia

What's the number-one cause of short-term sleeping adversities? That's right, stress. And, the sleep experts have some tips for winning the bedtime struggle against it.

• Shift Workers

If you work outside of the typical "9 to 5" business day, you may have some sleep difficulties. But, when they occur, do you know what you can do about them?

The Foundation for Great Sleep

Some people change where they live or what they drive more often than they change their mattress or pillows, but your bed plays a major role in the quality of your sleep. Discomfort can make falling asleep more difficult and lead to restless slumber.

Does your mattress provide the support you need? Do you wake with your back aching? Is there enough room for you and your sleep partner? Do you sleep better, or worse, when you sleep away from home?

Most mattresses in Australia are made of innersprings. However, Specialty bedding can be made of foam or air. Choose a mattress that is most comfortable for you.

What Does Your Bed Mean to You?

If you can fall asleep easily on your sofa or chair, and it is difficult to fall asleep in your own bed, you may be associating your bed with everything but sleep. Do you use your bed for work? Balance your checkbook while propped against the pillows? Watch television there? These are ways to tell your body to be alert in bed, not to go to sleep.

Learn to use your bed only for sleep and follow a regular wake-up schedule. You can restrict your time in bed, initially, to the number of hours you actually sleep. As you begin to sleep regularly during these hours, increase your time in bed by 15-30 minutes per night.

Reclaiming Your Bed for Sleep

• Use your bed for sleep.
• Choose a mattress that is comfortable and supports your body.
• Only get into bed when you're tired.
• If you don't fall asleep within 15 minutes, get out of bed. When you're sleepy, go back to bed.
• While in bed, don't dwell on not sleeping or your anxiety will increase.
• Think relaxing thoughts: picture yourself soothed in a tub of hot water, or drifting to sleep, each muscle relaxed.

Sleep Debt Can Cost You

Does it often take you more than 30 minutes to fall asleep at night? Do you wake up frequently during the night or too early in the morning, and have a hard time going back to sleep? Do you feel groggy and lethargic when you wake in the morning? Do you feel drowsy during the day, particularly during monotonous situations?

You may have a "sleep debt" if you answered "yes" to any of these questions.

Sleep debt can affect you in ways you don't even realise. And, you aren't alone.

According to research conducted by the National Sleep Foundation, a majority of adults experience sleep problems. However, few recognize the importance of adequate rest. In addition, most are unaware that effective methods of preventing and managing sleep problems now exist.

Being at risk for poor sleep is much more common than you may think. Virtually everyone suffers at least an occasional night of poor sleep. However, certain individuals may be particularly vulnerable. These include students, shift workers, travelers and persons suffering from acute stress, depression or chronic pain. People working long hours or multiple jobs may also find their sleep less refreshing.

What is the right amount of sleep?

Sleep needs vary. In general, most healthy adults need seven to nine hours of sleep a night. However, some individuals are able to function without sleepiness or drowsiness after as little as 6 hours of sleep. Others can't perform at their peak unless they have slept 10 hours. And, contrary to common myth, the need for sleep doesn't decline with age (although the ability to get it all at one time may be reduced).

How do you measure how much sleep you truly need?

If you have trouble staying alert during boring or monotonous situations when fatigue is often "unmasked," you probably aren't getting enough good-quality sleep. Other signs are a tendency to be unreasonably irritable with co-workers, family or friends, and difficulty concentrating or remembering facts.

Here are some tips for a good night's sleep many people, just like you, have found to be useful:

• Avoid caffeine, nicotine and alcohol in the late afternoon and evening. Caffeine and nicotine can delay your sleep, and alcohol may interrupt your sleep later in the night.
• Exercise regularly, but do so at least 3 hours before bedtime.
• If you have trouble sleeping when you go to bed, don't nap during the day, since it affects your ability to sleep at night.
• Consider your sleep environment. Make it as pleasant, comfortable, dark, cool and quiet as you can.
• Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it's time to sleep.
• If you can't go to sleep after 30 minutes, don't stay in bed tossing and turning. Get up and involve yourself in a relaxing activity, such as listening to soothing music or reading, until you feel sleepy.
  

A call to a doctor is another alternative

While many individuals will try an over-the-counter medicine to help them sleep, these should be taken with caution. Your physician or pharmacist can help inform you about the different types of medications available and which would be most effective for you. If your sleep problems persist for longer than a week and are bothersome, or if sleepiness interferes with the way you feel or function during the day, consult a doctor.

The bottom line is this: Adequate sleep is as essential to health and peak performance as exercise and good nutrition.

Sleep and Travel

Drowsiness or fatigue has been identified as a principal cause in at least 100,000 police-reported traffic crashes each year. Jet lag is one of the 84 known or suspected sleep disorders that impact millions of people each year. There is no question: sleep can affect travel, and travel can affect sleep.

Road travel and drowsiness

Some call driver fatigue a "silent killer" because drowsy-driving and fall-asleep crashes are underreported, state reporting practices are inconsistent and self-reporting is unreliable. Most researchers and traffic safety officials believe the statistics of drowsy driving are significantly higher than reported because of these reasons.

