Sleep problems treatment

We all have trouble sleeping from time to time, but it can cause serious health problems when it happens almost every night. If you have frequent sleep problems, it is important to find out what the cause is. Sleep deprivation can limit your ability to function during the day.  

An occasional night without sleep doesn't necessarily mean your performance will suffer the next day. But if poor sleep is a common occurrence it can lead to various problems, such as concentration difficulties, lethargy, fatigue and drowsiness. These problems are often caused by a sleep disorder.

Most healthy adults need between seven to nine hours of sleep per night to function at their best. One night of poor sleep is not harmful. But if you suffer from continued lack of sleep and this affects your ability to function during the day, this is classified as a sleep problem. Our sleep is composed of four stages, through which we cycle every 90 to 120 minutes.  

Stage 1: Falling asleep 

Stage 1 is a short stage in which you are not really asleep, but in which the body prepares for sleep. During this stage your muscles begin to relax, your body temperature drops, your heart rate slows down, your eyes slowly roll back and your brain activity decreases. After several minutes, you enter what is called light sleep.  

Stage 2: Light sleep 

During light sleep, you are asleep more deeply than in stage 1, but the body is still somewhat alert and easily awakened. The brain is less active, your heart rate slows down further, and your blood pressure and body temperature drop. During this stage, your body continues to relax.  

Stage 3: Deep sleep 

Deep sleep is essential for re-energising your body and mind. In stage 3, your heart rate slows down even further and your muscles relax even more. During deep sleep, you become less responsive to outside stimuli and have difficulty waking up. Stage 3 is the most rejuvenating and restorative sleep stage. This is when organ and muscle growth happens and when your brain consolidates and processes information from the day.  

Stage 4: REM sleep 

The final and fourth stage of sleep is REM sleep. REM stands for Rapid Eye Movement. REM is when the brain is more active and your eyes move rapidly in different directions (hence the name). Your blood pressure rises and your heart beats faster, causing your respiratory rate to increase. This stage requires a lot of energy and is when most dreaming occurs. During REM sleep, your brain is almost as active as it is when you are awake.  

The four stages of the sleep cycle will repeat several times during the night. Sleep is crucial to our well-being. While we sleep, our body and mind shut off for rest and repair, so that we wake up feeling refreshed and ready to take on the day. A lack of sleep can lead to problems with concentration, alertness and learning. In fact, 15% of all traffic accidents are caused by fatigue. Sleep deprivation also makes us irritable, moody and lethargic, which can make life more difficult. What’s more, poor sleep throws off our hormone balance, which increases the risk of obesity and other health issues. 

Sleep problems can have various causes. Worrying or ruminating can make it difficult to fall asleep. As soon as you relax, your mind gets filled with thoughts that keep you awake. A racing mind can be very hard to turn off and can rob you of valuable hours of sleep. Health issues, such as itching, respiratory problems or restless legs, can also make it difficult to fall asleep, or wake you up throughout the night after you’ve finally fallen asleep. Some of the most common health conditions that cause sleep problems are: 

• Restless legs syndrome (RLS)  

• Allergies  

• Asthma  

• COPD  

• Bowel diseases

Sleep problems can be grouped into four main categories:  

• Problems falling asleep  

• Problems staying asleep  

• Waking up early 

• Sleep-related disorders, such as narcolepsy and sleep apnoea

Here are some clues that indicate that you might not be getting enough sleep:  

• Not feeling rested or waking up stiff or still feeling tired. (If you feel stiff after sleeping, it can also mean your mattress does not provide enough support and needs to be replaced.)  

• Falling asleep at inappropriate times, mostly when sitting still while watching television or doing paperwork.  

• Perpetual fatigue or lack of energy during the day.  

• Headache, especially around the eyes.  

• Irritability, frequent crying or outbursts of anger (i.e., having a short fuse).  

• Lack of concentration. These signs, especially in combination with drowsiness, are known to be major contributing factors in motor vehicle collisions.  

• Memory problems.

Many sleep problems are the result of poor sleep hygiene or lifestyle habits. These tips will help you get a better night's sleep. 

Sleep hygiene: 

• Make sure your bedroom is as dark, cool, well-ventilated and quiet as possible. 

• The temperature in your bedroom should be between 17 and 21 degrees Celsius. 

• Are your surroundings loud or noisy? Consider using a white noise machine or app. 

• Follow a consistent sleep schedule. 

• Invest in a quality mattress, a good pillow and comfortable nightwear. 

• Avoid naps during the day. 

• Start a worry journal to write down anxieties and concerns in the evening before going to bed, so that they have a place to go. 

Lifestyle: 

• Turn off all electronic devices at least one hour before sleep. 

• Read a book or magazine, or listen to calming music. 

• Make sure you get enough physical activity (e.g., exercise or evening walks). 

• Don't overload your diary. Make time to relax. 

• Avoid alcohol or caffeinated drinks in the evening. Caffeine delays the production of melatonin (a hormone produced by your body that controls your wake/sleep rhythm) and stimulates brain activity. 

• Drink sufficient fluids. 

• Quit smoking. Smoking reduces blood flow to tissues and organs, and causes toxins to enter the blood. 

• Control your weight and adjust your eating habits, if necessary. Avoid eating late-night meals. 

Medication  

Doctors generally don't recommend prescription medication for sleep problems. This is because sleeping pills are habit forming and have lots of side effects. You could say that sleep medication is nothing but a temporary band aid until the underlying problem is addressed. But if you have chronic insomnia and need to resort to medication, only short-term or intermittent use is recommended. A short-acting benzodiazepine-antagonist (e.g., lormetazepam, temazepam, zolpidem or zopiclone) is preferred to alleviate symptoms immediately. These medicines are metabolised quickly and easily excreted from the body. The short duration of action also makes it possible to dose the medication more accurately. 

Alternative treatments  

There are also treatment options other than medication that can help to improve your sleep rhythm. Examples of alternative therapies include meditation and yoga, aromatherapy, herbal tea and melatonin. If this doesn’t improve your sleep, you can ask your doctor for a referral to a sleep clinic. Disorders such as sleep apnoea and narcolepsy, but also insomnia and snoring are treated here.  

 You can find more tips on how to improve your lifestyle and sleep hygiene under the heading ‘What can you do yourself to alleviate sleep problems?’. 

Given the risks and side effects associated with the use of sleep medication (daytime sleepiness, negative influence on driving ability, dependency), using a short-acting soporific medicine in the lowest possible dose is preferred. The effectiveness for inducing sleep wears off after two weeks once the body adjusts to the medicine. 

Sleep problems cannot always be prevented. Sometimes poor sleep is caused by a sleep disorder, or a health problem such as depression. However, you can prevent sleep problems from developing or becoming chronic if you follow the tips provided above, like avoiding unhealthy sleep habits.