Missing a good night’s sleep is not so bad if you can catch up the following night and restore your energy. However regular or persistent sleep deprivation causes serious short and long term health consequences.
According to research it only takes a week of poor sleep habits to alter metabolic and endocrine functions.
Chronic sleep debt is becoming increasingly more common in our society, affecting literally millions of people in more developed countries. Once thought to have no ill effects on health, research has now demonstrated the physiological consequences of chronic sleep deficiency.
Sleep debt can have a harmful effect on carbohydrate metabolism, leading to insulin and cortisol resistance and therefore obesity and possibly diabetes. Hormone balance in relation to pituitary, adrenal and sex hormone production is affected, interfering with health and wellbeing as well as sexual function and fertility.
Stress on the hypothalamic pituitary axis (the main hormone regulation system of the brain) caused by lack of sleep leads to disruption of thyroid hormone metabolism, which further aggravates weight regulation and may increase amounts of body fat, along with the fat accumulation which elevated cortisol levels can cause.
High blood pressure is aggravated by inadequate sleep in those who already have hypertension. This is due to sleep deprivation causing a rise in sympathetic nervous system tone – or tension.
Poor sleep practice leads to problems with cognitive (mental) functioning, perhaps precipitating age-related dementia, as well as other age-related chronic disorders. The signs of sleep deprivation mimic those of general ageing. Reduced immune resistance is also seen in those who do not enjoy regular, refreshing sleep.
There are several types of insomnia
- Difficulty falling asleep: Usually caused by excessive mental activity, particularly near bedtime. Finding it difficult to “switch off” and relax, having too much on one’s mind, being in “overdrive”. Also caused by caffeine and other stimulants, alcohol or overeating.
- Difficulty staying asleep: Waking at regular intervals during the night, usually on the two-hour cycle of REM sleep when dreaming occurs. Due to a dominant or vigilant state of mind, mental preoccupation with a worrying matter.
- Interrupted sleep: Factors cause waking, such as a snoring partner, a nocturnal pet (such as a cat) or a teenager arriving home in the early hours of the morning. Often interrupted sleep starts for new parents and continues for many years after the birth of the first child. Menopausal hot flushes notoriously disturb many women at this stage of their lives.
- Shallow sleep: Physical tension or pain, anxiety or fear, hunger and other types of stress can reduce the depth of sleep. Too much ambient light or noise prevents deep sleep.
- Early waking: Usually caused by ageing or depression
- Waking unrefreshed: Caused by adrenal exhaustion, sleep apnoea and allergies
- Disturbances of sleep rhythm: Jet lag and shift working
Physical problems which can cause insomnia
- Hypoglycaemia: This is an interesting cause of insomnia. Low levels of blood glucose during the night can lead to the brain shrieking out for more fuel and waking you up to go downstairs to raid the fridge. Usually this sort of sleep interruption responds immediately to some warm food or a nourishing drink in the belly.
- Menopause: Sleep disruption is very common with the menopause, starting as soon as a woman’s periods begin to falter. Sleep becomes lighter and often interrupted by hot flushes, causing women to throw of the bed clothes suddenly, then having to find the covers again when cooling down an hour later. These symptoms usually resolve after two years, but for most women the sleep disruption is too disabling to suffer and treatment for menopausal symptoms can give welcome relief.
- Dysthymia and depression: Dysthymia is a disorder which can cause sleep disturbances. It is milder than clinical depression and commonly lasts for at least two years, but is less disabling than major depression. About three percent of the population will suffer from dysthymia at some time, which is slightly less than the incidence of depression in the population. Along with sleep irregularities the warning signs of dysthymia are:
- poor school/work performance
- social withdrawal
- irritable hostility
- conflicts with family and friends
- General illness: Asthma and eczema; heartburn and reflux; arthritis, joint and spinal pain; heart and lung disease; prostate and other urinary problems; and other disabling and incapacitating health concerns can interrupt sleep due to inability to breathe, having pain or having to get up to the toilet throughout the night. Tinnitus – a constant noise hallucination perceived by the sufferer – is distressing and prevents relaxation at night when the sound becomes more intrusive than it is during the day.
