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Better sleep is a protective factor against dementia

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia is a progressive loss of cognitive abilities, such as memory, that is significant enough to have an impact on a person’s daily activities. It can be caused by a number of different diseases, including <a href="https://alzheimer.ca/en/about-dementia/what-alzheimers-disease">Alzheimer’s</a>, which is the most common form. Dementia is caused by a loss of neurons over a long period of time. Since, by the time symptoms appear, many changes in the brain have already occurred, many scientists are focusing on studying the risk and protective factors for dementia. A risk factor, or conversely, a protective factor, is a condition or behaviour that increases or reduces the risk of developing a disease, but does not guarantee either outcome. Some risk factors for Alzheimer’s disease and dementia, such as age or genetics, are not modifiable, but there are several other factors we can influence, <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">specifically lifestyle habits and their impact on our overall health</a>. These risk factors include depression, lack of physical activity, social isolation, high blood pressure, obesity, diabetes, excessive alcohol consumption and smoking, as well as poor sleep. We have been focusing our research on the question of sleep for over 10 years, particularly in the context of the <a href="https://www.nhlbi.nih.gov/science/framingham-heart-study-fhs">Framingham Heart Study</a>. In this large community-based cohort study, ongoing since the 1940s, the health of surviving participants has been monitored to the present day. As researchers in sleep medicine and epidemiology, we have expertise in researching the role of sleep and sleep disorders in cognitive and psychiatric brain aging. As part of our research, we monitored and analyzed the sleep of people aged 60 and over to see who did — or did not — develop dementia. <h2>Sleep as a risk or protective factor against dementia</h2> Sleep appears to play an essential role in a number of brain functions, such as memory. Good quality sleep <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2793873">could therefore play a vital role in preventing dementia</a>. Sleep is important for maintaining <a href="https://www.science.org/doi/10.1126/science.1241224">good connections in the brain</a>. Recently, research has revealed that sleep seems to have a function similar to that of a garbage truck for the brain: <a href="https://doi.org/10.1016/j.mad.2023.111899">deep sleep could be crucial for eliminating metabolic waste from the brain</a>, including clearing certain proteins, such as those known to accumulate in the brains of people with Alzheimer’s disease. However, the links between deep sleep and dementia still have to be clarified. <h2>What is deep sleep?</h2> During a night’s sleep, we go through several <a href="http://ceams-carsm.ca/en/a-propos-du-sommeil/">sleep stages</a> that succeed one another and are repeated. NREM sleep (non-rapid eye movement sleep) is divided into light NREM sleep (NREM1 stage), NREM sleep (NREM2 stage) and deep NREM sleep, also called slow-wave sleep (NREM3 stage). The latter is associated with several restorative functions. Next, REM sleep (rapid eye movement sleep) is the stage generally associated with the most vivid dreams. An adult generally spends around 15 to 20 per cent of each night in deep sleep, if we add up all the periods of NREM3 sleep. Several sleep changes are common in adults, such as going to bed and waking up earlier, sleeping for shorter periods of time and less deeply, and waking up more frequently during the night. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=279&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=279&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=279&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=350&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=350&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579041/original/file-20240229-16-efo9mx.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=350&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Sleep stages, and the role of deep sleep for brain health. (Andrée-Ann Baril)</figcaption></figure> <h2>Loss of deep sleep linked to dementia</h2> Participants in the <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2810957">Framingham Heart Study</a> were assessed using a sleep recording — known as polysomnography — on two occasions, approximately five years apart, in 1995-1998 and again in 2001-2003. Many people showed a reduction in their deep slow-wave sleep over the years, as is to be expected with aging. Conversely, the amount of deep sleep in some people remained stable or even increased. Our team of researchers from the Framingham Heart Study followed 346 participants aged 60 and over for a further 17 years to observe who developed dementia and who did not. Progressive loss of deep sleep over time was associated with an increased risk of dementia, whatever the cause, and particularly Alzheimer’s type dementia. These results were independent of many other risk factors for dementia. Although our results do not prove that loss of deep sleep causes dementia, they do suggest that it could be a risk factor in the elderly. Other aspects of sleep may also be important, such as its duration and quality. <h2>Strategies to improve deep sleep</h2> Knowing the impact of a lack of deep sleep on cognitive health, what strategies can be used to improve it? First and foremost, if you’re experiencing sleep problems, it’s worth talking to your doctor. Many sleep disorders are underdiagnosed and treatable, particularly through behavioural (i.e. non-medicinal) approaches. Adopting good sleep habits can help, such as going to bed and getting up at consistent times or avoiding bright or blue light in bed, like that of screens. You can also avoid caffeine, limit your alcohol intake, maintain a healthy weight, be physically active during the day, and sleep in a comfortable, dark and quiet environment. The role of deep sleep in preventing dementia remains to be explored and studied. Encouraging sleep with good lifestyle habits could have the potential to help us age in a healthier way.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222854/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andree-ann-baril-1494268">Andrée-Ann Baril</a>, Professeure-chercheure adjointe au Département de médecine, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> and <a href="https://theconversation.com/profiles/matthew-pase-1494296">Matthew Pase</a>, Associate Professor of Neurology and Epidemiology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/better-sleep-is-a-protective-factor-against-dementia-222854">original article</a>. </div>

Mind

Could not getting enough sleep increase your risk of type 2 diabetes?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes. So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex. <h2>The study</h2> Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade. The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk. As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets. Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category. The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours. One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less. Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations. <h2>Why might short sleep increase diabetes risk?</h2> In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body. We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes. Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>. This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses. These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours. While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes. Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase. The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>. <h2>Good sleep, healthy diet</h2> Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes. Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle. While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health. The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk. In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>. </div>

Body

The unique travel hack that is guaranteed to help beat jet lag

Experts have revealed how to beat jet lag on your next overseas holiday, and it all comes down to your modes of transport. Sleep researchers said it's good news for cruise lovers, as exposure to sea air and bright natural light improves sleep to cure the annoying condition quickly. Some experts say to avoid travelling by plane all together, and always opt for cruising holidays instead. However, if you have to travel to your cruise by plane, being on board is a great way to tackle the dreadful feeling, compared with holidaying on land, Panache Cruises said. Dr Lindsay Browning, expert at Trouble Sleeping said exposing yourself to bright lights at the right time after a long-haul flight is one of the most powerful things we can do to boost and help shift circadian rhythm, and being on a ship is the perfect place for that. "As a general rule, you want to get lots of bright light exposure during the daytime and avoid light at night," Browning said. "When travelling on a cruise ship, you will naturally get a lot of bright light exposure during the day, helping your circadian rhythm.” "Further, when travelling by ship you will have a cabin with a proper bed and curtain, enabling you to sleep at night when you want to." The company claimed research showed how prolonged exposure to sea air can improve blood oxygen levels, boost vitamin D, and improve breathing leading to higher-quality sleep, helping to rid travellers of pesky jet lag so they can enjoy their holidays. Image credits: Getty Images

Travel Tips

How to fall asleep without sleeping pills: 7 natural sleep aids that actually work

It’s 3am and you’re suddenly wide awake. Try these seven science-backed strategies to fall back to sleep fast. Give meditation a try As a mindfulness coach, I’m very aware of the day-to-day anxieties and worries that can interfere with a good night’s sleep. One of the most effective natural sleep aids is a quick meditation session to ease yourself out of those stresses. If you’ve never meditated before, you’ll likely find the meditation interrupted by thoughts flashing through your mind. It’s important for you to know that this isn’t a failure on your part, and that you aren’t doing anything wrong. Thinking is just what the brain does, as naturally as lungs take in air. The point is to be non-judgmental yet aware of your thoughts, bodily experiences and breath, moment by moment. Sleep better, feel better! <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/rollers-resistance/27-72435-gaiam-strengthen-stretch-kit?affiliate=GAIAM6O" target="_blank" rel="noopener">This Blackout Sleep Mask from Gaiam</a> will help you feel well rested and renewed. Stop wanting to fall asleep It’s counterintuitive, isn’t it? Sometimes trying too hard to do something is the very thing that prevents us from achieving it – and that’s never more true than when it comes to falling asleep. Desperately wanting to sleep will only stoke anxieties that will further stress your brain, essentially feeding it the message that it’s not safe to sleep. Throw in those worries about your to-do list at work the following day, and the whole thing can snowball into a panic attack. Try letting go of that feeling that you absolutely must sleep now, and observe your own anxieties for what they are without judgment. When you stop looking at sleep as a goal, you’ll find it easier to fall asleep. Before you climb into bed, set aside 10-15 minutes to help relax your body and mind, with <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/restore-massage/27-73353-gaiam-wellness-acupressure-neck-back-pillow?affiliate=GAIAM60" target="_blank" rel="noopener">this wellness acupressure neck and back pillow from Gaiam</a>. Start a journal If you find yourself struggling to fall asleep, pick up a pen and paper (not your phone!), and start writing: simply scribble down an account of what’s going on inside your head. Although there’s no “right” way to journal, you might start by listing the events of your day, and from there, how those events and encounters made you feel. Building this structured picture of your thoughts may help you see that the problem that’s keeping you up at night, and is likely less overwhelming than you thought. Why my insistence on a pen and paper? First off, studies show the simple motor action that’s involved in the act of handwriting has a calming effect. Secondly, the light emitted by laptops and phones isn’t conducive to falling asleep. Find yourself a "3am friend" Some of us are lucky to have a ‘3am friend’, that close confidant you can call up in the wee hours knowing that they won’t hold it against you in the morning. Although it’s great to have someone to talk to when you want to fall asleep, it’s important that the conversation doesn’t just rehash the anxieties that are preventing you from catching shut-eye in the first place. Rather than using the call to seek solutions for those issues, talk about things that calm your nerves, or even have them assist you in deep breathing. It may sound silly, but doing a series of deep, relaxing breaths can help you let go of the troubles that are keeping you wide awake. Take a warm shower Taking a warm shower not only relaxes your muscles and soothes minor aches and pains, but it also raises your core body temperature. As soon as you step out of the shower, your body starts working at lowering that temperature, which is something that normally happens when you’re falling asleep naturally. (That’s why we always feel the need for a blanket when we sleep, no matter how warm it is!) By kick-starting that temperature-lowering process, you’re tricking your body into falling asleep fast. Stretch yourself to sleep Anxiety keeping you up? Research suggests mild stretching can help take the edge off and relax muscles that have become stiff and sore after a long day. We’re not talking intricate yoga poses or acrobatics here, either: Simple stretches like an overhead arm stretch and bending over to touch your toes should do the trick. Ramp up the relaxation potential with a soundtrack of ambient noise at a volume that’s just barely audible. There are plenty of white noise apps that are free to download, but soft music can work as well (so long as there are no lyrics). Just remember, if you’re using an electronic device to play these sleep-promoting sounds, make sure it’s placed screen-down so you’re not distracted by the light it emits. Stretching is healing, and this <a href="https://gaiam.innovations.com.au/p/gaiam-wellness/rollers-resistance/27-72435-gaiam-strengthen-stretch-kit?affiliate=GAIAM60" target="_blank" rel="noopener">Strengthen and Stretch Kit from Gaiam</a> is a great way to start. An on-line workout is also included to get you started. Read (or listen!) to something new When you’re struggling with insomnia, it might be tempting to pull an old favourite off the bookshelf. In reality, it’s better to read or listen to an audio book that covers a topic on which you know absolutely nothing. New information, while taking attention away from the stressors that are keeping you up at night, gives your brain enough of a workout to make it tire more quickly than when it’s engaged with familiar subjects and concepts. Again, if it’s an audio book or podcast you’re listening to, make sure the light-emitting side of the device is face down to keep the room as dark as possible. Darkness and warmth play an essential part in the production and maintenance of melatonin, the hormone that plays the central role falling asleep. Image credits: Getty Images This article by Deepak Kashyap originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/sleep/how-to-fall-asleep-without-sleeping-pills-7-natural-sleep-aids-that-actually-work" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Why do I need to get up during the night to wee? Is this normal?

