Sleep and sleep problems

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1 STUDENT HEALTH CENTRE Sleep and sleep problems

2 Sleep and sleep problems: contents Sleepless nights 1 The different stages of sleep 1 Sleep problems 3 Causes of sleep problems 3 Sleep FAQ 4 Sleep advice 5 Use of sleep medication 6 Ideal sleeping conditions 7 2

3 Sleepless nights In Belgium about 1 in 3 people is thought to experience sleep problems. Generally, these problems are temporary and related to unusual circumstances. Not everyone needs the same amount of sleep. It is a myth that all people require 8 hours of sleep in order to have a good night s rest. Sleep studies indicate that sleep requirements vary between 4 to 11 hours a night. Geography also plays an important role. For example, people sleep less long near the sea and longer in the mountains. The term sleep problem is appropriate when someone sleeps badly for a longer period of time, causing them to experience discomfort during the day as well. Everyday tasks become more difficult as a result of sleepiness, fatigue or irritability. The different stages of sleep Our internal biological clock is regulated by a small area in the brain stem. Sleeping is a complex process which has been the subject of research for many years. From a medical perspective, sleep is subdivided in non-rem sleep and REM sleep. Sleeping occurs in cycles of about 90 to 120 minutes which are repeated 4 to 5 times throughout a typical night s sleep. wakker Jongvolwassene REM Slaapstadia Uren 1 1

4 Non-REM sleep: The non-rem sleep consists of 4 stages which are distinguished on the basis of brain activity: Stage 1: pre-sleep This is the transitional phase between being awake and falling asleep - in other words, drifting off. This is the lightest form of sleep and the individual is easily woken. In young adults, this stage makes up about 2 to 5% of the sleep process. When you wake up during this stage, you do not know you have been asleep. Stage 2: light sleep This stage has the physiological characteristics of real sleep and accounts for 40 to 50% of a normal night s sleep. The eyes are sometimes opened slightly without seeing anything. Usually, you experience a wonderful floating sensation. It becomes more difficult to wake you, but you can still respond to strong stimuli such as street noises, hunger pangs or someone knocking on the door. Stage 3: slow-wave sleep Around 3 to 8% of sleep is spent in this deep sleep. This stage occurs about half an hour after falling asleep. The muscles are now completely relaxed, breathing is very regular and the heart rate slows down. Stage 4: deep slow-wave sleep This is the deepest phase of sleep when you are least aware of your surroundings. It is at this stage that physical recuperation occurs. Stages 3 and 4 are most common in the first half of the night. These stages begin to decrease at the age of 40 and disappear almost entirely at the age of 70. This explains why elderly people do not sleep as deep. This stage accounts for 10 to 15% of the sleep process. REM sleep or active sleep: The Rapid Eye Movement sleep begins about 90 minutes after falling asleep. Your muscles are completely relaxed, your breathing and heart rate become irregular and your eyes make rapid movements. The REM sleep accounts for 20 to 25% of the sleep process and becomes longer as the sleep cycle is repeated. During this stage of sleep, vivid dreams tend to occur. When you are woken at this time, you can usually give an accurate account of your dreams. This stage allows you to break down and process the day s events. Some of these events will be stored in your short-term or long-term memory. For small children, who still have very much to learn, this dream sleep takes up more than half of the entire night s sleep. 2 2

5 Sleep problems The term insomnia is used when people complain of poor sleep quality which negatively affects the way they function during the day. Sleep problems can involve having difficulties falling asleep (takes more than 30 minutes) or having trouble sleeping through the night (frequently waking up throughout the night) or waking up very early in the morning. Insomnia is always a 24-hour problem. Medically, a distinction is made between short-term insomnia (less than three weeks) and long-term insomnia (more than three weeks). Causes of sleep problems Insomnia is not an illness in itself, but rather a symptom that something else might be wrong. Insomnia which appears suddenly is often related to unusual or traumatic events, such as a death, a fight, a stressful day or a heavy meal right before bed. These sorts of sleeping disorders usually disappear spontaneously after a few days once the cause has been resolved. People who do shift work or work nights are more prone to chronic insomnia because their body clock is disrupted. This also applies to people who travel often. In case of long-term insomnia for no apparent reason, it is advisable to consult a doctor as there might be a real medical problem that causes the sleeping disorder. Potential causes include thyroid problems, breathing difficulties, cardiac arrhythmia or blood sugar irregularities. Certain medication (such as some antidepressants) can have insomnia as a side effect. Another problem can be the restless leg syndrome, which is thought to affect 5% of the population. It involves a tingling sensation in the legs which makes it impossible to lie still. Snoring in itself is not a problem, but when it is associated with short interruptions in breathing, referred to as sleep apnoea, it is advisable to consult a doctor. Sleep apnoea is particularly common among older men who are overweight. 3 3

6 Sleep FAQ Can you catch up on your sleep? If you pull an all-nighter, it is not possible to make up for this lack of sleep right away. You will, however, have an increased number of deep sleep stages the following nights. For example, if you go to sleep at eight o clock in the morning, you will not be able to sleep for eight hours straight because your body clock is set to awake. You may continue to feel the effects of such a change in sleep pattern for a few days. Taking short naps during the day can help to make you feel better again. What is sleepwalking? Sleepwalking is encountered in 15% of children (usually boys) and tends to disappear spontaneously during puberty. It occurs during the deepest stage of sleep and can recur two to three times a night. Sleepwalking actually means the brain is half awake and half asleep. It is best not to wake the person and just escort them back to bed. Why do people yawn? Yawning is a reflex which originates from the brain stem. It starts in the back of the mouth with a slow, deep breath in, followed by a quick breath out. It is not entirely clear why people yawn. Yawning increases the oxygen levels in the blood when we feel tired. It can also be considered as a way to communicate that you are not interested. Excessive yawning can be a sign of drug addiction. What about a glass of wine before bed? Alcohol has a sleep-inducing effect because it relaxes the muscles. However, it suppresses REM sleep, which leads to interruptions in sleep and makes it difficult to sleep through the night. Excessive alcohol consumption causes you to wake up earlier in the morning and feel less fit during the day. What are dreams? Dreaming occurs during REM sleep. Since the REM stages become longer as morning approaches, dreaming is most common during this part of the night. It remains unclear why we dream exactly. People usually dream about events that happened during the day. This might suggest that dreams allow you to deal with these events. 4 4

