by Dr. Avery Gudgeon, Adelaide Health Clinic
Getting a good night’s sleep (consistently) is one of the best things you can do for your health, right up there with regular exercise and quitting smoking. Many of us are so busy with work and life that, when pressed for time, sleep is one of the first things to be sacrificed. However, there are many negative effects of skimping on sleep; deficits in alertness, performance, and health are linked to sleep deprivation, both acutely and cumulatively over time.
Sleep deprivation can arise from either an insufficient amount of sleep and/or poor quality of sleep.
So how much sleep is enough sleep? Clinical wisdom and supporting research suggest that most people require approximately 8 hours of sleep nightly, although there appears to be variation from person to person. Studies looking at consequences of sleep deprivation point to a minimum of 7 hours of sleep nightly. You can tell you’ve had enough sleep if you wake up feeling refreshed and are capable of moving through the day feeling alert without effort (or coffee), even when placed in boring or monotonous situations. Most individuals can adapt to acute sleep loss as long as they have slept a minimum of 6 hours, and return to normal sleeping duration shortly after.
It is possible to sleep for 8 hours and still suffer from sleep deprivation, if that sleep is of poor quality. Sleep quality is determined by the number of arousals (awakenings) from sleep during the night, as well as the pattern of sleep stages. Arousals are usually due to sleep disorders such as sleep apnea, but they can occur spontaneously. Most people are unaware of waking up overnight and so might not realize they suffer from poor quality sleep.
The consequences of sleep deprivation are widespread and include both psychological and physical health:
• Cognitive deficits – decreased reaction time and difficulties with concentration, memory, and decision- making
• Mental status – poor mood, irritability, low energy, decreased libido, and poor judgment, which can mimic depression or anxiety
• Crashes and workplace errors
• Quality of life – less energy for extracurricular activities, falling asleep on the job, relationship dissatisfaction
• Disruption of circadian rhythm
• Cardiovascular – increased risk of high blood pressure, heart attack, stroke
• Immune function – suppression of immune responses, more susceptible to illness
• Obesity – weight gain and increased risk of diabetes through effects on appetite and hormone secretion
Many of my patients complain of poor sleep or insomnia. It is important to take a detailed history and try to determine the root cause of an individual’s sleep disturbance, as there can be serious underlying conditions such as sleep apnea, periodic limb movement, or anxiety and depression, which require further investigation and treatment. In some cases, the culprit is something as simple as poor sleep hygiene. Sleep hygiene refers to actions that tend to improve and maintain good sleep.
Some basic rules for good sleep:
• Sleep only as much as you need to feel rested and then get out of bed
• Keep a regular sleep schedule (most important is waking up at the same time every day)
• Try not to force sleep
• Exercise regularly for at least 20 minutes, preferably more than four or five hours prior to bedtime
• Avoid caffeinated beverages after lunch
• Avoid alcohol near bedtime (eg. late afternoon and evening – no night cap!)
• Avoid smoking, especially in the evening
• Do not go to bed hungry
• Adjust bedroom environment (eg. keep room dark, turn away electronic lights, keep pets out of bed)
• Deal with your worries before bedtime
• Avoid daytime naps
• Remember the 3 S’s – reserve your bed for Sleep, Sex, and Sickness only
Working on these steps may take significant dedication initially, but behavioural strategies to improve sleep are safe and have long-lasting success. Medications can be prescribed to treat insomnia, and short-term or sporadic use of these may be appropriate depending on the situation. However, due to potential side effects and the risk of physical and psychological addiction with long-term use, a prescription for sleep should never be the only strategy.
In summary, the doctor’s orders; go get a good night’s sleep!