Introduction

Some form of sleep disturbance will affect the majority of us at some point in our lives. In most cases the disturbance is temporary and will resolve, but for some people sleep problems persist. In this fact sheet we outline some of the common causes of poor sleep and offer some simple tips to help improve sleep.  

About insomnia

Insomnia is the name given to the inability to go to sleep or to stay asleep. There are several types of insomnia. It’s more common in older people who, fortunately, need less sleep.

Primary insomnia

Most adults need about seven and a half to eight hours of sleep each night; however some people simply need less sleep. About two per cent of the population needs less than five hours a night. They can still be highly productive and quite happy. However, not everyone in this group wants to live this way. Many would rather go to bed at the same time as their partner or simply don’t want to lie there awake until 1:30am. These people may seek help and say, “Oh, I’ve never been a good sleeper”, but they still manage to function well and are generally not tired.

It’s interesting to note that other family members will often have the same complaints. This type of insomnia can be difficult to treat as it may be very resistant to non-drug strategies. Basically, it is recommended these people go to bed for fewer hours – while listening to their own body clock for clues. Some simple lifestyle changes may also have an impact.

See tips to improve your sleep. 

Insomnia stimulated by an incident

Have you always been a good sleeper but something has triggered a change in your sleep patterns? Often the trigger is a period of emotional trauma; perhaps your shifts at work have altered or you’ve had a baby. Habits persist beyond the trigger period because your body has now learned that this is the norm. Patients with insomnia often feel frustrated and anxious. This emotional state often makes the problem worse.

For this group a range of psychological techniques aimed at ‘unlearning’ the conditioned sleep pattern may be suggested. Strategies to overcome anxiety or frustration and changing lifestyle habits can help.

See tips to improve your sleep.

Disorders of the body clock

This is not true insomnia but instead some people have problems with their timing rather than quality or duration of sleep. Usually people with disorders of the body clock have trouble getting to sleep and are then unable to get up in the morning. This can pose a real problem for those who have to get up early to go to work. When the body clock is disrupted we are bound to feel sleepy during the day and will crave recovery sleep on the weekend. This pattern is very common in adolescents.

The body clock can be manipulated with carefully timed exposure to bright light. In the same way that our body clocks adjust to differing time zones when travelling, we can shift body clocks with light exposure. This is best managed with a sleep specialist or sleep psychologist.

Some other causes of sleep disturbance

If any of the following are causing you sleep disturbance, discuss with your General Practicioner or health professional.

• Menopause - menopause symptoms, particularly hot flushes and night sweats, can disturb sleep.
• Sleep apnoea - is when the airways are blocked, causing airflow and breathing to stop for a short time during sleep.
• Depression and anxiety - can affect sleep, or be caused by lack of sleep. Counselling may be helpful.
• Shift work - working when your body thinks you should be sleeping can impair sleep and lead to chronic sleep disturbance.
• Pain - pre-existing and chronic conditions can impair sleep. Addressing the pain may help.  

Tips to improve your sleep

Ask yourself whether you need to change a few of your habits to get a good night's sleep.  Sometimes a change in routine is all it takes. 

• Caffeine - cut your caffeine intake to two a day - including cola, as well as tea, coffee and chocolate.
• Alcohol - too much alcohol reduces sleep quality. Limit yourself to one or two standard drinks a day.
• Exercise - here's a secret tip: your body temperature will drop nicely, which is necessary for a good sleep, if you do some rigorous exercise four to six hours before going to bed. Be careful though, as you shouldn't exercise within the four hours before sleep, as the body temperature rises.
• Regular timing of bed and wake times - this is important for those with body clock disorders. Important: try to get out of bed at the same time each day and don't sleep in.
• Total time in bed - restrict the amount of time you spend in bed in an attempt to train yourself to sleep when you get there. Restrict bed time for sex and sleep - not eating, reading or watching TV.
• If not sleeping, get out of bed - frustration at your inability to sleep makes the problem worse. Regain control. Get out of bed and do a quiet, relaxing task in another room.
• Hide the clock - do not clock gaze during the night. This accentuates the sense of frustration. Turn you clock away from view.
• Relaxation techniques - meditation and relaxation may help some people to relax and get to sleep.

Medications for sleep disturbance

Sleep medications (e.g. benzodiazepines, stilnox) may be prescribed for short-term use; however these medications may cause dependence and should be taken with care.

Where can I get more information?

Sleep clinics are present in most large cities. The Women’s Weekly health series booklet Insomnia: how to sleep easy is also available for purchase online at www.jeanhailes.org.au or tollfree on 1800 151 441
www.healthforwomen.org.au
www.sleepaus.on.net – Australasian Sleep Association 02 9920 5415 –This is a health professional website but does have some information on ‘sleep disorders’ and ‘sleep services’
www.sleepoz.org.au – Sleep Disorders Australia 02 9990 3514

Content updated August 2010