Sometimes patients are already half out of the door when they say 'Doctor, actually I don't sleep well, It's going on for a while...'
Bruno Ariens is a family doctor in Herenthout and gives information and avice on this problem.
1. Nobody sleeps without waking up during the night
'Don't worry if you wake up for a minute, because that happens to everyone several times a night. In average, we wake up each 1.5 hours after a deep sleep. Most people open one eye, ensure theirselves that everything is safe and carry on sleeping. There are several mini-breaks from sleeping, an average of ten per hour. The people that sleep well, don't remember a thing. You have to be awake for more than 5 minutes to remember it. But poor sleepers open both eyes and look at the clock. That's making them restless. The art is to feel comfortable in bed, even if you're awake. Pretend there are the last 5 minutes that you can stay in bed before you have to get up.'
2. Put the clock out of sight
'Research in rest-homes shows that people who lay awake, because they worry about their sleeping problems. Once that starts, you get tense. Sleeping needs a relaxed situation. For many, it's better to put the clock out of sight. Poor sleepers panic if it's only 1 o'clock in the morning: ' I will lay awake for so long'- but even if it's 6 o'clock in the morning 'Oké, I won't be able to sleep'. If you lay awake, it's not important how late it is.'
3. Get up if you're awake 20 minutes
'If you can't fall asleep, you might better get up, to avoid that you associate your bed with negative feelings regarding sleep. I don't advice to wacht TV, because that can hold your attention for too long. Do something boring, read a strip or book that doesn't interests you. Until you feel sleepy again: then go back to bed. This advice is important when it comes breaking the cycle- 'I'm going to bed (stimulus) and that means I will lay awake (reaction). Conditioning arises after 3 weeks.'
4. Don't make a second living room out of your bedroom
' An advice that won't be appreciated in sleep stores. You obviously need a comfortable bed, in a good ventilated room, but the room is there to sleep in, not to watch TV or read. Even not to discuss your shedule for tomorrow or the next vacantion with your partner. People who have the ritual to read a little bit before they go to sleep, I don't wanna take that from them. The most important before you go to sleep is that you do something relaxing before you go to sleep and that you connect your thoughts with this peace. You can't be thought how to sleep. Sleep comes naturally, you need to turn your thoughts. But you can learn how to relax: sleeping is a late stage of relaxation.
5. Don't sport intensive before you're going to sleep
'Who sports intensive, lays awake a few hours after that. Sport causes an adrenaline rush, that helps you to work and perform well. It takes an hour or two before that energy level declines. Light acitivities before you go to sleep are good: a short hike, yoga. Seks relaxes people too.'
'Sport is good for the night's rest if you do it in the early evening the latest. The more active your day is, the better your night. As the expression says: the night is the mirror of the day. That's why naps are best avoided. A nap of maximum half an hour can give energy to people who sleep well. But if you have sleeping problems, you will sleep worse in the evening.'
6. Get up on the exact same time
'There is a small centre in our brain that makes sure that we wake up in the morning and helps to suppress the tired feeling. Because we get tired during the day. In the evening the mechanism changes and we get tired. This is the moment you should go to sleep. You need to get in the sleep train when it passes. If you get up early one moment and late the other, you confuse this mechanism. When you wake up at the same time, you keep your inner clock, your day and night rythm is tuned.'
'Sleeping longer is a bad idea, because the last hours of your sleep are superficial. It's deep sleep that we need. We have the saying that hours before midnight count double. It's even better, because the first 4 hours of your sleep count double. Laying in bed in the morning only makes you groggy, which leads to a bad night.'
7. Avoid alcohol in the evening
'People that drink alcohol before they go to sleep, maybe will sleep well. The beginning of the night goes well, nevertheless you have less REM-sleep. The second part of the night doesn't run so smooth: you wake up more, you have bad dreams. You don't have much deep sleep during this period, and this kind of sleep restores your body. During deep sleep, you produce a growing hormone. Who produces less of this hormone, gets older faster. The REM-sleep is good for our psychological recovery: compare it to cleaning your computer, the defragmentation of your hard drive. Alcholol is interfering with these processes. People who have problems sleeping, need to be carefull.
8. Avoid coffee, black thea, caffeïne and nicotine
'What most people don't know, is how long caffeïen stays in the body. The half-value of it is 5 hours: if you drink two cups of coffee at 6 pm, you feel like you drunk one cup at 11pm. That's why you sleep poor and some people want to fight that with coffee. It's a vicious circle.'
'Nicotine finishes faster, but smokers sleep worse. In the beginning nicotin keeps them awake for an hour. After that rehabilitation is experienced due to a lack of nicotin. In the morning they long for a sigaret.'
9. 3 good reasons to quit sleeping medication
'Even sleeping medication has a negative effect on your sleep. The architecture of your sleep changes, you don't experience a deep sleep and less REM-sleep and you experience more micro-breaks from sleep. Who stops, will sleep better and enjoy slep more. Even people who take medication for years, can quit, if you stop slowly or under supervision of a doctor.'
'Sleeping pills only work for two weeks. 'Ah' people say, 'if it doesn't help it, isn't bad'. But it is harmful. Sleeping medication have a bad effect on your muscles, they weaken. If you get up to go to the toilet, you can easily fall and break something. Another disadvantage is that you wake up groggy. More important than medication is a good sleeping ritual: only perform restfull rituals. This could be yoga-exercises, or to table or preparing a cup of thea or hot milk.'
10. Exclude medical causes and perform self-relaxation
'Sleeping problems can have a medical cause: people with depression or thyroid problems or people who need to take specific medication. The best thing is that you discuss this with your doctor to exclude medical causes. Anxiety or stress, due to problems at work, in your relationship or examens, can be fight through relaxation exercises. For that cause, I included 3 audio-fragments on a CD in my book. One of the three is destinate for children: I remind them of the beach, floating in the water or petting a sweet rabbit. Children are very responsive to that.'
More information on the blog of Dr. Ariens on www.uitgeslapenwakker.be
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