Before hitting the highway, especially for a long trip, you should:

• Get a good night's sleep. While this varies from individual to individual, sleep experts recommend between 7-9 hours of sleep per night for adults and 8 1/2-9 1/2 for teens.
• Plan to drive long trips with a companion. Passengers can help look for early warning signs of fatigue or switch drivers when needed. Passengers should stay awake to talk to the driver.
• Schedule regular stops, every 160kms or 2 hours.
• Avoid alcohol and medications (over-the-counter and prescribed) that may impair performance. Alcohol interacts with fatigue, increasing its effects.
• Consult a physician or a local sleep disorder center for diagnosis and treatment before your trip if you suffer frequent daytime sleepiness, often have difficulty sleeping at night and/or snore loudly every night.
  

Air travel and jet lag

Anyone who has ever flown is likely to have experienced some degree of time zone change disorder, commonly known as jet lag. This occurs when the body's biological clock is out of sync with local time. The result is that we feel excessively sleepy during the day or wide awake at night.

People may experience jet lag in varying degrees. In general, the severity of jet lag symptoms is directly related to the number of time zones crossed by a flight. Symptoms can include daytime sleepiness, nighttime alertness (insomnia), loss of appetite and other gastrointestinal dysfunctions, mood disturbances and difficulty concentrating or focusing.

The following are additional steps you can take to minimise jet lag:

• Shift your sleep times before you travel. In the few days before traveling west, go to bed and wake up 1 hour later each day. In the few days before traveling east, go to bed and wake up 1 hour earlier each day.
• Regulate your light exposure before you travel. In the few days before traveling west, seek evening light and avoid morning light. In the few days before traveling east, seek morning light and avoid evening light.
• Regulate your light exposure in your new time zone. If you traveled west, on arrival, seek morning light and avoid afternoon light. If you traveled east, on arrival seek evening light and avoid morning light.
• Avoid alcohol and caffeine for at least 3-6 hours before bedtime.
• Avoid heavy exercise close to bedtime.
• Bring earplugs and blindfolds to reduce noise and light while sleeping.

Pregnancy and Sleep

For most women, pregnancy is a time of great joy, excitement and anticipation. Unfortunately, for many it can also be a time of serious sleep disturbance, even for women who have never had problems sleeping. In fact, according to the National Sleep Foundation's 1998 Women and Sleep poll, 78 percent of women report more disturbed sleep during pregnancy than at other times. Many women also report feeling extremely fatigued during pregnancy, especially during the first and third trimesters. Considering the physical and emotional demands of pregnancy and the prevalence of sleep disorders among pregnant women, it's no wonder that expectant mothers become so tired.

Why pregnant women experience sleep disorders

One of the reasons for fatigue and sleep problems during pregnancy is changing hormone levels. For example, rising progesterone levels may partly explain excessive daytime sleepiness, especially in the first trimester. Hormonal changes may also have an inhibitory effect on muscles, which may result in snoring, and in obese women may increase the risk of developing sleep apnea and may be partly responsible for the frequent trips to the bathroom during the night.

These interruptions, as well as those caused by nausea and other pregnancy-related discomforts, can result in significant loss of sleep. Many women experience insomnia due to emotions and anxiety about labor and delivery, balancing motherhood and work, or their changing relationship with their partner. This is especially true of first-time mothers. For most women, getting a full night's sleep becomes even harder once the baby is born.

Several sleep disorders can be caused or made worse by pregnancy, including:

Restless Legs Syndrome. In a study of over 600 pregnant women, 26% reported symptoms of restless legs syndrome, a condition characterized by unpleasant feelings in the legs that worsen at night and that are relieved by movement.

Gastroesophageal Reflux Disease (GERD, also known as heartburn). One recent study found that 30-50 percent of pregnant women experience this condition almost constantly during pregnancy.

Sleep Apnea. This disorder, in which breathing is repeatedly interrupted during sleep, is one that pregnant women are at risk for developing. If developed, complications during pregnancy can occur. In fact, researchers recently found that women who slept fewer than 6 hours per night had longer labors and were 4.5 times more likely to have cesarean deliveries.

Based on these findings, researchers recommend that doctors and their pregnant patients discuss both sleep quantity and sleep quality as part of basic prenatal care and stress the importance of "sleeping for two."

In addition to working closely with your doctor, take a look at this list of nine tips we've compiled to help with some common pregnancy-related sleep issues:

• In the third trimester, sleep on your left side to allow for the best blood flow to the fetus and to your uterus and kidneys. Avoid lying flat on your back for a long period of time.
• Drink lots of fluids during the day, but cut down before bedtime.
• To prevent heartburn, do not eat large amounts of spicy, acidic (such as tomato products) or fried foods. If heartburn is a problem, sleep with your head elevated on pillows.
• Exercise regularly to help you stay healthy, improve your circulation and reduce leg cramps.
• Try frequent bland snacks (e.g., crackers) throughout the day. This helps avoid nausea by keeping your stomach full.
• Special "pregnancy" pillows and mattresses may help you sleep better. Or use regular pillows to support your body.
• Naps may help. The NSF poll found that 51 percent of pregnant or recently pregnant women reported at least one weekday nap; 60 percent reported at least one weekend nap.
• Learn to relax with relaxation and breathing techniques, which can also help when the contractions begin. A warm bath or shower before bed can be helpful.
• Talk to your doctor if you develop medical problems and/or insomnia persists.

