Battling Sleepless Nights: Strategies For Restful Sleep

Sleep is an essential pillar of health, and disruptions to it can have a significant impact on our daily lives. Insomnia, which affects about 10% of the world's population, is characterised by difficulties in falling or staying asleep, and can lead to feelings of tiredness, unwellness, and sleepiness during the day. There are various factors that can contribute to insomnia, including lifestyle choices, underlying health conditions, medications, stress, and poor sleep habits. It is important to address sleep issues as they can affect our ability to function optimally and, in the long term, increase the risk of obesity, high blood pressure, heart disease, and diabetes.

Sleep deprivation symptoms

Sleep deprivation can have a significant impact on your body and overall health, and the longer it goes on, the more severe the symptoms can become. Here are some of the common symptoms of sleep deprivation:

Changes in Sleep Patterns and Fatigue

• Falling asleep unintentionally, such as while reading or watching TV
• Falling asleep quickly when getting into bed
• Sleeping longer hours on the weekends to compensate for lack of sleep during the week
• Feeling fatigued or lethargic throughout the day, accompanied by frequent yawning

Mood and Mental Health

• Changes in mood, including feelings of depression, anxiety, stress, paranoia, or even suicidal thoughts
• Increased risk of depression and other mental illnesses
• Feeling less interested in sex
• Experiencing psychosis, including hallucinations and disorganized thoughts

Cognitive and Physical Impairment

• Difficulty concentrating and remembering things
• Slower processing of information
• Poor balance and coordination
• Increased appetite, especially for calorie-dense foods
• Craving more caffeine
• Slowed reaction times
• Impaired perception of reality
• "Microsleeps," which are brief periods of sleep during waking hours
• Uncontrollable eye movements (nystagmus)
• Trouble speaking clearly
• Drooping eyelids (ptosis)
• Impulsive or reckless behaviour

Health Risks

• Increased risk of stroke and asthma attack
• Higher likelihood of car accidents due to drowsiness
• Cardiometabolic conditions such as obesity, high cholesterol, diabetes, and hypertension
• Weakened immune system, making it harder to fight off infections
• Higher pain sensitivity
• Potential contribution to the development of Alzheimer's disease

Circadian rhythm disruption

Circadian rhythm disorders are disruptions in a person's internal clock, which regulates biological processes such as brain wave activity, hormone production, and cell regeneration. These disruptions can be caused by changes in routine, medications, and time zone changes.

Symptoms of circadian rhythm disruptions include extreme daytime sleepiness, decreased alertness, and problems with memory and decision-making. In delayed sleep phase syndrome, a type of circadian rhythm disorder, individuals fall asleep very late and have trouble waking up in the morning. Another disorder, advanced sleep phase syndrome, is characterised by early sleep onset and waking up earlier than desired.

To diagnose a circadian rhythm disorder, a doctor may inquire about sleep habits and suggest a sleep study or other diagnostic tests. Treatment options include external stimulus therapies such as bright light therapy and chronotherapy, which involves gradually adjusting bedtime to achieve the desired sleep schedule.

It is important to note that sleep deprivation can occur after just 24 hours of no sleep, and the symptoms tend to worsen the longer a person stays awake. Prolonged sleep deprivation can lead to severe health problems, including hallucinations and a distorted perception of reality.

Sleep disorders

Insomnia involves problems with falling and staying asleep. About one-third of adults experience insomnia symptoms, and 4-22% meet the criteria for insomnia disorder. To be diagnosed with insomnia disorder, sleep difficulties must occur at least three nights a week for at least three months and cause significant distress or problems at work, school, or other important areas of daily functioning.

Sleep apnea is a breathing disorder characterized by repeated interruptions in breathing during sleep, resulting in snoring, snorting, gasping, or breathing pauses. This interrupted sleep leads to daytime sleepiness and fatigue.

Restless leg syndrome (RLS) involves an urge to move the legs, accompanied by uncomfortable sensations such as creeping, crawling, tingling, or itching. These symptoms typically occur in the evening or at night and can cause difficulty falling asleep and frequent awakenings, leading to daytime sleepiness.

Hypersomnia is characterized by excessive sleepiness during the day, even when getting sufficient sleep. This includes narcolepsy, which causes extreme daytime sleepiness and episodes of sudden muscle weakness triggered by emotions like laughter.

