Sleep & Snoring - by Dr David Delvin

Sleep, as Shakespeare remarked, is the ‘chief nourisher in life’s feast’.

In other words, we need it, and we need it badly! If you don’t sleep well, then life soon starts to go wrong. You begin to feel tired, out of sorts, even grumpy. Your co-ordination becomes impaired, and your work and your hobbies may suffer. Even more importantly, your relationships with your loved ones may start running into trouble.

So in this article, I'm going to discuss some of the problems associated with sleep – including the major problem of snoring! Here goes.

Why do we need Sleep?

I wish I could give you an easy answer to that question.

Although a lot of research has been done in recent years, no scientist has yet come up with a really clear explanation of why human beings (and animals) do need this nightly period of unconsciousness.

But what is clear is the fact that during those hours of ‘kip’, the brain is re-charging itself. If you give it enough time sleeping, it will awake refreshed, with all electrical connections in good working order.

However, if you don’t let your brain have a good nightly slumber, the result will be that all sorts of odd bits of electrical activity will arise inside it. It's synapses (nervous connections) won’t ‘fire off’ properly. Special x-rays can now show that whole areas of it aren’t reacting as they should. So no wonder you feel below par!

How much sleep do we need?

There’s no doubt that as you get older, you do need less sleep.

For instance, while a newborn baby may sleep most of the day (with luck!), an 18 year old may well only need 10 hours. In the middle years of life, the average requirement is just eight hours. And most people who are in their 60s will only need about seven hours on average.

Very elderly folk can often get by on about six hours sleep each night. But if one tries to cut it down to much less than that, it could mean trouble.

Seriously bad sleep deprivation – like going for 36 to 48 hours without a snooze, tends to addle the brain very badly. People become confused, and may even hallucinate!

That is why torturers, all over the world, have used ‘sleep deprivation’ as a tool. For they know that lack of proper sleep will ‘screw up’ a man’s mind, and weaken his will.

Scientists say that the record period for going without sleep is about 260 hours –which is about 11 days. There are people who claim that they ‘never, ever sleep at all’. But when you get them into hospital and observe them, you usually find that they take little ‘cat naps’ that they’re not aware of.

What happens during sleep?

Sleep isn’t just a continuous, unchanging thing. While you're slumbering, you go through periods of great stillness and periods of considerable activity.

Indeed, in an average night, most people go through about five ‘sleep cycles’.

Each cycle lasts about 1.5 to two hours. And during a cycle, you will have a spell of deep sleep, followed by a spell of moving around and dreaming.

Dreaming

Yes, we all dream, as tests in ‘sleep laboratories’ have demonstrated. But many people don’t remember that they’ve been dreaming.

This is partly because of the fact that most dreams have an extraordinarily ‘forgettable’ quality. You’ve probably noticed that when you wake up, a dream may be really vivid. Yet by mid-morning, its often hard to remember what it was all about. Indeed, sleep researchers have found that if they want to analyse their dreams, they have to write them down as soon as they wake up. Otherwise the memory has soon vanished….

The significance of dreams is a matter of great debate. But most doctors still agree with Freud that tensions and stresses do need to ‘come out’ in dreaming – and that incidents in dreams very often represent things that we’re worried about.

For instance, I recently saw a patient who kept dreaming that she was hopelessly tied up in ropes and cords. I came to what I reckon was the reasonable conclusion, that she was deeply worried about the fact that she was trapped in a miserable marriage (to a pretty awful bloke!) and she couldn’t see a way out of it. When she eventually divorced him, the dreams stopped.

Nightmares

What about nightmares?

Most of us get these from time to time – particularly at periods of great stress, such as the illness of a loved one, or after a bereavement.

But if you keep on and on getting nightmarish dreams, then it’s worth talking to your doctor about them. Possible causes include:

  • Alcohol
  • A few medically prescribed drugs
  • Some illegal drugs
  • Depression
  • Anxiety states
  • Stress

If your doctor doesn’t find any medical reason for your bad dreams, it would certainly be worth considering the idea of consulting a trained counsellor, who could try and help you find out why terrifying things happen in your sleeping mind.

Those who have plenty of time and money will sometimes consult a Freudian or a Jungian analyst, who will try to help interpret bad dreams in their own particular style.

What is REM Sleep?

Whenever you read anything about sleeping problems in the newspapers, you’ll find that they mention something called ‘REM sleep’. What is this?

Well, the letters ‘R E M’ stand for 'Rapid Eye Movement’. You see, towards the end of each of the ‘sleep cycles’, which we mentioned above, you go through a period of about half an hour during which your eyes move rapidly from the left to the right and back again.

How on earth do scientists know this? Simply because they’ve attached small electrodes to people’s eyelids – in order to observe their eye movements during slumber.

Research suggests that we all need these spells of ‘REM sleep’. When scientists have deliberately deprived people of REM sleep, by waking them up as soon as their eyes start moving, then they rapidly become tired and grumpy and even ill.

During the periods of REM sleep, dreams happen. Also, men, even quite elderly men, get erections.

Insomnia

By far the biggest ‘sleep problem’ in Britain is insomnia.