<a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> It can be normal to wake up once or even twice during the night to wee, especially as we get older. One in three adults over 30 makes <a href="https://pubmed.ncbi.nlm.nih.gov/30085529">at least two</a> trips to the bathroom every night. Waking up from sleep to urinate on a regular basis is called <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">nocturia</a>. It’s one of the most commonly reported <a href="https://pubmed.ncbi.nlm.nih.gov/32249998/">bothersome urinary symptoms</a> (others include urgency and poor stream). So what causes nocturia, and how can it affect wellbeing? <h2>A range of causes</h2> Nocturia can be caused by a variety of <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">medical conditions</a>, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an <a href="https://www.nature.com/articles/s41598-023-44916-8">overactive bladder</a>, or gastrointestinal issues. Other causes include pregnancy, <a href="https://onlinelibrary.wiley.com/doi/10.1002/nau.24839">medications</a> and consumption of alcohol or caffeine before bed. While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055528/">insomnia</a>, can also cause nocturia. When we sleep, an antidiuretic hormone is released that slows down the rate at which our <a href="https://theconversation.com/is-urine-sterile-do-urine-therapies-work-experts-debunk-common-pee-myths-191862">kidneys produce urine</a>. If we lie awake at night, less of this hormone <a href="https://journals.physiology.org/doi/full/10.1152/ajprenal.00025.2023">is released</a>, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night. Stress, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153377/">anxiety</a> and watching television <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987">late into the night</a> are common causes of insomnia. <h2>Effects of nocturia on daily functioning</h2> The recommended amount of sleep for adults is between <a href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep">seven and nine hours</a> per night. The more times you have to get up in the night to go to the bathroom, the more this impacts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602727/#:%7E:text=Nocturia%20is%2C%20however%2C%20an%20important,(QoL)%20and%20general%20health.">sleep quantity and quality</a>. Decreased sleep can result in increased <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1251-5">tiredness</a> during the day, poor concentration, forgetfulness, changes in mood and impaired <a href="https://pubmed.ncbi.nlm.nih.gov/28425062/">work performance</a>. If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life. In more severe cases, nocturia has been compared to having a similar impact on <a href="https://www.racgp.org.au/getattachment/b43c05ba-e29e-47c3-b816-ec47ceeafe97/Nocturia-a-guide-to-assessment-and-management.aspx">quality of life</a> as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts. Nocturia not only upsets sleep, but also increases the risk of <a href="https://www.auajournals.org/doi/10.1097/JU.0000000000000459">falls</a> from moving around in the dark to go to the bathroom. Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed. <h2>Can you have a ‘small bladder’?</h2> It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is <a href="https://youtu.be/blVmyrBPves">smaller</a> relative to your other organs. If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often. <figure><iframe src="https://www.youtube.com/embed/blVmyrBPves?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Can you have a small bladder?</figcaption></figure> If you find you are going to the bathroom quite a lot during the day and evening (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903463/">more than eight times</a> in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate. If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP. There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night. <h2>A happy and healthy bladder</h2> Here are some tips to maintain a happy and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206217/">healthy</a> bladder, and reduce the risk you’ll be up at night: <ul> <li> make your <a href="https://theconversation.com/what-position-should-i-sleep-in-and-is-there-a-right-way-to-sleep-189873">sleep environment comfortable</a>, with a suitable mattress and sheets to suit the temperature </li> <li> get to bed early, and limit <a href="https://www.ncbi.nlm.nih.gov/books/NBK518987/">screens</a>, or activites before bed </li> <li> limit foods and drinks that irritate the bladder, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9811496/">coffee or alcohol</a>, especially before bedtime </li> <li> sit in a <a href="https://theconversation.com/does-it-matter-if-you-sit-or-stand-to-pee-and-what-about-peeing-in-the-shower-206869">relaxed position</a> when urinating, and allow time for the bladder to completely empty </li> <li> practice <a href="https://www.continence.org.au/about-continence/continence-health/pelvic-floor">pelvic floor muscle exercises</a> </li> <li> drink an adequate amount of fluids during the day, and avoid becoming <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">dehydrated</a> </li> <li> maintain a healthy lifestyle, eat <a href="https://journals.physiology.org/doi/full/10.1152/advan.00052.2023">nutritious foods</a> and do not do anything harmful to the body such as smoking or using illicit drugs </li> <li> review your medications, as the time you take some <a href="https://www.health.gov.au/sites/default/files/nocturia-going-to-the-toilet-at-night_0.pdf">pharmaceuticals</a> may affect urine production or sleep </li> <li> if you have <a href="https://pubmed.ncbi.nlm.nih.gov/28675633/">swollen legs</a>, raise them a few hours before bedtime to let the <a href="https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management">fluid drain</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224160/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/christian-moro-121754">Christian Moro</a>, Associate Professor of Science & Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/charlotte-phelps-1187658">Charlotte Phelps</a>, Senior Teaching Fellow, Medical Program, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-get-up-during-the-night-to-wee-is-this-normal-224160">original article</a>.

Body

Why Barnaby Joyce’s TV diagnosis of insomnia plus sleep apnoea is such a big deal

<a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> The <a href="https://theconversation.com/view-from-the-hill-how-does-david-littleproud-handle-the-latest-barnaby-joyce-embarrassment-223289">health</a> of Nationals MP Barnaby Joyce is in the news again, this time with a diagnosis of a sleep disorder made <a href="https://www.afr.com/companies/media-and-marketing/barnaby-joyce-to-be-diagnosed-with-a-sleep-disorder-on-live-tv-20240223-p5f79q">while filming</a> a TV documentary. Joyce’s diagnosis of insomnia plus sleep apnoea arose while filming <a href="https://www.sbs.com.au/whats-on/article/australias-sleep-revolution-with-dr-michael-mosley/nuyko305b">Australia’s Sleep Revolution with Dr Michael Mosley</a> in 2023. SBS has confirmed episode three, in which my Flinders University colleagues reveal his sleep disorder, is set to air on March 20. I was not involved in the program and have no knowledge of Joyce’s <a href="https://www.theaustralian.com.au/weekend-australian-magazine/australias-sleep-crisis-has-flinders-university-cracked-the-code-to-a-better-nights-sleep/news-story/d3b82617af33fff82487da2534722733">ongoing health care</a>. But I was part of the research team that in 2017 <a href="https://doi.org/10.1016/j.smrv.2016.04.004">coined the term COMISA</a> (co-morbid insomnia and sleep apnoea), the official name of Joyce’s on-screen diagnosis. Since then, I’ve led research into this <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> sleep disorder. Here’s why it’s so important to diagnose and treat it. <h2>What was Joyce’s diagnosis?</h2> People can be diagnosed separately with <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">insomnia</a> or <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/obstructive-sleep-apnoea">sleep apnoea</a>. Insomnia includes frequent difficulties falling asleep at the start of the night or difficulties staying asleep during the night. These can result in daytime fatigue, reduced energy, concentration difficulties and poor mood. Over time, insomnia can start to impact your <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and quality of life. Sleep apnoea (specifically, obstructive sleep apnoea) is when people experience repeated interruptions or pauses in breathing while they sleep. This reduces oxygen levels during sleep, and you can wake up multiple times at night. People with sleep apnoea may be aware of loud snoring, gasping for air when they wake up, or feeling exhausted the next morning. However, not all people have these symptoms, and sleep apnoea can go undiagnosed for years. But in Joyce’s case, both insomnia and sleep apnoea occur at the same time. We’ve known this could happen since <a href="https://doi.org/10.1126/science.181.4102.856">the 1970s</a>, with <a href="https://psycnet.apa.org/doi/10.1037/0022-006X.67.3.405">evidence growing</a> over <a href="https://doi.org/10.1378/chest.120.6.1923">subsequent decades</a>. Since then, sleep researchers and clinicians around the world have learned more about how <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> this is, its <a href="https://doi.org/10.1183/13993003.01958-2021">consequences</a> and how best to <a href="https://doi.org/10.1111/jsr.13847">treat it</a>. <h2>How do you know if you have it?</h2> Many people <a href="https://doi.org/10.1016/j.sleep.2005.08.008">seek help</a> for their sleep problems because of fatigue, exhaustion, physical symptoms, or poor mood during the day. If you think you have insomnia, a GP or sleep specialist can talk to you about your sleep pattern, and might ask you to complete <a href="https://www.sleepprimarycareresources.org.au/insomnia/assessment-questionnaires">brief questionnaires</a> about your sleep and daytime symptoms. You might also be asked to fill in a “sleep diary” for one to two weeks. These will allow a trained clinician to see if you have insomnia. If you or your GP think you may have (or are at risk of having) sleep apnoea, you may be referred for a sleep study. This normally involves sleeping overnight in a sleep clinic where your sleep patterns and breathing are monitored. Alternatively, you might be set up with a recording device to monitor your sleep at home. A trained medical professional, such as a sleep and respiratory physician, will often make the diagnosis. <a href="https://doi.org/10.1016/j.smrv.2021.101519">Up to 50%</a> of people with sleep apnoea report symptoms of insomnia. About <a href="https://doi.org/10.1016/j.smrv.2021.101519">30–40%</a> of people with insomnia also have sleep apnoea. <h2>What are the consequences?</h2> Insomnia and sleep apnoea (individually) are associated with reduced <a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">sleep quality</a>, <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and <a href="https://theconversation.com/health-check-heres-what-you-need-to-know-about-sleep-apnoea-26402">physical health</a>. Importantly, people with both at the same also tend to <a href="https://doi.org/10.3390/brainsci9120371">experience</a> worse sleep, daytime function, mental health, physical health and quality of life, compared with people with no sleep disorder. For instance, we know having both conditions comes with an <a href="https://doi.org/10.1111/jsr.13563">increased risk</a> of diseases of the heart. <a href="https://doi.org/10.2147/NSS.S379252">In</a> <a href="https://doi.org/10.1183/13993003.01958-2021">three</a> <a href="https://doi.org/10.1016/j.sleepe.2022.100043">studies</a>, we found people with both insomnia and sleep apnoea have about a 50–70% higher risk of dying early from any cause, compared with people with neither sleep condition. People with insomnia alone and sleep apnoea alone did not have an increased risk of dying early. However, there are effective treatments to reduce these health consequences. <h2>How is it treated?</h2> In general, it is best for people to access evidence-based treatments for both disorders. These treatments vary according to the patient and the severity of their condition. For instance, wearing a <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/cpap-continuous-positive-airway-pressure">CPAP mask</a> while sleeping improves breathing during sleep and reduces many of the daytime consequences of obstructive sleep apnoea. However, other effective treatments may be recommended based on each person’s symptoms, such as weight management, avoiding sleeping on your back, <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/oral-appliances-to-treat-snoring-and-obstructive-sleep-apnoea-osa">oral devices</a> (which look a bit like a mouthguard), or surgery. The <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">most effective</a> treatment for insomnia is cognitive behavioural therapy for insomnia, also known as <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a>. About four to eight sessions often lead to improvements in sleep, daytime function and mental health that are maintained for many <a href="https://doi.org/10.1080/16506073.2021.2009019">years</a>. This can be delivered by trained therapists such as psychologists, nurses or GPs, as well as via <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online</a> programs. Last year, we drew together evidence from more than 1,000 people with both conditions. We found CBTi is an <a href="https://doi.org/10.1111/jsr.13847">effective treatment</a> for insomnia in people with treated and untreated sleep apnoea. <h2>New treatments and approaches</h2> <a href="https://www.frontiersin.org/articles/10.3389/frsle.2024.1355468/abstract">We</a> and <a href="https://doi.org/10.1186/s13063-022-06753-4">other teams</a> internationally are developing and testing new ways of delivering CBTi. Several groups are testing devices, which <a href="https://doi.org/10.1002%2Flio2.761">stimulate</a> the tongue muscles during sleep, to treat sleep apnoea in people with both disorders. And we’re still working out the best order for patients to access treatments, and the best combination of treatments. <h2>The power of TV</h2> Joyce’s public diagnosis of both insomnia and sleep apnoea will no doubt raise awareness of what we suspect is an underdiagnosed condition. Based on how common insomnia and sleep apnoea are in Australia, we estimate Joyce is one of about <a href="https://doi.org/10.1016/j.sleep.2021.03.023">5–10%</a> of Australian adults to have both at the same time. The Conversation contacted Joyce’s spokesperson for comment but did not hear back before deadline.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224616/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-barnaby-joyces-tv-diagnosis-of-insomnia-plus-sleep-apnoea-is-such-a-big-deal-224616">original article</a>.

