“The sleep of a labouring man is sweet.” Ecclesiastes 5:12. “They may be weary, but how sweet is rest after a proper amount of labor. Sleep, nature’s sweet restorer, invigorates the tired body and prepares it for the next day’s duties.” –Child Guidance, p. 341. We are also counselled, “Love not sleep, lest thou come to poverty.” Proverbs 20:13. Sleep, after a hard day of labour is a blessing from God, however we are not to spend our days in sleep, as indolence is a sin.

As we learned last month, sleep is necessary to our survival. Not only humans, but all animals sleep. Horses are able to sleep standing up and only need 2 1/2 hours sleep a day. Giraffes take five minute naps throughout the day, totaling about 2 hours in a 24 hour period. Those of us who own cats will notice that they spend a lot of their time in sleep. They can sleep from 12–16 hours a day. Other animals, like dolphins, appear to sleep with one half of their brain at a time, with the other half of the brain remaining active which allows them to still emerge out of the water to breathe while sleeping. Regardless of the pattern and amount of sleep required, all animals sleep.

Sleep is restorative and necessary to maintain health, it rejuvenates us for the following day allowing our bodies to rest and recover from our labours.  But, what happens if we do not get the amount of sleep that is necessary for us to function at our best? We all know that after a few days of poor sleep, we are exhausted during the day, and even the simplest tasks seem difficult. And, what about those people who suffer poor sleep for weeks, months, and even years? What causes poor sleep and what are the effects of poor sleep?

Poor sleep can take on many forms. Let us look at the different ways that sleep can be affected. Specific sleep disorders can affect both the quality and the quantity of sleep that we receive.

Insomnia

The most common sleep disorder is called insomnia, and is described as a condition where people have difficulty falling and/or staying asleep. Everyone is different in terms of how insomnia manifests itself. Some people have no problem falling asleep, but they are wide awake again after a few hours, and cannot fall back asleep. Some people wake up frequently during the night, affecting their sleep cycle, which decreases the quality of sleep. Some people wake up too early in the morning, and others just feel tired upon wakening. Whatever the pattern is for each individual person, insomnia disrupts the overall quality and quantity of sleep. Because of this, most people with insomnia do not feel that they have received adequate sleep the night before, and they feel physically and mentally fatigued during the day.  Symptoms of insomnia can include sleepiness during the day, general tiredness, irritability, and problems with concentration or memory.

There are two types of insomnia. Primary insomnia means that a person is having sleep problems that are not directly associated with any medical, psychiatric, or environmental cause. Primary insomnia is uncommon and is caused by very specific sleep disorders. Secondary insomnia means that a person is having sleep problems as a symptom or side effect of something else, such as a health condition (asthma, depression, arthritis, cancer, heartburn); chronic pain; medication; drug use, such as alcohol; or environmental conditions such as noise, or bright lights during the night. Secondary insomnia is common and affects almost half the population at one time or another.

Insomnia also varies in how long it lasts and how often it occurs. Many people can have short-term (acute) insomnia, from one night to a few weeks of poor sleep, without long-term health effects. However, insomnia can become a chronic condition, which is defined as having problems with sleep at least three nights a week, lasting for a month or longer. Chronic insomnia has more negative implications for our health.

Often the main cause of acute insomnia is some type of significant stressful life event (job loss or change, death of a loved one, personal injury or illness, moving). Emotional or physical discomfort can temporarily affect sleep. Conditions in our environment can disrupt our sleep, such as light, noise (a snoring partner), or extreme temperatures (hot or cold). Once these conditions are changed, sleep is restored. Some of the medications that are used to treat illnesses such as colds, allergies, depression, high blood pressure, and asthma, also contribute to sleep problems. We can also have short-term sleep problems when there are factors which interfere with our normal sleep schedule, for example, jet lag or exposure to bright light at night.

