Sleep problems
A good night’s sleep is important for our health and wellbeing, but for some people, common sleep problems prevent this.
Shift work
Shift work requires people to be working during times that our bodies expect to be sleeping. Shift work can upset the normal circadian rhythms (body clock) that synchronise our sleep to the night/day cycle. Getting enough quality sleep can be a problem for people who work shift work as their work often involves high risk activities (driving, emergency services, medical services). It is important that the risks of mistakes and accidents are minimised by getting sufficient sleep.
There are things that shift workers can do to help improve their sleep:
- ensure bedrooms are dark and quiet
- turn off phones and let people know not to disturb you
- avoid caffeine, alcohol and large meals too close to bed time
- avoid exercise and bright sunshine before bed time
- if possible sleep before work, rather than immediately following work
- try to establish regular sleep routines that fit with your work shifts
- modify your family and social life to allow plenty of sleep where possible.
For more information read the Shiftwork Health Effects page.
Obstructive Sleep Apnoea (OSA)
OSA occurs when the throat (pharynx or upper airway) is obstructed during sleep and causes the person to stop breathing for short periods of 10 to 30 seconds (or more) at a time. The person briefly wakes up (called an arousal) and breathing starts again. These awakenings are often for such a short time that the person may not be aware of waking even though it may occur hundreds of times each night. These multiple awakenings result in disrupted and poor quality sleep.
People with OSA may snore, wake up during the night gasping and choking and may need to get up overnight to urinate. Disturbed sleep can lead to feeling sleepy or fatigued during the day and some people can doze off in the afternoon or early evening. Others may notice irritability or mood changes. OSA can occur at any age, but it is more common in middle and older aged adults. It is more common in those who are overweight or obese, but many people with OSA are normal weight.
OSA is one of the most common sleep problems, identified in about 25% of adult males and 10% of adult females. OSA rates are likely to be higher as the problem is often not diagnosed and sufferers are not always aware of the problem. Some children also experience OSA.People with OSA are more likely to have other health problems.
There are a number of treatment options for OSA. All people with OSA can benefit from weight loss, and in mild OSA this may be all that is needed. For others, commonly used treatments include using a mask with Continuous Positive Airflow Pressure (CPAP) or oral devices (mandibular advancement device).
For more information visit Adelaide Sleep Health.
Sleep restriction or insufficient sleep
Regular insufficient or poor quality sleep is common and can adversely affect our health and wellbeing. Insufficient sleep can result in daytime sleepiness, poor concentration, performance and mood and increase risk of mistakes and accidents especially motor vehicle and workplace accidents.
Restricted sleep has also been associated with poor metabolic function leading to health problems such as type 2 diabetes, obesity and metabolic syndrome.
Sleep restriction can be a result of health problems, but is often associated with shift work, and modern lifestyles that include late night social activities.Increased use of bright lights and technology at night time that stimulate the brain and provide excess artificial light also affect our sleep-wake cycles.
Insufficient sleep can also be a problem for some children and impacts on their daily functioning and school performance.
For more information visit the Sleep Health Foundation website.
Insomnia
Insomnia, or the inability to sleep, or sleep enough, is another common sleep problem. The key features of insomnia include regular or persistent trouble falling asleep, staying asleep, waking too early in the morning or worrying about being able to sleep. Insomnia can cause people to feel very tired during the day.
Insomnia can be caused from:
- medication or other drugs
- alcohol and caffeine
- chronic pain
- stress or anxiety.
Developing good sleep habits can help to improve insomnia. Some people may need professional treatment to improve their sleep. Studies have shown that certain therapies that do not use drugs work better than sleeping tablets. Sleep researchers have shown that cognitive behavioural therapy (CBT), is more effective and lasts longer than sleeping tablets. CBT can be done with a therapist in-person, in groups or on-line. It can involve exercises to “recognise, challenge and change stress-inducing thoughts” and learning techniques for better sleep.
To find out more information about Insomnia visit the Sleep Health Foundation website.
Children’s sleep behaviour problems
Some children find it hard to get to sleep and this is often due to problem sleep behaviours such as;
- refusing to go to bed
- difficulty settling
- being over tired
- waking and getting out of bed.
Some children also experience fear of the dark and nightmares that make them anxious about going to bed.
It is important to establish good sleep habits and routines appropriate for the age of the child to help support good and long enough sleep. For more information visit the Child and Youth website and the Sleep Health Foundation website.
Health problems related to reduced or poor sleep
Many people who have reduced or poor sleep are aware of the effect this has on their mood, concentration, and ability to perform their daily tasks. What is less well known is that regular insufficient or poor quality sleep and long-term contributes to health problems such as obesity, type 2 diabetes, heart and kidney disease. The relationship may work the other way as well with poor sleep contributing to the development of these conditions. People with such conditions are also likely to have interrupted, poor quality sleep.
Sleep is now considered as important in preventing the development of these conditions as a healthy diet and plenty of physical activity.
Obesity
Recent research has shown that people who regularly sleep less than six hours per night are more likely to be overweight or obese. This is due to disruptions to metabolic and hormonal processes that occur during sleep. This can affect insulin levels and hormones that control appetite and signal when we have eaten enough.
Short sleep and tiredness may also lead to increased consumption of sweet foods and drinks to boost energy levels as well as decrease the desire or ability to be active.
Children who do not get sufficient sleep are also more likely to be overweight and at risk of obesity.
Obesity can also be a cause of poor sleep. It is a known cause of sleep apnoea and overweight and obese people are more likely to experience nocturia, the need to urinate during the night, that disrupts sleep, perhaps several times per night.
Type 2 diabetes
There are known links between reduced sleep and Type 2 diabetes.
Insufficient sleep and lifestyles that upset normal circadian rhythms (body clock) can impact on metabolic and hormonal processes that occur during sleep.This can affect insulin and glucose levels which contribute to the development of type 2 diabetes.
Additionally, insufficient sleep may also cause weight increase and being overweight or obese is a major cause of Type 2 diabetes. Sleep apnoea has also been linked to an increased risk of developing diabetes.
Heart (cardiovascular) disease
During sleep heart rate and blood pressure are lower. Exposure to bright light at night can increase heart rate and hormone levels. Insufficient or poor quality sleep or disrupted circadian rhythms (body clock) can result in increased blood pressure and heart rate, increasing the risk of developing cardiovascular disease and stroke.
Sleep apnoea is also associated with high blood pressure and together with obesity are known to increase the risk for developing heart disease.
Mental health problems
It is well known that when we don’t get enough sleep we are more likely to be irritable or anxious and less able to concentrate, perform task and solve problems.
Poor sleep is common in people with mental health problems such as depression and anxiety, but it is possible that poor sleep may contribute to the development of these problems.
Sufficient good quality sleep may encourage emotional resilience.
This information has been compiled by SA Health and The University of Adelaide.