Sleep and Sleeping Well - Dr Linda Schachter

Sleep and Sleeping Well - Dr Linda Schachter
Sleep and Sleeping Well
          Dr Linda Schachter
     Sleep & Respiratory Physician
Sleep and Sleeping Well - Dr Linda Schachter
What are YOUR key questions
  or problems on sleep ?
Sleep and Sleeping Well - Dr Linda Schachter

1.   Sleep basics
2.   Sleep deprivation
3.   Trouble sleeping
4.   Getting good sleep
Sleep and Sleeping Well - Dr Linda Schachter
Sleep and Sleeping Well - Dr Linda Schachter
Why do we need sleep ?
• Sleep is a dynamic behavior. Not simply the absence of waking,
sleep is a special activity of the brain, controlled by elaborate and
precise mechanisms.
–   Rest and Recharge
–   Aid memory and learning
–   Hormone secretion
–   Maintain normal immune function
–   Healing and repair of tissues
–   Maintain optimal emotional and social functioning while awake
Sleep and Sleeping Well - Dr Linda Schachter
Sleep Stages
Sleep and Sleeping Well - Dr Linda Schachter
Rollercoaster of sleep

Sleep and Sleeping Well - Dr Linda Schachter
Differing types
of sleep across
    the ages
Sleep and Sleeping Well - Dr Linda Schachter
Circadian rhythms

Our circadian rhythm tell us when
we are sleepy and when we sleep best
Sleep and Sleeping Well - Dr Linda Schachter
• Melatonin rise delayed with

• Adolescent monkeys also
  delay melatonin rise with

• Blue computer screens
  suppress melatonin

‘Orange’ substitute:

• ‘Nightshift’ Iphone iOS 9.3
• F lux program for PCs
When we sleep also determined by …

Sleep drive

How much sleep do we need?

•   The amount that allows us to be wide awake, alert and
    energetic throughout the day
•   The average sleep need for an adult is about 8-9 hours (range
    4-10 hours)
•   The specific value varies considerably from person to person
    and may be a genetically determined attribute.
•   Amount required decreases over life cycle
Lack of sleep - causes
– Lifestyle
   •   Late bed time
   •   Habits
   •   Sporting commitments
   •   Phone / computer
   •   Work
   •   Children
– Health
   • Pain
   • Sleep disorders – snoring, sleep apnoea, insomnia,
     restless legs
   • Medication
– Psychological - depression / anxiety / stress
– Environmental - noise / light / travel
– Shift work
The statistics…

• 4 in 10 Australian adults – 7.4 million frequently suffer
  from inadequate sleep
   – 1.1 million – sleep disorders like insomnia & sleep apnoea

   – 2.5 million with health problems that affect sleep

   – 3.8 million routinely fail to get enough sleep
Likely if

v Still tired when wakes in the morning

v sleeping less than 9 hours a night

v sleeping in on the weekends

v still groggy on way
  to school

v sleepy after lunch
Partial sleep deprivation
                  (effects on school work)
–   Hard to think
–   Hard to concentrate
–   Poor complex problem solving
–   Poor memory
–   Poor visual and spatial abilities
–   Less creativity

Get a good sleep to help learning
Get a good sleep before exams
Partial sleep deprivation
          (emotional effects)

– More mood swings
– More chance of depression
– Easily irritated
– Less able to handle stress
– More quickly aggressive

  Get a good sleep to be in control emotionally
Partial sleep deprivation
         (physical effects)

– Less immunity

– Increases likelihood of weight gain

– More physical injuries in sport

       Get a good sleep to stay well
Many different reasons


                         q Going to sleep

                         q Staying asleep

                         q Waking too early

                         OR Feeling unrefreshed
Poor sleep is often more to do with
what happens when awake than
        when trying to sleep
Anxiety / Stress and sleep

– Heightened cortical and peripheral arousal (cf sleep -
  restorative state of diminished cortical arousal)
– Problems with sleep initiation, maintenance and structure
– Sleep that is restless and unsatisfying
– Fatigue and irritability (may be due to sleep loss)
Anxiety / Stress

• Biggest cause of poor sleep

• Your thoughts can stress you
  Are your thoughts realistic?

• Share stressful thoughts

• What relaxes you? Try to do it everyday
Am I awake or asleep?

• Easy to mix up

• Mind keeps going in sleep

• More aware of mind if stressed

• Anxiety slows time

• Most poor sleepers get more sleep than they think

Even dozing in bed is good
Healthy Sleep Habits
 •   Sleep schedule
 •   Sleeping environment
 •   Pre-bed routine
 •   Bed is for sleep
 •   Go to bed when tired
 •   Avoid stimulants
 •   Daytime exercise
 •   Alcohol
 •   Nicotine
Sleep environment - Bedroom

                                   More electronic devices in
                                   bedrooms = less sleep

– Comfortable mattress / pillow
– Cool - Don’t overheat with
  heavy bedclothes
– Quiet - Reduce noise
– No disturbances e.g. pets
– Dark
– Feel secure (night light?)
– No clock if clock watch
– Leave curtains open if needed
– Consider app of white noise or
Daytime / Lifestyle

–   Routine sleep/wake times
–   Avoid sleeping in (no more than one hour extra on weekends)
–   Morning bright light
–   Long naps can be a problem

– Exercise
– Moderate alcohol, if any
– No Nicotine

– Have a ‘worry time’
…complete a ‘constructive worry sheet’
Pre bedtime routine - Evening
   • Have one hour ‘wind-down time’ before bed
   • e.g. music, bath, TV, magazine, chatting or novel
   – not school-work and not computers

• Breathing exercises (Breathe2Relax app)
• Mindfulness (Smiling Mind / headspace app)

   • No caffeine after 4pm
   • No late heavy meal
   • Avoid late major exercise
   • Don’t fall asleep before bedtime,
      not even for a minute
   • Avoid close screens
Bedtime routine

§ Get ready for bed in good time
§ Consider warm milk drink or herbal tea
§ Think positively about getting into your snug, calm bed

Wait for a wave of sleepiness before trying to sleep
In bed

§   Turn off the mobile phone
§   Feet not too hot or too cold
§   Attitude is important
§   Think ‘feel good’ statements
§   Slow down your breathing
§   Exercise the imagination…create a story
§   Calm music may be Ok

Can’t make yourself fall asleep
Make your ‘worry time’ earlier in the day
Bed is not the place to think about school work

If wide awake and frustrated get out of bed and do something
    else for while
•   Don’t give up quickly….be persistent… don’t expect

•   The more relaxed you are about moving between sleep,
    wake and dozing the better your sleep will become
In conclusion….

– Sleep is as important as food and water
– Sleep deprivation / sleep issues are prevalent and affect
  mood, memory, health & weight
– Everyone can improve their sleep
– If getting enough sleep and still tired, important to see
  your doctor
For more information about sleep
Click on Information Library/Fact Sheets A - Z

  qAnxiety and sleep
  qDepression and sleep
  qGood Sleep Habits
  qUnderstanding and Helping Poor Sleep
Consider seeing a doctor…
•      Have trouble getting to sleep or wake up frequently during the
    night for a period of several weeks
•      Waking up tired despite getting enough sleep
•      Fall asleep at inappropriate times even after a night of
    adequate sleep
•      Have nightmares or night terrors (the experience of awakening
    in a terrified state without recollection of a dream) that interrupt
    your sleep
•      Sleep-walk
•      Have been told by someone that you stop breathing during
    sleep, especially if you have morning headaches or fall asleep
    easily during the day
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