Yes, lots of us have great difficulty in sleeping at some period of our lives. That’s why sleeping pills used to be so widely prescribed in the UK. (They aren’t widely used now, because the risks of taking them are now much better understood).

Why do people suffer from insomnia? I can't emphasise strongly enough that again and again, when a person can’t sleep, it is usually because he or she is depressed. This is particularly likely to be the diagnosis if you keep on waking up in the early morning (say, at two or three a.m.) and can’t ‘get off’ again.

Anyway, here’s a list of the main causes of insomnia:

  • Depression
  • Worry
  • Job stress
  • Marital stress
  • Pain
  • Excessive use of caffeine (e.g., coffee, tea or cola).

You’ll immediately see that physical illnesses are not a common cause of insomnia.

What to do if you have Insomnia

If you keep being troubled by insomnia, you should most certainly go to your doctor and talk over the problem with her.

Please do not expect her to reach for her prescription pad and give you a supply of sleeping pills. She wouldn’t be much of a doctor if she did that!

Obviously, she will try and help you sort out the cause of the problem. She may well suggest commonsense measures for getting a good night’s sleep – without the use of drugs.

These include:

  • Having a warm, milky drink when you go to bed:
  • Trying to clear your mind of all worries when you lie down;
  • Using one of the mild and safe low-dose or herbal or homeopathic remedies which are available from all chemists these days;
  • Listening to one of the many excellent ‘sleep-inducing’ tapes which you can buy.

Of course, there are lots of simple tricks which people have long used to get themselves off to sleep. They include:

  • Counting sheep;
  • Saying repetitive rhymes (particularly familiar nursery rhymes);
  • Listening to soft, soothing music;
  • Having sex (do not laugh, this works very well!).

Snoring

People tend to regard snoring as a bit of a joke. But for some folk, it certainly isn’t. This is because:

  • It can keep your partner from getting a decent night’s rest;
  • It can keep you from getting a good night’s rest;
  • Severe snoring is sometimes associated with breathing difficulties during sleep. This is particularly likely in large, older men who may actually become seriously deprived of oxygen at night, especially if they also have the condition called ‘sleep apnoea’, in which breathing stops altogether for a while.

Simple ways of dealing with mild snoring include:

  • Getting your partner to roll you over as soon as she/he hears you starting to snore;
  • Having a golf ball stitched into the back of your pyjama jacket – the idea of this is that it stops you from lying on your back!
  • Having any nasal catarrh treated;
  • Blowing your nose and using a nasal inhaler just before going to sleep;
  • Losing weight – snoring is more common in the overweight.

But if snoring is more serious and is giving you (or your partner) real trouble, then please do go and see your doc.

She can check out your nasal passages, and perhaps refer you to an Ear, Nose and Throat Specialist. She may also be able to send you to a ‘Sleep Laboratory’ for assessment.

This is essential if you are getting the episodes of ‘sleep apnoea’ (non-breathing), which I’ve mentioned above.

If things are as serious as this, you may possibly be advised to have an operation on your nasal passages, or to remove part of the very back of your palate. However, I must emphasise that these ‘ops’ are not guaranteed to cure the problem.

Also, Sleep Laboratories can now prescribe special devices, which help stop snoring and prevent sleep apnoea. They include Continuous Positive Pressure Airways (CPPAs), which fit over the nose at night and blow air gently through it. There are also devices which alter the position of the jaw and tongue, so as to make noisy snoring less likely.

Sleep tight!

Q. Is it possible for people to have totally different sleeping patterns? I have recently met a very nice lady, who is the same age as me (60), and we are thinking of getting married.

Only trouble is, she is a person who always sleeps from 9pm to 6am. I, on the other hand, have always gone to bed at midnight, or one a.m. Neither of us thinks we can change.

A. Well, you certainly couldn’t change your habits with medicine, sir. Yes, different people do have very differing ‘time clocks’. And my experience has been that couples whose sleep patterns are wildly contrasting tend to have trouble in ‘getting on’ together, so do think carefully before you take the trip up the aisle.


Q. My mother – aged 71 – has recently been taking barbiturate sleeping pills. Since she started them, she has been getting awful nightmares, and also seeing non-existent people walking round the house! Could it be the pills?

A. Very definitely. Barbiturate sleeping tablets are notorious for causing dreadful nightmares, and even hallucinations, in elderly folk. Really, no one should be on these pills nowadays. So ask your Mum’s doctor for a change in medication.


Q. I wake up exhausted after eight hours’ sleep. What’s going on?

A. To wake up shattered after what should have been a good night’s sleep suggests that you may have some physical problem. Please see your GP for a check-up and maybe some blood tests.


Q. When I have been asleep for a few hours, I get the most awful tingling in my hands, and it wakes me up.

A. This is a very common symptom. It strongly suggests that something is pressing on the nerves that lead to your hands. For instance, you may have the well-known ‘carpel tunnel syndrome’.

Please see your GP, he’ll be able to help sort out this distressing sleep disturbance.

© Dr D Delvin / Retirement Matters Ltd 2007