Chronic insomnia tends to be caused by long-term conditions that affect sleep, such as depression and/or anxiety, ongoing stress, pain or discomfort at night. People who have had disrupted sleep cycles over years because of work or travel tend to develop chronic insomnia. The body’s normal 24-hour circadian rhythm, which determines when we should sleep has been permanently affected. Long-term health consequences of prolonged circadian rhythm disruption include cancer, heart disease, high blood pressure, obesity, diabetes, and mental health issues such as depression. Studies show that female nurses who are exposed to bright lights while working the night shift have a higher incidence of breast and colon cancer. Men who do shift work have a higher incidence of prostate cancer.

Forty-eight percent of Americans report occasional insomnia, while 22% experience insomnia every or almost every night. Thus, insomnia has a significant impact on the general health of the population.

Treatment of Insomnia

Acute insomnia may not require treatment. Mild insomnia often can be prevented or cured by practicing good sleep habits, also called sleep hygiene. Certain herbal remedies such can alleviate acute insomnia such as valerian root. This medicinal herb has been used to treat sleep problems since ancient times. Valerian can be sedating and may help you fall asleep. If you try valerian as a sleep remedy, be patient. It can take a few weeks for it to take effect. Melatonin is produced by the brain to allow us to feel sleepy and puts our body into sleep mode. Melatonin production is increased with the daily onset of darkness. Natural melatonin production decreases with age. Melatonin supplements may help with insomnia, and controlling sleep patterns in people who travel regularly and are affected by jet lag, and for shift workers. Melatonin can be used to allow people to sleep outside of the typical night time sleep. Almond milk is an excellent source of calcium, which helps make melatonin. Magnesium plays a key role in sleep. Even a small lack in magnesium can prevent the brain from settling down at night. You can get magnesium from food. Good sources include green leafy vegetables, wheat germ, pumpkin seeds, and almonds. Check with your doctor before taking magnesium supplements as magnesium can interfere with other medications. Lavender oil is calming and can help encourage sleep in some people with insomnia. Try taking a hot bath with lavender oil before bed to relax your body and mind.

Most medications provided by health practitioners for insomnia should not be used long-term because they can cause dependence. Most pharmacies, also, have several shelves of medications advertised as sleep aids. However, these over-the-counter sleeping pills should be avoided because they may have undesired side effects and tend to lose their effectiveness over time. Therefore, insomnia is much better treated with methods that do not rely on medication.

Jet lag is a traveler’s sleep condition that affects the body’s internal clock by causing sleep disruptions in a new time zone. The severity of jet lag depends on many factors—including age, quantity of time zones, and the direction of travel—causing the sufferer to become fatigued, nauseated, headachy, and unable to fall to sleep. To reduce the effects of jet lag, some doctors try to adjust the circadian rhythm with a technique called light therapy. They expose people to special lights, many times brighter than ordinary household light, for several hours near the time the people want to wake up. This helps them reset their biological clocks and adjust to a new time zone.

With shift workers, because their work schedules are at odds with powerful sleep-regulating cues like sunlight, they often become uncontrollably drowsy during work, and they may suffer insomnia or other problems when they try to sleep. The number and severity of workplace accidents also tend to increase during the night shift. Treatment is to try to reduce shift-related fatigue by using bright lights in the workplace, minimizing shift changes, and taking scheduled naps. Non-medical options, like following good sleep hygiene, making adjustments to your schedule and sleep environment (block light from your room if you sleep during the day), and practicing relaxation techniques. Shift workers also tend to eat at a time that is not in alignment with the circadian rhythm, which contributes to obesity and diabetes. Studies show that shift workers live on average nine years less than the average person, because of the health effects of interrupted sleep patterns.

Treatment for chronic insomnia includes first treating any underlying conditions or health problems that are causing the insomnia. If insomnia continues, your health care provider may suggest behavioural therapy. Behavioural approaches help you to change behaviours that may worsen insomnia and to learn new behaviours to promote sleep. One successful technique is the use of relaxation exercises.

