Good Night Sleep Tight
Laurence McKenna PhD
February 2005 © British Tinnitus Association
This information is not a substitute for medical advice. You should always see your GP / ENT Consultant
Insomnia is defined, amongst other things, as difficulty in falling and/or staying asleep. Mild sleep disturbances are very common, to be classified as ‘insomnia’ the delay in going to sleep or going back to sleep needs to be considerable, occurring at least three or four times a week and persisting for six months or more.
Sleep disturbance affects most people at some stage of our lives. It is common not only in adults but also in children, and is particularly prevalent amongst the elderly.
A normal night's sleep has several stages, from light to deep sleep, including several awakenings, the first after just a couple of hours sleep. Natural awakenings are usually forgotten by the morning, but if a person worries about his or her tinnitus during them, they will last much longer. It seems most likely that tinnitus does not actually wake people, but of course, it can be the first thing they notice when a natural awakening occurs.
As people grow older they experience less very deep sleep and more awakenings. Sleep becomes lighter and more fragmented and there is a tendency to nap during the day. Most people get about seven or eight hours sleep, but normal sleep times vary enormously.
Why sleep?
Surprisingly, the exact reason for sleep is unclear. Possibly it conserves or restores energy, but the evidence for this is not completely clear. People do tend to feel bad if they have not slept well, but no known changes in the body's biochemical or metabolic mechanisms result from sleep loss. Long term or ‘chronic’ sleep loss should be distinguished from short term loss.
People who have been deliberately deprived of sleep in the laboratory tend to do less well on psychological and other tests. The effects of ‘jet lag’ are also well known to many; however, it is not clear whether this is a result of sleep loss, or more to do with disruption of the body clock.
The pattern is different, however, amongst those who have chronic poor sleep. There are large individual differences in how well or how badly they do in tests. Many people perform very well on little sleep. Clearly, people need to act sensibly and be aware of their limitations, but for many people a loss of sleep may not have the devastating consequences that most of us fear. Worrying about sleep loss is one of the things most likely to keep it going. As far as we know, no-one has ever died just from lack of sleep.
Some do's and don'ts
It is worth talking to your doctor if you suffer from insomnia. Sleep loss may be related to some other medical condition which may be treatable. Many GPs offer medication to help people sleep. Such medications have had a bad press in recent years, but should not be rejected out of hand. With medical guidance in the selection of the right medicine and its proper use, a short term crisis can be greatly relieved. Sleep is very much a matter of habit or routine. More often than not, poor sleep results from poor routines, and often people's attempts to solve their sleep problems actually make them worse.
Avoid using alcohol to induce sleep it may send you to sleep but, apart from the obvious problems associated with alcohol abuse, it will disrupt the normal sleep pattern. You may wake sooner and have trouble getting back to sleep.
Avoid using ‘over the counter’ medicines to help you sleep many have a similar effect to alcohol. Herbal remedies and "natural" products may help some people.
Limit the amount of caffeine (tea, coffee, cola, etc.) & nicotine you take both are stimulants and will keep you awake.
Fit people tend to sleep better but get fit carefully. Avoid exercise near bedtime. It may tire you out but it also disrupts the normal sleep cycle.
A busy mind makes it more difficult to sleep if you have worries, spend a set amount of time (say half an hour) each evening, considering how to resolve them. Write your ideas down.
Try to unwind for at least an hour before bedtime. Draw a curfew between daytime and night or bed activities. Relegate worrying thoughts to the next day's "worry session".
Go to bed when you feel sleepy not just because it's a certain time on the clock.
Relaxation can be enormously helpful classes and tapes are widely available. Practise relaxation exercise during the day and find some short form of relaxation to try at night.
Avoid using the bedroom for things apart from sleep don't watch television, do crosswords, write reports etc. in bed.
When you get into bed turn the light off straight away tell yourself that sleep will come when it is ready. Don't try to go to sleep, resting in bed can be just as helpful. If you are not asleep in 20 to 30 minutes, get up and go to another room and do something relaxing like reading. Go back to bed when you feel sleepy again. Repeat the process if you are not asleep in another 30 minutes.
Don't eat if you wake at night you may train your body to expect food at that time.
Get up at the same time each day even at weekends. Don't sleep beyond a set point in the morning even if you have only had a small amount of sleep. Getting up at the same time each day is one of the most important things to do to try and improve your sleep.
Try not to sleep in the day or catch up on lost sleep cat napping is not helpful in improving sleep, but some elderly people might find this difficult.
Stick to a routine.
There is a wide range of information sheets on tinnitus and associated subjects which can also be downloaded from the following website – www.tinnitus.org.uk
British Tinnitus Association Registered charity no: 1011145 Freephone: 0800 018 0527 Website: www.tinnitus.org.uk
Patron: The Duchess of Devonshire DL President: The Rt Hon Sir Stephen Sedley
Vice Presidents: Jack Shapiro Stephanie Beacham Geoffrey Bates OBE