Men’s Health Peer Education Magazine Vol. 13 No. 3 November 2014 – Sleep Better Issue
The Myths and Facts about Sleep
Most people have trouble sleeping at one time or another. If we worry about not sleeping, the worry may actually affect us more than the lack of sleep itself. This is why there are a number of things you should know about sleep. What is normal sleep? What happens to sleep as we age? What are the best treatment options for sleep difficulties? It’s important to understand the myths and facts when it comes to sleep.
Inside this issue
Why I wear overalls to bed
Sleep is not simple and neither is dreaming. Despite or because of the twisted insights of Sigmund Freud, the stuff we dream about remains fascinating. The ancients considered dreams to be messages from the Gods. Aristotle told us it was all within our own brains. Since all humans and most animals engage in dreaming it probably has a useful purpose.
VVCS helping veterans get a good night’s sleep
Getting a good’s night sleep is vital to our physical, mental and emotional wellbeing. Sleep is the brain’s ‘maintenance shift’ that helps the body to recover from daily activities; by washing away the toxins that have built up during the day and to ‘tidy up’ information accumulated from thoughts and activities while awake.
Snoring
About 40% of men have at least mild snoring, on at least some nights. This number is smaller for women (around 30%). About 15% of people snore on most nights. People of any age can snore. But the age group with most risk are middle aged people.
Also in this issue: Sleep apnoea, A good night’s sleep: DVA’s Wellbeing Toolbox, Good sleep habits, and much, much more.
Wanted MHPE Volunteers! Turn to pages 31-32 for information on the MHPE programme.
MHPE Magazine and reproduction of content
Just a reminder to our readers, if you would like to include an article that’s appeared in an edition of the magazine in your own publication, please contact the Editor to confirm if there are any restrictions on the re-publication of the material.
MHPE Magazine Editorial Committee Membership
Naomi Mulcahy DVA (Editor)
Dr Graeme Killer AO, DVA Principal Medical Adviser
Dr Warren Harrex, DVA Senior Medical Adviser
Dimitri Batras, DVA National Health Promotion Adviser (outgoing member)
Mariusz Kalinowski DVA
Michael Correll VVCS
Chris Jones DVA
Dr Justin Harding DVA
We would like to thank Dimitri for his valuable contributions to the Committee during his two-year term. We also would like to acknowledge George Macris (DVA Public Affairs) for her advice and assistance with this issue.
Editorial
Sleep is an essential human need. When the need isn’t met, we long for it. We struggle through the day, and our mental and physical capabilities are diminished. We spend a large part of our life asleep, so it makes sense that we establish habits and an environment that is conducive to achieving good sleep. Sleep deprivation, especially over a prolonged period, will impact on your health, and it may suggest an underlying medical condition.
Sleep requirements vary as we age, and some sleep disorders, such as snoring are more common in men. Military life, especially involvement in sustained operations, may require days without sleep. Our mind and body are programmed to a particular body clock, and changes to this routine, whether through military service, shift work, jet lag and parenting demands can take its toll. For some people, a disrupted sleep can be due to certain physical and mental conditions. Chronic pain can cause a person to wake up several times throughout the night. Anxiety or exposure to a traumatic event may delay falling asleep and cause broken sleep if the individual experiences nightmares.
So how do we establish and maintain good sleep? Often it can be achieved by making simple changes to your environment and to your routine, or as it’s now known ‘sleep hygiene’. It’s often recommended that keeping a sleep log is a useful way to pinpoint the factors that may be causing a poor sleep. You can then implement changes and see if they make a difference. You’ll find a sleep log example on page 13. If you’ve not been sleeping well for sometime, make an appointment with your doctor. You may have a sleep disorder requiring treatment, or it might be appropriate for you to visit a mental health professional for assistance.
Inside this issue you’ll find articles about common sleep disorders, sleep hygiene, the myths and facts about sleep and helpful apps, books and websites if you want additional information. Our medical advisers discuss daytime sleepiness, the importance of dreaming and how to get a good night’s sleep. Also, one of our MHPE volunteers shares his story about having sleep apnoea and the impact that it’s had on his life. We hope these articles provide guidance and encourage you to make changes to achieve a good sleep.
As you know, this year marks the centenary of World War I, and recently there have been many excellent TV documentaries, dramas and radio broadcasts discussing The Great War. We also have the great classic novels and poetry that describe this period. The themes discussed and the stories told are shared throughout earlier and later conflicts. One of the common themes is a soldier’s fatigue and the overwhelming need for sleep. The following quote is appropriate for this issue:
“No human being knows how sweet sleep is but a soldier”
J.S Mosby
War Reminiscences, 1887
On a final note, Dr Graeme Killer AO, will be retiring at the end of the year. Dr Killer has been DVA’s Principal Medical Adviser for 23 years and has been contributing to the MHPE Magazine since the first issue was published in June 2002.
In March 2008, we were introduced to Penny, Dr Killer’s wise canine companion. Since that time, readers have enjoyed and been informed by the conversations between Dr Killer and Penny, as they discussed a range of health and wellbeing topics. Dr Killer has advised that he and Penny are moving to Melbourne, and that once settled in, Penny might send a few postcards to the magazine.
In addition to the MHPE Magazine, Dr Killer has presented at the annual MHPE National Workshops and provided ongoing advice to the MHPE programme.
On behalf on all MHPE volunteers and the MHPE Magazine Editorial Committee, I’d like to thank Dr Killer for the support he has provided to the MHPE programme, and extend our best wishes for his well-earned retirement.
Sleep Essentials
Sleep is as essential for good health as oxygen, food and water. Yet we still don’t know exactly what it is or how it works. Most scientists agree that sleep is important for restoring physical and mental health. It refreshes the mind and repairs the body. Lack of sleep, or sleep deprivation, can cause fatigue, poor concentration and memory, mood disturbances, impaired judgement and reaction time, and poor physical coordination.
