I Can't Get No Sleep

Sleep, ageing, health, mental wellbeing. More and more doctors are factoring in poor sleep as a factor in poor health but in the middle of a pandemic, with the stresses of working, teaching, parenting, worrying and more from home sleep is often the big loser.

On some level, we all know that a good night’s sleep is vital but what happens when stress, worry, children and alcohol play havoc with your eight hours? One of the great losers (among many great losers) in this pandemic has been sleep. It really hasn’t been a great 11 months for a full night’s shuteye and many of us are feeling the effects of that right down into our core.

You can see it on our faces, our waistlines, our uncharacteristically sluggish wit, our foggy memories and our exhausted gait. A good night’s sleep plays such a serious role in our physical health as well as our mental wellbeing that surviving on a less than the ideal amount is, well, less than ideal.

There is no perfect number when it comes to sleep. Eight hours is often cited as the optimal amount, but some people need more than this to function at their best and some people do brilliantly on less. Quality of sleep is the most important factor, being in bed for 11 hours is not necessarily the same as having a great night’s sleep.

So, what happens when you’re regularly not sleeping well? Dr Doireann O’Leary is a GP based in Cork and believes that sleep is paramount when it comes to living a healthy life.

“Sleep is the foundation of good physical and mental health and well-being. In the short term, poor sleep results in low mood, anxiety, poor concentration and poor judgement. It’s also associated with higher rates of workplace errors and road traffic accidents. Lack of sleep also causes hormonal imbalances; in particular, it causes a spike in our hunger hormone ghrelin and a reduction in our satiety hormone lepton; this drives the body to eat sugary foods even when it’s not really hungry.

Chronic sleep deprivation, when is inadequate sleep over a long period of time, is associated with higher rates of type 2 diabetes and heart disease. It also weakens immunity; people who get eight hours sleep a night a less likely to become unwell with common viruses like influenza than those who don’t. Chronic sleep deprivation is also associated with a higher risk of cancer.”

Dr Doireann also asks about sleep when a patient comes to her with low mood or anxiety.

“It’s one of the first questions I ask. I need to know if the person is sleeping well or not as it will inform how we manage their mood or anxiety. If sleep isn’t right, we won’t get anything else right. It’s one of the first things that must be addressed. Then it’s about discussing whether low mood or anxiety is causing the poor sleep or vice versa. We can then discuss measures like sleep hygiene in conjunction with other interventions as appropriate too.”

Of course, one night of bad sleep won’t cause all these problems. The occasional off-night will be rectified by a good sleep the next but if you have a continuous pattern of poor sleep you may well see an effect on your health and on your face. There is also evidence that menopause and perimenopause go hand in hand with insomnia – another yeay for women!

So, what can you do to improve your sleep? There is a long list of sleep hygiene tips that will make it easier to fall asleep and stay asleep. You need to have a room that’s the right temperature so make like Goldilocks and ensure your bed chamber is neither too hot nor too cold. There should be good ventilation. You don’t want to drink so much water that you’re getting up to pee at night but you also don’t want to be dehydrated because that will also cause night waking. Alcohol is a big factor here because although you’ll fall asleep more easily its dehydrating effects will mean that you’ll probably find yourself waking up. Exercise, though good for sleep in general, shouldn’t be done too close to bedtime either.

And then, there’s technology. This is everything from having a TV in your bedroom that you fall asleep to, to being on your phone right before you go to bed.

Nobody in their right mind would think that doom scrolling for 30 minutes in the dark would be conducive to a good nights sleep and yet here we are, all doing it.

Working from home means that the line between the office and your house is blurred and you can often find yourself checking emails on your phone on the couch in the evening.

In the ideal world, we would shut off from work at a decent time, in the hours before bed would watch something gentle, or do a relaxing task like reading or knitting and sit in a softly lit room so that you weren’t over stimulating your senses. You would then retire to your well-ventilated bedroom where you sleep nowhere near your phone, marvel at the perfect temperature, nod off in your cloud-like sheets and wake naturally with the dawn.

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slumber strategies

We don’t live in an ideal world though, so here are some more realistic tips:

Try and switch off from work at least two hours before bedtime. DO NOT ANSWER LATE EVENING EMAILS – people should not be sending them anyway.
If you’re going to have a drink, try to just have just one so you’re not actively interfering with your rest.
Stop doom scrolling. This is important. The world is on fire. Cut out Twitter or Instagram or whatever it is that raises your hackles in the hours before bed.
Keep your phone on the other side of the room. An old-fashioned alarm clock can be transformative to your sleep.
If you wake during the night, don’t reach for your phone. If you can’t fall back asleep, get up, read a book, make a non-caffeinated warm drink and go back to bed when you feel ready. Don’t just lie there fretting.
Remember that your bed should be for sleep and sex and not watching endless Bernie Sanders memes.

Jennifer Stevens, January 2021