Sleep and fatigue

21.07.2020
Gut health

We spend about a third of our lives sleeping, and the amount of sleep we need changes as we age. If you persistently miss out on getting a good night’s sleep, you’ll increase the risk of contracting chronic conditions like obesity, diabetes and heart disease. It’s not just about quantity either. Poor quality sleep, or regular interruptions to sleep, can have a detrimental effect on your health. And did you know that too much sleep is also bad for you?

How much sleep do we need?

We’re all different when it comes to sleep. Some politicians famously sleep for just four or five hours a night, but this is what the National Sleep Foundation recommends:

  • Newborns 14-17 hours
  • Infants 12-15 hours
  • Toddlers 11-14 hours
  • Pre-schoolers 10-13 hours
  • School age children 9-11 hours
  • Teenagers 8-10 hours
  • Young adults 7-9 hours
  • Older adults 7-8 hours

Are we getting enough?

The short answer seems to be no.

It’s estimated that one in three adults don’t get enough sleep and more than a third of children may have sleep problems. The latest report from Australia’s Sleep Health Foundation suggests the problem is even more widespread.

That means millions of us aren’t getting a good night’s sleep. And according to Sleep Health Foundation, getting enough shut eye is as important as good diet and exercise.

Children who don’t get enough sleep can face delayed physical and mental growth and are more prone to infections and health complications such as obesity.

Adults who are deprived of sleep increase their risk of illness, accidents and injury. Even just missing out on the recommended amount of sleep for a few nights can cause microsleeps. These typically last just a few seconds and they can be a major factor in car accidents.

Can you sleep too much?

Yes, you can have too much of a good thing!

Ironically, too much sleep can make you feel tired. If you sleep more than 10-12 hours o a night, or if you regularly oversleep at the weekend, you might have what’s called hypersomnia. One of the symptoms of hypersomnia is excessive tiredness during the day.

Too much sleep can lead to anxiety, low energy levels and problems with your memory.

It’s worth getting a medical check-up because, although rare, some of the underlying causes of hypersomnia include, kidney failure, low thyroid function, heart disease and chronic fatigue syndrome.  

What happens when you’re deprived of sleep?

Quite apart from the obvious risks of accidents and injuries, if you suffer long-term sleep deprivation you’re more likely to:

  • Catch a cold
  • Gain weight
  • Feel anxious or depressed
  • Develop diabetes
  • Have high blood pressure
  • Suffer a heart attack
  • Develop Alzheimer’s

Fatigue

Fatigue is not just another word for tiredness. Fatigue is a pervasive feeling of lethargy and lack of energy, although feeling sleepy can be one of the symptoms. Fatigue has physical and mental implications in the workplace and is officially recognized as a workplace health and safety issue.

Signs of fatigue include:

  • Worsening hand-eye coordination
  • Greater difficulty with communication
  • More risk-taking behaviour
  • Feeling sleepy
  • Short term memory problems
  • Blurred vision
  • Feeling tired even after sleep
  • Sore muscles
  • Loss of appetite
  • Irritability
  • Slow reflexes

Every year, around 1.5 million Australians visit their GP complaining of fatigue.

What causes fatigue?

Fatigue can be caused by many things. Work, lifestyle, physical health and emotional issues can all play a part, and sometimes it’s a combination of factors.

It’s worth remembering that depression, anxiety, stress and grief can all lead to fatigue. Studies have shown that over 50 percent of cases of fatigue have an underlying psychological cause.

How can I tell if I’m fatigued or just tired?

If you’re getting enough sleep, you exercise regularly and you enjoy a varied diet but you’re still experiencing symptoms of fatigue, it’s time to see your doctor. Fatigue accompanied by weight loss, pain, loss of appetite or heavier than normal periods can all be signs you should consult a health professional.

Shift workers and people who travel extensively are at higher risk, and so are people who undergo prolonged periods of intense physical or mental activity.

Don’t drive tired

Driver fatigue is a killer. You’re six times more likely than any other driver to die in a crash if you’re fatigued. Being awake for 17 hours straight has a similar effect on performance as a blood alcohol level of 0.05%. In 2015, more people died of fatigue-related crashes than alcohol-related crashes.

The NSW government has a handy tool called Test your Tired Self to check how tired you are. You might be surprised at the result.

Chronic fatigue syndrome

What is it?

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyetitis (ME), is an illness characterised by long-term feelings of profound fatigue, which don’t improve with rest and which can’t be explained by any other medical condition.

CFS/ME can be difficult to diagnose because there are no specific tests for it.

It’s thought around 240,000 Australians suffer from chronic fatigue syndrome.

What are the symptoms?

The main symptom of CFS/ME is overwhelming fatigue without any obvious cause. The level of fatigue can vary from mild to intense.

Other symptoms can include.

  • Muscle or joint pain
  • Frequent headaches
  • Loss of memory
  • Trouble concentrating
  • Swollen lymph nodes and/or sore throat

How is it diagnosed?

Doctors are unlikely to diagnose CFS or ME until other possible causes, such as multiple sclerosis, fibromyalgia or Lyme disease have been ruled out. Chronic fatigue syndrome can be diagnosed once symptoms have been present for at least six months.

How is it treated?

There is no simple cure, so if you’re suffering from CFS, or you know anyone who is, treat with caution any ‘remedy’ or ‘cure’.

The aim of treatment is to manage symptoms to allow people to live as normal a life as possible.

Common sleep disorders

Obstructive sleep apnea

Obstructive sleep apnea (OSA) can make you wake up many times a night, without even realising. OSA is caused by partial or complete obstructions of the throat that reduce breathing or stop it completely. Your body then interrupts your sleep so you can start breathing again. In some cases, this can happen hundreds of times a night.

