Sleep is essential to optimal daily functioning. For this reason, it is incredibly important that individuals who consistently experience sleep problems seek immediate medical attention. Unfortunately, finding a solution to sleep problems is not always straightforward, as sleep is affected by a complex combination of various factors.

Factors Affecting Sleep

Chronic Illness: Sleep can be disrupted by illnesses such as diabetes, HIV/AIDS, lupus, arthritis, Parkinson’s disease, and Alzheimer’s disease.

Chronic illness disrupts sleep due to the pain and discomfort it causes patients. Furthermore, these illnesses are often associated with mood disorders (such as anxiety and depression) which are comorbid with sleep problems. Lastly, chronic illnesses often require pharmaceutical medication which can also adversely impact sleep.

The first step to treat sleep problems caused by chronic illness is to address the pain they cause. There are a range of effective painkillers which can help to alleviate pain due to illness, such as tramadol and codeine. If sleep problems persist, patients can buy zopiclone tablets (a particularly effective sleep medication) to help induce sleep.

Psychiatric Disorders: Sleep and psychiatric disorders such as depression and schizophrenia are closely related. Psychiatric disorders are also the most common cause of insomnia and often cause other sleep issues such as daytime drowsiness, fatigue and nightmares.

Disorders such as depression and anxiety cause sleep disruptions. By the same token, sleep problems can also exacerbate mental illness. David Neubauer, MD, an associate professor of psychiatry and behavioural sciences at Johns Hopkins School of Medicine, elaborates on this bidirectional relationship:

“The formula varies — some start off with insomnia that develops into depression, while others start off with depression that leads to insomnia. There does appear to be a circular relationship between sleep health and mental health. Worse sleep or mental health can have a negative impact on the other. The good news is that improvement in either can be beneficial for the other. When someone comes in with persistent insomnia, we should look for mental health issues.”

Stress: Stress is our physical, behavioural and psychological response to the pressures of daily life. The right amount of stress can be useful and productive. Too much stress, however, can result in a host of health issues including sleep problems. Common effects of stress include anxiety, depression, poor concentration, and apathy. Fortunately, stress can be managed in the following ways:

• Identify your stressors. The first step to reduce stress is to understand what is causing it.
• Seek social support. Family and friends are crucial support structures during stressful times.
• Try cognitive therapy. This is focused on identifying automatic negative and irrational thought processes which may exaggerate the true nature of the stress source. Once identified, the focus then shifts to replacing these dysfunctional thoughts with more rational ones.
• Exercise. The health benefits of regular exercise are astronomical and undisputed within the medical world.
• Eat a healthy and balanced diet. Excessive consumption of junk food can disrupt sleep and cause a slew of adverse health issues.

Menopause: This ageing process occurs when a woman stops menstruating and her ovaries stop producing the hormones oestrogen and progesterone, signalling the end of her capacity to reproduce. The loss of these hormones results in symptoms such as hot flashes and profuse sweating. These symptoms can cause significant discomfort, reducing sleep.

Severe symptoms of menopause can be treated with hormone replacement therapy which involves giving a woman oestrogen, sometimes in combination with progesterone. Medications such as antidepressants and SSRIs can also help to alleviate hot flashes.

Pregnancy: Pregnancy can cause sleep disruptions which occur for varying reasons depending on the trimester. Sleep disruptions occur due to the physical discomfort and hormonal changes which arise during pregnancy.

• First trimester-sleep problems occur due to frequently waking to use the bathroom; and physical and emotional stress.
• Second trimester- sleep problems tend to ease during this trimester due to the baby moving above the bladder as it grows, reducing the need for night-time urinating.
• Third trimester- sleep problems are generally at their worst during this trimester due to discomfort caused by the enlarged belly; physical symptoms such as heartburn, leg cramps and sinus congestion; and night-time urination (which increases again due to the baby frequently changing positions).

Disrupted sleep due to pregnancy can be reduced in the following ways:

1.) Extra pillows: these can be used to support the back and tummy. Placing a pillow between the legs can also help lower back pain and can make sleeping on one’s side easier.
2.) Nutrition: warm milk and carbohydrates can also help to induce sleep.
3.) Relaxation techniques: this includes yoga, deep breathing, a warm bath or shower, and massages.
4.) Prescription medication: while most prescription medications are discouraged while pregnant, there is a selection of sleep medications which are safe to use during pregnancy. It is essential to consult your doctor before taking any medication.

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