HEALTH PLUS MED­ICAL COR­RE­SPON­DENT

For mil­lions of us, the pur­suit of a good night’s rest has be­come a kind of dark ob­ses­sion. The Na­tion­al In­sti­tutes of Health states that 70 mil­lion adults suf­fer from sleep dif­fi­cul­ties. In a 2018 sur­vey of the top health com­plaints, sleep is­sues have climbed to Num­ber two. “It didn’t use to be in the top five,” says Mayo Clin­ic pul­mo­nolo­gist Tim­o­thy Mor­gen­thaler, for­mer pres­i­dent of the Amer­i­can Acad­e­my of Sleep Med­i­cine. Now, the glob­al COVID-19 pan­dem­ic has wreaked hav­oc on our lifestyle habits with qual­i­ty sleep be­ing one of them.

Thus, HEALTH PLUS con­tin­ues from last week, in­creas­ing aware­ness and ad­vice to op­ti­mise your Sleep Health.

In­som­nia can take a heavy toll on your phys­i­cal and men­tal health.

Skimp­ing on qual­i­ty sleep can im­pact one’s en­er­gy, fo­cus, and abil­i­ty to func­tion dur­ing the day, es­pe­cial­ly if you have the added pres­sure of try­ing to work from home or of home­school­ing your chil­dren. A lack of qual­i­ty sleep can al­so make you moody and ir­ri­ta­ble, ex­ac­er­bate symp­toms of anx­i­ety and de­pres­sion, and even weak­en your im­mune sys­tem.

Stress, wor­ry, and tur­moil cre­at­ed by this pan­dem­ic have made ex­ist­ing sleep chal­lenges even worse, in­creas­ing ones “SLEEP DEBT”, trig­ger­ing new sleep prob­lems in those who used to be “good sleep­ers”. But by ad­dress­ing these chal­lenges, you can start the jour­ney to end the frus­tra­tion of ly­ing awake for hours and fi­nal­ly get a good night’s rest.

Fig­ur­ing out why you can’t sleep

To prop­er­ly iden­ti­fy the cause of in­som­nia, you need to be­come a sleep de­tec­tive. Once you fig­ure out the root cause, you and your health care pro­fes­sion­al can tai­lor treat­ments ac­cord­ing­ly.

• Are you un­der a lot of stress?

• Do you feel emo­tion­al­ly flat or hope­less?

• Do you strug­gle with chron­ic feel­ings of anx­i­ety or wor­ry?

• Have you re­cent­ly gone through a trau­mat­ic ex­pe­ri­ence?

• Are you tak­ing any med­ica­tions that might be af­fect­ing your sleep?

• Do you have any health prob­lems that may be in­ter­fer­ing with sleep?

• Is your sleep en­vi­ron­ment qui­et and com­fort­able?

• Do you try to go to bed and get up around the same time every day?

Com­mon psy­cho­log­i­cal and med­ical caus­es of in­som­nia

Some­times, in­som­nia on­ly lasts a few days and goes away on its own, es­pe­cial­ly when the in­som­nia is tied to an ob­vi­ous tem­po­rary cause, such as stress over an up­com­ing pre­sen­ta­tion, a painful breakup, or jet lag. Oth­er times, in­som­nia is stub­born­ly per­sis­tent. Chron­ic in­som­nia is usu­al­ly tied to an un­der­ly­ing men­tal or phys­i­cal is­sue.

Anx­i­ety, stress, and de­pres­sion are some of the most com­mon caus­es of chron­ic in­som­nia. Oth­er com­mon emo­tion­al and psy­cho­log­i­cal caus­es in­clude anger, wor­ry, grief and trau­ma. Treat­ing these un­der­ly­ing prob­lems is es­sen­tial to re­solv­ing your in­som­nia.

Med­ical prob­lems or ill­ness

These in­clude asth­ma, al­ler­gies, Parkin­son’s dis­ease, hy­per­thy­roidism, acid re­flux, kid­ney dis­ease, and can­cer. Chron­ic pain is al­so a com­mon cause of in­som­nia.

