March 15 marks World Sleep Day, an annual event, intended as a call to action on important sleep-related issues such as medicine, education, social issues and driving. The event is organized by the World Sleep Society and aims to decrease the burden of sleep problems in society through better prevention and control of sleep disorders.
Undoubtedly, this disturbance of our rest is an issue to be addressed that affects hundreds of thousands of people and that already in the sixteenth century made one of the most famous writers of world literature reflect, as we remember in these verses of Shakespeare: “O sleep, sweet sleep, Nature’s gentle nurse! […] Can you, O arbitrary sleep, give your repose in the rudest hour to the terrified cabin boy and in the most serene moche, in the midst of comforts and luxury, deny it to a king?”
Normalize the problem
This is the first step in finding a solution to a problem that, as we see, takes its toll on kings and commoners alike. One of the most widely held beliefs is that having a sleepless night comes at a significant cost to the person. But for most of us, a sleepless night does not produce a significant decline in our performance at work or in our relationships, unless the thought is constantly swirling around in our minds throughout the day.
Between 30 and 48% of the population report complaints of insomnia, and of these between 10 and 28% report that it is very frequent or describe it as severe. However, only 6% of the population has been diagnosed with insomnia, so we should not worry if it is just a bad night.
We should therefore maintain realistic expectations about the amount of sleep one can get at night, and later examine the causes of the lack of sleep. Our habits and routines can be changed if we feel they are affecting our bedtime (alcohol, indigestible dinners, stress, etc.).
Let’s increase our resilience
It is important not to blame everything bad that may happen during the day solely on insomnia. We must evaluate what else may have caused poor performance, bad temper or the feeling of tiredness. A bad night’s sleep is not a catastrophe and we can all have such episodes at some point. Conclusion: let’s not give so much importance to the problems and work on their solution.
A good starting point is to change the mentality to develop some tolerance to the effects of a sleepless night, even though it is normal to feel exhausted. Enjoy pleasurable activities without trying too hard to sleep, sleep is a physiological process, we should never force ourselves to sleep if our body does not want to, as we will see later.
Listen to our body’s message
As with other very common disorders in our society such as anxiety, insomnia is a messenger of important news, a messenger that sometimes we try to get out of the way by the fast track, but fortunately it does not let itself be eliminated. Its message keeping us awake may be shouting at us that we should be worried about things to solve, for example, pending decisions that we are delaying, or changes in our life or habits that we must face. When we fall asleep, sleep is conceived as an escape, allowing us to forget about problems and, therefore, not to face them.
In addition, insomnia is also an important symptom of the presence of a psychological disorder. Thus anxiety favors the insomnia of conciliation, depression causes insomnia of maintenance or early awakenings, the episodes of mania are usually accompanied by reduction of the need to sleep. In order to obtain a good quality and quantity of sleep it is essential that our habits are healthy and asking for professional help can be key in dealing with both insomnia and other psychological problems.
Making an accurate diagnosis
The Diagnostic Manual of Psychiatric Disorders, DSM-V, classifies insomnia within the group of sleep-wake disorders. Insomnia is a primary sleep disorder within the diagnostic category of dyssomnias (disturbances in the quantity, quality and/or timing of sleep). Excessive sleepiness disorders (hypersomnia, narcolepsy, sleep apnea) and circadian rhythm disorders are also included in this category.
Knowing and locating the type of disorder that afflicts us is fundamental, since not all are the same. In addition, it will not only help us to establish a proper medical assessment, but also to know ourselves and thus be able to deal effectively with our problems.
Improving our sleep hygiene
Contrary to the opinion conveyed by the media, sleep hygiene is not effective on its own, although it always complements other insomnia treatment techniques. The most effective technique is the control of stimuli, secondly the restriction of time in bed and finally cognitive techniques such as paradoxical intention or thought stopping.
The Spanish Sleep Association offers a series of recommendations for good sleep hygiene.
Create a pleasant and quiet environment
The resting space should be adequate to the conditions necessary for just that, to rest. A room with a good temperature, darkness and proper sound insulation will be the perfect environment in which to begin to build our sleep. Loose-fitting pajamas and other textile elements such as bed linen should provide us with textures and thicknesses adjusted to the time of year to avoid waking up in the middle of the night with attacks of heat or cold.
As far as the mattress is concerned, it is important to choose one with the correct measurements to allow freedom of movement and posture changes. A mattress made of a thermal fabric, with anti-mite treatment, and offering an optimal ratio between firmness and comfort will be more than enough.
In addition, avoid or minimize access to television or electronic devices (tablets or cell phones) a few hours before bedtime. The American Academy of Pediatrics recommends avoiding their use in children at least 30-60 minutes before bedtime. A good alternative? Pick up a book or listen to the radio.
Bedtime, how long should I sleep?
Establishing a regular schedule for going to sleep, waking up and napping every day (a habit that has also proven to be very effective for children’s sleep) will help us to establish all of the above steps. Sleeping more or less than the recommended hours can lead to higher levels of impulsivity and hyperactivity. In addition to the behavioral and mood consequences, cognitive consequences have been observed, especially in younger children: deficits in concentration and memory that can lead to learning problems.
The hours of sleep are variable depending on each age group. The American Sleep Foundation published the following recommendations on the total hours needed per day, including naps:
- Up to age 1: The newborn sleeps 16 to 17 hours. Over time, sleep hours decrease (especially daytime sleep hours). At one year of age, they sleep 13 to 14 hours a day.
- From 1 to 3 years old: Each child should sleep between 10 and 13 hours a day.
- Between 4 and 6 years old: Sleeps 10 to 12 hours at night. They no longer need a nap, but it is good to rest a little after lunch if the child needs it.
- Adolescents: from the age of 16, they need between eight and nine hours of sleep for the performance of their daily activities.
- Adults: an adult usually feels rested with between 7.5 and eight hours of sleep a day.
- Seniors: the average is about seven hours of sleep, but the problem at this stage is that sleep becomes less deep.
Watch out for drugs
Finally, be careful with the abusive use of drugs because, although thanks to them a person with insomnia can get a restful sleep and feel better to face the difficulties of the day, the pills are only a crutch. With it, we learn a dangerous way in the long run to face life’s problems, not tolerating frustration and discomfort in order to act in an escapist way.
It is not that insomnia is romantic and seductive in itself, as much as we like to talk about it in family and work, but that, if it has caught up with us, we keep our way in spite of it.