7 Others claim that the degree of consciousness is considerably reduced when we sleep. Dreams can thus be seen as a sort of substitute to satisfy hidden psychological needs which surface at this stage. Does winter fatigue really exist? Winter fatigue is not a myth. A lack of sunlight can interfere with your biological clock, making you feel chronically tired and irritable. This phenomenon is season-related. Am I a morning or an evening person? Every individual has their own sleep-wake pattern, which on average takes about 25 hours. As a result of the light-dark cycle we follow a 24-hour rhythm. A morning person s internal clock runs ahead of that of an evening person. This is not a problem as such, except when your biorhythm does not match the schedule imposed on you by society. Is it true that the hours of sleep before midnight count twice? This is a myth and not supported by any scientific evidence. It is true that the first 4 hours of sleep are the most valuable, because the deep, restorative sleep (stages 3 and 4) mainly occurs in the first part of the night. The main concern, however, is not when you go to sleep, but that you sleep well and long enough. Sleep advice Make an estimate of what is a good night s rest for you. Sleep as many hours as you need in order to feel fit the next day. Limit alcohol and caffeine consumption before bedtime. Smoking stimulates the brain, so avoid nicotine before going to bed. Be sure to get plenty of exercise during the day. However, it is best not to play sports right before going to bed, as physical activity usually has a stimulating effect. Taking a bath about 90 minutes before going to bed can have a beneficial effect. A warm bath causes the body s temperature to rise and then decrease again afterwards. Such a drop in body temperature has a strong sleep-inducing effect. Try to respect your biological clock as much as possible. Make an effort to get up and go to bed at around the same time every day. If you experience difficulty falling asleep, do not keep tossing and turning. Avoid lying awake in bed for more than 20 minutes. Instead, get up and do something else for a while. 5 5

8 Make sure the temperature in your bedroom is comfortable (around 20 Celsius). Ventilate your bedroom during the day. It is best to keep the windows closed while you sleep in order to prevent temperature fluctuations. Watch what you eat. Heavy meals to close to bedtime are not recommended as they require your body to invest a large amount of energy in the digestive process. On the other hand, going to sleep with an empty stomach is not advisable either, as hunger pangs are likely to keep you awake. Refrain from using sleep medication as much as possible! Addictive effects may occur after just one week of usage. A fixed sleeping ritual promotes a good night s rest. Your bed should be reserved for sleeping. Reading, watching TV or studying is best done somewhere else. Sleep is not something that can be enforced. It should come naturally. You can use relaxation techniques to help you fall asleep. Taking a nap during the day is strongly discouraged for people who have trouble sleeping. It is best to save your tiredness until nighttime. People who have a normal sleep pattern may find a nap of 30 minutes (maximum) refreshing. Does a cup of warm milk with honey really help? Milk products contain a chemical substance called tryptophane, which is thought to play an important role in the sleep mechanism. Sugar (in the honey) activates the tryptophane, making you feel more relaxed. Use of sleep medication Unfortunately, about 1 in 10 adults in Belgium take sleep medication on a daily basis. Taking medication without consulting a doctor first is strongly discouraged. Sleep medication is only available from pharmacies on prescription. Herbal remedies such as valerian are a potential alternative. Sleep medication should only be taken temporarily! Addictive effects tend to occur fairly quickly and the medication is no longer as effective after long-term usage. 6 6

9 Ideal sleeping conditions The bedroom The bedroom should be reserved for sleep and sex. A well-ventilated room with a suitable temperature (preferably 18 to 20 degrees) and as little noise as possible will increase your sleeping comfort. Using the room for other purposes such as studying, reading or watching TV can prevent you from falling asleep. Most students who live in a student room, however, have no other choice. They are advised to leave their room for a little while before they use it to sleep in. The mattress In order to get a good night s rest the whole body should be evenly supported, following the natural contours of the spine. If you lie on your side, your spine should be kept aligned. A good mattress will distribute your body weight and absorb any transpiration, then allowing it to evaporate. The pillow Your pillow should fit the natural curve of your back. A pillow that is either too thick or too hard will cause stress on the spine. The ideal sleeping position While sleeping you are advised to lie either on your back or on your side. Lying on your front puts intense strain on the spine as a result of the strong rotation of the head which is necessary to breathe properly. This sleeping position is likely to cause neck problems and headaches. 7 7

10 8 8 January 2015 Copyright Student Services KU Leuven

11 9

12 STUDENT SERVICES General practitioners Naamsestraat 80 box LEUVEN, Belgium tel fax This leaflet was printed on CyclusPrint, 100% recycled fiber paper. Student Services KU Leuven works for the Student Health Centre together with the Social service associations for the students of the LUCA- Campus Lemmens Institute and Vlerick Leuven Gent Management School. v.u.: Jan De Vriendt, Naamsestraat 80, 3000 Leuven

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