Body

Christmas drinks anyone? Why alcohol before bedtime leaves you awake at 3am, desperate for sleep

<a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/chris-irwin-249481">Chris Irwin</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/grace-vincent-1484516">Grace Vincent</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>, and <a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> You’ve come home after a long day at work, you have dinner, put the kids to bed, and then you have your usual nightcap before drifting off to sleep. Or, perhaps you’re at the pub for the work Christmas party, and you think you’ll just have one more drink before heading home. That last drink might help you fall asleep easily. But your nightcap can also wreck a good night’s sleep. How could it do both? Here’s what’s going on in your body when you drink alcohol just before bedtime. And if you want to drink at the Christmas party, we have some tips on how to protect your sleep. <h2>What happens to my body when I drink?</h2> Soon after you drink, alcohol enters your bloodstream and travels to your brain. <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1530-0277.1998.tb03695.x">There</a>, it affects chemical messengers known as neurotransmitters and <a href="https://pubmed.ncbi.nlm.nih.gov/2700603/">slows down communication</a> between nerve cells. Certain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040959/">regions of the brain</a> are particularly vulnerable to the effects of alcohol. When alcohol interacts with cells in these regions, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826822/">overall effect</a> leads to those characteristic feelings of relaxation, lowered inhibitions, slurred speech, and may induce feelings of drowsiness and lethargy. Alcohol can also have immediate effects on the heart and circulatory system. Blood vessels widen, resulting in a <a href="https://link.springer.com/article/10.1007/s11906-021-01160-7">drop in blood pressure</a>, which can make you feel dizzy or lightheaded. <h2>What happens soon after a nightcap?</h2> Drinking alcohol before sleeping is like flipping a switch. At first, alcohol has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826822/">sedative effect</a> and you will probably feel <a href="https://pubmed.ncbi.nlm.nih.gov/23347102/">more relaxed</a> and <a href="https://www.nature.com/articles/s41598-020-62227-0#:%7E:text=In%20this%20large%2C%20population%20based,sleep%20(cross%20sectional%20analyses).">drift off easily</a>. At this point, you still have a high level of alcohol in your blood. But don’t be fooled. As your body <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">processes the alcohol</a>, and the night goes on, alcohol actually <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12621">disrupts your sleep</a>. <h2>And later that night?</h2> As your body processes the alcohol and your blood alcohol level drops, your brain rebounds from the drowsiness you would have felt earlier in the night. This disturbs your sleep, and can wake you up <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">multiple times</a>, particularly in the second half of the night. You may also have vivid and stressful <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">dreams</a>. This sleep disruption is mainly to the deep, “rapid eye movement” or REM sleep. This type of sleep plays an important role in regulating your emotions and for your cognitive function. So not getting enough explains why you wake up feeling pretty lousy and groggy. Drinking alcohol before bedtime also tends to mean you <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775419/?source=post_page---------------------------">sleep less overall</a>, meaning important rest and recharge time is cut short. There are also <a href="https://pubmed.ncbi.nlm.nih.gov/31234199/">long-term impacts</a> of alcohol on sleep. Moderate and heavy drinkers consistently have <a href="https://academic.oup.com/sleepadvances/article/3/1/zpac023/6632721">poor sleep quality</a> and more <a href="https://www.nature.com/articles/s41598-020-62227-0#:%7E:text=In%20this%20large%2C%20population%20based,sleep%20(cross%20sectional%20analyses).">sleep disturbances</a> over time. <h2>How about the Christmas party then?</h2> If you plan to drink this holiday season, here are some tips to minimise the effect of alcohol on your sleep: <ul> <li> swap every other drink. Try swapping every second drink for a non-alcoholic drink. The more alcohol you drink, <a href="https://academic.oup.com/sleep/article/44/1/zsaa135/5871424?casa_token=okbJAuf8TXUAAAAA:ye_q-DACToxvj8H3IVaiKrjNkDhHZnl-LKJdds3iteaKyzJFuHUzitlRv45DqxNO-FraDRAlQMV53z8">the more</a> sleep disruption you can expect. Reducing how much you drink in any one sitting can minimise the effect on your sleep </li> <li> avoid drinking alcohol close to bedtime. If you give your body a chance to process the alcohol before you go to sleep, your sleep will be less disrupted </li> <li> eat while you drink. Drinking on an empty stomach is going to worsen the effects of alcohol as the alcohol will be absorbed <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-3010.2006.00588.x?casa_token=TQiCqcbasYAAAAAA:GbEvnTT82aB3_sPfmJLOQXIV3ivjnbZdIoP2_XZBa8IDZ0YLaPxNfE6DMHLgH7obnpA22VDsM4vyGZV4dQ">faster</a>. So try to eat something while you’re drinking </li> <li> ditch the espresso martinis and other caffeinated drinks. <a href="https://www.sciencedirect.com/science/article/pii/S1087079207000937?casa_token=NJsobF-C-vwAAAAA:opzPjrglPdZTwXEo7rHil5vm0a1K3KmXw9vp0Het-eRHZEWbfRAA40vgicU3Z5kC8x7uEJF39C8">Caffeine</a> can make it hard to get to sleep, and hard to stay asleep </li> <li> be careful if you have sleep apnoea. People who have sleep apnoea (when their upper airway is repeatedly blocked during sleep) can be even more impacted by drinking alcohol. That’s because alcohol can act as a muscle relaxant, <a href="https://academic.oup.com/sleep/article/5/4/318/2753287">leading to</a> more snoring, and lower oxygen levels in the blood. If you have sleep apnoea, limiting how much alcohol you drink is the best way to avoid these effects </li> <li> drink plenty of water. Staying hydrated will help you <a href="https://academic.oup.com/sleep/article/42/2/zsy210/5155420">sleep better</a> and will hopefully stave off the worst of tomorrow’s hangover.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216834/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, Postdoctoral research fellow, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/chris-irwin-249481">Chris Irwin</a>, Senior Lecturer in Nutrition and Dietetics, School of Health Sciences & Social Work, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/grace-vincent-1484516">Grace Vincent</a>, Senior Lecturer, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>, and <a href="https://theconversation.com/profiles/saman-khalesi-366871">Saman Khalesi</a>, Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/christmas-drinks-anyone-why-alcohol-before-bedtime-leaves-you-awake-at-3am-desperate-for-sleep-216834">original article</a>.

Body

How can I get some sleep? Which treatments actually work?

<a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months? If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia. You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next? <h2>What not to do</h2> These probably won’t help: <ul> <li> spending more time in bed often results in more time spent awake in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a> </li> <li> drinking coffee and taking naps might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening </li> <li> drinking alcohol might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid. </li> </ul> <h2>What to do next?</h2> If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours. So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills. It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia. You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>. Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some. <a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>. <h2>What if that doesn’t work?</h2> If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia. It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep. Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor. <h2>What about sleeping pills?</h2> Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful. Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep. However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence. Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits. <h2>Are there new treatments? How about medicinal cannabis?</h2> Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant). These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines. However, we don’t know if they work or are safe over the long term. <a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>. In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>. But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment. So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term. <h2>What now?</h2> If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these. Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors. <hr /> For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.

Body

How dangerous is insomnia? How fear of what it’s doing to your body can wreck your sleep

