Home' LOTL : June 2006 Contents 34
A. You know, I was just about to give you all my sympathy for the common problem of
garden-variety insomnia, but a few things in your letter set off warning bells. One was your
suggestion of “sleeping pills” and the other was that mention of “vices”. Dr Ann gets cranky
with the whole quick-fix mentality, and she’s not really a fan of patients who are into self-
sabotage. So as punishment she’s going to tell you a thing or two about sleep and sleep
“hygiene”, and if you’re still awake at the end of it, she’ll give you a few tips
You might want to know about how sleep works before you try to get some. Sleep is
a process which occurs in four stages. In Stage 1, you spend a few minutes losing that
sensation of wakefulness. Stage 2 lasts about 15 to 30 minutes, with your brainwaves shifting
to a slightly different pattern before progressing to Stages 3 and 4, which are together known
as “slow wave sleep”.
Slow wave sleep lasts 30-45 minutes before reverting to a Stage 2 pattern. During the night
these stages occur in sequence 4-5 times. Each of these cycles ends in “REM” or rapid eye
movement sleep, where your brainwaves are low in voltage, your muscles are floppy, and
your eyes sporadically make rapid movements beneath your eyelids. With each cycle of sleep
stages, the REM part lengthens, so that you might get 10 minutes of REM after your first cycle
and then 40 minutes after the last. Hello!! Are you still
od. Insomnia (which refers to difficulty falling to sleep,
intaining sleep, or poor quality of sleep) affects 30%
the population. Women get it more than men, and the
erly are more at risk than the young. There are many
asons why we find it difficult to fall asleep, but what all
omniacs have in common is the negative impact it has
your quality of life.
o why might you have trouble drifting off, even when
ou’ve counted sheep until you’re on a first name basis
ith the whole flock? There are some basic rules about
hat is now called “sleep hygiene”.
Make sure the environment you sleep in is comfortable.
ave some time before you get into bed where you are
winding down from the stresses of the day (a warm bath,
stening to music, reading). A full hour of this is ideal.
Grandma’s tip of drinking a glass of warm milk actually
works (milk is full of tryptophan – one of the “relaxer”
chemicals for your brain). Avoid exercise, and don’t be
tempted to cram in studying or working while lying in
bed. In fact, you should only get into bed when you are
sleepy. If you get there and find that you are not sleepy
after 10-20 minutes, get up and go to another room,
returning only when that sleepiness returns. Try to have
a routine you can fall into, like getting to bed by 10pm for 7
days in a row. Put off all your social engagements to get your sleep patterns back to normal.
Now for the bad news. All the “vices” you might love could be contributing to your insomnia.
Don’t drink coffee, tea or cola after 4pm. Better still, try to cut down your caffeine intake. Don’t
drink alcohol excessively – it is a relaxant initially, but can contribute to waking in the early
hours of the morning, and gives you a generally unrefreshing sleep.
Finally, recreational drugs will disrupt your sleep patterns, no matter what time of the day you
use them, and no matter what your level of use. Amphetamines keep you awake when they
are first taken, but can prevent you from regaining a normal sleep pattern.
Even drugs which some use to make them feel sleepy, like THC (marijuana), can make you
anxious and agitated. If you do get to sleep, they will throw out your natural sleep rhythms, so
you end up fatigued during the day, and wide awake the following night.
You might be tempted to consider medication like temazepam, but before you rush off to your
24 hour chemist, remember that there may be other reasons why you are not getting to sleep.
Certain physical illnesses, prescription medications, or conditions like depression and anxiety
can lead to insomnia. The person who can best assess your type of insomnia, and look for
the real cause and an appropriate treatment, is your doctor.
Q. I haven’t been able to sleep and nothing I do seems to work. I’ve thought of resorting
to sleeping pills but don’t want to get addicted (I’ve got too many vices already!).
By Dr Ann
Dr Ann is a doctor at a Sydney metropolitan area hospital. The opinions expressed in this column
are those of the author and are not intended as a substitute for medical advice. If you have
concerns about your health please consult your health practitioner.
Here are some tips to keep you
snoozy in the sack:
• Keep your bed times and wake
times regular. Try not to alter
these too much on weekends.
• Your body needs to know it’s
bedtime. Take up a routine
which relaxes you before bed:
soak in a tub, read a book, or
even consider some physical
exertion and satisfaction
between the covers that sends
you to the land of zzzzs.
• Keep computers, paperwork, and
tools (unless battery operated)
out of the bedroom. Not only
are they bad feng shui; they
symbolise work not rest.
• Don’t skimp when it comes
to purchasing your bedding.
Mattresses that sag in the
middle or ﬂat or bumpy pillows
can’t help things.
• Be strict with your pets. If they
are disturbing your desired 8
hours of uninterrupted sleep,
keep them outside the bedroom.
• Don’t try to sleep on a full
stomach. You should ﬁnish
eating 2-3 hours before
• If you exercise after work, leave
a few hours before sleeping.
Yoga and the gym energise the
body and require time for you to
• Nicotine, coffee and alcohol act
as stimulants and are not good
close to bedtime (if at all).
• If you are a quitting smoker,
remove your nicotine patch
before bedtime, unless you enjoy
vivid dreams, hallucinations,
mystery itches, and jumpy legs.
• If your partner reports that
you snore, consult your doctor.
Snoring could be a symptom of
Visit bettersleep.org, sleepnet.com
or shuteye.com for other
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