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Sleep diary www.sleepfoundation.org/_content/tools/SleepinessDiary2.pdf

Sleep & depression - sleep-wake cycle management (pdf)

Insomnia pdf  & Sleep Timing Disorders pdf

Sleep problems

How much sleep do we need?

Many people are not aware that the hours of sleep we need for normal health varies with our age. Also, adults are different in the amount of sleep they need; for some, 4 hours a night is ample; for others, 10 hours is not enough. The average sleep for a 50-year-old is 7 hours a day.

What is a sleep problem?

There is a problem when lack of sleep or too much sleep interferes with your activities during the day. The commonest cause is insomnia, which may be caused by anxiety or depression. There are other problems that can interfere with sleep, including problems of your bed mate. These problems include restless legs, sleep apnoea (brief periods of not breathing) and snoring.

What is insomnia?

Insomnia is a lack of adequate sleep, which may be difficulty getting off to sleep, difficulty staying asleep or waking early. It is a temporary problem in most instances and is usually due to a passing personal problem; however, sometimes it just happens for no reason.

What can I do to settle to sleep?

If you have difficulty going to sleep, the following guidelines might be useful:

• Do not try too hard in attempting to go to sleep.
• Establish a routine to follow before going to bed.
• Try to settle down before going to bed. Do not try to sleep immediately after a heavy meal, after difficult work that required a lot of concentration, after strenuous exercise or after an emotional upset or argument.
• Try to recognise what helps you settle best. The following are useful to some people: glancing through a magazine, listening to the radio, having a warm (not too hot) bath or shower, or some other relaxation technique. You might find something else that works better for you.
• Often, having a warm milk drink as you retire to bed will help.
• Many people find that drinks containing caffeine (such as tea, coffee and cocoa) make it difficult to go to sleep.
• Alcohol can stop many people from settling to sleep and can cause others to have disturbed sleep.
• Decide the hours during which you want to sleep and try to sleep only within that period. Repeated 'naps' during the day will make sleep at night difficult.
• In general, you will come to no harm if you do not sleep at all for one or two nights; you will catch up later.
• Find a settling-down routine that works best for you. Even if it seems only partly effective, the fact that you have a routine will eventually assist your sleep.

What about sleeping tablets?

• Doctors prefer you to work at getting a natural sleep by the various relaxation techniques. However, sometimes drugs can help you over a difficult period and may help you get into a pattern.
• The benzodiazepine drugs are the safest, but should be taken for a short time (say 2 nights) and taken in the lowest effective dose. Most people seem to make a prescription of 25 tablets last for 3 months, and this is sensible.
• Rarely, some people with chronic insomnia manage best with regular use of sleeping tablets and cannot manage without them. In such instances, long-term use of sleeping tablets is justified.

A special tip

Special sleep disorder units to help your problem are present in most major cities. Ask your doctor about them.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia