Sleep On It

It’s as essential to our very survival as water, food, and shelter, yet sleep tends to be pushed aside when it comes to priorities, considered an afterthought or even an inconvenience amid our busy schedules. That sleep ranks so low in terms of healthy lifestyle habits is a phenomenon that can have serious effects on our well-being.

“At the end of the day, we’re not valuing sleep,” says Dr. Charles Samuels, medical director of Calgary’s Centre for Sleep & Human Performance. “Most of the problem comes from people not understanding the health benefits of normal sleep.”

Lack of sleep and poor sleep are two distinct issues. In North America, 20 to 30 percent of the population has a sleep debt averaging approximately 10 hours. They are normal sleepers who lack sufficient shut-eye. Others have a sleep disorder—such as insomnia or obstructive sleep apnea (snoring)—that disrupts their nighttime rest.

Sleep debt comes with high costs 

Both come to the same end point: cognitive, behavioural, and physical impairment, and a higher likelihood of developing chronic illness.

“When you either have not enough sleep or poor quality sleep, you end up with cognitive impairment; your ability to think, your memory, and your concentration are impaired,” Samuels says.

“Classic signs of behavioural impairment are irritability, sleepiness, and fatigue. Classic examples of physical impairments would be increased appetite for calorie-dense food, leading to obesity or problems with weight control.

“As you accumulate sleep debt or have a sleep disturbance, you’re at higher risk of cardiovascular disease, metabolic disease, and diabetes,” he says. “There’s a higher risk of mood disorders. Anxiety is exacerbated.”

Blissful, sufficient sleep doesn’t have to be the stuff of dreams, however.

Children 

Developing sound sleep habits starts early in life. Little ones need to learn to self-soothe so they can fall asleep and stay asleep on their own.

As they grow, kids need different amounts of sleep

Note: Amount of required sleep in a 24-hour time span includes naps and varies among individuals.

Approximately 30 percent of kids have sleep problems. 

Sleep-onset association disorder

Common in young children, sleep-onset association disorder is characterized by a child needing certain conditions from a caregiver to fall asleep, such as being rocked or having their back rubbed.

Delayed sleep phase syndrome

Older kids and teenagers commonly experience this sleep problem marked by going to bed very late and waking up late. Being a night owl can negatively affect daytime responsibilities. “Delayed sleep phase syndrome is often misinterpreted as insomnia,” Samuels says, referring to the condition involving dissatisfaction with sleep quality or duration.

Sleep disturbances in teens can be associated with mental illness, such as anxiety and depression.

Developing healthy sleep habits 

Quiet darkness

To help develop lifelong healthy sleep habits, it’s crucial that a child’s brain recognizes nighttime, with a bedroom that’s quiet and dark. That same sleep-inducing environment is vital for teens as well.

Technology-free space

Kids (like adults) need a technology-free zone for good quality sleep. That means not having a computer, mobile phone, tablet, gaming console, or other electronic devices in their room. Technology stimulates brain activity, making it harder to fall asleep, and electronic devices emit bright light that interferes with sleep.

Consistent sleep/wake times

Bedtime and waking time should be similar every day and not vary by more than 30 minutes between weekdays and weekends.

Adults 

Adults typically sleep seven and a half or eight hours a night, on average, but that can range between six and nine hours.

Healthy young adults take 10 to 20 minutes to fall asleep on average, and many adults enjoy consistent sleep: they go to bed at regular times, fall asleep quickly, and experience little wakefulness.

About 32 percent of adults have sleep problems. 

Insomnia

Work demands, especially in conjunction with parenting and caring for aging parents, financial strain, and substance use are just some of the things that can get in the way of sufficient sound sleep. “With adults, insomnia is associated with stress and lifestyle habits or with mental illness,” Samuels says.

Sleep apnea

The most common sleep disorder affecting adults is obstructive sleep apnea, where breathing stops and starts. There are a number of possible causes, including obesity, hormone issues, and large tonsils.

Developing healthy sleep habits 

Give it priority

Adults can improve their sleep by making it a priority, deeming it as important as exercise and diet when it comes to healthy living.

