Sleep problems

Most healthy adults need between seven and nine hours of sleep each night. While an occasional night of poor sleep is not harmful, ongoing sleep difficulties that affect daily life are considered sleep problems. Sleep consists of four stages, cycling every 90 to 120 minutes: 

Stage 1: Falling asleep 

This initial stage is a light transition to sleep, where muscles relax, heart rate slows, and brain activity decreases. 

Stage 2: Light sleep 

During light sleep, you are asleep but can still be easily awakened. The body continues to relax as heart rate, blood pressure, and temperature drop. 

Stage 3: Deep sleep 

Deep sleep is restorative, allowing the body to recover. It supports muscle repair, organ growth, and memory consolidation. 

Stage 4: REM sleep 

Rapid Eye Movement (REM) sleep is marked by heightened brain activity and is the stage where most dreaming occurs. Blood pressure and heart rate increase during REM, making it a vital phase for mental restoration. 

These stages repeat throughout the night, supporting physical and mental well-being. Inadequate sleep can lead to irritability, concentration difficulties, and increased health risks. 

Common causes of sleep disturbances include stress, anxiety, or health conditions like: 

• Restless legs syndrome (RLS) 
• Allergies 
• Asthma 
• COPD 
• Digestive issues 

Physical discomfort, racing thoughts, or other medical problems can make it difficult to fall or stay asleep. 

Sleep issues generally fall into four categories: 

1. Difficulty falling asleep 
2. Trouble staying asleep 
3. Waking up too early 
4. Sleep disorders such as sleep apnoea and narcolepsy 

Indicators of poor sleep quality include: 

• Waking up feeling tired or stiff 
• Falling asleep during sedentary activities 
• Persistent daytime fatigue 
• Frequent irritability or mood swings 
• Memory and concentration issues 

Improving sleep hygiene and lifestyle can significantly enhance sleep quality: 

Sleep hygiene: 

• Keep the bedroom dark, cool (17-21°C), and quiet. 
• Use white noise to mask disturbing sounds if necessary. 
• Maintain a consistent sleep schedule. 
• Invest in a supportive mattress and pillow. 
• Avoid daytime naps. 
• Use a worry journal to release anxious thoughts before bed. 

Lifestyle adjustments: 

• Power down electronic devices at least an hour before sleep. 
• Engage in calming activities like reading or listening to soothing music. 
• Stay physically active. 
• Avoid alcohol and caffeine in the evening. 
• Maintain a balanced diet and avoid heavy late-night meals. 
• Quit smoking, as it affects blood flow and tissue health. 

While sleep medication may offer temporary relief, it should not be a long-term solution due to potential side effects and dependency risks. Short-term use of medications like lormetazepam or zolpidem may be considered for acute cases. Non-pharmacological treatments such as meditation, aromatherapy, or herbal teas may also help improve sleep quality. 

Long-term use of sleep medication can lead to dependency, reduced effectiveness, and daytime drowsiness. The lowest effective dose for the shortest duration is recommended. 

While some sleep issues may stem from underlying conditions like depression or sleep disorders, many can be mitigated by adopting healthy sleep habits. Avoiding irregular sleep patterns, limiting caffeine, and managing stress can help prevent sleep problems from becoming chronic.