Sleep disorders

Background

Sleep deprivation is a health risk that affects most people at some time. It can have varying levels of impact on the way you function and can have serious side-effects if you are driving.

• Insomnia is the second most common medical complaint in Australia, with up to 40% of people reporting trouble with sleep in one year. It is twice as common in women.
• There are more than 150 known types of sleep disorders that have the potential to affect your waking day. These can range from teeth grinding to night terrors and narcolepsy (uncontrollable attacks of sleep).
• Insomnia affects people in different ways. It can mean difficulty falling asleep, difficulty staying asleep or waking up too early.
• People need enough sleep to feel alert during the day. It varies from person to person, but typically 7 to 9 hours of good quality sleep is enough.
• Sleep Research in Adelaide has shown that after 17 hours without sleep you drive as poorly as if you had a blood alcohol level of 0.05 (the legal level to drive) and after 24 hours without sleep it's the same as a level of 0.10.
• Some people suffer from Excessive Daytime Sleepiness where they feel drowsy during the day even when they get enough night time sleep.
• Infants spend most of the day asleep. As we move into old age sleep becomes lighter and more interrupted.
• Nearly a third of our life is spent asleep.

Have you ever been driving and suddenly found your eyelids droop, your eyes go out of focus and you can't remember driving the last few kilometres? If so, you have been a "drowsy driver" and you're not alone! A 1999 survey by the National Science Foundation in the United States found that in one year alone, 62% of adults surveyed reported driving a car or other vehicle while feeling drowsy. An alarming 27% reported that they had actually dozed off while driving.

Restless legs and periodic limb movements of sleep

If you suffer from unpleasant creeping sensations or your legs twitch during the night you may have Restless Legs Syndrome (RLS) or Periodic Limb Movements of Sleep (PLMS). In PLMS, the movements occur only during sleep whereas in RLS the movements may occur while you are awake or asleep. Sufferers tend to complain of irritability, anxiety and depression.

Sleep apnea

Apnea means absence of breath. People with sleep apnea may have hundreds of these episodes throughout the night, disrupting their sleep and starving the body of vital oxygen. Sleep apnea is a common condition affecting between 2 and 4% of adults. People with sleep apnea are at least 4 times as likely to have a car crash. Fortunately effective treatment is available and once treated the person with sleep apnea leads a normal healthy life. It is illegal to drive once diagnosed, unless treated.

Delayed sleep phase syndrome

Everyone's sleeping habits differ, but once we have adapted to a particular sleeping pattern, most of us are able to keep to that schedule. People who suffer from Delayed Sleep Phase Syndrome are unable to get their sleep pattern back in line with what is considered normal and even if they do, they are not able to maintain this. This is a significant problem to the person suffering from DSPS, leading to insomnia and depression.

Shift work

The body has a natural 'circadian' rhythm which helps you sleep at night and stay alert during the day. When you work shift work you must struggle against this. Long shifts or insufficient daytime sleep lead to tiredness and accidents.

Good sleep habits

• Otherwise known as Sleep Hygiene, good sleep habits can positively affect the duration and quality of your sleep.
• Exercise regularly.
• Establish a regular, relaxing bedtime routine that will allow you to unwind and signal to your brain that it's time to go to sleep.
• Try relaxation exercises when you go to bed. Think about a relaxing scene. Practice deep muscle relaxation exercises. Practice the self-relaxation technique of focusing intently on a soothing word or on breathing in and out slowly.
• Go to bed at the same time each day.
• Keep the room dark. Use dark blinds to block early morning sun.
• Keep the temperature in your room comfortable and keep it quiet.
• Use your bed only for sleep and sex. If you believe that reading, listening to the radio, or some other in-bed activity helps you fall asleep, do so for no longer than 20 minutes.
• Eat a light bedtime snack. Hunger can disrupt sleep.
• Have a warm bath with soothing oils such as lavender or rosemary.
• Drink a glass of warm milk before bed. Milk contains an amino acid that is converted to a sleep-enhancing compound in the brain.
• If you are not sleeping due to stress, get help to assist you in managing this.

Things to avoid

• Don't do rigorous exercise within three hours of sleep.
• Avoid caffeine, nicotine and alcohol in the late afternoon and evening. Caffeine and nicotine can delay your sleep and alcohol may interrupt your sleep later.
• Don't read important documents for work or use the bedroom as a study area.
• Don't lie awake for more than half an hour. Do something relaxing until you feel tired.
• Don't engage in mentally stimulating activity just before going to bed, such as watching exciting or disturbing TV programs.
• Eliminate the bedroom clock. You can set your alarm by placing it in a position that is not visible from bed.
• Don't eat a heavy meal just before bed or go to bed hungry.

Never drive a vehicle if you are drowsy. Fatigue is one of the major killers on our roads: University of South Australia.

Next steps/action.

There's increasing evidence that a 15-20 minute nap can improve alertness, sharpen memory and generally reduce the symptoms of fatigue. If you're coping with the impact of lost sleep from the night befor or you know you're going to lose sleep tonight, a nap can help.

Sleep deprivation can be treated. Talk to your counsellor or family doctor about the problem first and a referral to a sleep physician can be made if necessary. Try and keep a diary over 10 days to document when you sleep and wake, what you consume and how much exercise you've had. Patient support groups are also available to assist.

For further information, visit: www.mynrma.com.au or Sleep Disorders Australia, New South Wales Branch: PO Box 303 Roseville NSW 2069 Tel: (02) 9990 3514.