<a href="https://theconversation.com/profiles/leon-lack-1142">Leon Lack</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> I (Leon) have recently seen several patients who were concerned their insomnia symptoms would increase their risk for dementia. They were in their 70s and were awakening two or three times a night, which they took to be insomnia. But they were not impaired in the daytime in a way typical of insomnia. Their brief awakenings are normal for most people and <a href="https://theconversation.com/broken-sleep-its-a-rollercoaster-ride-1792">completely harmless</a>. Brief awakenings emerge from the periodic phases of light sleep that occur naturally between the four or five 90-minute deep sleep cycles. If you’re unaware of this “rollercoaster” of 90-minute cycles, you might think such awakenings are a sign of disease. In fact, they are perfectly normal and experienced more as people age when sleep naturally becomes lighter and shorter – <a href="https://theconversation.com/mondays-medical-myth-you-need-eight-hours-of-continuous-sleep-each-night-5643">with no ill effect</a>. Therefore, I reassured them their sleep patters were normal and they did not have insomnia. This requires daytime impairments – fatigue, cognitive problems, mild depression, irritability, distress or anxiety – in addition to night time symptoms. I trust they were reassured, and so they avoided the type of fear and worry that would have triggered a cascade of events leading to insomnia. <h2>Is it really insomnia?</h2> So where did my patients get the notion their sleep symptoms could lead to dementia? Let’s pick apart this tsunami of alarming information. It usually starts with very <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1623-0">large surveys</a> that find a statistically significant relationship between measures of sleep problems and subsequently developing dementia. First, most of these studies ask participants to report how long they typically sleep. Those reporting less than six hours a night show a small but statistically elevated risk of developing dementia. These studies do not say if people have clinical insomnia diagnosed by a health professional. Instead they rely solely on participants guessing how long they’ve slept, which <a href="https://academic.oup.com/sleep/article/25/5/559/2750164?login=false">can be inaccurate</a>. The studies would have also included many people without insomnia who are not allowing themselves adequate opportunity for sleep. Perhaps they’d been in the habit of socialising or playing computer games late at night. In other words, we don’t know what proportion of these short-sleepers are simply over-estimating their sleep problems, or restricting their sleep and experiencing chronic sleep loss rather than insomnia. <h2>What do the numbers really mean?</h2> A second problem is with interpreting the meaning of “statistically significant”. This only means the results were unlikely to be due to pure chance. If a single study shows a 20% increased risk of a physical health problem associated with insomnia, how worried should we be? This single finding does not necessarily mean it’s worth considering in our everyday lives. Studies relating insomnia to health risks are also typically inconsistent. For example, although some studies have found small increases in dementia risk with having insomnia, a very <a href="https://mentalhealth.bmj.com/content/ebmental/26/1/e300719.full.pdf">large UK study</a> did not find any relationship between the amount of sleep or sleeping difficulties and dementia risk. <h2>What’s the context?</h2> A third problem is communicating a balanced perspective to the public about the potential dangers of insomnia. Some in the mainstream media, with the help of the researcher’s institution, will report on studies showing a statistically significant increase in the risk of a frightening disease, such as dementia. But <a href="https://theconversation.com/essays-on-health-reporting-medical-news-is-too-important-to-mess-up-68920">not all media reports</a> ask about how clinically meaningful the risk is, whether there are alternative explanations, or how this result compares with what other researchers have found. So the public is left with no context to temper the scary, “increased risk” narrative. This narrative is then shared on social media, amplifying the scary finding. <h2>Obesity, diabetes, high blood pressure</h2> We’ve used dementia as one example of how fears about potential risks to physical health from insomnia arise and are magnified. But we could have used a potential increased risk of obesity, diabetes or high blood pressure. All have been associated with shorter sleep, but researchers are debating whether these links are real, meaningful or related to insomnia. When we looked at the impact of sleep problems on life expectancy, we found <a href="https://pubmed.ncbi.nlm.nih.gov/30529432/">no evidence</a> sleep symptoms alone shorten your life. Only when daytime symptoms such as fatigue, memory problems and distress are included is there a <a href="https://www.nature.com/articles/s41598-023-36016-4">small increased risk</a> of dying prematurely. However, it’s difficult to know if that excess mortality can be explained by undiagnosed heart, kidney, liver or brain disease causing those daytime symptoms. <h2>We should be talking about mental health</h2> However, there is stronger evidence of increased <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">mental health</a> problems, especially depression, with insomnia. The typical daytime impairments of fatigue, distress, cognitive impairments and irritability certainly lower the quality of life. Life becomes more of a challenge and less enjoyable. Over time, this can trigger <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">hopelessness and depression</a> in some people. This is enough reason to seek help to improve sleep and quality of life. People with these problems should seek help from a health practitioner. The good news is there is an effective, long-term, non-drug treatment with no side effects – cognitive behavioural therapy for insomnia <a href="https://bmcprimcare.biomedcentral.com/articles/10.1186/1471-2296-13-40">or CBTi</a>. Even better, successful CBTi also <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945720303828">decreases</a> symptoms of depression and other mental distress. What is not helpful is unnecessary fear triggered by reports suggesting serious physical health dangers of insomnia. This fear is only likely to increase insomnia rather than mitigate it. <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/212248/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leon-lack-1142">Leon Lack</a>, Emeritus Professor of Psychology, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, Associate Professor, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-dangerous-is-insomnia-how-fear-of-what-its-doing-to-your-body-can-wreck-your-sleep-212248">original article</a>.

Body

What’s insomnia like for most people who can’t sleep? You’d never know from the movies

<a href="https://theconversation.com/profiles/aaron-schokman-1463327">Aaron Schokman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nick-glozier-94435">Nick Glozier</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Hollywood appears fascinated by sleep’s impact on the mind and body. Blockbuster movies featuring someone living with insomnia include <a href="https://www.imdb.com/title/tt0108160/">Sleepless in Seattle</a> (1993), <a href="https://www.imdb.com/title/tt0137523/">Fight Club</a> (1999) and <a href="https://www.imdb.com/title/tt0278504/?ref_=fn_al_tt_1">Insomnia</a> (2002). But how well do these and other portrayals compare with what it’s really like to live with insomnia? As we’ll see, most movies tend to either minimise or exaggerate symptoms. Insomnia is rarely depicted as a treatable illness. And these portrayals have implications for the estimated <a href="https://www.sleep.theclinics.com/article/S1556-407X(22)00022-4/fulltext">one in three</a> of us with at least one insomnia symptom. <h2>Back in the real world</h2> Insomnia is a common <a href="https://doi.org/10.1378/chest.14-0970">sleep disorder</a> where a person struggles to fall asleep, stay asleep, or wakes up too early – despite having adequate opportunity for sleep. <a href="https://doi.org/10.1111/j.1753-6405.2012.00845.x">Around 5%</a> of adults experience significant insomnia to the degree that it causes distress or impairs daily life. It’s a common misconception that insomnia is only a night-time issue. <a href="https://www.healthdirect.gov.au/insomnia">Insomnia</a> can impact your ability to stay awake and alert during the day. It can also affect your <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">mental health</a>. At work, you might be more prone to accidents, more forgetful, or make poorer decisions. At home, you might be irritable or short with your friends and family. So what is it like living with insomnia? Apart from the effects of poor sleep quality, many people experience <a href="https://doi.org/10.1016/j.smrv.2021.101583">anxiety or dread</a> about the night ahead from the moment they wake up. From early in the day, people plan how they can improve their sleep that night. <a href="https://doi.org/10.1016/j.smrv.2016.01.003">A review</a> found people living with insomnia felt their sleep concerns were often trivialised or misunderstood by health-care professionals, and stigmatised by others. <h2>Movies can minimise symptoms …</h2> Nicholas Galitzine’s character in the recent romcom <a href="https://www.imdb.com/title/tt10172266/?ref_=fn_al_tt_1">Red, White and Royal Blue</a> (2023) has insomnia. We’re briefly told he struggles to fall asleep at night. However, we never see any meaningful impact on his life or depiction of the difficulty living with insomnia entails. That said, minimising the impact of insomnia can have benefits. It shows insomnia is an invisible illness, doesn’t have obvious visual symptoms and anyone can have it. But this can perpetuate the expectation someone with insomnia should be able to function unencumbered. Or it can fuel the misconception having insomnia may be beneficial, as in <a href="https://www.imdb.com/title/tt0050543/?ref_=fn_al_tt_1">Insomnia Is Good for You</a> (1957). <h2>… or exaggerate symptoms</h2> But most Hollywood portrayals of insomnia tend to depict the most extreme cases. These usually feature insomnia as a symptom of another condition rather than a disorder itself, as is commonly experienced. These movies tend to be psychological thrillers. Here, insomnia is often used as an enigma to keep the audience guessing about which events are real or figments of a character’s imagination. Take <a href="https://www.imdb.com/title/tt0361862/?ref_=fn_al_tt_1">The Machinist</a> (2004), for example. The main character is emaciated, ostracised and plagued by paranoia, hallucinations and delusions. It’s only towards the end of the movie we learn his insomnia may be the result of a <a href="https://doi.org/10.9740/mhc.n101819">psychiatric disorder</a>, such as post-traumatic stress disorder. <figure><iframe src="https://www.youtube.com/embed/-R4rQMImHwE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In The Machinist, the main character has paranoia, hallucinations and delusions.</figcaption></figure> Hollywood’s focus on extreme cases of insomnia is a recurring pattern (for instance, <a href="https://www.imdb.com/title/tt0137523/">Fight Club</a> 1999, <a href="https://www.imdb.com/title/tt0434165/?ref_=fn_al_tt_3">Lucid</a> 2005). It’s understandable why Hollywood latches onto these extreme portrayals – to entertain us. Yet these portrayals of insomnia as something more severe or threatening, like psychosis, can increase anxiety or stigma among people living with insomnia. While it’s true other medical conditions including <a href="https://theconversation.com/explainer-whats-the-link-between-insomnia-and-mental-illness-49597">mental illnesses</a> can lead to insomnia, insomnia often exists on its own. Insomnia is often <a href="https://theconversation.com/explainer-what-is-insomnia-and-what-can-you-do-about-it-36365">caused by</a> more mundane things like too much stress, lifestyle and habits, or longer daylight hours at higher latitudes (such as in <a href="https://www.imdb.com/title/tt0278504/?ref_=fn_al_tt_1">Insomnia</a>, 2002). Something these exaggerated portrayals do well is highlight the impact sleep deprivation can have on safety, albeit extremely dramatised. Regardless of profession, <a href="https://doi.org/10.1037/xge0000717">not getting enough sleep</a> at night can substantially impact cognitive function, increasing the chance of making a mistake. <figure><iframe src="https://www.youtube.com/embed/emIHzg4VH8A?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In Insomnia, one character has insomnia because of extended daylight hours.</figcaption></figure> <h2>Movies rarely depict treatment</h2> It is rare to see insomnia depicted as a health condition requiring medical care. Very few characters struggling with insomnia seek or receive help for it. An exception is the narrator in <a href="https://www.imdb.com/title/tt0137523/">Fight Club</a> (1999). But he has to pretend to have other illnesses to receive therapy, again suggesting insomnia is not a legitimate condition. <figure><iframe src="https://www.youtube.com/embed/BdJKm16Co6M?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>The narrator in Fight Club pretends to have other illnesses to receive therapy for insomnia.</figcaption></figure> <h2>Why does accurate representation matter?</h2> Many people only learn about the symptoms and impact of sleep disorders through pop culture and film. These portrayals can affect how others think about these disorders and can impact how people living with these disorders think about themselves. Uniform and stereotypical portrayals of insomnia can also impact people’s <a href="https://doi.org/10.1080/15402002.2011.620671">likelihood of seeking help</a>. Most of these films show young or middle-aged men experiencing insomnia. Yet women are <a href="https://doi.org/10.1093/sleep/29.1.85">more likely</a> to have insomnia than men. Insomnia is also <a href="https://doi.org/10.1016/j.jsmc.2022.03.003">more common</a> in older adults, people with a lower socioeconomic background and those living alone. People at higher risk of developing insomnia might not recognise their risk or symptoms if their experience doesn’t match what they’ve seen. <h2>We can do better</h2> While the reality of living with insomnia may not be particularly cinematic, filmmakers can surely do better than using it as a convenient plot point. There are a number of main characters living with different health conditions across pop culture. For instance, the movie <a href="https://www.imdb.com/title/tt4034228/">Manchester by the Sea</a> (2016) features someone with <a href="https://www.rcpsych.ac.uk/news-and-features/blogs/detail/cultural-blog/2017/07/08/manchester-by-the-sea">prolonged grief disorder</a> and the TV series <a href="https://www.imdb.com/title/tt6315640/?ref_=nv_sr_srsg_0_tt_8_nm_0_q_Atypical">Atypical</a> (2017-2021) features someone’s experience living with autism. But if you’re looking for an accurate portrayal of insomnia, Hollywood still has some way to go. It’s about time insomnia is depicted in a way that accurately reflects people’s experiences.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211823/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aaron-schokman-1463327">Aaron Schokman</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nick-glozier-94435">Nick Glozier</a>, Professor of Psychological Medicine, BMRI & Disciplne of Psychiatry, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-insomnia-like-for-most-people-who-cant-sleep-youd-never-know-from-the-movies-211823">original article</a>.

