Increasing Your ZZZs

Like exercise and good nutrition, adequate sleep is essential to health and peak performance.

How Much Sleep Is Enough?

In general, most healthy adults need an average of seven to nine hours of sleep at night. However, sleep needs vary. It isn't simply how many hours of sleep time you're logging in that matters, but how you feel and how well you're able to perform each day. So, how do you measure how much sleep you truly need? If you have trouble staying alert during monotonous situations when fatigue is often "unmasked" you probably aren't getting enough good-quality sleep. Other signs are a tendency to be irritable and having difficulty remembering facts.

What Is Insomnia?

Insomnia is the inability to sleep, or to sleep satisfactorily. It may involve one or more of the following:

• difficulty falling asleep
• waking up frequently during the night with difficulty returning to sleep
• early wakening
• unrefreshing sleep.

What Causes Sleep Problems?

Certain conditions seem to make individuals more likely to experience insomnia e.g. chronic depression, internalised and unexpressed anger, anxiety, physical problems. Transient and intermittent insomnia can occur if you experience: stress; an unsatisfactory lifestyle; shiftwork; jet lag; unsatisfactory sleep environment.

What can I do that will help me sleep better?

Not all of sleep hygiene rules suit all people, you will need to try them and devise strategies that seem to work best for you.

• Exercise regularly.
• Go to bed at the same time each day.
• Keep the temperature in your room comfortable.
• Eat a light bedtime snack. Hunger can disrupt sleep.
• Drink a glass of warm milk before bed. Milk contains an amino acid that is converted to a sleep-enhancing compound in the brain.
• Try relaxation exercises when you go to bed. Think about a relaxing scene. Practice deep muscle relaxation exercises. Relax your muscles, beginning with your feet and working your way up to your head. Use a relaxation tape or come in for some relaxation training at the Counselling Centre. Practice the self-relaxation technique of focusing intently on a soothing word of 'mantra', or on breathing in and out slowly.
• Keep the room quiet when sleeping.
• Keep the room dark enough. Use dark blinds or wear a mask if needed.
• Use your bed only for sleep and sex. If you believe that reading, listening to the radio, or some other in-bed activity helps you to fall asleep, then do so but do it no longer than about 20 minutes.
• Sexual intercourse has a relaxing effect for many people.
• Establish a regular, relaxing bedtime routine that will allow you to unwind and "send a signal" to your brain that it's time to go to sleep. In general, try to build into your schedule, time for seven to eight hours of sleep, and follow this routine as regularly as possible. Even on week-ends.
• Have a warm bath with soothing oils such as lavender or rosemary.
• Eliminate the bedroom clock. You can set your alarm by placing it in a position that is not visible from bed.

Avoid the following:

• Never try to sleep. The more you try to sleep, the more aroused you will get. Do something to distract yourself. Adapt the ancient task of counting sheep with a more modern day boring task.
• Don't count the hours you sleep; whenever you wake up reasonably refreshed you have had enough sleep. You may be sleeping more than you think. Sleep laboratory studies have shown that we tend to underestimate the amount of time we sleep.
• Don't exercise just before going to bed. Exercise at least three hours before bedtime.
• Don't engage in mentally stimulating activity just before going to bed. For example, watching an exciting or disturbing program on TV.
• 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.
• Don't lie awake for more than half an hour.

Stress Management

If you are not sleeping because you are worrying about something that is happening in your life, the best thing to do is to do something about the problem. Perhaps you can't remove the problem but you can do some constructive things like:

• During the day, talk to someone about the problem. Seek support from friends or a professional counsellor.
• Most of the thinking and worrying that we do in bed needs to be done - it just does not need to be done in bed. If you are lying in bed and not being able to get off to sleep because you are worrying, sit up and write about the problem. Keep a journal of your thoughts and feelings which you write in your journal when you feel the urge.
• Try an imagery of storing your worries away for a night. This works very effectively when used in conjunction with some physical relaxation exercises.
• Devote some time during the day (5-60 minutes) for thinking and worrying. This should end at least a couple of hours before going to bed. Then, when the thoughts come when you are in bed, say gently: "Stop, I thought about this today. I will think about it again tomorrow. Now is the time to sleep".

To Nap Or Not To Nap?

The mid-afternoon slump most of us experience, even when we've slept well, suggests that the human body may be meant to nap. There's increasing evidence that a 15-20 minute nap can improve alertness, sharpen memory and generally reduce the symptoms of fatigue. If you're coping with the impact of lost sleep from last night or you know you're going to lose sleep tonight, a nap can help you through. A few cautions. First, a nap is not a substitute for a full night's sleep; it is only a short-term solution. Second, if getting to sleep or staying asleep at night is a problem, naps are probably not for you. Explore napping, it may or may not be useful in improving your night time sleep.

A Note On Drug Treatment

When sleep problems are a result of general stress, dealing with your lifestyle and associated problems is better than using sleeping pills. Sleeping tablets are mainly used to treat short-term insomnia that may occur as a result of things going on in your life. Take sleeping tablets only as prescribed.

If you still can't sleep...

If you have tried the above suggestions and your sleep problems continue to persist it may be a good idea to visit a counsellor or doctor. To get the most of this visit, you'll find that it may be helpful to keep a diary of your sleep habits for about ten days to identify just how much sleep you're getting over a period of time and what you may be doing to interfere with it. In your diary record sleep and wake times, what you orally consume, how often and when you exercise.

The Repatriation General Hospital at Daw Park, in Adelaide runs a Sleep Disorders Unit. It adopts a multidisciplinary approach to diagnosis and management of sleep problems.

Useful websites

• http://www.shuteye.com/
• http://www.sleepfoundation.org/