Stress and Insomnia

Stress

Stress is considered by most sleep experts to be the No. 1 cause of short-term sleeping difficulties. Common triggers include:

• School- or job-related pressures
• A family or marriage problem
• A serious illness or death in the family

Usually the sleep problem disappears when the stressful situation passes. However, if short-term sleep problems such as insomnia aren't managed properly from the beginning, they can persist long after the original stress has passed.

Without realising it, you may be doing things during the day or night that can work against getting a good night's sleep - lifestyle stressors. These include drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and working or doing other mentally intense activities right before or after getting into bed.

Insomnia

According to the National Institutes of Health, about 30-40 percent of adults say they have some symptoms of insomnia within a given year, and about 10-15 percent of adults say they have chronic insomnia.

The word "insomnia" comes from the Latin in ("no") and somnus ("sleep"), so it literally means "no sleep" or the inability to sleep. Insomnia is an experience of inadequate or poor quality sleep as characterized by one or more of the following sleep complaints:

• Difficulty initiating sleep
• Difficulty maintaining sleep
• Waking too early in the morning

Sleep specialists classify insomnia in two primary categories: acute and chronic. Short-term or acute insomnia, which is often due to a temporary situation such as stress, jet lag, change or loss in a job or relationship, can last up to 1 month and is treatable. It is important to address the underlying cause. Effective and safe prescription medications can help.

Long-term or chronic insomnia, which is experienced for a month or longer, can be secondary to causes such as medical, physical or psychological conditions, another sleep disorder or medications and substances. It is essential to get a medical diagnosis.

Treating insomnia

Fortunately, there are treatment options available for insomnia, ranging from behavioral therapy to the use of prescription medicines, or a combination of the two.

Although the specific causes of insomnia differ from one person to the next, there are some general habits you can adopt that may help you sleep better. Not each of these practices may apply to everyone with insomnia, so you may want to focus on one or two that seem particularly relevant to your situation.

Sleep experts recommend the following tips to help you overcome sleep problems:

• Establish a regular bedtime routine and a regular sleep-wake schedule.
• Don't spend too much time in bed.
• Do not eat or drink too much before bedtime.
• Create a sleep-promoting environment that is quiet, dark, cool and comfortable.
• Consume less or no caffeine, particularly late in the day.
• Avoid alcohol and nicotine, especially close to bedtime.
• Exercise, but not within three hours before bedtime.
• Avoid naps, particularly in the late afternoon or evening.
• Keep a "sleep diary" for two weeks to record sleep and health habits; share this record with your doctor or other healthcare professional.

Shift Workers

A shift worker is anyone who follows a work schedule that is outside of the typical "9 to 5" business day, including doctors and nurses, pilots, bridge builders, police officers, customer service representatives and commercial drivers.

Risks involved with shift work

While shift work does create potential productivity advantages, it also has many inherent risks. Some of the most serious and persistent problems shift workers face are frequent sleep disturbance and associated excessive sleepiness. Sleepiness/fatigue in the workplace can lead to poor concentration, absenteeism, accidents, errors, injuries and fatalities. The issue becomes more alarming when you consider that shift workers are often employed in the most dangerous of jobs, such as firefighting, emergency medical services, law enforcement and security.

The main complaint for people with shift work sleep disorder is excessive sleepiness. Other symptoms include:

• Insomnia
• Disrupted sleep schedules
• Reduced performance
• Difficulties with personal relationships
• Irritability/depressed mood

Staying on top of shift work

For some shift workers, napping is essential. It can be extremely effective at eliminating fatigue-related accidents and injuries and reducing workers' compensation costs. Although most employers do not allow napping in the workplace, a ban on napping may soon prove to be a legal liability.

Here are some tips for sleeping during the day:

• Wear dark glasses to block out the sunlight on your way home.
• Keep to the same bedtime and wake time schedule, even on weekends.
• Eliminate noise and light from your sleep environment (use eye masks and earplugs).
• Avoid caffeinated beverages and foods close to bedtime.
• Avoid alcohol; although it may seem to improve sleep initially, it actually disturbs sleep later in the night..
  

Here are some tips for staying alert on the job:

• Avoid long commutes and extended hours.
• Take short nap breaks throughout the shift.
• Work with others to help keep you alert.
• Try to be active during breaks (e.g., take a walk, shoot hoops in the parking lot or even exercise).
• Drink a caffeinated beverage (coffee, tea, colas) to help maintain alertness early in the shift.
• Don't leave the most tedious or boring tasks to the end of your shift when you are apt to feel the drowsiest. Night-shift workers are most sleepy around 4:00-5:00 a.m.