Body

6 common factors that are impacting your sleep

While we all do our best to make sure we’re get our eight hours every night, at times it can feel as though we’re our own worst enemies. And while we’re all aware of the importance of sleep, it can sometimes be difficult to figure out what the root of the problem is. Here are six common factors that may be negatively impacting your ability to get shut eye. Correct these and you’ll be on your way to enjoy a good night sleep. 1. Light Studies have shown the exposure to light can wreak havoc in terms of our internal circadian rhythm. Try to avoid having your vision obstructed by any light when you’re about to get to sleep and keep the use of mobile and computer devices to a minimum. 2. Food Asides from the correlation between poor quality sleep and processed foods, it’s generally not recommended you have large, heavy meals just before you’re about to go to bed. Also, try to avoid sugar and caffeine in the few hours leading to bedtime. 3. Noise Noise can also affect the pattern of your sleep as anyone who’s tossed and turned at the sound of a neighbour’s party. Earplugs are one option you can explore. It’s also an idea to perhaps try a light fan to drown the noise out somewhat, or some sort of gentle recording. 4. Temperature Each person has an optimal temperature for falling asleep and it varies between people. If you’re feeling a bit hot under the collar (or too cool to start sleeping) it’s worth experimenting with the temperature in your room until you find one that better suits. 5. Schedule Are bodies are fiends for routines, so try to go to bed and get up at the same time every day, even on weekend. Not only will this help integrate your body into a regular sleep/wake pattern, it will also make the actual process of falling asleep seem much easier. 6. Naps While there’s nothing quite as nice as an afternoon nap during the day, it can actually significantly disrupt out sleep patterns during the night. If you really do have to nap during the day, try to keep it short and avoid napping too much in the later parts of the day. Image credits: Getty Images

Body

9 tricky ways to clean your house while you sleep

1. Soak a showerhead Mineral deposits can clog a showerhead and affect its pressure over time. To clean, fill a plastic bag with vinegar. Place the bag around the showerhead, submerging it in the liquid. Secure the bag to the neck of the showerhead with a twist tie and leave overnight. The vinegar will break down the buildup by morning. 2. Remove stains on pots and pans If a batch of cookies left your baking sheet gunky, let a dryer sheet clean it overnight. Place the sheet on the pan and fill with warm water. Cleaning agents in the dryer sheet will help loosen stuck-on grime and stains. In the morning, easily wipe off with a sponge. 3. Polish stove grates Cleaning greasy, food-splattered stove burners can be a tiresome chore. Before you go to bed, seal each burner in a large plastic bag with ¼ cup of ammonia. The overnight soak will make it easy to wipe off the surface with a sponge the following day. 4. Banish rust on tools If your rusty tools have seen better days, fill a tray with Coca-Cola. Submerge the tools, allow to soak overnight, and scrub clean with a stiff brush in the morning. The soda’s phosphoric acid will help loosen the gunk. 5. Eliminate wet messes If your sofa or carpet became the victim of an icky, wet mess (say, vomit or urine), mix a paste of baking soda and water to soak it up. Use a spoon to spread the paste over the soiled area. Allow to dry overnight, then vacuum in the morning. 6. Descale a kettle Limescale can build up from calcium carbonate deposits in water, leading to an off-white, chalky deposit in your kettle. To clean, cut a lemon into large slices, place in the kettle, and add water. Bring to a boil, then take the kettle off the heat and leave overnight. The lemon’s citric acid will loosen the limescale. Toss the fruit and water mixture in the morning and rinse before using your newly cleaned kettle. 7. Clean bath toys To make grubby rubber duckies, boats, and other bath toys new again, mix one gallon warm water with ¾ cup vinegar. Soak the toys overnight. Rinse thoroughly and allow to air dry. 8. Make diamonds sparkle Quickly polish a diamond ring by filling a bottle cap with Windex. Soak the ring overnight and dry with a soft cloth in the morning to remove grime and add shine. 9. Remove red wine stains If red wine marked up your favorite garment, sprinkle the stain with salt and cover with club soda. The salt absorbs the stain while the club soda’s carbonation and sodium helps lift it. Leave overnight before laundering. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/diy-tips/9-ways-clean-house-your-sleep" target="_blank" rel="noopener">Reader's Digest</a>.

Home & Garden

Do blue-light glasses really work? Can they reduce eye strain or help me sleep?

<a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Blue-light glasses are said to <a href="https://www.baxterblue.com.au/collections/blue-light-glasses">reduce eye strain</a> when using <a href="https://www.blockbluelight.com.au/collections/computer-glasses">computers</a>, improve your <a href="https://www.ocushield.com/products/anti-blue-light-glasses">sleep</a> and protect your eye health. You can buy them yourself or your optometrist can prescribe them. But <a href="https://mivision.com.au/2019/03/debate-continues-over-blue-blocking-lenses/">do they work</a>? Or could they do you harm? We <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">reviewed</a> the evidence. Here’s what we found. <h2>What are they?</h2> Blue-light glasses, blue light-filtering lenses or blue-blocking lenses are different terms used to describe lenses that reduce the amount of short-wavelength visible (blue) light reaching the eyes. Most of these lenses prescribed by an optometrist decrease blue light transmission by <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">10-25%</a>. Standard (clear) lenses do not filter blue light. A wide variety of lens products are available. A filter can be added to prescription or non-prescription lenses. They are widely marketed and are becoming <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">increasingly popular</a>. There’s often an added cost, which depends on the specific product. So, is the extra expense worth it? <h2>Blue light is all around us</h2> Outdoors, sunlight is the main source of blue light. Indoors, light sources – such as light-emitting diodes (LEDs) and the screens of digital devices – emit varying degrees of blue light. The amount of blue light emitted from artificial light sources is much lower than from the Sun. Nevertheless, artificial light sources are all around us, at home and at work, and we can spend a lot of our time inside. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" alt="Blue light-filtering lenses block some blue light from screens from reaching the eye" /></a><figcaption>Screens emit blue light. The lenses are designed to reduce the amount of blue light that reaches the eye. <a class="source" href="https://www.shutterstock.com/image-vector/blue-light-blocking-ray-filter-lens-2286229107">Shutterstock</a></figcaption></figure> Our research team at the University of Melbourne, along with collaborators from Monash University and City, University London, sought to see if the best available evidence supports using blue light-filtering glasses, or if they could do you any harm. So we conducted a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">systematic review</a> to bring together and evaluate all the relevant studies. We included all randomised controlled trials (clinical studies designed to test the effects of interventions) that evaluated blue light-filtering lenses in adults. We identified 17 eligible trials from six countries, involving a total of 619 adults. <h2>Do they reduce eye strain?</h2> We found no benefit of using blue light-filtering lenses, over standard (clear) lenses, to reduce eye strain with computer use. This conclusion was based on consistent findings from three studies that evaluated effects on eye strain over time periods ranging from two hours to five days. <h2>Do they help you sleep?</h2> Possible effects on sleep were uncertain. Six studies evaluated whether wearing blue-light filtering lenses before bedtime could improve sleep quality, and the findings were mixed. These studies involved people with a diverse range of medical conditions, including insomnia and bipolar disorder. Healthy adults were not included in the studies. So we do not yet know whether these lenses affect sleep quality in the general population. <h2>Do they boost your eye health?</h2> We did not find any clinical evidence to support using blue-light filtering lenses to protect the macula (the region of the retina that controls high-detailed, central vision). None of the studies evaluated this. <h2>Could they do harm? How about causing headaches?</h2> We could not draw clear conclusions on whether there might be harms from wearing blue light-filtering lenses, compared with standard (non blue-light filtering) lenses. Some studies described how study participants had headaches, lowered mood and discomfort from wearing the glasses. However, people using glasses with standard lenses reported similar effects. <h2>What about other benefits or harms?</h2> There are some important general considerations when interpreting our findings. First, most of the studies were for a relatively short period of time, which limited our ability to consider longer-term effects on vision, sleep quality and eye health. Second, the review evaluated effects in adults. We don’t yet know if the effects are different for children. Finally, we could not draw conclusions about the possible effects of blue light-filtering lenses on many vision and eye health measures, including colour vision, as the studies did not evaluate these. <h2>In a nutshell</h2> Overall, based on relatively limited published clinical data, our review does not support using blue-light filtering lenses to reduce eye strain with digital device use. It is unclear whether these lenses affect vision quality or sleep, and no conclusions can be drawn about any potential effects on the health of the retina. High-quality research is needed to answer these questions, as well as whether the effectiveness and safety of these lenses varies in people of different ages and health status. If you have eye strain, or other eye or vision concerns, discuss this with your optometrist. They can perform a thorough examination of your eye health and vision, and discuss any relevant treatment options.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213145/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, Associate Professor in Optometry and Vision Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-blue-light-glasses-really-work-can-they-reduce-eye-strain-or-help-me-sleep-213145">original article</a>.

Body

What do people think about when they go to sleep?

