Sleep disorders: Don't take it lying down

Millions suffer from sleep disorders – and many never seek help. But the cures are out there, says Roger Dobson
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Indy Lifestyle Online

Getting to sleep tonight will be a big problem for millions of Britons. Insomnia affects one in four of us at some time, but it's far from the only disorder that spoils our sleep – researchers have now identified 75 such conditions, from snoring, sleep apnoea, restless legs, bruxism and nocturnal cramps, to sleep-talking, rhythmic movement disorder and confusional arousal. Some 31 per cent of people, including children and teenagers, have one or more of these disorders at some time. They can severely affect everyday life.

"Most of those with sleeping problems considered them to have an impact on their daily functioning, with family life most affected," say Paris University researchers who quizzed 10,000 men and women in the UK and other countries.

The research shows that many people don't seek help with their problems. "Almost half had never taken any steps to resolving them, and the majority had not spoken to a physician about their problems," researchers found. Yet treatments exist for many of the conditions that work well for large numbers of patients. Although half of those who see a doctor are prescribed drugs, other treatments and lifestyle changes can work, too.



Diet

Sleep is influenced by chemical signals in the brain, so foods that change the balance of these signals can affect how well we sleep. Caffeinated drinks such as coffee and drugs such as decongestants stimulate parts of the brain and can prevent sleep. For insomnia, avoid caffeine and alcohol, which cuts the time spent in restful deep sleep. Some foods that tackle insomnia contain tryptophan, which can cause sleepiness.

A good night- time snack contains a carbohydrate and protein, such as cereal with milk. According to the University of Maryland: "Foods rich in carbohydrates and low in protein and fat may boost production of serotonin and melatonin, brain chemicals that are associated with sleep. A carbohydrate snack of cereal or crackers with milk before bed may help.''

People with sleep apnoea, a breathing disorder that manifests as loud snoring and brief periods when breathing stops, should avoid alcohol, tobacco and sleeping pills.

Plenty of dietary iron and iron supplements can ease periodic limb movements – repeated twitches or kicks of the leg during sleep. This disorder is thought to be responsible for up to one in five cases of insomnia and daytime sleepiness, although in many cases patients are unaware of it.

Avoid tobacco. Heavy smokers often sleep very lightly and tend to wake up after merely four hours of sleep because of nicotine withdrawal.



A hot bath

An evening soak can help with sleep disorders, as it has a calming effect. Research at the University of California suggests that it can reduce insomnia in 20 per cent of people.



Bright Light Therapy

This is used for treating circadian rhythm disorders – disruptions to the 24-hour body clock that can result in continuous or occasional disruption of sleep patterns. According to the Cleveland Clinic, exposure to bright light can be used to advance or delay sleep by resetting the circadian clock. A high-intensity light is required and the exposure is one to two hours. If possible, wake up with the sun, or use very bright lights in the morning, say researchers. Sunlight helps the body's internal clock reset itself each day: "Sleep experts recommend exposure to an hour of morning sunlight for people having problems falling asleep.''



Drugs

Anti-Parkinson's drugs and anticonvulsants ease restless legs. Some antihistamines are used as sleep aids because they are calming, although they can have a hangover effect. Stimulants and antidepressants can treat narcolepsy –daytime sleep attacks. Hypnotics like zopiclone or benzodiazepines can be prescribed for less than a fortnight to treat severe insomnia. They can cause drowsiness the next day and can be addictive.



Exercise

Daily exercise can help people sleep, according to the National Institute of Neurological Disorders, but avoid workouts in the three hours before bed. "Try to get your exercise about five to six hours before going to bed,'' say the researchers. Regular physical activity, especially aerobic exercise, can help you fall asleep faster and make sleep more restful.



Behaviour therapy

Changing sleep-wake times, avoiding naps, engaging in a regular routine of exercise, and avoiding caffeine and nicotine within several hours of bedtime is important in treating circadian rhythm disorders and insomnia, according to the Mayo Clinic.



Relaxation

Relaxation, meditation, yoga, guided imagery, hypnosis, or biofeedback can break the vicious cycle of sleeplessness by decreasing feelings of anxiety about not being asleep, according to Maryland University researchers. "These therapies reduce the time it takes to fall asleep, increase total sleep time, and cut nightly awakenings."

Psychotherapy can be helpful in treating insomnia. Sleep therapy includes cognitive behaviour therapy which can deal with anxieties that may be stopping sleep and helps develop positive ideas about sleep.



Melatonin

A pineal gland hormone, melatonin is at its highest levels at night, and plays a key part regulating the body clock. A trial where the hormone is being used to treat children with insomnia is under way in Utrecht. It's based on the idea that the time at which melatonin production starts to increase plays a key role in the synchronisation of circadian rhythms.



Herbal remedies

The herb valerian may help with insomnia. Valerian acts as a mild sedative. Wild lettuce, passionflower, hops, Jamaica dogwood, lemon balm, lavender flowers, German chamomile, motherwort, gotu kola and skullcap are also used.



Devices

For sleep apnoea, there are positive airway masks where gently pressurised air is breathed in during sleep to stop the airways collapsing and preventing proper breathing. Devices that fit over the teeth can combat snoring, by pushing the lower jaw forward, improve breathing, and also stop teeth grinding.

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