Sleep and insomnia

A healthy adult typically needs between seven and nine hours of sleep each night. Occasionally sleeping less isn’t a major concern, but if it happens regularly and starts to interfere with daily functioning, it becomes a sleep problem. 

During sleep, the body goes through a cycle of four stages several times each night. These stages include: 

1. Stage 1: A transition phase where the body starts to relax. Muscles loosen, temperature drops, heart rate slows, and eye movement stops. 
2. Stage 2: Light sleep, during which you can still be awakened by minor disturbances. 
3. Stage 3: Deep sleep, where the heart rate and muscle activity are significantly reduced. This stage is crucial for physical and mental restoration. 
4. REM (Rapid Eye Movement) sleep: Characterized by vivid dreaming and high brain activity similar to being awake. This stage is essential for cognitive functions and emotional processing. 

These stages repeat multiple times throughout the night, and balanced distribution across the cycles is important for quality sleep. 

Sleep is essential for physical and mental health. It allows the body to repair tissues, consolidate memories, and regulate various physiological processes. Without adequate sleep, concentration, learning, and mood are negatively affected. Chronic sleep deprivation can also increase the risk of health problems such as obesity and cardiovascular issues.  

Sleep problems can arise from a variety of factors, including: 

• Poor sleep hygiene: Habits or environmental factors that disrupt sleep. 
• Worry and stress: When relaxed, anxious thoughts can surface and prevent sleep. 
• Physical discomfort or medical conditions: Itching, breathing issues, and conditions like restless leg syndrome, allergies, asthma, COPD, or digestive disorders can disturb sleep. 

Sleeping problems can be categorized into four main groups: 

1. Snoring or frequent waking 
2. Difficulty falling asleep 
3. Trouble staying asleep 
4. Sleep-related disorders, such as narcolepsy and sleep apnea 

Signs that you may not be getting enough sleep include: 

• Waking up feeling tired and stiff 
• Falling asleep during activities like watching TV or reading 
• Lethargy and difficulty starting the day 
• Headaches, especially around the eyes 
• Irritability and mood swings 
• Poor concentration, which can be dangerous when driving 

Improving sleep hygiene can significantly enhance sleep quality. Some tips include: 

• Create a suitable sleep environment: Keep the bedroom dark, cool, and well-ventilated. Use white noise if needed. 
• Limit screen time: Avoid using phones, tablets, or laptops before bed, as blue light can disrupt sleep. 
• Establish a routine: Go to bed and wake up at the same time each day to regulate your body's internal clock. 
• Use comfortable bedding: Ensure your mattress, pillows, and nightwear are suitable for you. 
• Keep a worry diary: Write down any concerns before bed to clear your mind. 
• Practice relaxation techniques: Deep breathing exercises or visualizing peaceful scenes can help. 

Medication for sleep problems is typically a last resort, as these drugs can be addictive and may not address the root cause. When medication is necessary, short-term use of sleep aids like lormetazepam, temazepam, zolpidem, or zopiclone is preferred to avoid next-day drowsiness.  

Non-medical treatments can also help regulate sleep patterns, such as: 

• Meditation and yoga: To relax the body and mind. 
• Aromatherapy: Using essential oils like lavender or chamomile, though not scientifically proven. 
• Herbal teas: Chamomile, valerian, or lemon balm can have a calming effect. 
• Melatonin supplements: This sleep hormone can be used under a doctor's guidance if necessary. 

If these measures don’t help, seeking a referral to a sleep center may be beneficial. These centers can diagnose and treat various sleep disorders, from insomnia and snoring to sleep apnea. 

Lifestyle modifications can play a crucial role in improving sleep. Key changes include: 

• Limit screen exposure before bed: Opt for relaxing activities like reading or listening to calming music instead. 
• Exercise regularly: Physical activity like yoga, walking, or dancing can improve sleep quality. 
• Manage stress: Keep a balanced schedule with enough downtime. 
• Avoid stimulants: Reduce caffeine and alcohol intake, especially in the evening. 
• Stay hydrated: Ensure adequate fluid intake throughout the day. 
• Quit smoking: Nicotine disrupts circulation and sleep. 
• Maintain a healthy weight: Obesity can exacerbate fatigue and sleep disturbances. 
• Adopt healthy eating habits: Avoid heavy meals and unhealthy foods close to bedtime. Focus on a diet rich in fruits, vegetables, and essential nutrients. 

Wayenberg, S (z.d.), why is sleeping important, consulted on 15 April 2019, at https://npofocus.nl/artikel/7741/waarom-is-slapen-belangrijk 

Sonnevelt, A., (9 February 2018), The importance of sleep and 8 sleep tips, Consulted on 15 April 2019, at https://gezondnu.nl/blogs/belang-slaap-en-8-slaaptips/