<a href="https://theconversation.com/profiles/melinda-jackson-169319">Melinda Jackson</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/hailey-meaklim-151642">Hailey Meaklim</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> You’re lying in bed, trying to fall asleep but the racing thoughts won’t stop. Instead, your brain is busy making detailed plans for the next day, replaying embarrassing <a href="https://www.tiktok.com/@ryanhdlombard/video/7052464974324583681?q=sleep%20thoughts&t=1693536926124">moments</a> (“why did I say that?”), or producing seemingly random thoughts (“where is my birth certificate?”). Many social media users have shared <a href="https://www.tiktok.com/@komasawn/video/7267320333613419818">videos</a> on how to fall asleep faster by <a href="https://www.tiktok.com/@lilslvrtt/video/7225272823562997000">conjuring</a> up “<a href="https://www.tiktok.com/@ekai.is.okay/video/7169530076143439131?q=fake%20scenario%20fall%20asleep&t=1693537172625">fake scenarios</a>”, such as a romance storyline where you’re the main character. But what does the research say? Does what we think about before bed influence how we sleep? <h2>How you think in bed affects how you sleep</h2> It turns out people who sleep well and those who sleep poorly have different kinds of thoughts before bed. <a href="https://www.sciencedirect.com/science/article/pii/S1087079219302217">Good sleepers report</a> experiencing mostly visual sensory images as they drift to sleep – seeing people and objects, and having dream-like experiences. They may have less ordered thoughts and more hallucinatory experiences, such as imagining you’re participating in events in the real world. For people with insomnia, pre-sleep thoughts tend to be less visual and more focused on planning and problem-solving. These thoughts are also generally more unpleasant and less random than those of good sleepers. People with insomnia are also more likely to stress about sleep as they’re trying to sleep, leading to a vicious cycle; putting effort into sleep actually wakes you up more. People with insomnia often <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/014466500163284">report</a> worrying, planning, or thinking about important things at bedtime, or focusing on problems or noises in the environment and having a general preoccupation with not sleeping. Unfortunately, all this pre-sleep mental activity can prevent you drifting off. One <a href="https://academic.oup.com/sleep/article/27/1/69/2707948">study</a> found even people who are normally good sleepers can have sleep problems if they’re stressed about something at bedtime (such as the prospect of having to give a speech when they wake up). Even <a href="https://pubmed.ncbi.nlm.nih.gov/17884278/">moderate levels of stress at bedtime</a> could affect sleep that night. Another <a href="https://jcsm.aasm.org/doi/full/10.5664/jcsm.6704">study</a> of 400 young adults looked at how binge viewing might affect sleep. The researchers found higher levels of binge viewing were associated with poorer sleep quality, more fatigue, and increased insomnia symptoms. “Cognitive arousal”, or mental activation, caused by an interesting narrative and identifying with characters, could play a role. The good news is there are techniques you can use to change the style and content of your pre-sleep thoughts. They could help reduce nighttime cognitive arousal or to replace unwanted thoughts with more pleasant ones. These techniques are called “cognitive refocusing”. <h2>What is cognitive refocusing?</h2> Cognitive refocusing, developed by US psychology researcher <a href="https://artsandsciences.syracuse.edu/people/faculty/gellis-phd-les-a/">Les Gellis</a>, involves distracting yourself with pleasant thoughts before bed. It’s like the “fake scenarios” social media users post about – but the trick is to think of a scenario that’s not too interesting. Decide before you go to bed what you’ll focus on as you lie there waiting for sleep to come. Pick an engaging cognitive task with enough scope and breadth to maintain your interest and attention – without causing emotional or physical arousal. So, nothing too scary, thrilling or stressful. For example, if you like interior decorating, you might imagine redesigning a room in your house. If you’re a football fan, you might mentally replay a passage of play or imagine a game plan. A music fan might mentally recite lyrics from their favourite album. A knitter might imagine knitting a blanket. Whatever you choose, make sure it’s suited to you and your interests. The task needs to feel pleasant, without being overstimulating. Cognitive refocusing is not a silver bullet, but it can help. One <a href="https://doi.org/10.1080/07448481.2022.2109031">study</a> of people with insomnia found those who tried cognitive refocusing had significant improvements in insomnia symptoms compared to a control group. <h2>How ancient wisdom can help us sleep</h2> Another age-old technique is mindfulness meditation. Meditation practice can increase our self-awareness and make us more aware of our thoughts. This can be useful for helping with rumination; often when we try to block or stop thoughts, it can make matters worse. Mindfulness training can help us recognise when we’re getting into a rumination spiral and allow us to sit back, almost like a passive observer. Try just watching the thoughts, without judgement. You might even like to say “hello” to your thoughts and just let them come and go. Allow them to be there and see them for what they are: just thoughts, nothing more. <a href="https://doi.org/10.1007/s12671-021-01714-5">Research from our group</a> has shown mindfulness-based therapies can help people with insomnia. It may also help people with <a href="https://doi.org/10.1007/s11920-022-01370-z">psychiatric conditions</a> such as bipolar disorder, obsessive-compulsive disorder and schizophrenia get more sleep. <h2>What can help ease your pre-sleep thoughts?</h2> Good sleep starts the moment you wake up. To give yourself your best shot at a good night’s sleep, start by getting up at the same time each day and getting some morning light exposure (regardless of how much sleep you had the night before). Have a consistent bedtime, reduce technology use in the evening, and do regular exercise during the day. If your mind is busy at bedtime, try cognitive refocusing. Pick a “fake scenario” that will hold your attention but not be too scary or exciting. Rehearse this scenario in your mind at bedtime and enjoy the experience. You might also like to try: <ul> <li> keeping a consistent bedtime routine, so your brain can wind down </li> <li> writing down worries earlier in the day (so you don’t think about them at bedtime) </li> <li> adopting a more self-compassionate mindset (don’t beat yourself up at bedtime over your imagined shortcomings!).<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207406/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/melinda-jackson-169319">Melinda Jackson</a>, Associate Professor at Turner Institute for Brain and Mental Health, School of Psychological Sciences, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/hailey-meaklim-151642">Hailey Meaklim</a>, Sleep Psychologist and Researcher, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-do-people-think-about-when-they-go-to-sleep-207406">original article</a>.

Mind

The science of dreams and nightmares – what is going on in our brains while we’re sleeping?

<a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Last night you probably slept for <a href="https://www.sciencedirect.com/science/article/pii/S2352721816301292">seven to eight hours</a>. About one or two of these was likely in deep sleep, especially if you’re young or physically active. That’s because <a href="http://apsychoserver.psych.arizona.edu/jjbareprints/psyc501a/readings/Carskadon%20Dement%202011.pdf">sleep changes with age</a> and <a href="https://www.hindawi.com/journals/apm/2017/1364387/">exercise</a> affects brain activity. About three or four hours will have been spent in light sleep. For the remaining time, you were likely in rapid eye movement (REM) sleep. While this is not the only time your brain is potentially dreaming – we also dream during other sleep stages – it is the time your brain activity is most likely to be recalled and reported when you’re awake. That’s usually because either really weird thoughts or feelings wake you up or because the last hour of sleep is nearly all <a href="https://www.researchgate.net/profile/Elizaveta-Solomonova/publication/320356182_Dream_Recall_and_Content_in_Different_Stages_of_Sleep_and_Time-of-Night_Effect/links/5a707bdb0f7e9ba2e1cade56/Dream-Recall-and-Content-in-Different-Stages-of-Sleep-and-Time-of-Night-Effect.pdf">REM sleep</a>. When dreams or your alarm wake you, you’re likely coming out of dream sleep and your dream often lingers into the first few minutes of being awake. In this case you remember it. If they’re strange or interesting dreams, you might tell someone else about them, which may further <a href="https://link.springer.com/article/10.1007/s00426-022-01722-7">encode</a> the dream memory. Dreams and nightmares are mysterious and we’re still learning about them. They keep our brains ticking over. They wash the thoughts from the day’s events at a molecular level. They might even help us imagine what’s possible during our waking hours. <h2>What do scientists know about REM sleep and dreaming?</h2> It’s really hard to study dreaming because people are asleep and we can’t observe what’s going on. Brain imaging has indicated certain <a href="https://www.sciencedirect.com/science/article/pii/S1087079216300673#sec3">patterns of brain activity</a> are associated with dreaming (and with certain sleep stages where dreams are more likely to occur). But such studies ultimately rely on self-reports of the dream experience. Anything we spend so much time doing probably serves multiple ends. At the basic physiological level (indicated by <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409">brain activity, sleep behaviour and studies of conciousness</a>), all mammals dream – even the platypus and echidna probably experience something similar to dreaming (provided they are at the <a href="https://www.wired.com/2014/07/the-creature-feature-10-fun-facts-about-the-echidna/#:%7E:text=It%20was%20long%20thought%20that,re%20at%20the%20right%20temperature.">right temperature</a>). Their brain activity and sleep stages align to some degree with human <a href="https://www.sciencedirect.com/science/article/pii/S1053810021001409#b0630">REM sleep</a>. Less evolved species do not. Some <a href="https://www.sciencedirect.com/science/article/pii/S2468867319301993#sec0030">jellyfish</a> – who do not have a brain – do experience what could physiologically be characterised as sleep (shown by their posture, quietness, lack of responsiveness and rapid “waking” when prompted). But they do not experience the same physiological and behavioural elements that resemble REM dream sleep. In humans, REM sleep is thought to occur cyclically every 90 to 120 minutes across the night. It prevents us from sleeping too deeply and being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972941/">vulnerable to attack</a>. Some scientists think we dream in order to stop our brains and bodies from getting too cold. Our core body temperature is typically <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00210-1/fulltext">higher while dreaming</a>. It is typically easier to <a href="https://www.tandfonline.com/doi/pdf/10.2147/NSS.S188911">wake from dreaming</a> if we need to respond to external cues or dangers. The brain activity in REM sleep kicks our brain into gear for a bit. It’s like a periscope into a more conscious state, observing what’s going on at the surface, then going back down if all is well. Some evidence suggests “fever dreams” are far less common than we might expect. We actually experience <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00053/full">far less REM sleep</a> when we have a fever – though the dreams we do have tend to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830719/">darker in tone and more unusual</a>. Spending less time in REM sleep when we’re feverish might happen because we are far less capable of regulating our body temperature in this stage of sleep. To protect us, our brain tries to regulate our temperature by “skipping” this sleep stage. We tend to have fewer dreams when the weather is hot <a href="https://www.tandfonline.com/doi/abs/10.1080/23744731.2020.1756664">for the same reason</a>. <h2>A deep-cleaning system for the brain</h2> REM sleep is important for ensuring our brain is working as it should, as indicated by studies using <a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">electoencephalography</a>, which measures brain activity. In the same way deep sleep helps the body restore its physical capacity, dream sleep “<a href="https://www.cell.com/current-biology/pdf/S0960-9822(17)31329-5.pdf">back-flushes</a>” our neural circuits. At the molecular level, the chemicals that underpin our thinking are bent out of shape by the day’s cognitive activity. Deep sleep is when those chemicals are returned to their unused shape. The brain is “<a href="https://www.science.org/doi/abs/10.1126/science.1241224">washed</a>” with cerebrospinal fluid, controlled by the <a href="https://theconversation.com/on-your-back-side-face-down-mice-show-how-we-sleep-may-trigger-or-protect-our-brain-from-diseases-like-als-181954">glymphatic system</a>. At the next level, dream sleep “tidies up” our recent memories and feelings. During <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">REM sleep</a>, our brains consolidate procedural memories (of how to do tasks) and emotions. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC534695/">Non-REM sleep</a>, where we typically expect fewer dreams, is important for the consolidation of episodic memories (events from your life). As our night’s sleep progresses, we produce more cortisol - the <a href="https://psycnet.apa.org/record/2005-01907-021">stress hormone</a>. It is thought the amount of cortisol present can impact the type of memories we are consolidating and potentially the types of dreams we have. This means the dreams we have later in the night may be <a href="https://learnmem.cshlp.org/content/11/6/671.full.pdf">more fragmented or bizarre</a>. Both kinds of sleep help <a href="https://www.researchgate.net/profile/Jb-Eichenlaub/publication/313545620_Daily_Life_Experiences_in_Dreams_and_Sleep-Dependent_Memory_Consolidation/links/5c532b0ba6fdccd6b5d76270/Daily-Life-Experiences-in-Dreams-and-Sleep-Dependent-Memory-Consolidation.pdf?ref=nepopularna.org">consolidate</a> the useful brain activity of the day. The brain also discards less important information. <h2>Random thoughts, rearranged feelings</h2> This filing and discarding of the day’s activities is going on while we are sleeping. That’s why we often dream about things that happen <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264574">during the day</a>. Sometimes when we’re rearranging the thoughts and feelings to go in the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921176/">bin</a>” during sleep, our level of consciousness allows us to experience awareness. Random thoughts and feelings end up all jumbled together in weird and wonderful ways. Our awareness of this process may explain the bizarre nature of some of our dreams. Our daytime experiences can also fuel nightmares or anxiety-filled dreams after a <a href="https://www.sleepfoundation.org/dreams/how-trauma-can-affect-dreams">traumatic event</a>. Some dreams appear to <a href="https://rai.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1467-9655.2010.01668.x">foretell the future or carry potent symbolism</a>. In many societies dreams are believed to be a window into an <a href="https://digitalcommons.ciis.edu/cgi/viewcontent.cgi?article=1050&context=ijts-transpersonalstudies">alternate reality</a> where we can envisage what is possible. <h2>What does it all mean?</h2> Our scientific understanding of the thermoregulatory, molecular and basic neural aspects of dreaming sleep is <a href="https://www.nature.com/articles/nrn2716">good</a>. But the psychological and spiritual aspects of dreaming remain largely hidden. Perhaps our brains are wired to try and make sense of things. Human societies have always interpreted the random – birds wheeling, tea leaves and the planets – and looked for <a href="https://brill.com/display/book/edcoll/9789047407966/B9789047407966-s003.xml">meaning</a>. Nearly every human society has regarded dreams as more than just random neural firing. And the history of science tells us some things once thought to be magic can later be understood and harnessed – for better or worse.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210901/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/drew-dawson-13517">Drew Dawson</a>, Director, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-science-of-dreams-and-nightmares-what-is-going-on-in-our-brains-while-were-sleeping-210901">original article</a>.