Sleep Apnea

Many people report sleeping a full night, however they wake up feeling tired. The cause for this can be sleep apnea. This  is a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep, sometimes up to 30 times an hour. The “apnea” in sleep apnea refers to a breathing pause that lasts at least ten seconds. When someone’s breathing pauses or becomes shallow, the person often moves out of deep sleep and into light sleep. As a result, the quality of sleep is poor, which makes people tired during the day. Sleep apnea is a leading cause of daytime sleepiness. In obstructive sleep apnea, the most common, the airway collapses or becomes blocked during sleep. When the person tries to breathe, the air must squeeze around the blockage, causing loud snoring. This type of sleep apnea is more common in overweight people, but it can be caused by many other reasons. With aging, the muscles in the throat become weaker, which cause the airway to collapse, leading to sleep apnea. Untreated sleep apnea can increase the risk of high blood pressure, heart attacks, strokes, obesity and diabetes. It can cause the heart to have irregular beats. It increases the risk of having work-related or driving accidents. Treatments for sleep apnea include lifestyle changes or devices such as CPAP’s to prevent pauses in breathing.

Restless Legs Syndrome is a brain disorder that causes someone to feel like they need to move their legs or other parts of their bodies constantly. This is also considered a sleep disorder as the constant urge to move affects sleep. Circadian rhythm disorders are uncommon, and they are believed to be caused by the body being unable to reset the sleep/wake cycle in response to environmental cues, such as light and dark.

Blue Light

There is increasing awareness on the impact that blue light has on our sleep patterns. “Blue light” is part of the light spectrum that we obtain from the sun, Getting blue light (especially from the sun) in the daytime is very important. It helps us to stay alert, while improving performance and mood; it tells our bodies that we need to be awake. However, a lot of the electronic devices that we use on a daily basis mimic the blue light from the sun. When we sit in front of our laptops, tablets, and cell phones before we go to bed, the blue light tricks our brains into thinking that it is day time and an increase in melatonin production does not occur, thus we do not develop the normal drowsiness that promotes sleep. Our circadian rhythms are also interrupted. Many people also leave their devices on during the night, with the blue light reflecting into the sleeping area. Blue light not only causes sleep disruptions, but can also effects our eye health. Many sleep problems are caused by electronics that emit blue light, that can be easily remedied. To promote sleep, avoid using electronic devices for at least 2–3 hours before bedtime. Amber or orange sunglasses can block blue light, for those who need to use electronics closer to bedtime. Shut all electronic devices off during the night. The emission of blue light can have an impact on sleep even when one’s eyes are closed.

GOOD SLEEP HYGIENE

  • Try to go to sleep at the same time each night and get up at the same time each morning.
  • Try not to take naps during the day, because naps may make you less sleepy at night.
  • Get regular exercise. Try not to exercise close to bedtime, because it may stimulate you and make it hard to fall asleep. Try not to exercise for at least three to four hours before the time you go to sleep.
  • Do not eat a heavy meal late in the day. Avoid food within 2 hours of bed.
  • Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a “white noise” machine to cover up the sounds. Do not use your bedroom for anything but sleep.
  • Follow a routine to help you relax before sleep. Read a book, listen to music, or take a bath.
  • Avoid using your bed for anything other than sleep.
  • If you cannot fall asleep and do not feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
  • Turn off all the lights, including electronic devices. Use blackout shades in your windows.

If you find yourself lying awake worrying about things, try making a to-do list before you go to bed. This may help you to not focus on those worries overnight.

“Make it a habit not to sit up after nine o’clock. Every light should be extinguished. This turning night into day is a wretched, health-destroying habit, and this reading much by brain workers, up to the sleeping hours, is very injurious to health. It calls the blood to the brain and then there is restlessness and wakefulness, and the precious sleep that should rest the body does not come when desired.” – Daughters of God, p. 177  “Nature will restore their vigor and strength in their sleeping hours, if her laws are not violated.” –Healthful Living, p. 46