The body’s internal clock regulates when and how we sleep depending on the amount of light around us. When the sun sets, your brain releases hormones to make you sleepy. In the morning, exposure to daylight suppresses these hormones and releases brain chemicals to keep you awake.
Getting enough sleep
Before electricity, people used to sleep between sunset and sunrise. The typical person’s sleep averaged a generous ten hours – the same amount enjoyed by other primates like chimpanzees and baboons. Today, sleep deprivation is common in developed nations, with the average adult sleeping for only six or seven hours each night.
Most of us feel fatigued at least some of the time. It is thought that fatigue causes about one road accident in six. Studies show that a common distraction from sleep is the Internet and more recently, texting. Parenthood, shift work, travel across time zones, illness, poor sleeping habits and some medications are other common sleep-stealers. New parents lose, on average, between 450 and 700 hours of sleep during their child’s first 12 months of life.
Sleep stages
Sleep isn’t a static state of consciousness. The brain moves through distinct stages of sleep, over and over, every night. The two broad categories of sleep include:
Rapid eye movement (REM) sleep
Non-rapid eye movement (NREM) sleep.
Rapid eye movement (REM) sleep
Rapid eye movement sleep occurs regularly, about once every 90 to 120 minutes. It makes up about one-quarter of your night’s sleep. The brain in REM sleep shows significant electrical activity. The sleeper’s eyes tend to dart about under closed lids, hence the name.
The bulk of dreams are thought to occur during REM sleep. Sleep researchers have established that at least some eye movements correspond with dream content, which suggests that we watch our dreams like we watch movies on a screen. REM sleep makes up a larger proportion of the total sleep period in babies (especially premature babies), which suggests that dreams help to mature a developing brain.
Non-rapid eye movement (NREM) sleep
Non-rapid eye movement sleep is what you experience for the remaining three-quarters of your sleep time. The amount and type of NREM sleep vary with age and the degree of sleep deprivation.
The four broad stages of NREM sleep include:
· Stage 1 – Dozing or drowsiness. You hover between being asleep and awake.
· Stage 2 –You lose awareness of your surroundings. Body temperature starts to drop. Breathing and heart rate slow down.
· Stages 3 and 4 – Deep sleep, also known as ‘delta sleep’. Your blood pressure, heart rate and breathing become very slow and your muscles relax. Growth and repair processes occur during this stage.
Sleep disorders
Common conditions that can affect a person’s sleep include:
· Insomnia
· Sleep restriction/insufficient sleep/sleep-related habits that reduce sleep time
· Parasomnias such as nightmares, sleep walking and night terrors
· Circadian rhythm disorders where the desire and ability to sleep are out of phase with the 24-hour social environment, such as jet lag and shift work sleep disorder
· Narcolepsy
· Periodic limb movement disorder and restless legs syndrome
· Snoring and obstructive sleep apnoea.
Where to get help
· Your doctor
· Accredited sleep disorders clinic
· www.betterhealth.vic.gov.au
· www.vvcs.gov.au/
Things to remember
· Sleep is essential for your health.
· It refreshes the mind and repairs the body.
· Lack of sleep can cause fatigue, poor concentration and memory, mood disturbances, impaired judgement and reaction time, and poor physical coordination.
· Common causes of sleep deprivation are parenthood, shiftwork, travel across time zones, illness, poor sleeping habits, some medications and the Internet.
· It is thought that fatigue causes about one road accident in six.
Source: www.betterhealth.vic.gov.au
© 2014 State Government of Victoria
How do sleep problems affect you?
Sleep deprivation over time is associated with:
· Aging more rapidly;
· More susceptibility to illness;
· Increased risk of accidents;
· More emotional problems such as depression and anxiety;
· Mood swings and irritability;
· Concentration problems, impaired judgement, difficulty making decisions;
· Reduced ability to deal with stress;
· Increased risk of general health concerns such as heart disease, diabetes, increased blood pressure;
· Apathy, low energy, fatigue;
· Headache;
· General feeling of malaise or sickness; and
· Weight gain.
Source: ADF Mental Health Strategy Sleeping Soundly Fact Sheet
How many hours of sleep are enough for good health?
The amount of sleep you need depends on various factors — especially your age. Consider these general guidelines for different age groups:
Age group / Recommended amount of sleepInfants / 9-10 hours at night, plus 3 or more hours of naps
Toddlers / 9-10 hours at night, plus 2-3 hours of naps
School-age children / 9-11 hours
Adults / 7-8 hours
In addition to age, other factors can affect how many hours of sleep you need. For example:
· Pregnancy. Changes in a woman's body during early pregnancy can increase the need for sleep.
· Aging. Older adults need about the same amount of sleep as younger adults. As you get older, however, your sleeping patterns might change. Older adults tend to sleep more lightly and for shorter time spans than do younger adults. This might create a need for spending more time in bed to get enough sleep, or a tendency toward daytime napping.
· Previous sleep deprivation. If you're sleep deprived, the amount of sleep you need increases.
· Sleep quality. If your sleep is frequently interrupted or cut short, you're not getting quality sleep. The quality of your sleep is just as important as the quantity.
Although some people claim to feel rested on just a few hours of sleep a night, research shows that people who sleep so little over many nights don't perform as well on complex mental tasks as do people who get closer to seven hours of sleep a night. Studies among adults also show that getting less or much more than seven hours of sleep a night is associated with a higher mortality rate.
If you experience frequent daytime sleepiness, even after increasing the amount of quality sleep you get, consult your doctor. He or she might be able to identify any underlying causes — and help you get a better night's sleep.