Mind

How can I get better sleep on long-haul flights?

<a href="https://theconversation.com/profiles/leigh-signal-1462806">Leigh Signal</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> For most of us, the prospect of a long-haul flight is exciting, mixed with a few nerves. We’re off somewhere different – perhaps a holiday, maybe to catch up with friends or family. Even work can be more interesting when you’re in a new location. Of course, you want to arrive fully rested and ready to go. But by its very definition, a long-haul flight involves travelling for a long period of time, often more than 12 hours. If you’re on a flight from New York to Singapore, it can be close to 19 hours. All that time you’re confined in a seat that’s supposed to recline but feels like it hardly moves, while the seat in front seems to recline ten times lower than yours. So, what can you do to get a a decent rest? <h2>Accept the situation</h2> The first tip for sleep in this setting is to relax your expectations a little. Humans are just not well designed to sleep in an almost upright position. Unless you’re lucky to fly in a class with a lie-flat seat, you’re very unlikely to step off a long-haul flight having had a solid eight hours of sleep. Research by colleagues and myself <a href="https://academic.oup.com/sleep/article/36/1/109/2656896">has shown</a> pilots – who get a bunk to sleep in during their in-flight rest breaks – have light and fragmented sleep. Despite not having great quality sleep, you can be assured <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/jsr.12071?casa_token=S_3bRlU31x8AAAAA:BDeXhWwlMUXfDvtz59M0eSRGfXiK2jm45Tsr5uzMM02t3hktXfEEzU9OjSdGwbVZ_YuCIoUvnpDaKO0">our research</a> <a href="https://www.ingentaconnect.com/content/asma/asem/2014/00000085/00000012/art00007">also shows</a> pilots remain very good at their job throughout a long-haul flight. This, <a href="https://www.tandfonline.com/doi/full/10.3109/07420528.2012.719957?casa_token=zoFj2qt5RPMAAAAA%3ANeXdd1ALMMv9zxRJF3GhpoCS3u3eT8Q_kmNqFpsWh7oz1dLyVJgDpU3vo547iGotvX5d9CCiTfi62g">plus findings</a> from <a href="https://www.sciencedirect.com/science/article/abs/pii/B9780444537027000099">many other lab-based studies</a>, tells us that even a short amount of light sleep has benefits. So, even if you can’t get your usual eight hours during the flight, any sleep you do get will help you feel and function better at your destination. Also, we’re not great at judging how much sleep we’ve had, particularly if our sleep is light and broken. So you’re likely to have slept more than you think. <h2>Time your sleep and drinks</h2> The timing of your flight, and consumption of alcohol and caffeine will directly impact your ability to sleep on an aircraft. Assuming you’re adjusted to the time zone the flight departs from, daytime flights will make sleep on board much harder, whereas nighttime flights make sleep easier. All humans have a circadian (24-hour) time-keeping system, which programs us for sleep at night and wakefulness during the day. Sleeping (or waking) against this biological time-keeping system poses significant challenges. We do have a natural decrease of alertness in the middle of the afternoon, which makes this a good time to try for sleep on a daytime flight. On nighttime flights it will be easier to sleep once the dinner service is finished, otherwise you will be battling noise, light and the movement of people around you. As a stimulant, caffeine helps us stay alert. Even if you’re a regular coffee drinker and can fall asleep after drinking caffeine, your sleep will be lighter and <a href="https://doi.org/10.1016/j.smrv.2016.01.006">you’ll be more easily woken</a>. On the other hand, alcohol makes us feel sleepy, but it interferes with our brains’ ability to have REM sleep (also known as dreaming sleep). Although you may fall asleep more easily after consuming alcohol, your sleep will be more disturbed once your body metabolises the alcohol and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">attempts to catch up</a> on the REM sleep it’s missed out on. <h2>What about taking melatonin or other drugs?</h2> Some people find taking a sleeping tablet or melatonin can help on a plane. This is a very personal choice. Before taking sleeping medication or melatonin you should see your doctor, and only take what’s prescribed for you. Many sleeping medications <a href="https://www.ingentaconnect.com/content/ben/cnsnddt/2023/00000022/00000002/art00006">do not allow perfectly normal sleep to occur</a> and can make you feel <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657033">groggy and drowsy</a> after waking. Importantly, melatonin is a hormone our brains use to tell us it’s nighttime. Melatonin can assist with sleep, but depending on when and how much you take, it can also shift your circadian clock. This could shift you further away from being aligned with the destination time zone. Taking melatonin in your biological afternoon and evening will shift your circadian time-keeping system east (or earlier) and taking it toward the end of your biological night and in your biological morning will shift the circadian time-keeping system west (or later). It gets complicated very quickly! <h2>Prepare your clothes and accessories</h2> Be prepared so you can create the best possible sleep situation within the constraints of an aircraft seat. Wear comfy layers, so you can take things off if you get too hot or put things on when you cool down, and hang on to that blanket instead of losing it under your seat. Light and noise disturb sleep, so pack eye shades and earplugs (or a noise cancelling headset) to block these out. Practice with eye shades and earplugs at home, as it can take a few sleeps to get used to them. A normal and necessary part of the falling asleep process is relaxation, including our neck muscles. When sitting up, this means our heavy heads will no longer be well supported, resulting in that horrible head-dropping experience most of us have had. Try supporting your head with a neck pillow or, if you have a window seat, against the aircraft wall. (Unless you know the person in the next seat well, they are probably not a good option to prop you up.) <h2>Don’t try to force it</h2> Finally, if you wake up and are struggling to go back to sleep, don’t fight it. Take advantage of the in-flight entertainment. This is one of the few times sleep scientists will tell you it’s okay to turn on the technology – watch a movie, binge-watch a TV series, or if you prefer, listen to music or read a good book. When you feel sleepy, you can try going back to sleep, but don’t get stressed or worried about getting enough sleep. Our brains are very good at sleeping – trust that your body will catch you up when it can.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211821/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leigh-signal-1462806">Leigh Signal</a>, Professor in Fatigue Management and Sleep Health/Associate Dean, Research, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-get-better-sleep-on-long-haul-flights-211821">original article</a>.

Travel Tips

Why do I fall asleep on the sofa but am wide awake when I get to bed?

<a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/sally-ferguson-64">Sally Ferguson</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> After a long day, you flop onto the sofa and find yourself dozing off while watching TV. The room is nice and warm, the sofa is comfortable, and the background noise of the TV lulls you to sleep. Then a loved one nudges you awake and reminds you to go sleep – in bed. But when you get there, you find to your frustration that you’re wide awake. Why does sleep come so easily on the sofa but not always in bed? <h2>Why is it so easy to fall asleep on the sofa?</h2> <a href="https://www.sleepfoundation.org/circadian-rhythm/sleep-drive-and-your-body-clock#:%7E:text=Sleep%2Fwake%20homeostasis%20balances%20our,that%20it's%20time%20to%20sleep.">Sleep pressure</a> is one reason why you fall asleep on the sofa. This refers to the strength of the biological drive for sleep. The longer you’ve been awake, the greater the sleep pressure. Your body clock or <a href="https://www.thensf.org/what-is-a-circadian-rhythm/">circadian rhythm</a> is another factor. This tells you to be awake during the day and to sleep at night. Your environment will also impact how likely it is you fall asleep. You might have just <a href="https://theconversation.com/health-check-food-comas-or-why-eating-sometimes-makes-you-sleepy-44355">eaten a meal</a>, your very comfortable sofa is in a warm room, with dim lighting and maybe a TV program in the background. For many people, this environment is perfect for falling asleep. So by the end of the day, sleep pressure is strong, your circadian rhythm is telling you it’s time for sleep and your environment is cosy and comfortable. <h2>What happens after a nap on the sofa?</h2> If you’ve had a nap on the sofa before heading to bed, your sleep pressure is likely much lower than it was before your nap. Instead of having more than 16 hours of wakefulness behind you, you’ve just woken up and therefore have less sleep pressure. This can make it much harder to fall asleep in bed. If you just fell asleep on the sofa for five minutes, you might not have too much trouble getting to sleep in bed. This is because a nap that short is unlikely to reduce your sleep pressure very much. But if you were asleep for an hour, it might be a different story. Your sleep cycles might also be working against you. Most sleep cycles are about <a href="https://www.researchgate.net/profile/Mary-Carskadon/publication/287231408_Normal_Human_Sleep_An_Overview_Principles_and_Practice_of_Sleep_Medicine_MH_Kryger_Ed/links/5db0c338299bf111d4c026c5/Normal-Human-Sleep-An-Overview-Principles-and-Practice-of-Sleep-Medicine-MH-Kryger-Ed.pdf">90 minutes long</a>. They start with light sleep, progress to deep sleep, and then end with light sleep again. If you wake up during deep sleep, you’re probably going to feel groggy – and it might be easy to get back to sleep when you go to bed. But if you wake up during light sleep it could be harder to fall asleep again in bed. The activities you might do when you get up from the sofa – like turning on bright lights or brushing your teeth – can also make you feel more alert and make it harder to sleep when you get to bed. <h2>Why can’t I fall asleep in my own bed?</h2> There are other reasons why falling also in your bed could be challenging. Many people experience anxiety about falling asleep. They <a href="https://pubmed.ncbi.nlm.nih.gov/24005330/">worry</a> about getting enough sleep or falling asleep fast enough. In such cases, getting into bed can be associated with feelings of stress and apprehension, which make it even harder to sleep. It might be easier to fall asleep on the couch, where there is less stress involved. It might also be harder to fall asleep in bed because of poor <a href="https://www.sleepfoundation.org/sleep-hygiene">sleep hygiene</a>. This refers to your pre-sleep behaviours and sleep environment. Good sleep hygiene, or healthy sleep habits, includes having a regular routine before bed, a dark, quiet room to sleep in, and not using your mobile phone in bed. For many people who don’t have good sleep hygiene, their behaviours before bed and their bedroom environment might not be conducive to sleep. <h2>How can I make it easier to fall asleep in bed?</h2> First, make sure your room is dark, quiet and comfortable. In winter this might mean putting a heater on 20 minutes before you go to bed or taking a heat pack to bed with you. In summer, you might consider air conditioning or a fan to make your bedroom comfortable for sleeping. If you find it easy to fall asleep with the TV on, you might like to play “<a href="https://www.youtube.com/watch?v=2iL1Ce1PZFM&t=1s">white noise</a>” in your bedroom as you fall asleep. Some evidence suggests this may make it <a href="https://www.sciencedirect.com/science/article/pii/S1087079220301283#abs0010">easier to fall asleep</a> by masking other disruptive noises. Your behaviour before bed also impacts how easy it is to fall asleep. Making sure you follow the same bedtime routine every night (including going to bed at the same time) can help. Also, even though it’s hard, try not to look at your phone while you’re in bed. Scrolling on your phone before bed can make it <a href="https://ieeexplore.ieee.org/document/8329667">harder to sleep</a> due to both exposure to blue light and the potentially stressful or alerting effect of the content you interact with. <h2>In a nutshell</h2> The best way to make it’s easier to fall asleep in your bed is to avoid falling asleep on the sofa in the first place. This will ensure all the sleep pressure you build up during the day will be directed towards a deep sleep in your bed.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208371/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/madeline-sprajcer-1315489">Madeline Sprajcer</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/sally-ferguson-64">Sally Ferguson</a>, Director, Appleton Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">original article</a>.

