Is lack of sleep affecting your mental health?

Sleep, or lack of a quality night's rest, has been a problem of mine for around a decade. It's not a coincidence that this corresponds with pregnancy, small children and juggling job and home responsibilities. It is also known that women and men have different sleep physiology. Daniel Buysse, professor of sleep medicine at University of Pittsburgh notes,

"differences in stress sensitivity, particularly interpersonal stress sensitivity, may play a role. Women are generally more attuned to social evaluation and social stress, which can disrupt sleep.'

Fortunately there is some help at hand. We have invited a local resident, Professor Danny Smith of University of Glasgow's Institute of Health and Wellbeing, to speak during the Festival about sleep, circadian rhythms and mental health, and I'll be first in the queue for tickets.

Prof Danny Smith

It's a subject that our partners at A Year of Small Changes have also explored in their blog. Izzy Howat, a consultant in diabetes and endocrinology, writes,

"Sleep is vital for optimal brain and body functioning.

As a society there has been a gradual reduction in the amount we sleep. Over the last 100 years the National Sleep Foundation data suggests the average duration of sleep per night has reduced from 9  to 7.5 hours. 

The increase in the rates of diabetes and obesity have occurred over the same time period.  Some studies in children and teenagers have indicated that short sleep duration may lead to weight problems.

The amount of sleep we need varies at different stages of life, but most studies define short sleep duration as being less than 6.5 hours a night.

The Science

Poor sleep duration and quality have widespread effects on the body.  Elevation of various hormones including adrenaline and cortisol mean it's harder for insulin to do its job, so more difficult for the body to maintain a normal blood sugar. Changes in the levels of appetite hormones lead to increased appetite, and consumption of more food.  Finally there is increased release of substances associated with inflammation.

The long-term consequences of poor sleep can therefore be significant in terms of health - leading to higher blood pressure, weight gain and increased risk of the development of Type 2 diabetes.

What can we do to improve our quality of sleep?

Sleeping tablets should probably come last on the list of interventions. Careful consideration into the cause behind the sleep disorder is essential - is there a prostate problem, or stress affecting sleep, for example.

Consider your environment - room temperature, air quality, light level, mattress and pillows and noise levels are all important.. Take care not to overstimulate with exercise, and avoid alcohol, over-eating, nicotine and caffeine.

For people with difficulty sleeping having a relaxing routine for an hour or more before bed can help.  For example, stop working, have a non-caffeinated drink and a snack.  Consider activities that help you relax eg. a bath, watching something on TV, listening to music, reading a book.

Consider using a relaxation technique like mediation or guided relaxation.  Relaxation is a skill that can be learned with practise.  There are lots of resources you can use eg. the Headspace or Calm.

Drug treatments for sleep disorders are controversial. 

There are plenty of drugs available eg. diazepam, nitrazepam or the more modern "Z-drugs" Zolpidem and Zopiclone.  They do help people to fall asleep more quickly and to sleep for longer.  Unfortunately they often come with side effects such as difficulty concentrating, sleepiness and tiredness during the day, and dependency.

Melatonin is also available on prescription for people over the age of 55 with poor quality sleep.  It is a hormone which regulates our circadian (day/night) rhythm. Its effectiveness is variable, and in trials different people seem to need very different doses, complicating its use. 

Cognitive Behavioural Therapy (CBT) has been shown to be highly effective and safe.  The main downside is that it is time consuming.  Self led courses are available via the internet or in book form. Have a look at the NHS-approved digital CBT tool Sleepio.

Izzy Howat ©Ayearofsmallchanges 2018

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