Getting Better Sleep: What You Need to Know

Sleeplessness and Depression
Sleeplessness, frequent nighttime waking, or sleeping too much can be symptoms of depression. Clinical depression is more than passing sadness. It’s not something a person can snap out of. It is a real, treatable imbalance in brain chemicals.

In addition to changes in sleep patterns, people with depression have a sad, low mood that lasts more than two weeks. They lose interest in things they once enjoyed. They may feel worthless, hopeless or excessively guilty. Their eating habits and weight may change. They may also be tearful, restless, exhausted and unable to concentrate. Thoughts of death or suicide may enter their minds.

There are many different treatment options for depression, including talk therapy, medication and support from people who understand. Seeking treatment is nothing to be ashamed of. It is the first step toward getting back into the swing of life and feeling good about who you are. Don’t let fear or embarrassment stand in the way of talking honestly with your health care providers about depression. You can take the first step by taking a confidential depression screening at www.SleeplessInAmerica.org.

Sleeplessness and Bipolar Disorder
Sleeplessness can also be a symptom of bipolar disorder (also known as manic depression). People with bipolar disorder have alternating periods of high and low mood. During the low periods, they have the symptoms of depression described above. During the high periods they may feel extremely self-confident and goal-directed. They might have racing thoughts and be unable to stay on one topic. They may overspend, have a lot of sex or engage in other risky behavior. They might be extremely energetic, talkative or irritable. And they may go for days without sleep and not miss it. They might spend their nights writing, working, or making phone calls.

Awake all night?
Do you:

• Have trouble getting enough sleep?

• Wake up feeling tired?

• Fall asleep while reading or watching TV, whether you want to or not?

• Have trouble paying attention?

• Feel moody, easily annoyed, quick to anger?

You don’t have to live with sleepless nights. The first step in getting help is finding out more about sleep and what may be causing your sleep loss.

How much sleep do we need? 
Everyone needs sleep. Infants sleep for up to 16 hours per day. Teenagers need nine hours per day, and adults need between five and ten hours, though seven or eight hours are ideal. Older adults need seven or eight hours, but they may be less able to sleep continuously and deeply.

What causes sleep loss? 
Physical illness can be a cause of sleep loss.

Sleep loss may also be caused by a person’s mental state. Insomnia can sometimes be a temporary response to stress. But if your stress and sleep trouble last for more than two weeks and interfere with your life, they may be signs of something more serious. People in mania can be productive and happy at first. But it’s difficult to sustain such a high level of activity, and enthusiasm may lead to angry outbursts and bizarre thoughts. Many people report intense paranoia during mania, as well as difficulty thinking clearly and sometimes a loss of contact with reality. Bipolar disorder is treatable with medication, talk therapy and/or support.

The earlier a person gets and stays with treatment, the more likely he or she will be able to manage future episodes. Find out more about your symptoms and what they mean by visiting www.SleeplessInAmerica.org for a confidential bipolar disorder screening.  

Things that can keep you awake

• Excessive fluids and heavy, spicy meals close to bedtime can interfere with sleep

• Caffeine Try to stop your caffeine intake (including chocolate, colas and some teas) by afternoon or earlier for the best chance of easy sleep.

• Alcohol may seem like a sleep aid because it slows you down and can make it easier to fall asleep. But alcohol affects the depth and restfulness of your sleep by disrupting normal sleep patterns.

• Nicotine in cigarettes is a stimulant. It can keep you up if you smoke before bed, or cause you to wake up too early because of withdrawal.

• Over-the-counter cold or sinus medications can keep you awake or make your sleep less restful.

• Herbal energy boosters may also keep you awake. Read labels carefully and discuss any supplement you take with your doctor to make sure it is safe for you.

How can we get better sleep? 
Make an appointment to see your health care provider as soon as possible. Bring the results of any screenings you’ve taken. Find a health care provider who makes you feel comfortable, respects you, and is willing to work with you to find a treatment that is right for you. Lifestyle changes can help you, too. They can help your treatment work better or they may work alone to help improve your sleep. With illnesses such as depression and bipolar disorder, getting the right amount of sleep can make a significant difference in your health.

Go to bed and wake up at the same time each day. Getting your body used to a schedule can help regulate your sleep cycle. Avoid sleeping late on weekends to keep your schedule consistent and make it easier to wake up on Mondays.

Relax before bed. A warm bath, reading, listening to soft music, or meditation can help you unwind from the day and get ready for sleep. If it bothers you to leave work undone at the end of the day, make a to-do-tomorrow list before you go to bed.

Use natural or artificial light to help you. Avoid bright lights before going to sleep. Wake up with the sun if possible. Spend some time in natural sunlight (not necessarily direct) during waking hours. If you can’t wake up with the sun, turn bright lights on when you get up.

Get active earlier. Try to exercise or do some type of physical activity for 20-30 minutes each day. But don’t do it too close to bedtime. Three to six hours before going to bed is ideal.

Do something. Don’t lie in bed awake for more than 15 minutes. This can make you anxious and worsen insomnia. Read or do another quiet activity until you feel tired.

Keep your bedroom comfortable. If the temperature in your bedroom is too hot or too cold, it can disrupt your sleep. Make an effort to limit noise as much as you can – use earplugs if necessary. Be sure your bedroom is dark enough. You may need heavier blinds or a sleep mask. If a pet or a partner keeps you awake, do what you can to help change his or her habits.

Take inventory. Keep track of your sleep – how much you get, how long it takes you to get to sleep, when you wake up, and other things that are happening in your life. See if you notice patterns. Discuss them with your health care provider.

Try not to nap during the day. If you do, try to keep your naps under 30 minutes.

Use your bed only for sleep and intimacy. Choose someplace other than your bed to watch TV, eat, do paperwork, and talk on the telephone.

There is hope and help. 
If you have trouble sleeping, you are not alone. Don’t give up. You don’t have to just live with your sleep problem. See your doctor to discuss your sleep problem and what you can do. You can feel better and get the sleep you need.