Avoid before bedtime

• caffeine
• nicotine
• alcohol
• heavy meals

Create a sleep sanctuary

• Reserve your bedroom for sleep and intimacy.
• Keep your bedroom cool and dark.
• Skip the screens.

Seniors 

Our sleep changes as we age. Older adults tend to go to bed earlier than younger adults, may sleep more during the day, and might experience more nighttime awakenings.

Aging can also introduce all sorts of sleep-disrupting factors. Sleep apnea is common; so are repetitive limb movements. That’s not all.

About a third of seniors have sleep problems. 

“In the elderly, chronic pain, congestive heart failure, chronic obstructive pulmonary disorder, and other medical illnesses can disturb sleep,” Samuels says. He notes that certain medicines can have detrimental effects. It’s important for people to talk to their health care practitioner about the effects of drugs on their sleep. Turning to sleeping pills isn’t the answer.

“People seeking medication in any form means they have a clinical, significant sleep disturbance, and that should be discussed with their primary care physician,” Samuels says.

“We do not promote over-the-counter medication for sleep. At the Centre for Sleep, we have a very strong behavioural sleep medicine program. There’s an array of interventions based on the principles of cognitive behavioural therapy, but it goes beyond that into relaxation techniques, exercise, diet, and more.”

Developing healthy sleep habits 

Older people can improve their sleep by adopting regular sleep/wake cycles, being physically active, and diminishing worry as much as possible before bedtime.

Sleep disorders through the ages 

Children

Sleep-onset association disorder

What it looks like: 

Common in young kids, this occurs when a child needs to have their caregiver do certain things to help them fall asleep, whether it’s being fed, rocked, or having someone lie down next to them. When they wake up in the middle of the night, they can’t get back to sleep without those same activities.

How to fix it: 

To overcome this problem, kids need to learn how to soothe themselves to sleep. It helps to have a bedtime routine, such as a warm bath followed by reading alone in bed.

Delayed sleep phase syndrome

What it looks like: 

Although this can occur at any age, teens are particularly prone to becoming “night owls,” developing a routine of going to bed late, sleeping in, and skipping breakfast.

How to fix it: 

It’s important for teenagers to go to bed at roughly the same time every night and wake up around the same time daily. Also important is to avoid caffeine and other stimulants during the evening.

Insomnia

What it looks like:

Insomnia can strike people of all ages, including children. It involves trouble falling asleep, waking up throughout the night, or waking too early. It becomes a clinical problem when people experience difficulty falling or staying asleep several nights per week, leading to mood disturbances, concentration problems, and overall fatigue.

How to fix it: 

Relaxation techniques can help; so can going to bed only when you feel sleepy, exercising regularly (but not right before bed), and taking at least one hour to unwind before going to bed, whether it’s listening to music, reading, or writing down worries and setting them aside for the evening.

Adults

Obstructive sleep apnea

What it looks like: 

This condition involves intermittent cessation of breathing during sleep. Severe cases can raise the risk of heart disease, stroke, and diabetes. Sleep apnea can be caused by obesity or being overweight, while drinking alcohol and smoking can also increase the risk.

How to fix it: 

Along with healthy lifestyle changes, someone diagnosed with obstructive sleep apnea can use continuous positive airway pressure (CPAP), which consists of a portable machine that delivers pressurized air to the nose through a mask.

Seniors 

Periodic limb movement disorder 

What it looks like:

This phrase describes repetitive, uncontrollable movements of the arms and legs during sleep that may cause “microarousals.” There may be a genetic link or other issues, such as iron deficiency or nerve or blood circulation problems.

How to fix it: 

If iron deficiency is detected, supplementation may be suggested; in other cases, regular exercise can help alleviate symptoms.

Restless legs syndrome 

What it looks like: 

Uncomfortable or unpleasant sensations in the legs when lying down lead to an overwhelming urge to move the legs during rest, affecting the ability to sleep.

How to fix it: 

Warm baths, leg massages, and applying hot and cold packs can help. Making sure you’re getting enough magnesium (food sources include leafy green vegetables, wheat germ, pumpkin seeds, and almonds) may also help alleviate the symptoms.