Sleep is a process that takes up a third of our lives.
Sleep quality is determined by the number of awakenings that occur throughout the night. These awakenings are normally only remembered if they last longer than two minutes, so you may not always recall if you had a disturbed night’s sleep.
Some people will have unrealistic views of what is considered to be an appropriate amount of sleep.
Do we all need the same amount of sleep?
No, it depends on your age. For example, those aged 20-45 years usually require seven to eight hours of sleep a night, whereas those over 70 years require an average duration of just six hours a night – this can be further reduced by daytime napping.
What's important is whether you feel you get enough sleep, and whether your sleep is good quality.
If you have sleeping problems, you may:
find it difficult to fall asleep
lie awake for long periods at night
wake up several times during the night
wake up early in the morning and not be able to get back to sleep
not feel refreshed when you get up
find it hard to nap during the day, despite feeling tired
feel tired and irritable during the day and have difficulty concentrating
What causes sleep disturbances?
chemical - caffeine, alcohol or medicine
physical - sleep apnoea (temporary cessation of breathing, especially during sleep), asthma, tinnitus (ringing or buzzing in the ear), restless leg syndrome (a condition that causes an irresistible urge to move the legs especially in the evening or at night) , night-time urination, chronic pain.
mental – anxiety, depression, mania and dementia.
psychological – stress, tensions, excessive concern about sleeping, being ‘on call’
physiological – eating or exercising late at night, noise or shift work.
● take regular exercise, but more than 4 hours before sleeping
● have a routine for both waking and going
● keep the bedroom dark, quiet and
● associate the bed with sleep only – do not lie
in bed watching TV or listening to music
● ensure natural exposure to daylight (try to avoid black out curtains in the bedroom) to maintain the circadian rhythm.
● sleep or take naps throughout the day
● consume caffeine close to bedtime
● smoke before bed
● exercise late in the evening
● lie awake – if a person has not fallen asleep within 30 minutes of going to bed, then they should get up and do something else for a short time, e.g. walk around the house or read
● allow the bedroom to get too hot or cold
● conduct strenuous mental activity before bed, such as completing work or studying.
Low to moderate amounts of alcohol may aid sleep in some people; however it is not recommended, as when taken in excess it can disturb the quality of sleep.
Treatment for insomnia
Valerian – may improve sleep quality
Magnesium - appears to improve insomnia regarding, sleep efficiency, sleep time and sleep onset latency (length of time that it takes to accomplish the transition from full wakefulness to sleep , early morning awakening.
Melatonin (low dose of 1mg or less) - may help some people with certain sleep disorders, including jet lag, sleep problems related to shift work, and delayed sleep phase disorder (one in which people go to bed but can’t fall asleep until hours later), and insomnia. When you take a melatonin supplement is important because it may affect your biological clock.
Talk to your pharmacist or doctor for information on over the counter or prescription medications.
More to Consider
If you or a family member has trouble sleeping, ask your pharmacist or doctor for advice.
Regulations for dietary supplements are different and less strict than those for prescription or over-the-counter drugs.
Some dietary supplements may interact with medications or pose risks if you have medical problems or are going to have surgery.
To use dietary supplements, such as melatonin safely, read and follow label instructions, and recognise that “natural” does not always mean “safe.”
Always give your pharmacist or doctor a full picture of what you take to manage your health including supplements OTC and prescription medicines. This will help ensure safe and coordinated care.
Over the counter (OTC) medications for insomnia
Diphenhydramine (Nytol® has 50mg while Dreemon® has 25mg) are the fastest acting over the counter medicines available for insomnia. Dreemon® has half the dose of Nytol® so might possibly cause less of a 'hangover' effect compared to Nytol® the next morning. On the other hand, if one finds Dreemon® not effective a switch to Nytol® could do the trick. Both should be taken 20 minutes before bed and used temporarily for not more than 15 days.
Both cause drowsiness and one should not drive or operate machinery after taking them. Alcohol should be avoided.
If one uses this medicine for long periods of time they may become tolerant to its effects and it may become less effective at aiding sleep.
If you have continued trouble sleeping, you should consult your doctor for advice.
Michael DeBrincat is a community pharmacist in a pharmacy in Hamrun.
The information on this blog is provided for educational purposes only. It is not intended as medical advice. A Pharmacist or Doctor should be consulted if you have any concerns about your health.
Copyright Michael DeBrincat B.Pharm. (Hons.) (UOM) MSc. Community Pharmacy (QUB). All rights reserved.