Information and Tips on Sleep

Almost everyone has trouble sleeping sometimes. Stress from work, financial stress, relationship problems, loss of a loved one, or depression can keep us from sleeping normally.

What is normal sleep? Most adults need about 7-8 hrs of sleep a night, though our need for sleep may decrease slightly as we get older. Some individuals seem to more or less than the “normal” 7-8 hours. Most people fall asleep in 20 minutes or less. After about age 50, it is normal to need to get up once or twice during the night to use the bathroom.

What is sleep? Sleep is an in interesting and mysterious part of our lives, and we are just beginning to understand how complex it is. All organisms, except the most primitive, need some kind of regular rest to remain healthy. During sleep our body repairs and rebuilds itself. Without good sleep we lose our ability to function normally and become vulnerable to illness. Sleep moves through several stages during the night. We descend gradually from light sleep to deeper sleep; in the deepest phase (Stage IV) our mind rests and our body may toss and turn, and in the REM stage (for rapid eye movement) our mind is active, dreaming, and our body is still. A period of several hours of continuous sleep is necessary to reach these essential stages of sleep, so frequent awakening can interfere with the quality of sleep and cause us to feel tired the next day.

What can interfere with sleep? In addition to stress and worry, there are a number of things that can interfere with sleep. These include:

• Sleep deprivation due to work, young children at home, or other demands on our time.
• Disruption due to travel, time change, changing shifts, unfamiliar surroundings.
• Unusual noise or light.
• Indigestion or heartburn.
• Acute or chronic pain conditions.

What are sleep disorders? There are several medical disorders that are related to sleep and can affect our physical health. These include sleep walking, “restless legs,” narcolepsy (sudden daytime sleep attacks), sleep paralysis (awake but briefly unable to move), and sleep apnea (breathing is briefly interrupted during sleep). Occasional body jerks when falling asleep (myoclonus) is considered normal.

Self-Care tips to improve sleep:

• Set a regular sleep schedule. Try to have roughly the same bedtime and getting-up time each day. This helps your body establish a regular sleep-wake cycle.
• Avoid naps, or limit an occasional nap to 15-20 minutes. Naps tend to reduce night-time sleep and disrupt the normal sleep cycle.
• Create a good sleep environment. Your bed should be comfortable, and your bedroom as quiet and dark as posible
• Regular exercise promotes stress reduction and improves sleep, but you should avoid heavy exercise within 3 hours of bedtime.
• Watch what you eat or drink in the evening. A large or spicy meal sometimes causes a bad night. A large glass of water before bed almost guarantees one or more trips to the bathroom. While alcohol can cause drowsiness, it also decreases the quality of sleep and can cause wakefulness when it wears off. Caffeine (from coffee, tea, sodas, or chocolate) is a powerful stimulant, and is one of the most common causes of poor sleep. Our sensitivity to caffeine often increases as we get older. Try to limit caffeine consumption to one or two caffeinated drinks in the morning.
• Have a routine of relaxation during the hour or so before bedtime. Find what works best for you; some suggestions include reading, watching TV, listening to music, meditation, prayer, or a warm bath.
• Light cues our body that it’s daytime and time to wake up, so it’s best to avoid any exposure to bright light during the night. You can try equipping your bedroom and bathroom with nightlights, preferably dim and near the floor, so that you have enough light to move around safely without turning on the room lights. Conversely, exposure to sunlight or other bright light can help us wake up and be more alert in the morning.
• If you have persistent heartburn that is worse after you lie down, ask your medical provider to give you medication to reduce stomach acid. If you have a condition called GERD (gastro-esophogeal reflux), your doctor may advise placing blocks under the head of your bed to give it a gentle down-hill slope.

David Ringo MD

Draft 1
November 1, 2002