Recent­ly, there has been an increased focus and aware­ness of sleep and many Aus­tralians are report­ing sleep issues.  Step into your local book­store and you will find a whole sec­tion ded­i­cat­ed to sleep and many of us now pur­chase items such as can­dles and herbal med­ica­tions to help us sleep and wear elec­tron­ic devices which track sleep allow­ing us to scru­ti­nise sleep pat­terns on a dai­ly basis.  Yet, many peo­ple don’t actu­al­ly under­stand the process of sleep, why we need it and how our actions and behav­iours inter­fere with and inter­rupt this impor­tant bio­log­i­cal process.

The sleep/wake cycle is trig­gered by a com­plex inter­play between exter­nal cues such a day and night, hor­mon­al influ­ences and oth­er phys­i­o­log­i­cal func­tions such as eat­ing and exer­cise.  Each night, we pass through sev­er­al stages of sleep which are bro­ken down into Non-REM (rapid eye move­ment) sleep and REM sleep.  Most of the night is spent in Non-REM sleep with about 20–25% of our time in REM sleep when most dreams occur.  REM sleep is more fre­quent ear­li­er in the night and decreas­es in length and inten­si­ty as the night pro­gress­es.

Non-REM sleep starts with a relaxed state with a pro­gres­sion through sev­er­al stages where brain waves slow, breath­ing deep­ens, and your heartrate slows as your blood pres­sure falls. After a while, you enter REM sleep where your phys­i­o­log­i­cal state rep­re­sents that of being awake yet your mus­cles are in a paral­ysed state only mov­ing for twitch­ing and spasms pri­mar­i­ly seen in the eyes which flick­er back and forth.  The whole cycle lasts about 90 min­utes and you progress through around 4–6 of these cycles through­out the night with peo­ple sleep­ing less as they age.

Sleep allows the body and brain to rest and recov­er and it is essen­tial for opti­mal health and well­be­ing. Sleep makes us feel bet­ter.  It increas­es our ener­gy, helps us to con­sol­i­date mem­o­ries and learn­ing, pro­motes brain cell con­nec­tions and improves over­all func­tion­ing and well­be­ing. Yet, accord­ing to the 2016 Sleep Health Sur­vey of Aus­tralian Adults(1), 30 to 45 per cent of Aus­tralians have poor sleep health.

Poor sleep has been asso­ci­at­ed with weight gain, the onset of dia­betes, an increased risk for car­dio-vas­cu­lar dis­ease, depres­sion, anx­i­ety, a com­pro­mised immune sys­tem and poor­er cog­ni­tive func­tion­ing includ­ing risk assess­ment and sleep depri­va­tion has been asso­ci­at­ed with high­er error rates of impor­tant tasks such as dri­ving.

Sleep reg­u­lates the metab­o­lism and is impor­tant for the release and reg­u­la­tion of hor­mones such as ghre­lin and lep­tin which is impor­tant for appetite con­trol. Peo­ple who sleep less than six hours per night are more like­ly to have a high­er body mass index (BMI) than peo­ple who sleep for 8 hours.  In fact, lack of sleep is the third high­est risk fac­tor for obe­si­ty after lack of exer­cise and overeat­ing.   Sleep­ing also reg­u­lates the release of insulin which reg­u­lates our blood sug­ar lev­els and reg­u­lates the stor­age of fat.  High­er lev­els of insulin are asso­ci­at­ed with weight gain and dif­fi­cul­ties metabolis­ing fats in our blood.  Poor sleep also inter­feres with the sig­nals from the brain which sig­ni­fy the sense of full­ness after eat­ing and can increase crav­ings for sug­ary foods.

Sleep also plays an impor­tant part in our men­tal health.  When we sleep, our brain reg­u­lates the release of cor­ti­sol, the ‘stress hor­mone’.  Poor sleep increas­es cor­ti­sol which is linked with increased symp­toms of anx­i­ety and chron­ic sleep depri­va­tion has been cor­re­lat­ed with the onset of clin­i­cal depres­sion.  Alco­hol and drug abuse prob­lems are also more preva­lent in peo­ple who expe­ri­ence poor sleep as peo­ple often attempt to ‘self-med­icate’ using alco­hol and or drugs in an attempt to bring on the onset of sleep.  Whilst alco­hol and drugs ini­tial­ly make you feel sleepy, they then stim­u­late the brain mak­ing remain­ing asleep dif­fi­cult and can increase the like­li­hood of devel­op­ing an addic­tion dis­or­der.

The Sleep Health Study (1)found that near­ly 50 per cent of all adults report hav­ing two or more sleep-relat­ed prob­lems which impact­ed on sev­er­al of their life domains.  Some of the prob­lems report­ed by par­tic­i­pants includ­ed expe­ri­enc­ing sleep dis­or­ders such as; insom­nia where it is dif­fi­cult to fall asleep or stay asleep, Nar­colep­sy where peo­ple sud­den­ly fall into REM sleep dur­ing nor­mal day­time activ­i­ties, Sleep Apnea where peo­ple stop breath­ing dur­ing sleep and night­mares and night ter­rors all of which not only affect func­tion­ing and well­be­ing but can be high­ly dis­tress­ing.  Whilst some of these con­di­tions have a neu­ro­log­i­cal basis, the best way to avoid sleep issues is to not mess with the sleep/wake cycle and to have good sleep hygiene.  Like every­thing else which is good for us, this requires dis­ci­pline and rou­tine.

Our reliance on dig­i­tal devices and social media is prob­lem­at­ic and is hav­ing a sig­nif­i­cant impact on our sleep with con­cern­ing con­se­quences.  Night time com­put­er usage is a major con­tribut­ing fac­tor to poor sleep with 44 per cent of adults report­ing inter­net usage just before bed every night.  This rate increased to 75 per cent in the 18–24 yr age brack­et.  Twen­ty nine per cent of adults report dri­ving whilst drowsy at least once a month and 20 per cent report hav­ing nod­ded off at the wheel whilst dri­ving.  Twen­ty one per­cent of men and 13 per cent of women report hav­ing fall­en asleep at work, and 29 per cent of those sur­veyed report mak­ing errors at work due to feel­ing sleepy (1).  Being too tired was also a com­mon rea­son for miss­ing out on social activ­i­ties with 45 per cent of 18–24 yr olds report­ing that they missed out on at least one social event in the past month due to being tired.

With poor sleep impact­ing so many areas of our lives, here are a few things you can do to improve your sleep;

  • Have a reg­u­lar rou­tine for wak­ing, eat­ing, exer­cis­ing and going to bed.
  • Spend time out­doors, this pro­motes hor­mones which help set and main­tain your body clock
  • Try to avoid day time naps
  • Exer­cise dai­ly
  • Avoid caf­feine in late after­noon
  • Prac­tice relax­ation tech­niques to wind down after a busy day
  • Avoid excess alco­hol use and quit smok­ing
  • Have a good bed­time rou­tine and only go to bed when you are sleepy
  • Avoid tele­vi­sion and oth­er elec­tron­ic devices in the bed­room which can keep you awake or wak­en you dur­ing the night
  • Check out web­sites (dur­ing the day­time) which have plen­ty of tips to help you get qual­i­ty sleep like Beyond Blue and the Sleep Health Foun­da­tion.
  • Above all, if sleep prob­lems con­tin­ue to be an issue, vis­it your GP.
  1. Report to the Sleep Health Foundation 2016 Sleep Health Survey of Australian Adults

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