Body

How to stay awake after a terrible night’s sleep

How to stay awake There are ideals and then there’s real life. In truth, you will at times find yourself tired but still obligated to stay alert. Here’s how to stay awake and make those moments as painless as possible. Play music This brain hack works best if you opt for something cheery, with a beat that’s strong and fast but not exhausting (100 to 130 beats per minute). Music with heart-rate lowering tempos – think 60 beats per minute or less – can actually induce sleep, so consider yourself warned. Go outside or place yourself near a bright light Your body takes its sleep-wake cues from light, so draw back the curtains and let in the sunshine. If it’s not a sunny day, fool your system into thinking it is by cranking the dimmer switch up to maximum, and ensuring your workspace is properly illuminated with task lighting. Drink water Dehydration increases sleepiness. According to Harvard Health, keeping yourself hydrated can help to curb fatigue. It doesn’t necessarily have to be water, either – there are plenty of hydrating drinks that can count towards your daily fluid intake, even caffeinated beverages! Exercise Aerobic activity pumps oxygen through your system and releases hormones that give you energy. There are plenty of other health benefits from increasing your physical activity level, of course. Stimulate your mind Boredom itself promotes fatigue. Break the cycle by starting a conversation, engaging in a new activity, or reading an article about a topic that interests you. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/how-to-stay-awake-after-a-terrible-nights-sleep" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Counting the wrong sheep: why trouble sleeping is about more than just individual lifestyles and habits

<a href="https://theconversation.com/profiles/mary-breheny-1269716">Mary Breheny</a>, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a> and <a href="https://theconversation.com/profiles/rosie-gibson-1051224">Rosie Gibson</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> Sleep may seem straightforward – everyone does it, after all. But as many of us know, getting enough sleep is not necessarily a simple task, despite what you might read in the media. How to sleep “properly” is a favourite topic of self-help articles, with <a href="https://www.mirror.co.uk/news/health/expert-advice-good-nights-sleep-27900333">headlines</a> such as “Expert advice to get a good night’s sleep whatever your age” promising the answer to your nocturnal awakenings. Older people are commonly the audience of these messages. <a href="https://doi.org/10.1093/geront/gnad058">Our analysis</a> of articles published in the New Zealand media between 2018 and 2021 found sleep is presented as inevitably declining with age. At the same time, sleep is portrayed as a cure for everything: a good night’s sleep is depicted as a way to maintain productivity, ward off illness and dementia, and ultimately live longer. But most of these articles are aimed at the individual and what they can do to improve their sleep. Often missing is any reference to the external factors that can contribute to poor sleep. <h2>Personal choice and sleep</h2> A key message in many of the articles we examined is that sleep is a simple matter of making the right choices. So, if you’re not getting enough sleep it’s probably your own fault. People are lectured about poor “<a href="https://www.cci.health.wa.gov.au/%7E/media/CCI/Mental-Health-Professionals/Sleep/Sleep---Information-Sheets/Sleep-Information-Sheet---04---Sleep-Hygiene.pdf">sleep hygiene</a>” – staying up too late looking at their phone, having too many cups of coffee, or not getting enough exercise during the day. And it’s true, drinking too much caffeine or staring at a screen into the small hours might interfere with sleep. It’s also true that good sleep is important for good health. But things are a bit more complicated than this. As anyone who has struggled to maintain good sleep knows, simple tips don’t always overcome the complex situations that contribute to these struggles. <h2>Awake to other factors</h2> Good sleep is not just a matter of “making the right choices”. Internationally, there’s a growing body of research showing sleep is affected by much more than individual behaviour: it’s often shaped by a person’s <a href="https://www.annualreviews.org/doi/10.1146/annurev-publhealth-040119-094412">social and economic circumstances</a>. New Zealand research is adding to this pool of knowledge. <a href="https://www.sciencedirect.com/science/article/pii/S235272181600019X?via=ihub">One study</a>, based on survey results from just over 4,000 people, found insufficient sleep was more common among Māori than non-Māori, partly due to higher rates of night work. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524484/">research</a> has also found women are more likely to experience insomnia due to their caregiving roles. One US study found unpaid caregivers for children or parents (or both) reported shorter sleep quantity and poorer sleep quality than paid caregivers or people without such roles. A <a href="https://journals.sagepub.com/doi/10.1177/1471301220915071">survey</a> of 526 carers in New Zealand showed two-thirds reported mild or severe sleep disturbance. We also know lack of sleep is <a href="https://www.cdc.gov/sleep/about_sleep/chronic_disease.html">linked to serious disease</a>, including diabetes and heart disease. Sleep duration and quality have been identified as predictors of levels of haemoglobin A1c, an important marker of blood sugar control. And hypertension, stroke, coronary heart disease and irregular heartbeats have been found to be more common among those with disordered sleep than those without sleep abnormalities. Failure to acknowledge the social context of poor sleep means sleep messages in the media ignore the fundamental causes in favour of the illusion of a quick fix. <h2>The commodification of sleep</h2> Sleep is also increasingly characterised as a commodity, with a growing market for products – such as sleep trackers – that claim to help improve sleep quality. Sleep trackers promise to measure and enhance sleep performance. However, their reliability may be limited – <a href="https://mhealth.jmir.org/2021/6/e26462">one study found</a> the tested tracker did not accurately detect sleep, particularly in older adults who had greater levels of nighttime movement. Framing public health problems as matters of personal choice is common. Alcohol and fast-food consumption, for example, are regularly presented as <a href="https://journals.sagepub.com/doi/full/10.1177/1745691619896252">matters of individual responsibility</a> and poor personal choices. The <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.737">role of marketing</a> and access to healthy food gets a lot less attention. Of course, simple tips for getting good sleep may be useful for some people. But ignoring the underlying social and economic factors that shape the possibilities for good sleep will not address the problem. Health promotion messages that focus on individual behaviour miss <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12112">the structural barriers to better health</a>, including poverty, low levels of education, high rates of incarceration, substandard or crowded housing and racism. We need to move beyond messages of individual behaviour change and start talking about inequities that contribute to the problem of who gets a decent night’s sleep and who doesn’t.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210695/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-breheny-1269716">Mary Breheny</a>, Associate Professor of Health Psychology, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a> and <a href="https://theconversation.com/profiles/rosie-gibson-1051224">Rosie Gibson</a>, Senior lecturer, School of Psychology, Massey University, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/counting-the-wrong-sheep-why-trouble-sleeping-is-about-more-than-just-individual-lifestyles-and-habits-210695">original article</a>.

Caring

What to eat before bed if you want a good night’s sleep

What to eat before bed It’s after 8 pm and you can feel your stomach grumbling. Should you stick it out until morning or head to the kitchen? Night-time eating tends to get a bad reputation – people often worry it causes weight gain, heartburn, indigestion or all three. But it all depends on what you reach for, says nutritionist Nishta Saxena. Saxena says there isn’t a clear-cut time of day that we have to stop eating. Studies have found that it’s not when you’re eating, but how much and what you’re eating which matters. Super salty snacks at the end of the day can, for example, make you dehydrated and interrupt your sleep – and they’re not the only culprits that can affect whether you have a good night’s rest. In general, it’s best to eat small portions before bed. Also try to stay away from foods high in protein or fat, which can be harder for our bodies to digest and can interrupt the natural cadence of our systems, which slow down for the night by producing sleep-inducing hormones like melatonin. Excessive sugar can also act like a stimulant – a bad choice if you’re trying to catch some Zzzs. Saxena suggests eating something that’s high in carbohydrates, which can promote sleep and help you to relax. This is because carbs don’t require as much blood flow or work from your body to digest and are therefore unlikely to interrupt your sleep. If you find yourself with an after-dinner case of the munchies, follow these tips on what to eat before bed. Kiwis Kiwis can help to promote sleep because they are rich in serotonin and antioxidants (such as Vitamins C and E). Serotonin helps to make you feel relaxed and certain antioxidants have sleep-promoting qualities. Plus, these fuzzy fruits are extremely high in vitamin C and our bodies can digest them quickly, says Saxena. They also support heart and digestive health as well as natural immunity. Tart cherries Tart cherries and tart cherry juice contain concentrated amounts of melatonin, a hormone that helps your body regulate sleep-wake cycles, says Saxena. Studies show that they can help to reduce insomnia, plus they also contain other sleep-inducing agents like tryptophan (a precursor of serotonin). Since tart cherries can be a little bit harder to find than other fruits, Saxena suggests keeping some in your freezer and using them to make a smoothie. Nuts Nuts are great for a variety of health benefits, says Saxena, and they’re also a good late-night snack. Just don’t dish out a whole cup of nuts, she warns, because they do contain surprising amounts of protein and fat. In particular, she recommends walnuts and almonds – they contain natural melatonin as well as magnesium, which has the potential to reduce insomnia in adults. Popcorn While pre-packaged microwave popcorn most likely contains too much salt to be a good bedtime snack, popping your own can satisfy people who are craving snack foods like chips. Popcorn is also relatively filling – just don’t drown your bowl in butter and salt. Yoghurt Dairy products, while not consumed by everyone, have a lot of components that stimulate sleep, says Saxena. Something like yoghurt doesn’t require a lot of digestive processes, and even full fat yoghurt doesn’t have a ton of fat in it, making it easy to digest. Plus, it’s filled with amino acids, like tryptophan, which promote sleep. Green bananas Saxena says a greenish banana, “almost the colour of a tulip stem,” is a great evening snack. At this point, the banana is full of starch, which means it hasn’t yet become sugar, and this can be great for our gut bacteria and also helps to promote sleep. She adds that the banana should be firm and have a tiny bit of yellow in the midsection. If it has black spots, it’s too ripe to help with sleep and won’t provide a benefit. Warm milk The benefits of warm milk for sleep are well-documented, says Saxena. This is in part because milk contains tryptophan, an amino acid that promotes sleep. Warm fluids in general can relax our digestive muscles. “It can be a self-care moment when you’re having something warm,” Saxena says. “Your hands are wrapped around the mug and it’s a sensory experience.” Cottage cheese While cottage cheese has lots of protein, it also has the benefits of dairy, including amino acids, that help to promote sleep. It’s also nutrient-dense, containing calcium, magnesium, iron, and phosphorus, which are essential for bodily function. It can also be a good late-night snack for athletes, because it’s high in the protein casein, which helps to reduce muscle breakdown overnight. Still, stay away from other cheeses before bed – most are very high in fat and easy to overeat, warns Saxena. Oatmeal While people often think of oatmeal as a breakfast food, oats are high in melatonin and so can make a good bedtime snack. Like dairy products, oats also contain the amino acid tryptophan. You can also spice up your oatmeal with many of the other foods that are okay to eat before bed – tart cherries, yogurt, or almond butter, for example. Pasta If you’re really hungry, try some pasta – but keep the portion small and be careful to not load your dish with toppings that are high in protein or fat. For example, you don’t want to have a super-cheesy meatball pasta before bed, says Saxena. But a small serving of plain pasta with pesto sauce might do the trick. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/sleep/what-to-eat-before-bed-if-you-want-a-good-nights-sleep?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

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Better sleep is a protective factor against dementia

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