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Fatigue & sleep

While sleep needs vary between individuals, most adults require between 7 and 9 hours sleep daily to function at their best. 

Poor quality sleep or insufficient hours of sleep has a number of adverse health implications for people with or without neurological conditions.

There is so much that can be done to help with improving sleep and you can then feel so much better and more alert and able to cope with life.

Sleep problems such as insomnia are common in the general population and people with neurological conditions. Other common sleep problems include snoring and sleep apnoea. Causes can include anxiety, stress, depression, reaction to some medications, problems with urinary frequency as well as the problems associated with disturbed sleep or sleep apnoea as part of normal ageing.

Make sure you have good sleep hygiene and discuss unresolved sleep problems with a nurse or your GP or neurologist. It may be necessary to have a formal assessment which may recommend the use of overnight sleep apnoea devices eg C-PAP.

Practical tips

  • Stress or worry can seem larger at night when you have nothing to distract you from your thoughts. Using strategies like a journal, worry rituals, gratitude diary, relaxation and meditation can help clear the mind before going to sleep. If it becomes a bigger issue, counselling can be very helpful to work through issues that may stress you to your worry point.
  • Sleep is a 24-hour cycle, so be aware of what happens in your day that can impact on your sleep at night.  For example, if your nap in the afternoon helps then go with it. Just make sure you don’t sleep longer than 30 minutes as that may interfere with your night time sleep.
  • It is recommended not to have a TV in the bedroom, but to keep the bedroom for intimacy and sleep. Reading and quieter activities are better for preparing to sleep. Avoid TV and computer activities in the half hour before going to sleep.
  • Menopause with hormone fluctuations can certainly cause wakefulness and trouble sleeping. Keep the bedroom temperature cool and wear cotton pyjamas to counter any hot flushes.
  • Some new mattresses cause overheating and this can wake you during the night. Overlays are available to assist with cooling.
  • Exercise is great for reducing stress and may help with promoting sleep, but not in the few hours before bedtime. A regular massage also improves quality of sleep.
  • Restrict coffee and alcohol intake, or swap coffee with chamomile tea.
  • Light pollution is a common sleep interrupter and people find sleeping masks can reduce this issue. We have lights on digital clocks and LEDs on electrical equipment all contributing to light pollution in the bedroom and these can cause sleep disturbance. A nice aromatherapy eye mask may help you here.

Frequently Asked Questions

Q: Why can I get to sleep but often wake an hour later and am wide awake for the next 3 hours?

A: This is common – it is called “middle insomnia” Try not to stress. Get up and do something relaxing, then try to sleep again later. Lying in bed worrying only makes matters worse.

Q: If you’ve tried various methods to sleep and it’s not working, are there any medications that you can take?

A: Make sure you don’t have a sleep disorder eg sleep apnoea, insomnia, restless leg syndrome. There is another sleep disorder called REM behaviour disorder; this is associated with punching or kicking type movements. You may need to get a referral to a sleep specialist.

Try having a ‘get ready to sleep’ ritual.... take a warm shower, have some warm milk and practice deep breathing or relaxation – this can sometimes help to initiate and maintain sleep. There may be interactions between your drugs, anti-depressants, medication for spasms etc. and sleeping medication so please discuss this with your pharmacist/doctor.

Resources

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