1. Low sleep drive
Sleep drive is a biological term for how much our body needs sleep at a particular point in time. When sleep drive is high we feel sleepy and when it is low we don't. Typically, the longer a person has been awake, the higher their biological drive for sleep will be. For restful nighttime sleep, the sleep drive needs to be high.
This might sound strange but people with long term Insomnia may have a low sleep drive and this is a factor maintaining the poor sleep. It is possible to feel fatigued but not sleepy and this is often the case in Insomnia ("I'm tired but I can't sleep"). Napping, spending extra time in bed to make up for poor sleep, and low daytime activity levels can all lead to reduced sleep drive. Working to increase the sleep drive is something we address in treatment for Insomnia.
2. Body clock problems
The body has an internal clock which is managed deep in the brain (the suprachiasmatic nucleus). The body clock regulates the release of hormones such as melatonin and causes ebbs and flows in energy levels and sleepiness during the day. The operation of the body clock means that people often feel more alert mid-morning and sleepy after lunch. Sleep difficulties related to the body clock have been linked to the abnormal timing of melatonin production. Melatonin, also known as the ‘sleep’ hormone, helps the body to fall and stay asleep. If melatonin is released too late, this can mean difficulty getting to sleep, if melatonin is released too early, this can mean falling asleep early but then waking at 3 or 4am. careful and regular timing of exposure to bright light such as sunlight can be very helpful in managing body clock related sleep. problems.
Arousal can be physical (tense muscles, racing heart, butterflies in the stomach), emotional (feeling anxious, fed up, sad, frustrated), and/or mental (busy mind, worrying, planning). Each of these can get in the way of restful slumber. Being able to recognise and manage increased arousal levels is an important part of learning to sleep well again. Arousal may be increased by many things such as increased stress levels, worry about sleep, anxiety problems, an overloaded schedule, caffeinated or sugary drinks, stimulant medications or illicit drugs, foods with high sugar contents, and cigarettes during the day and before bed.
Following from these barriers to good sleep, are some important tips for good sleep:
- have a regular rising time in the morning
- have a pre-bed routine that helps you to wind down
- minimise daytime naps
- daily exercise and exposure to sunlight
- avoid caffeine in the later afternoon and evening
If you would like to hear more about sleep and how to improve it, come to our FREE public lecture on SATURDAY NOVEMBER 19th at 1.30pm. Hollywood Hospital, Nedlands.