How much sleep is enough?
When we are very young we need more sleep to grow and develop and generate new tissues. Babies will ideally sleep 12 hours per night, with another two hours sleep during the day; children require 9-10 hours per night; teenagers can manage with 8 hours’ sleep but often need that long lie-in on weekends as they go through their growth spurts. As we get to our 20’s and 30’s we need eight hours’ sleep per night, but usually do not get quite that much due to other life commitments (jobs, travel, families). After 50 we can reduce our sleep to six-seven hours, unless we are still very physically active, in which case it will often be a good rule to get eight hours’ sleep per night for physical recovery.
Sleep and exercise
Often sleep is light or reduced through lack of physical activity during the day. When we exercise more we create a state of physical tension release and a physiological need for rest and recovery after the energy expenditure, which naturally induces a deep and restful sleep – unless you get “restless legs syndrome” from all that exercise, in which case you need to take a good dose of magnesium before going to bed to prevent leg twitchings.
This could be one of the reasons that sufferers of Chronic Fatigue Syndrome have insomnia problems after an initial phase of hypersomnia (excessive sleep), since they are unable to achieve their “sleep-deserving exercise” with their physical incapacity. This leads to a vicious cycle of poor sleep, depression, demotivation, inability to exercise and then more insomnia. Chronic mental or physical exhaustion will also cause this scenario to a less severe degree.
The importance of a soothing sleeping environment
Your bedroom needs to be a place of refuge and relaxation. Decorate it in subdued or dark colours with very little clutter, perhaps with candles to create a warm and soothing luminosity at night. Play calming ambient or classical music to create a mellow atmosphere in your bedroom. Fresh air and an even room temperature are important factors to address so that quality of sleep is not impaired.
Do not have your office/computer/desk in the same room – ensure that you separate your place of business from your space for rest
Melatonin hormone levels are depleted by light stimulation and it is darkness which stimulates melatonin, which in turn induces sleep naturally. If we think of life before the electric light we would have been reading a while by candlelight before bed, going to sleep only a short while after sunset and rising again with the sun. The closer we operate to the day-night rhythm, the more regulated our melatonin levels become and also the better our sleep quality.
With artificial lighting and electronic equipment we can be awake, working, surfing the net or emailing throughout the night, doing terrible things to our sleep rhythm. I have had several patients addicted to their computers, especially international chat rooms, so that they were unable to sleep during the night and dragged themselves exhausted through each day.
More sex and less fat!
The best way to improve your libido and at the same time to lose weight is to get a good night’s sleep. And it’s free! No expensive hormones or weight loss programs are necessary if you establish a better sleep rhythm, make your own sex hormones and improve your fat-burning capacity.
Of course the best results are achieved by exercising DAILY – increased activity and formal exercise increases sexual energy and stamina in both men and women, as well while increasing sleep quality and duration. Increasing exercise levels will increase your basal metabolic rate so that you will be burning more fat, not only while your active but also while you are asleep.
Sleep drugs – handle with caution
Sedative and hypnotic drugs, such as “sleeping tablets” (benzodiazepines and antihistamines) cause a state of drowsiness which may last as a hangover the next day. The stronger the drug the more comatose your sleep becomes, which prevents the natural rolling movements and changing of body positions during the night which normally keep our digestive juices and lymphatic fluids moving to aid processing of food and elimination of wastes. It is also important to consider the addictiveness of many of these drugs, causing serious withdrawal problems in the future if the medication needs to be ceased.
I prefer to prescribe herbal sleeping draughts, which are individually formulated and dispensed by a herbalist, which may contain herbs such as skullcap, hops, valerian, passionflower, vervain, lemon balm and zizyphus. Bach flower remedies may be added for particular emotional issues such as over concern about someone else, depressed mood or nightmares.
9 tips for a good night’s sleep
Also, if you get up during the night try not to have a cup of tea with caffeine, read something intellectual, listen to talk-back radio or watch television. These activities will cause more mental stimulation. Try a relaxation exercise, listen to hypnotic music or read poetry.