Med­ica­tions

Many pre­scrip­tion drugs can in­ter­fere with sleep, in­clud­ing an­ti­de­pres­sants, stim­u­lants for AD­HD, cor­ti­cos­teroids, thy­roid hor­mone, high blood pres­sure med­ica­tions, and some con­tra­cep­tives. Com­mon over-the-counter cul­prits in­clude cold and flu med­ica­tions that con­tain al­co­hol, pain re­liev­ers that con­tain caf­feine and slim­ming pills.

Sleep dis­or­ders. In­som­nia is it­self a sleep dis­or­der, but it can al­so be a symp­tom of oth­er sleep dis­or­ders, in­clud­ing sleep ap­nea, rest­less legs syn­drome, and cir­ca­di­an rhythm dis­tur­bances tied to jet lag or late-night shift work. [These will be fur­ther dis­cussed in the up­com­ing ar­ti­cles in HEALTH PLUS]

Neu­tral­is­ing the vi­cious cy­cle of anx­i­ety

The more trou­ble you have with sleep, the more it starts to in­vade your thoughts. You may dread go­ing to sleep be­cause you just know that you’re go­ing to toss and turn for hours or wake up at 2am again. Or maybe you’re wor­ried be­cause you have a big day to­mor­row, and if you don’t get a sol­id eight hours, you’re sure you’ll blow it. But ag­o­nis­ing and ex­pect­ing sleep dif­fi­cul­ties on­ly makes in­som­nia worse. Wor­ry­ing about get­ting to sleep or how tired you’re go­ing to be floods your body with adren­a­line, and be­fore you know it, you’re wide-awake.

Chal­leng­ing self-de­feat­ing thoughts that fu­el in­som­nia

It’s al­so help­ful to chal­lenge the neg­a­tive at­ti­tudes about sleep and your in­som­nia prob­lem that you’ve de­vel­oped over time. The key is to recog­nise self-de­feat­ing thoughts and re­place them with more re­al­is­tic ones.

1) Self-de­feat­ing thought:

Un­re­al­is­tic ex­pec­ta­tions: I should be able to sleep well every night like a nor­mal per­son. I shouldn’t have a prob­lem!

Sleep-pro­mot­ing pos­i­tive re­sponse: Lots of peo­ple strug­gle with sleep from time to time. I will be able to sleep with prac­tice.

2) Self-de­feat­ing thought:

Ex­ag­ger­a­tion: It’s the same every sin­gle night, an­oth­er night of sleep­less mis­ery.

Sleep-pro­mot­ing pos­i­tive re­sponse: Not every night is the same. Some nights I do sleep bet­ter than oth­ers.

3) Self-de­feat­ing thought:

Cat­a­stro­phiz­ing: If I don’t get some sleep, I’ll tank my pre­sen­ta­tion and jeop­ar­dise my job.

Sleep-pro­mot­ing pos­i­tive re­sponse: I can get through the pre­sen­ta­tion even if I’m tired. I can still rest and re­lax tonight, even if I can’t sleep.

4) Self-de­feat­ing thought:

Hope­less­ness: I’m nev­er go­ing to be able to sleep well. It’s out of my con­trol.

Sleep-pro­mot­ing pos­i­tive re­sponse: In­som­nia can be cured. If I stop wor­ry­ing so much and fo­cus on pos­i­tive so­lu­tions, I can beat it.

5) Self-de­feat­ing thought:

For­tune telling: It’s go­ing to take me at least an hour to get to sleep tonight. I just know it.

Sleep-pro­mot­ing pos­i­tive re­sponse: I don’t know what will hap­pen tonight. Maybe I’ll get to sleep quick­ly if I use the strate­gies I’ve learned.

Re­mem­ber, learn­ing how to in­cul­cate healthy sleep be­hav­iours takes time and prac­tice. Be pa­tient and seek eval­u­a­tion by a Sleep Health Pro­fes­sion­al. The sup­port they can of­fer is in­valu­able. It starts first­ly with iden­ti­fy­ing the trig­gers and be­ing com­mit­ted to ad­just the un­healthy be­hav­iours. Small steps can be ex­tra­or­di­nar­i­ly re­ward­ing when you awake the next day, fi­nal­ly feel­ing rest­ed and re­vi­talised.

Look out for HEALTH PLUS every Tues­day for more in­for­ma­tive and health­ful ar­ti­cles. If you have any ques­tions or con­cerns re­gard­ing this top­ic, please email Guardian­Health­Plus2020@gmail.com