The dark circles under our eyes are the least of our worries when sleep evades us. Yes, a sleepless night will leave us irritable, tired, and yearning for at least 30 minutes to close our eyes and drift off, but the more restless nights we tolerate, the more at risk we are of long term mental and physical effects caused by sleep deprivation.
“Sleep is an imperative component of every person’s overall health and wellbeing,” says Dr Ahmeda Ali, GP with webdoctor.ie, an online GP consultation service. “It is crucial because it enables the body to repair and is as vital as regular exercise and eating a balanced diet.”
As unique as we are, the number of hours we need to clock up will also be individual to us. As Dr Ali suggests, a block of six to nine hours per night is average, with less sleep becoming normal as we get older. “What is important is that the amount of sleep you get should be sufficient for you and that you feel refreshed and not sleepy during the daytime,” she says.
Our normal sleep rhythms contain three varying sleep stages — restorative sleep often referred to as deep sleep, rapid eye moment (REM) sleep when we ordinarily dream, and short periods of waking. Many of us struggle to maintain a traditional nightly sleep routine to rejuvenate our body and minds.
“About one-third of adults do not get as much sleep as they would like,” says Dr Ali. “Poor sleep can mean, not being able to drift off to sleep, waking up too early, waking for long periods during the night, or not feeling refreshed after a night’s sleep.”
Over a long period of time, sleep deprivation can adversely affect our lives causing excessive fatigue, poor concentration levels, irritability, loss of interest in daily activities, depression, and anxiety.
“Numerous studies have found that insufficient sleep greatly increases a person’s risk of obesity, diabetes, infections, and cardiovascular disease in later life,” says Dr Ali. “Progressive sleep deprivation can also lead to visual disturbances, reduced levels of perception, reduced logical thinking, slower reactions, poor decision-making, reduced sex drive, and poor mood. Severe and prolonged deprivation can cause or worsen tremors, muscle jerks, poor speech, and slurring.”
Added to the physical ailments we experience, sleep deprivation can impact our psychological functioning in a number of ways. “Restorative sleep is usually associated with ‘deep sleep’,” says Dr Damien Lowry, Senior Counselling Psychologist and Chartered Member of the Psychological Society of Ireland. “A lack of deep sleep is likely to result in physical and mental fatigue. Mental fatigue can affect ‘downstream’ mental processes, which can include attention deficits, problem solving abilities, and the ability to regulate our moods through cognitive reasoning. REM sleep is known to facilitate the brain’s processing of emotional information, where salient information is retained and stored. A lack of REM sleep is known to be especially harmful to the consolidation process of positive or useful emotional content, which in turn, can influence mood reactivity or regulation. These are issues that can feature in those with mental health problems.”
Dr Lowry explains that research also suggests there is a bidirectional relationship between sleep and mental health. “This means it works in both directions,” he says. “Sleep problems may be both a cause and or consequence of mental health problems. One’s mental health profile can be adversely affected by sleep disruption, such as poor-quality sleep or not enough of it, but sleep can also be impacted negatively by marked and persistent mood states such as anxiety, depression, or other mental health diagnoses.”
The good news is there are many things we can do to reignite a healthy sleeping rhythm. “One of the most common causes of sleeping problems is sleep hygiene,” says Dr Lowry, “which is the term given to our pre-sleep routines and habits. A good rule of thumb is to fall asleep and wake up on different days, in other words, fall asleep before midnight, and establishing a set bedtime routine is advisable.”
While there remains mixed evidence on whether ‘blue light’ from mobile devices cause sleep problems, Dr Lowry suggests minimising the use of screens before bedtime. “Getting exercise during the day, but not too late in the evening, usually helps us to feel fatigued come bedtime and investing in a good, comfortable mattress is worth considering, given that we spend close to one third of our lives lying on it!” he also advises.
Both Dr Ali and Dr Lowry agree that if sleep is a major problem for you, and you’re experiencing issues like insomnia, the best way of addressing this is behaviourally, and not pharmaceutically as some might think.
“Pharmaceutical aids are helpful, sometimes, for short term use, but they’re not an appropriate solution to a persistent sleep issue,” says Dr Lowry. “Cognitive Behavioural Therapy for Insomnia (CBT-I) is a psychological approach with a proven track record in reducing sleep problems. It is worth talking to your GP or a Chartered Psychologist with expertise in this area if you are experiencing insomnia and finding it difficult to address.”
Dr Ali suggests a number of additional ways to encourage a good night’s rest:
- Reduce caffeine — do not have any food or drinks that contain caffeine or other stimulants for six hours before bedtime
- Do not smoke within six hours before bedtime
- Do not drink alcohol within six hours before bedtime
- Do not have a heavy meal just before bedtime (although a light snack may be helpful)
- Do not do any strenuous exercise within four hours of bedtime (but exercising earlier in the day is helpful)
- Body rhythms — try to get into a routine of wakefulness during the day and sleepiness at night. The body becomes used to rhythms or routines. If you keep to a pattern, you are more likely to sleep well. Therefore, no matter how tired you are, do not sleep or nap during the day
- Always get up at the same time each day, seven days a week, however, short the time asleep. Use an alarm to help with this. Resist the temptation to lie in even after a poor night’s sleep
- Do not use weekends to catch up on sleep, as this may upset the natural body rhythm that you have got used to in the week
- The bedroom should be a quiet, relaxing place to sleep. It should not be too hot, cold, or noisy. Earplugs and eye shades may be useful if you are sleeping with a snoring or wakeful partner. Make sure the bedroom is dark with good curtains to stop the early morning sunlight
- Do not use the bedroom for activities such as work, eating or television
- Do not do anything mentally demanding within 90 minutes of going to bed — such as studying
- If you cannot drift off to sleep after 20 to 30 minutes, get up. It’s best not to lie in bed, worrying about getting to sleep. Get up and do something you find relaxing until you feel sleepy, and then go back to bed
