Are you sleeping well? Cause and prevention of sleep problems

10. April 2019

If you answer this question with a slightly exasperated NO… Then you are not alone! One in five Germans suffers from sleep disorders, problems falling asleep and staying asleep, nightmares, tossing and turning at night, circles of thoughts, dark circles under the eyes and a crumpled face the next morning – every day, or rather every night, the groundhog says hello.

Psychological stress and sleep problems

Sleep problems are common and can be a disease in their own right, without the presence of other medical conditions (Riemann et al., 2015). According to a report by the Robert Koch Institute, approximately 25% of adults suffer from sleep disorders. Across the lifespan, the numbers vary from 12-35%. The triggers for sleep problems can be varied. A careful examination by a family doctor can clarify and determine physical causes, such as thyroid or kidney diseases. If there are no physical diseases, it may also be that the reasons for the sleep problems lie in the psyche. In the case of mental illnesses, sleep problems can occur as a frequent accompanying phenomenon.

In the case of depression, sleep problems in the sense of increased or decreased sleep even belong to the diagnostic criteria (cf. ICD-10). It corresponds to the common cliché about depression that those affected lie in bed all day, sleep and can’t get up to do anything.

Sleep problem is not equal to sleep problem

From the outside, this is certainly true in some cases, but the connection between sleep patterns and depression is multifaceted. It is almost certainly not a case of restful and relaxed sleep for sufferers who have an increased need for sleep! Sleep is rather an escape from the harsh reality of this serious illness. Preoccupation with underlying problems is avoided and a leaden fatigue prevents health-promoting activities such as sports and fitness.

Some, however, cannot sleep at all, such as those suffering from depression, among others, because the mind is constantly brooding and gets caught in endless loops. Falling asleep is then unthinkable and sufferers toil for hours through the night. Another stressful sleep phenomenon in depression or mental exhaustion is waking up early.

Typical characteristics of early waking are:

  • Already being awake before the alarm rings
  • Turning around
  • Having dread about the coming day

Sleep as an important resource and warning sign

Outsiders might now advise getting up and out of bed to start the day. If it weren’t for the nasty morning slump that ties sufferers to bed with low mood, hopelessness and listlessness. In other mental illnesses such as bipolar disorder or schizophrenia, sleep disturbances can indicate that a manic or delusional episode is approaching. Sometimes sleep disorders are also a trigger for addictive disorders such as drug or alcohol dependence.

In general, one should pay attention to sleep behavior and sleep quality in cases of psychological stress. Not only to have enough resources for recovery, but also as a warning sign if there is a worsening of symptoms. Now and then, in the treatment of mental illness, sleep modification is used as a method of therapy. It sounds paradoxical, but intentional sleep deprivation in the second half of the night has been shown to improve mood the following day and promotes sleep quality on subsequent nights. This online article provides more background on this.

Sleep hygiene: tips to prevent sleep problems

Hygiene in this case has nothing to do with being germ-free, but with habits and measures that ensure healthy sleep and prevent sleep problems. The following sleep hygiene tips can help make your bed an oasis of calm again.

What is good for you is allowed

First, it is important to find a regular sleep-wake rhythm. During the day, the bed should be avoided so that the head really only links the bed with sleeping. A varied day with fresh air and exercise helps to find rest in the evening. This is because daylight ensures that the production of the sleep hormone melatonin is stopped. In the evening, production is automatically stimulated again by darkness. Soothing evening rituals prepare you for the night:

  • Browsing through a novel
  • Listening to an audio book
  • Drinking a cup of sleep-inducing herbal tea
  • Relaxing exercises

All of these can help us fall asleep. So there are a variety of options for a more restful sleep, but their effectiveness is different for everyone. Therefore, there is no limit to creativity. The only important thing is not to lose sight of the essentials, so that the soothing evening ritual does not become a real power program.

Finger off!

Be careful with artificial lighting from cell phones & co: The blue light emitted by the devices can severely disturb sleep. Some devices can be set to night mode, in which the light is less disturbing. Late and too rich meals can also deprive us of sleep, as the body is then overwhelmed with digestion. We should also be careful with alcohol and nicotine, as both substances have a stimulating effect on our system and can increase sleep problems. It is fundamental to ensure that the conditions in the bedroom are right: a pleasant temperature, silence and darkness are conducive to this. Earplugs and sleep mask are useful aids if the conditions are not quite right.

With frequent nightly waking up one should avoid above all the look on the clock, in order not to set itself further under pressure. Bright lights should also be turned off. Due to the high risk of addiction, sleeping pills may only be taken in consultation with the attending physician. Some antidepressants also have a sleep-inducing effect and can be used in the treatment of sleep disorders. However, here too there is an urgent need for medical supervision. An overview of various measures for sleep disorders can be found in the book by Müller & Paterok on sleep training.

Fresh into the new day

Part of the quality of sleep, of course, is getting up in the morning. This is not easy for most people, but in the case of mental illness, the jokingly titled bed pull is often extreme. Not even necessarily because the bed is so comfortable, but because there is often a lack of drive to start a new day. Sleep problems at night often affect the complete course of the next day.

Only how can you outsmart the morning low?

The prospect of a delicious and healthy breakfast or appointments for pleasant activities can help. In addition, the thought that a structured daily routine helps to overcome the mental illness can be motivating. Then, as the mental illness subsides, sleep problems often normalize as well. As already indicated, however, sleep problems can be a sign of a recurrence of the symptoms or too much stress and should therefore be taken seriously.

In conclusion, we humans sleep through almost half of our lives, and for good reason. Body and mind need the nightly rest to recover and gather strength. Hopefully, with our tips and tricks, we can help you get some sleep so that the new day can be tackled full of energy. With this in mind: Sleep well!

References

(1) Dilling, H., & Freyberger, H. J. (2012). Pocket guide to the ICD-10 classification of mental disorders. Bern (Huber)

(2) Penzel, T., Peter, J. H., Peter, H., Becker, H. F., Fietze, I., Fischer, J., … & Schäfer, T. (2005). Topic 27″ Sleep disorders”

(3) Riemann, D., Morin, C. M., & Reynolds, C. F. (2015). The sleep disorders chapter in DSM-V-an interim report. Journal of psychiatry, psychology, and psychotherapy.

Friederike Reuver
Autor:in Friederike Reuver
"Die LIMES Schlosskliniken haben sich auf die Behandlung von psychischen und psychosomatischen Erkrankungen spezialisiert. Mit Hilfe des Blogs möchten wir als Klinikgruppe die verschiedenen psychischen Erkrankungen näher beleuchten und verschiedene Therapien sowie aktuelle Themen vorstellen."

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