Circadian rhythm disorders involve misalignment between an individual's sleep-wake rhythms and the external light-darkness cycle, resulting in significant sleep problems and extreme daytime sleepiness. This can be caused by internal factors, such as a person's unique body clock, or external factors like shift work or jet lag.

Parasomnia involves unusual behaviours during sleep, such as walking, talking, or eating. Examples include sleepwalking, sleep terrors, nightmare disorder, and rapid eye movement sleep behaviour disorder.

Treatment for sleep disorders depends on the specific disorder but may include good sleep habits, lifestyle changes, cognitive behavioural therapy, relaxation techniques, medication, and natural products like melatonin.

Lifestyle factors

Establish a Consistent Bedtime Routine:

• Start winding down 30 to 60 minutes before your desired bedtime.
• Turn down the lights, turn off electronic devices, and avoid stimulating activities.
• Engage in relaxing activities such as brushing your teeth, washing your face, changing into pajamas, and getting into bed.
• Be consistent with your routine, signalling to your brain that sleep is approaching.

Reduce Time Spent Awake in Bed:

• If you don't fall asleep within 15 to 20 minutes, get up and go to another room.
• Keep the lighting dim and avoid turning on electronic devices, as these can stimulate your brain.
• Engage in light reading, listen to quiet music, or practice relaxation techniques in a sitting position.
• Return to bed when you feel sleepy, not just tired.

Avoid Caffeine and Limit Screen Time:

• Reduce or eliminate caffeine from your diet, especially after 3 pm or six to eight hours before bedtime.
• Put down your smartphone, tablet, laptop, or TV at least two hours before bed, as the blue light emitted from these devices can disrupt melatonin production.

Maintain a Healthy Diet:

• Avoid heavy meals and the consumption of alcohol before bedtime.
• Consider dietary changes, as research suggests that replacing saturated fats with unsaturated fats, protein, or carbohydrates can reduce the risk of excessive daytime sleepiness.
• Include melatonin-rich foods such as almonds, kiwifruit, and fatty fish in your diet, as melatonin is a hormone that signals your body to sleep.

Engage in Regular Physical Activity:

• Exercise regularly, as physical activity can help improve sleep quality.
• Even light walking can make a difference in preparing your body for better sleep.

Create a Conducive Sleep Environment:

• Keep your bedroom dark, cool, and quiet, with a temperature between 60–67°F (15–19°C).
• Consider using earplugs or a white noise machine to block out disturbing noises.
• Leave your phone and other electronic devices in another room to create a tech-free sleep zone.

Medical causes

There are many potential medical causes for not being able to sleep for two days. Firstly, it is important to note that insomnia is a common sleep disorder that affects about 10% of the world's population. It is characterised by disruptions in sleep patterns and can be acute (short-term) or chronic (long-term). Insomnia may be primary, meaning it occurs on its own, or secondary, indicating that it is a symptom of another condition.

Medical conditions that can cause insomnia or sleep disruption include:

• Chronic illnesses: Certain long-term health issues, such as acid reflux, Parkinson's disease, and chronic obstructive pulmonary disease (COPD), can interfere with sleep.
• Temporary illnesses or injuries: Minor infections, injuries, or short-term health issues can also impact sleep.
• Circadian rhythm disorders: Conditions that affect your body's natural sleep/wake cycle, such as delayed sleep phase syndrome (DSPS), can make it difficult to fall asleep at a typical time.
• Mental health conditions: Anxiety, depression, and other mental health disorders are commonly associated with insomnia. About half of the people with chronic insomnia also experience anxiety or depression.
• Sleep disorders: Various sleep disorders can cause insomnia or disrupted sleep. These include sleep apnea, restless leg syndrome, narcolepsy, and REM sleep behaviour disorder.
• Medications: Certain medications, such as antidepressants and blood pressure drugs, may disrupt sleep patterns and contribute to insomnia.
• Physical discomfort: Uncomfortable sensations in your legs, heartburn, or other physical ailments can interfere with your ability to fall and stay asleep.

Additionally, it is worth noting that sleep deprivation can have adverse effects on your health and well-being. If you have been unable to sleep for two days, you may experience symptoms such as perceptual distortions, increased irritability, temporal disorientation, and even hallucinations. It is important to address sleep difficulties and consult a healthcare professional if they persist or interfere with your daily life.

Frequently asked questions