Snoring, obesity and sleepiness during the day could all signal possible issues with sleep apnoea, and partners are often more aware of the issue than sufferers. Some estimates suggest up to 25% of men in Australia suffer from sleep apnoea.

It’s important to seek treatment. With OSA, you’re at increased risk of high blood pressure, stroke, diabetes, heart attack and depression. You are also two and a half times more likely to have a car accident. 

Restless leg syndrome

Up to five percent of men and women experience restless leg syndrome (RLS) which is characterised by an irresistible urge to move your legs. RLS tends to be worse in the evenings and can often interrupt sleep. Massage, hot baths and alternating heat and ice packs can help, so can reducing caffeine and alcohol and quitting smoking.

Medication can help, so it’s worth seeking treatment for serious cases.

Tip: RLS can be caused by iron deficiency. A simple blood test can tell if you’re anaemic.

Insomnia

If you regularly find it hard to fall asleep, or stay asleep, you have insomnia. It can be caused by chronic pain, stimulants such as medicines or drugs, as well as stress, depression or anxiety. Around one in three people sometimes experience mild insomnia.

Sleeping tablets only work in the short term. Practicing good sleep habits is a better long-term strategy.

If you suffer from insomnia caused by depression or anxiety, the CBHS Better Living program might be able to help. You’ll need to hold an appropriate level of CBHS Hospital cover or packaged to participate, so contact our Wellness team on 1300 174 534 or wellness@cbhs.com.au.

We can help you check if you’re eligible.

Snoring

Snoring affects 40% of men and 24% of women. And let’s not forget their long-suffering partners. Snoring also gets worse with age, although men become less likely to snore after 70.

Excess fat around your neck can make your throat narrow, which means it vibrates more easily. You also snore more when you sleep on your back or breathe through your mouth. Allergies can sometimes be a culprit, and alcohol relaxes your muscles which also makes snoring more likely.

Over 10% of snorers have sleep apnoea, which is linked to serious health complications, so if that’s the case it’s important you seek treatment.

To fix snoring, try sleeping on your side, shed any excess kilos and avoid alcohol for at least four hours before bed.

Tip: Children who snore might have enlarged tonsils. Removing the tonsils can help.

Other common sleep disorders sleep include narcolepsy, bruxism, hypoventilation, sleep walking and rapid eye movement disorder. 

Good sleep habits

The key to getting a good night’s sleep starts long before your head hits the pillow.

Sunlight

Melatonin is a natural hormone that helps induce sleep. Levels fall after dawn and climb after dark. Sunlight can affect production of melatonin, so exposure to light at the right time will help keep your sleep patterns on track. Draw the curtains in the morning to let in light and keep them closed at night.

Exercise

Aerobic exercise can help you fall asleep faster, spend more time in deep sleep and wake less often in the night, but avoid vigorous exercise in the two hours before bed. The ideal time to exercise for good sleep is in the morning.

Routine

Establish set times for going to bed and getting up in the morning. Your body’s internal clock works best when it has a regular routine.

Relax

Relax and avoid mental strain in the hour before bed. Ideas for relaxing include taking a warm bath, reading a book, listening to quiet music and meditating. Mindfulness can help you get to sleep quicker and get better quality sleep. Check out this ABC series of meditations designed to help you fall asleep.

Switch off

Turn off screens at least an hour or two before bed. The blue light of a computer screen can reduce your body’s levels of melatonin, the hormone that helps promote sleep. Anything over 1.5 hours of screen time will affect your body’s production of melatonin.

Eat

A full stomach can make you lie awake but so can an empty one. Try to finish your evening meal at least two hours before bedtime and don’t go to bed hungry.

Avoid

Avoid tea, coffee, caffeinated soft drinks and cigarettes in the two hours before bed. Alcohol might help you fall asleep, but your sleep is more likely to be disturbed. The soporific effects wear off after a few hours.

Quit

People who successfully stop smoking fall asleep more quickly and wake less often than smokers. Get help to quit with CBHS.

Comfort

Make your bed comfortable and your bedroom a sanctuary. Remove distractions like televisions, phones and devices. Most people sleep best in a cool room at around 18 degrees.

De-stress

Don’t fret if you can’t fall asleep. The aim is to equate bed with sleep, not insomnia. If you’re not asleep after 20 minutes, get up and sit quietly in a dark room. Resist the temptation to do anything (especially computer-related) then, when you start to feel sleepy, go back to bed.

Calm

If you can’t shut off your chattering mind, turn your thoughts to something calmer. Picture yourself lying on a patch of grass under a tree, or in a favourite holiday destination. Or try practicing mindfulness.

Did you know?  Adults spend less time in deep sleep than children, so they’re more likely to be woken by noises at night.

Sleep during pregnancy and menopause

Pregnancy

Many women have trouble sleeping when pregnant, especially in the last two or three months. 

Follow good sleep habits and try these tips:

  • Use pillows to support your abdomen
  • Try to sleep on your side to lessen discomfort
  • Raised pillows under your head may help manage indigestion
  • Avoid drinking too much before bed
  • Make a trip to the toilet just before bed
  • Avoid spicy or acidic foods that contribute to heartburn

If you’re pregnant and start snoring loudly, or stop breathing during sleep, see your doctor. You may have other medical problems that could affect your health and the health of your baby.

Menopause

Many women find it harder to sleep during menopause. The changing levels of hormones that cause hot flushes also tend to wake women at night.

Choose cotton nightwear, sleep in a cool room, avoid heavy bedclothes and follow recommended good sleep habits. There is some evidence that hormone therapy may have a beneficial effect on sleep.

The good news is that sleep generally improves after the menopause.

 

All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.

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