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Wednesday, September 28, 2011

Sleep

Most people...I think...understand the role that nutrition and exercise play in health, but few realize the importance of sleep.

Sleep deficits can lead to serious cognitive, emotional and physiological problems. Sleep difficulties can also be a symptom of a variety of physical and mental illnesses.

Insufficient sleep can cause:

*Accident and injury (car accidents, etc. due to fatigue and cognitive deficits);
*Impaired cognitive functioning (poor work/academic performance);
*Stress and anxiety;
*Weight gain (excess stress hormones which increase appetite and subcutaneous fat storage);
*Increased risk of chronic disease like diabetes and heart problems (subcutaneous fat storage around midsection, stress on the heart, etc.);
*Altered mood (sadness, anger, irritability);
*Depressed immune function.

Sometimes behavioural and/or environmental factors can prevent us from getting enough sleep:

*Caffeine, medication, alcohol, nicotine;
*Erratic schedule/shift work/jetlag;
*Physical inactivity;
*Physical environment (noise, light, temperature, etc.).

Medical conditions are often the underlying cause of insomnia:

*Depression/anxiety/Post-traumatic stress disorder;
*overactive thyroid;
*Gastric reflux;
*Arthritis, chronic pain, etc.;
*Sleep apnea;
*Restless leg syndrome;
*Night eating disorder.

How much sleep do you need?

This depends on:
a) age;
b) and on 2 individual factors:
1. basal sleep need – the amount of sleep our bodies need on a regular basis for optimal performance; and
2. sleep debt – the accumulated sleep that is lost to poor sleep habits, sickness, awakenings due to environmental factors or other causes. Some research suggests that healthy adults have a basal sleep need of 7-8 hours every night, but there is a complex interaction between the basal need and sleep debt.


Here are some of the signs that you may have a medically significant sleep problem:

*You snore loudly;
*You or others have observed that you stop breathing or gasp for breath during sleep;
*Feel sleepy or doze off while watching TV, reading, driving or engaged in daily activities;
*Have difficulty sleeping 3 nights a week or more (e.g., trouble falling asleep, wake frequently during the night, wake too early and cannot get back to sleep or wake unrefreshed);
*Feel unpleasant, tingling, creeping feelings or nervousness in your legs when trying to sleep;
*Interruptions to your sleep (e.g., heartburn, bad dreams, pain, discomfort, noise, sleep difficulties of family members, light or temperature).

All you moms out there will not likely be surprised to hear that infant sleep problems are strongly correlated with the risk of post-partum depressions in new mothers!!

If you know or suspect that you are not getting enough sleep, it is extremely important to make sleep a priority. If it's a time-management or scheduling issue, you may need to make changes to your routine. If it's behavioural factors, a change in lifestyle may be necessary.

Some of the things you can do to improve your chances of getting enough sleep include:

*Establish consistent sleep and wake schedules, even on weekends;
*Create a regular, relaxing bedtime routine such as soaking in a hot bath or listening to soothing music – begin an hour or more before the time you expect to fall asleep;
*Create a sleep-conducive environment that is dark, quiet, comfortable and cool;
*Use aromatherapy (Jasmine, lavender and chamomile promote relaxation);
*Sleep on a comfortable mattress and pillows;
*Use your bedroom only for sleep and sex (keep "sleep stealers" out of the bedroom – avoid watching TV, using a computer or reading in bed);
*Eat foods that contain tryptophan,the amino acid that the body uses to make the sleep-inducing substances serotonin and melatonin, along with some complex carbohydrates, which maximizes the availability of tryptophan to the brain;
*Finish eating and drinking at least 2-3 hours before your regular bedtime;
*Exercise regularly during the day or at least a few hours before bedtime;
*Avoid caffeine and alcohol products close to bedtime and give up smoking.

Do not rely on pharmacological sleep aids. Over-the-counter products, such as Sominex,Nytol or Unisom, can be habit forming and their effectiveness decreases over time. This also goes for products such as Benadryl, Gravol, etc. which can initially induce sleepiness. Most available herbal sleep remedies have not been proven effective and can be extremely expensive.

If you suspect that an underlying medical problem is responsible for your sleep deficit or insomnia, see you doctor immediately. Your doctor may prescribe you medication such as Ambien or a benzodiazepine, but these are also habit forming and lose effectiveness over time. It is best to try and determine the underlying reason for the sleep problem. If it is a mental health issue, cognitive behavioural therapy (CBT) has been found to be more effective than medication for treating insomnia.

If stress/anxiety is to blame, try some of these strategies:

*Write down what’s bothering you before bed. Decide what things you can do something about and what things you can’t. Make a plan for how to deal with the things you can do something about. Put worrying on hold for both until the next day;
*Make lists of tasks for the next day/week, if you are worried about forgetting;
*If there is something you can quickly and easily do to ease your concern about a matter, do it immediately (ex. Send an email to your friend who’s birthday your forgot, apologize and promise to make it up to her);
*Avoid looking at the clock, try not to obsess about what time it is.

Here is a list of foods that contain tryptophan:

*Dairy products: cottage cheese, cheese, milk
*Soy products: soy milk, tofu, soybean nuts
*Seafood, meat and poultry
*Whole grains, rice
*Beans, lentils
*Hazelnuts, Peanuts, sesame and sunflower seeds
*Eggs

Sweet dreams!

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