Thank you to all for listening in to the talk on Sleep Disturbance on Tuesday. As promised here is the summary. Next Tuesdays talk is all about Insomnia.
Sleep: Optimum amount
We all need sleep. The optimum amount for a healthy adult is deemed to be around seven hours. Insufficient sleep has been shown to have later detrimental effects on things like our mental health, heart health, cognitive functions and even risk of osteoporosis.
The Best Kinds of Sleep: The stages of sleep
Stage 1
During stage 1, you drift from being awake to being asleep. This is a light, NREM sleep that doesn’t last very long. You may start to relax and dream, but may also twitch as you transition into stage 2.
Stage 2
Stage 2 of the sleep cycle is still a light sleep, but you are drifting into a steadier sleep. Your breathing and heartbeat slow down, and your muscles relax. Your body temperature decreases, and your brain waves are less active.
In stage 3
You enter deep sleep, and stage 4 is the deepest sleep stage. During deep sleep, your breathing, heartbeat, body temperature, and brain waves reach their lowest levels. Your muscles are extremely relaxed, and you are most difficult to rouse.
Stage 4
Is known as the healing stage, when tissue growth and repair take place, important hormones are released to do their jobs, and cellular energy is restored.
REM sleep
Often referred to as stage 5, is when you are most likely to dream. Your first REM cycle of the night begins about 90 minutes after you fall asleep and recurs every 90 minutes. The first period of REM typically lasts 10 minutes. Each of your later REM stages gets longer, and the final one may last up to an hour. Your eyes move around quickly behind your eyelids and your brainwaves look similar to those of someone who is awake. Your breathing, heart rate, and blood pressure rise to near-waking levels.
Types of sleep disturbance include:
- Difficulty getting to sleep
- Difficulty staying asleep (awakening during the night)
- Early morning wakening
- Less total sleep time
- Overall quality of sleep (non-restorative)
- Problems with sense of well-being
- Overall functioning
- Sleepiness/fatigue during the day
Your sleep as you move through menopause.
Sleep disturbances are common during the perimenopause, menopause and postmenopause. Figures given for how many women experience sleep disturbance during the menopause range from 28 to 63%.
Possible Causes
Hormones
The menopausal decline of oestrogen can result in menopausal symptoms which contributes to disrupted sleep:
- hot flushes and sweats
- anxiety leading to difficulty getting to sleep
- depression leading to non-restorative sleep and early morning wakening.
- Joint aches and pains
- bladder problems such as passing urine at night
Menopausal progesterone decline may also be involved in sleep disturbance since progesterone has a sleep-inducing effect by acting on brain pathways.
Melatonin, another vital hormone for sleep, decreases with age. Secretion of melatonin is partly influenced by oestrogen and progesterone and levels decrease during the perimenopause, often compounding the problem.
Sleep apnoea
Studies have shown that night sweats and hot flushes may be linked to increased risk of sleep apnoea, and it appears to be more common in women who have had a surgical menopause compared to natural menopause. It may also be associated with weight gain.
Progesterone has an effect on muscle activity at the back of the throat as well as stimulus for breathing, such that decline in progesterone may contribute to partial upper airway obstruction and reduced breathing drive. Sleep apnoea is not just about loud snoring and gasping. Sleep apnoea in women can also manifest itself in other ways including headaches, insomnia, depression or anxiety and daytime fatigue. Not every woman will snore or snort loudly whilst asleep.
Restless legs syndrome (RLS)
Women are about twice as likely as men to experience it. Sufferers get tingling, creepy crawly sensations in their legs at night. One study of RLS patients found 69 per cent of post-menopausal women perceived their symptoms as worse than before menopause.
However, it is not clear whether restless leg syndrome contributes to sleep disturbance, or if women who are not sleeping well are more aware of the problem.
Treatment
A steady sleeping and eating schedule combined with caffeine avoidance and counselling sessions using behavioural therapy has reduced insomnia for some people, as has listening to relaxation tapes.
Smokers are more likely to have insomnia than non-smokers. As with many other health conditions, it is important for people with insomnia to quit smoking.
Tips for improving sleep long term: General
- Go to bed and get up at a regular time. Routine is very important for establishing a good sleep pattern. Establishing and sticking to set times may take a few weeks so bear that in mind.
- Ideally avoid having a nap in the day. If you do, make it no more than 30-40 minutes in the early afternoon.
- Exercise regularly but don’t overdo it within two hours of going to bed.
- Get to know what sleep you need. The average is 6-8 hours but this does vary for individuals and reduces as you age.
- Other factors can of course interfere with sleep if you are taking medication for other reasons ensure you take them at the time of day they are prescribed for.
Tips for improving sleep long term: Before going to bed
- Get yourself into a routine, perhaps have a warm Epsom salt bath or do some light reading.
- Avoid going to bed when you’re too hungry or too full. A light snack is OK.
- Have your last caffeine drink in the morning before midday or considering reducing or stopping completely, including any fizzy drinks or chocolate.
- Alcohol does not help you to sleep so best avoided if you can.
Thank you for reading. Please do not make any changes to the way you eat before consulting a trained health care professional.
Fiona
Waring
Dip Nut, BSc.(Hons), MSc PHN, ANutr
Nutritional
Therapist
M: +44 07957 267 964
eatyourgreens@fionawaring.com
‘Registered with the Association for Nutrition
– www.associationfornutrition.org
Protecting the public and promoting high standards in evidence-based science
and professional practice of nutrition.’
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