Getting a Good Night's Sleep

 

2 November 2001

 

We all know the frustration of not being able to sleep.Without sleep, we can feel tired and irritable for the whole of the next day.This may impair our performance at work, adversely affect our driving anddiminish our ability to cope with some day to day situations. With the clocksgoing back on to 'winter time' recently, the agony of insomnia for some peoplewill no doubt have been made worse. Adjusting the 'body clock' to this timechange is difficult for those who already feel they don't have a regular sleeppattern. The commonest cause of insomnia is stress or worry; but it isimportant to remember that alcohol, recreational drugs and prescriptionmedicines can make it worse.

 

As part of BUPA's ongoing focus on sleep Dr PaulaFranklin, assistant medical director at BUPA, outlines some of the substancesthat can affect our sleep and offers some advice on what can be done to makesure sleep disruption is kept to a minimum.

 

DrFranklin says: "Alcohol is perhaps the biggest culprit for interferingwith sleep. After a few drinks, we tend to go to sleep quickly - but thequality of sleep we have is not good. We dream less and spend more time in deepsleep. We awake feeling less refreshed. With heavier drinking, our bodiessuffer other effects associated with this kind of binge, such as a quickenedheart rate and dehydration. This may cause wakefulness in the early hours ofthe morning. As a result, the next day we can feel fatigued, weak and want tospend the whole day in bed, catching up on sleep lost.

 

"Caffeine,a stimulant found in tea, coffee, colas and chocolate is also a common causefor insomnia. Although hot drinks at night can be comforting, it is best to optfor caffeine-free products. Anyone who cannot sleep should try adding up thenumber of cups of tea or coffee they drink in a day. This can turn out to besurprisingly high! A cup of tea or coffee contains around 80-150 mg ofcaffeine, depending on its strength. Caffeine levels in the blood then peakaround 15-45 minutes after drinking. Insomnia is common in people whose intakeis over 600 mg per day - that may be after just 4 cups. Giving up caffeinesuddenly though can cause problems too, as it is an addictive substance. Youmay experience severe headaches, low mood and irritability if high caffeinedoses are suddenly stopped. So it is better to cut down on your caffeine intakeover several weeks.

 

"Stimulant,illicit 'street' drugs such as ecstasy, amphetamine (speed), and cocaine havemany dangers, but certainly interfere with sleep. For this reason they tend tobe favoured by people who want to stay awake all night for raves and parties.When the effects wear off, a typical 'crash' or 'comedown' occurs, as the bodytries to recover from sleep deprivation. People then sleep for hours, and mayfeel low. These drugs don't actually stop the need for sleep, but simply delayit.

 

"Drugsprescribed by doctors can also contribute to sleep problems. Many drugs such asopiate painkillers (for example dihydrocodeine) can cause drowsiness. Insomniais a recognised problem too with all sorts of drug treatments. Often why thesedrugs cause a problem with sleep is not understood - we just know that they do.If you are taking a new medication and have noticed your sleep is suffering, itis worth consulting your doctor to see if the tablets may be causing insomniaand whether an alternative treatment is available."

 

Drugs,which commonly causesleep problems, include:

 

Antidepressants

Fluoxetine (Prozac)

Paroxetine

Sertraline

Venlafaxine

Asthma Treatment

Theophylline

Prednisolone (a steroid)

Parkinson's disease

Levo-Dopa (in Sinemet)

Amantadine

Heart Drugs

Amiodarone

Digoxin

Antibiotics

Ciprofloxacin

 

"Ofcourse, this list is not exhaustive. If you are worried your tablets arecausing insomnia, it is best to consult your doctor. It is often possible tofind alternative tablets, or change the time of day they are taken with goodresults.

 

"Paradoxically,sleeping tablets such as temazepam can be a cause of insomnia if taken overlong periods. The brain becomes tolerant to their sleep-inducing effects andstarts to need more and more. This means that sufferers feel they need toincrease the dose of their tablets to fight their increased sleeplessness.

 

"Somedrugs interfere with sleep by causing vivid dreams or nightmares. Peoplesuffering from anxiety and stress commonly experience nightmares, but sometimesdrugs are responsible. 'Beta-Blockers', such as propanolol and atenolol arewell recognised for causing nightmares. These drugs may be used to treat highblood pressure, or to slow the heart down after a heart attack. Nicotinepatches, and the heart drugs digoxin (in high doses) and verapamil can allinterfere with dreaming.

 

"Terrifyingnightmares may also occur when people stop taking addictive drugs suddenly.This is seen dramatically in people who are dependent on heroin (asdemonstrated in the film 'Trainspotting') but can also occur when sleepingtablets such as temazepam or diazepam (Valium) are stopped suddenly.

 

"Finally,although taken for its allegedly 'pepping-up' properties, Ginseng has also beennamed as a cause of insomnia! Others may complain it has no effect at all.Everybody is different, and responds to drugs differently. If you have troublesleeping, remember that there are lots of causes and the answer may be sittingin your medicinecabinet."

 

- - -ENDS - - -

 

Forfurther information contact:

GayleSiblock/Camilla Saunders

BUPACorporate Communications

0207 6562292/2545

siblockg@bupa.com