1 / 24

Insomnia and poor sleep

Insomnia and poor sleep. Dr Phillippa Lawson Consultant sleep physician East Anglia. About me. Live in Saffron Walden Consultant in sleep, respiratory and general medicine at West Suffolk Hospital Founder of the good sleep programme Mother to two professors!. Outline. What is it?

quiana
Download Presentation

Insomnia and poor sleep

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Insomnia and poor sleep Dr Phillippa Lawson Consultant sleep physician East Anglia

  2. About me • Live in Saffron Walden • Consultant in sleep, respiratory and general medicine at West Suffolk Hospital • Founder of the good sleep programme • Mother to two professors!

  3. Outline • What is it? • Who does it affect? • How is it diagnosed? • What can be done?

  4. What is insomnia? • Difficulty falling asleep • Difficulty staying asleep • Early morning wakening • Non-refreshing or non-restorative sleep plus • Daytime symptoms • Prolonged

  5. Who does it affect? • Anyone! • Prevalence 10 – 48 % depending on study methods • UK study§ found incidence to be 15 %, prevalence 37% • More common in females (55 %) • Median age 50 years (18 – 98) • Persistence of insomnia associated with increasing age • Associated with mental health problems • Associated with physical health problems • Associated with other sleep disorders §Morphyet al SLEEP 30 (3) 2007

  6. What causes insomnia? • Precipitating factors • Acute stress • Illness (physical or mental) • Medications • Worry and rumination • Predisposing factors • Genetics • Hyperarousal • Depression • Tendency to worry and ruminate • Perpetuating factors • Dysfunctional attitudes about sleep • Staying awake in bed • Increased time in bed • Worry and rumination about insomnia

  7. How do we diagnose it? • Who? Self-diagnose GP Specialist in sleep medicine • How? ‘Sleep history’ Questionnaires Sleep diary Actigraphy Polysomnogram

  8. Sleep diary example

  9. How do we diagnose it? • Who? Self-diagnose GP Specialist in sleep medicine • How? ‘Sleep history’ Questionnaires Sleep diary Actigraphy Polysomnogram

  10. What can be done? Set your goals General wellbeing • Nutrition and fluid intake • Alcohol intake • Caffeine intake • Nicotine • Exercise • Sun light • Incorporating rest times • Positive attitude

  11. What can be done? Preparing the sleep environment • Temperature • Bed and bedding • Light • Calm, uncluttered environment • Clocks and technology! ‘Sleep hygiene’ • Regular bed/rise times • Avoiding napping • ‘Wind down’ routine

  12. What can be done? Stimulus control • Get out of bed when can’t sleep • Stop all sleep-incompatible activities • Strengthen the bed-sleep association Sleep restriction • Reduce time in bed to actual sleep time • Shorten time in bed • Improves sleep efficiency and strengthens bed-sleep association • Avoids disrupted and fragmented sleep

  13. Sleep efficiency Total sleep time (time from falling asleep to time you woke for final time minus estimated time spent awake during night) ÷ Total time in bed (time from lights out to time you finally got up) X 100

  14. Sleep diary example

  15. What can be done? Stimulus control • Get out of bed when can’t sleep • Stop all sleep-incompatible activities • Strengthen the bed-sleep association Sleep restriction • Reduce time in bed to actual sleep time • Improves sleep efficiency and strengthens bed-sleep association • Avoids disrupted and fragmented sleep

  16. What can be done? Relaxation • Progressive muscle relaxation/yoga/Alexander technique • Breathing exercises • Mindfulness • Imagery Cognitive techniques • Thought blocking • Listing the positives • Turning the tables • Trying to stay awake • Alternative thinking techniques • Carefree attitude towards sleep • Test the hypothesis • Consider cognitive behavioural therapy and related techniques

  17. Alternative thinking example

  18. A carefree attitude towards sleep!

  19. What can be done? Relaxation • Progressive muscle relaxation/yoga/Alexander technique • Breathing exercises • Mindfulness • Imagery Cognitive techniques • Thought blocking • Listing the positives • Turning the tables • Trying to stay awake • Alternative thinking techniques • Carefree attitude towards sleep • Test the hypothesis • Consider cognitive behavioural therapy and related techniques

  20. But what about medication? • Many on the market • Frequently employed • Intended as short term aid but often become long term crutch • Daytime side effects • Treating a symptom, not the cause • Perhaps more useful as an ad hoc adjunct, for acute problems

  21. Conclusion • Insomnia is not a life sentence • Seeking help is the first step towards moving forward • The ability to succeed comes from within but gaining support will increase your chances of doing so • Positive thinking is key • Believe!

  22. "If you think you'll lose, you're lost,For out in the world we findSuccess begins with a fellow's will;It's all in the state of mind.Life's battles don't always goTo the strongest or fastest man;But soon or late the man who winsIs the man who thinks he can."Walter D. Wintle

  23. thegoodsleepprogramme take charge, move forward, live life

More Related